Hormone Pellet Therapy and Weight Loss

As women approach their 40’s, weight gain is a common complaint that I hear.  Of course, lifestyle changes can be responsible a lot of the time.  In general, as we age we tend to  exercise less, work more, and eat a bit more mindlessly.  However, there is also a chance that unwanted weight gain may also be related to hormone deficiency. Yet, in my private practice I have really only found a shift in body composition when using low doses of testosterone in female patients who may be low.  Low testosterone may contribute to weight gain via the route of lowering basal metabolic rate due to  decreased muscle mass. One of the ways to combat this is hormone replacement therapy (HRT), including hormone pellet therapy. I do not recommend to use hormone replacement treatment specifically for weight loss.  At The Natural Path, we be sure to test our patients hormone levels prior to offering any treatment options.

Testosterone Replacement Therapy may have a subtle impact on  Weight Loss

The connection between testosterone and weight is complex. Weight gain has been linked to low testosterone for years, but until recently, scientists weren’t sure why. Now, while there is some evidence that significant weight gain can lower testosterone levels, it is becoming increasingly clear that low testosterone can exacerbate weight gain.  Researchers are working to  investigate the potential of testosterone therapy to facilitate weight loss in men with testosterone deficiency—with promising results.

In a 2014 metareview, Dr. Abdulmaged M. Traish, Professor of Urology at Boston University School of Medicine, notes:

Long-term testosterone therapy in men with testosterone deficiency produces significant and sustained weight loss, marked reduction in waist circumference and BMI and improvement in body composition. Further, testosterone therapy ameliorates components of the metabolic syndrome. The aforementioned improvements are attributed to improved mitochondrial function, increased energy utilization, increased motivation and vigor resulting in improved cardio-metabolic function and enhanced physical activity.

More recent research has found similar results, including a 2019 study published in the Journal of the Endocrine Society. In this study, a cohort of German and American researchers followed over 800 men with obesity and hypogonadism over a 10-year period to determine the impact of HRT on weight and body composition. Their findings were stark:

Over 10 years, the testosterone-treated men lost 20.3 percent of their baseline weight (50.5 lb; 22.9 kg); their waist circumference dropped by 12.5 cm (4.9 in). BMI decreased by 7.3 kg/m2, and the waist-to-height ratio decreased by 0.07. By contrast, the untreated men gained 3.9 percent of their baseline weight (3.2 kg; 7.1 lb), and their waist size increased by 4.6 cm (1.8 in). In this group, BMI increased by 0.9 kg/m2, and waist-to-height ratio increased by 0.03.

Additionally, “testosterone therapy was associated with a reduced risk of death, heart attack and stroke.”

It is important to note that hormone optimization should only be used in patients who have a legitimate hormone deficiency.  If you suspect that your weight gain may in part be related to low testosterone, it is important to undergo hormone testing to identify any deficiencies. If your testosterone is found to be low, HRT may not only help you lose unwanted weight, but also elevate your overall level of wellness.

Hormones and Weight in Women

While research findings on weight gain and HRT in men are relatively clear, they are more complicated for women. I can never promise that optimizing hormone levels with will be helpful for the body composition of my patients. The female body is a bit more complex due to  the fluctuations of estrogen that occur during peri/menopause.  However, in my clinical practice, I find that if women eat well and do resistance training alongside low dose testosterone therapy we see promising changes on our body composition analyzer.  Increasing lean mass can increase basal metabolic rate and therefore help with weight loss.  We also see that night sweats that lead to fatigue in females can also indirectly contribute to weight gain as when fatigued we do not always make the best choices with food.

We do not suggest that HRT should be taken by women for the express purpose of weight loss. Rather, it suggests that hormone therapy may be one way to support greater physiological, emotional, and behavioral wellness during perimenopause and menopause, which may help women address or avoid unwanted weight gain.

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