Weight Loss Surgery and Testosterone

In addition to its main objective of causing weight loss, a new study shows that sleeve gastrectomy has the added benefit of returning testosterone to normal levels in men.

The findings were presented at the 2015 Clinical Congress of the American College of Surgeons. Doctors at California’s Stanford University found that, following the procedure, obese patients who had previously suffered from low testosterone had a notable testosterone increase over the year following the surgery.

Sleeve gastrectomy is currently considered by many in the medical community to be a preferable operation to gastric bypass. It’s been around for about 10 years, and is seen as lower risk compared to gastric bypass, as well as being a shorter procedure to perform. Sleeve gastrectomy involves removing about 75 to 80 percent of the stomach along the greater curvature, and inserting a narrow “sleeve” which is about the size of a banana. Afterwards, the patient’s food intake is limited as they will feel full after eating only small amounts.

Being seriously overweight is linked to lower than normal testosterone, consequently leading to a weakened sex drive. There’s also evidence that it is associated with a higher risk for heart disease. On top of all that, as the study coauthor, Dr. John Morton, points out, “Low testosterone also increases the risk of sarcopenia, a loss of muscle that accelerates the aging process.”

The study looked at the effect of weight loss on serum testosterone following sleeve gastrectomy. DHEA, which is a precursor to testosterone, and prostate-specific antigen were also considered. All three were measured after the operation at the three-, six- and 12-month mark. By the end of the study, the results showed a significant average increase in serum testosterone, from 295 to 423 ng/dl, putting study patients in the lower end of the normal range of 300 to 1,000 ng/dl.

Previous to the operation, 63 percent of the patients were below 300 ng/dl. After the procedure, just 41 percent were. PSA concentration rose from 0.62 to 0.75 ng/mL while PSA mass remained unchanged. DHEA rose from 12.8 to 39.6 ng/mL.

Weight loss in itself is of course a laudable, important health goal. This study shows there are likely accompanying benefits related to improving low testosterone. In obese men, fat is converted to estrogen, which prompts the lowering of testosterone levels. With a sleeve gastrectomy procedure, lower fat leads to lower estrogen and therefore higher testosterone.

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