Urologist | Advocate for Sexual, Hormonal, and Genitourinary Wellness | Entrepreneur | Innovator in HealthTech
???Urologists Have a Role in Muscle Preservation for Patients on GLP-1 Medications At the?2024 AUA Annual Meeting, I presented a case during the?Sexual Medicine Society of North America (SMSNA) section?that highlights something I’m passionate about—helping men not just lose weight, but also?preserve muscle and optimize their health. Here’s the case: A?47-year-old male—a former runner who had gained significant weight—came to see my?twin sister, Michelle Pearlman, M.D., a gastroenterologist, for weight loss. He had all the usual symptoms we see in obesity and low testosterone:?fatigue, sluggishness, and reduced libido. She started him on a?GLP-1 agonist, and he started losing weight—great, right? Not so fast.?GLP-1s don’t just lead to fat loss; they also often result in muscle loss.?And this guy already had?low skeletal muscle mass?at baseline. When my sister checked his?testosterone, it was in the?high 200s—low, but not surprising. She sent him to me, I started?testosterone therapy, and that’s when things changed. A?year later, not only had he?lost 44 pounds and 10 inches off his waist, but he had?more muscle mass than when he started. That should be a headline! While pharmaceutical companies are scrambling to develop new drugs to preserve muscle in GLP-1 patients,?what if we already have a solution? ???Testosterone replacement therapy. As urologists, we already know how to optimize testosterone.?We have a place in weight management.?For my patients on GLP-1s, my go-to therapies are: ??Oral testosterone (Kyzatrex by Marius Pharmaceuticals) ??Testosterone cypionate injections Choice depends on?patient preference, risk tolerance, and goals. Let’s start talking about this more.?Weight loss doesn’t have to mean muscle loss.?And as urologists, we need to be at the table when it comes to managing men’s health in the era of GLP-1s. Always a pleasure interviewing with Urology Times https://lnkd.in/e9umPCCv #Urology #MensHealth #GLP1 #Testosterone #AUA2024 #ObesityMedicine #MusclePreservation
Marc Harris
1 周
Very informative. Can these lessons be applied to the early stages of cachexia?
This is amazing finding.. should push for more evidence
Amy Pearlman absolutely! The synergy between GLP1s and TRT for obese, testosterone deficient men is phenomenal. I hate it that most obese men on GLP1s don’t seem to ever make it to the TRT doc.
Urologist
1 周I see a lot of men on these GLP-1s who warrant testosterone therapy. It’s no surprise that low testosterone is found in men with obesity and insulin resistance. The muscle preserving benefits of TRT can be profound. The testosterone can also help energy and motivation which can be adversely affected by the GLP-1s. This keeps them in the gym doing resistance training despite the fatigue that can occur with these drugs and the calorie deficit they induce. Unfortunately, it seems that a lot of men are getting these drugs online or from medi-spa clinics. They are not informed of potential side effects or monitored correctly. This has led me to consider prescribing them myself in certain cases. I’ve brought on an endocrinologist to my practice to ensure it’s done properly.