Coffee with Alice: A Possible Link Between Testosterone & Covid?

As promised, we are doing our best to keep you up to date with all things related to Covid-19 and your health. And today, we are bringing you another episode of the coffee with Alice segment. In this week, Amir and Dr. Alice dig into some breaking news that is attempting to associate high testosterone with an increased risk of mortality from Covid-19, but don't worry, we will uncover the truth for you now. During this Coffee with Alice session, we wanted to address the news reports coming from medical outlets that they're trying to link Testosterone to Covid-19. What does this mean, and is there actually a connection between sex hormones and this virus?

Doctor Alice shares "So that has been something that has been causing a lot of angst, at least on my side. Let me read off some stats in regards to the reason why people are coming to this conclusion. So, it appears that 58% of the patients who are passing from Covid-19 are male. 58. 

Now, if you break it down and stratify it, like who's actually dying according to age, then they're saying that about, the 30 to 39 group, about 82.4% are actually male. Among the 40 to 49-year-olds, 73.1% are male and 50 to 59-year-olds, 78.5% are male and 60 to 69, that's 79% male. And so on. So of course some scientists are asking, 'Oh, is it testosterone?' "

Of all the possible things, possible factors that could go into the mortality rate of a male and Covid 19, testosterone? That doesn't make much sense, especially when you consider that in males, testosterone has been on a massive decline for decades now, to the point where sperm count has dropped 50% in developed nations.

Dr. Alice goes on to share her experience of recently treating two teenagers who had lower testosterone than their 40 and 50-year-old fathers to further emphasize how unlikely this link is to testosterone, considering how at least half of all men are currently lacking the sex hormone. 

"This is one of those situations where you have a bunch of PhDs, maybe some MDs who are PhDs as well, and they're more on the research mind. They are not going out there and clinically treating patients, yet make these really, really unfortunate correlations."

Some people have asked the question if you can simply test this correlation by checking testosterone levels postmortem, but unfortunately for science, that is not happening, nor is testing during treatment of live patients, reinforcing that there is truly nothing to back up these inflammatory claims besides correlation.

This lead us to start questioning who benefits from this rumor,; what's the catch? But as far as Dr. Alice can figure, it is truly a case of misinformation, as there is really no one who wins by promoting this damaging hypothesis, but patients definitely will suffer. Doctors are starting to consider treating male Covid patients using testosterone deprivation therapy, which is essentially giving them drugs that will completely castrate them. 

These cocktails of testosterone blockers and estrogen are used to treat certain prostate cancer cases where it appears that testosterone is feeding the cancerous pathways, as well as for individuals looking to hormonally transition. These things have lasting impacts on the patient mentally and physically, which is why this false link is so dangerous. 

They recently found if the patient had low free testosterone, the chance of developing aggressive prostate cancer is higher, which counters what everyone was concerned about in regard to prostate cancer or enlarging the prostate. Also, estrogen is there to regulate your immune system, so you need a little bit of it, but men do not need excessive amounts of it. For women, interestingly enough, once they start to head towards perimenopause and menopause, the chances of them developing an autoimmune disease actually goes up, so a lot of autoimmune diseases actually start to rear its’ ugly head in woman's forties when her estrogen starts to decline. But again, it's a balance. You don't want too much, but you don't want too little. And in the case of men, you do not want more of it.

Alice adds "I mean, here's the fact: I just read that the age group in which these men that are the stratification of who's passing from this, that age group notoriously has low testosterone already."

At Stark, we rarely ever see optimal levels of testosterone without some sort of assistance such as testosterone replacement, and many aren’t getting assistance because they are told they are within a "normal range”, despite the fact that range is 200 to 1400, which is massive. People also often make the mistake that total testosterone and free testosterone are interchangeable, but there is an important difference. Total testosterone is the total output of "your boys". Or if you are on replacement therapy, then it's the total amount that's actually injected into you. Now, most of that testosterone is actually bound up by something called sex hormone-binding globulin, making it inactive. That can be positive, but in the case of most males, that is negative, since the free testosterone is whatever that's left around to actually go and exert. So your total could be “normal” at 1000, but your free is actually 100, and that’s when we see major problems.

It is clear based on the reporting that there is an overpopulation of males that are seen in these age groups. So if are there some correlations such as men who don’t see their doctor regularly, or eat and drink too much, what other factors would actually contribute to this perfect storm of mortality?

“So Davidson Claire, a longevity researcher at Harvard, actually just did a post where the top five risk factors, are kind of elements that would result in you passing from a particular drug. One was being male. One was being over the age of 65, then diabetes. Another one is hypertension and I believe the last one is obesity. So in general, males are going to have a lot more of an issue around cardiovascular disease.

Most males do not eat well. They drink a lot and they definitely don't go to the doctor. So they don't even know that any of this is happening in their system. And that's in fact what we see mostly here at Stark is just like the early signs of some sort of cardiovascular disease. Either high lipids, high inflammation or prediabetes or overt diabetes. And a lot of these patients had no idea that was happening.”

Some of Dr. Alice’s patients weren't even aware that they had high blood pressure until they walked into her office and had their vitals checked. Once Dr. Alice voiced her concern that they had a potential hypertensive emergency here, they would dismiss it because they ‘felt fine’. That’s precisely why it's called the silent killer.

Another effect of lower testosterone that most men don’t realize is their brain will not function properly. There are a lot of receptors in the brain for testosterone. A gross majority of my men, whenever they go on testosterone, they will mention that it's like a light switch. Their motivation is so much higher, and they feel so much better and so much more motivated. They aren’t ‘cranky, crabby old men’ anymore.

Some patients who have to come off of their testosterone for reproductive reasons will feel it. When you go on TRT, you're not making your own testosterone anymore, so stopping will often result in a sudden drop and all of a sudden they feel old now. Men’s ability to regenerate and heal is something that is mediated by testosterone as well, so they're going to feel joint pain and not recover from their workouts as well. In fact, Dr. Alice had one patient whose orthopedic surgeon put a testosterone pellet in him to facilitate the healing process after surgery on his femur following a bike accident.