The crisis of low testostorone and what South Florida doctors advise patients

Men’s testosterone levels have been declining over the last few decades, and no one knows exactly why. But South Florida doctors and researchers offer new ways to combat the problem.

When a man’s level falls below normal, his sex drive, energy levels, body hair, and muscle size are affected. Low testosterone also can be a trigger for depression.

A simple blood test  — at home or in a lab — can reveal whether testosterone levels are low.

South Florida doctors say they now have many options to raise testosterone levels: shots, gels, patches, and more recently, pills.

Pembroke Pines urologist Maury A. Jayson says he treats many patients for low testosterone. “It’s a huge health issue,” he said. Jayson advises against patches (they tear up the skin) and topical gels (they run off as men sweat in hot South Florida).

“I use mostly injections or self-injections,” he said. “There have been new formulas.”

Another newer option is pellets. “I insert testosterone pellets under the skin twice a year,” he said. Jayson said with the pellets the dosage is customizable, and the effects are long-lasting. “It’s convenient for men who are busy, and the levels stay elevated consistently over four to six months,”

Treatments for low testosterone typically have side effects: One side effect can be infertility. For older men, this may be less of a concern than for younger men who are still planning to have children.

At the University of Miami, researchers studied a nasal testosterone gel in a clinical trial. The results proved promising for younger men looking for a method to raise their testosterone levels without infertility.

The nasal gel is short-acting and doesn’t cause the body to maintain high testosterone levels throughout the day. Because it’s short-acting, it preserves the production of hormones from the pituitary gland responsible for sperm production.

“We did a trial to see whether nasal gel would maintain sperm production, and it did,” said Dr. Thomas Masterson, assistant professor of clinical urology at UM. “There was still some sperm production decline, but the overwhelming majority maintained sperm count while on that drug.”

In the last few years, the U.S. Food and Drug Administration has approved oral medications to boost testosterone — Jatenzo, Kyzatrex and Tlando. However, they have side effects that include an increase in blood pressure, and possible liver injury. “Because they are so new, our experience with these drugs is still somewhat limited,” Jayson said.

“I don’t prescribe those as much because of insurance issues,” Masterson said.

Doctors say supplements such as vitamin D, zinc and magnesium may also help to boost testosterone.

“When there is a sea of options, we want to tailor these medications to the patient,” Masterson said. “I pick and choose what may work better for each patient.”

Urologists advise looking at your health as a whole, rather than rushing to take testosterone boosters. “Low levels can be caused by other factors, including medication side effects, obstructive sleep apnea, thyroid problems or diabetes,” Masterson said.

Florida study shows orange peels help prevent heart attacks

Extract from orange peels may be a key to heart health, a new study from the University of Florida Institute of Food and Agricultural Sciences has found.

Researchers at UF looked at how the orange peel can inhibit the production of harmful chemicals in the human body. Their findings showed that orange peel extracts — rich in beneficial phytochemicals — worked to inhibit the enzyme responsible for trimethylamine, a gut bacteria that increases blood pressure.

About 95% of Florida’s oranges are used to make juice. Their peels are usually tossed as waste,  the researchers learned. The Food and Drug Administration considers natural orange peel extracts safe for human consumption. So, UF research Yu Wang, a faculty member at the UF/IFAS Citrus Research and Education Center, wants to put the peels to better use.

“These findings suggest that orange peels, often discarded as waste in the citrus industry, can be repurposed into valuable health-promoting ingredients, such as diet supplements or food ingredients,” Wang said.

Coral Springs company uses AI to get medical equipment approved by Medicare faster

Adam Nadler, co-founder of Coral Springs-based CompliantRx noticed that seniors were waiting a long time for their medical equipment ordered by a doctor. The patients wanted their wheelchairs, hospital beds, CPAP machines or walkers right away but the hold-up seemed to be the supplier getting Medicare or Medicare Advantage Plan approval.

Nadler discovered about 20% of claims are denied, and that Medicare coverage criteria changes often.

So Nadler created an artificial intelligence platform that analyzes medical records to ensure claims meet coverage criteria and patients can get medical supplies faster.

Medicare could require as many as 25 different pieces of information to approve a wheelchair, or other equipment, he explained.

“For the supplier, it can be burdensome to review medical records, and that can cause patients not to get the product,” he said.

CompliantRx’s AI-assisted technology uses a digitized checklist — with green check marks — that makes it easy to see when a required piece of information is missing. The company can customize the checklist for each supplier.

“Because it identifies quickly what’s missing, the supplier can go back to doctor and say ‘you left out what type of insulin this patient is on,'” Nadler said.

CompliantRx debuted its product at a trade show in March and already has customers across the U.S. Nadler also operates a Coral Springs company, Quest Health Solutions, that sells contiuous glucose-monitors and insulin pumps. In operating that company, he discovered the need for the techology sold by CompliantRx to speed up the delivery of medical supplies to patients.

New autism center in South Florida

ABA Centers of Florida, which provides applied behavior analysis (ABA) therapy services to children with autism spectrum disorder, is opening centers across the state. Earlier this month, ABA Centers opened a location in Jensen Beach.  The original regional location for ABA Centers of Florida opened in Port St. Lucie in 2022, and a Boca Raton location opened in fall of 2023. “We have three centers planned later this year in Orlando, Tampa and West Palm Beach,” said Katie Murphy of ABA Centers, who said families tend to wait many months to get a diagnosis. “We are able to get them a diagnois within 47 days.”

Murphy said the professionals who diagnose and determine a treatment plan are board-certified behavior analysts. Those who implement the plan are registered behavior technicians who use a play-based approach that is rooted in positive reinforcement.

“We treat adults as well, but our primary audience is children,” she said. “The demand is crazy. In addition to what we offer in the clinics, we also offer in-home, in-community and in-school therapy where allowed.”

According to the U.S. Centers for Disease Control and Prevention, 1 in 36 children in the United States has autism.

“Five percent of children are diagnosed with autism here in Florida. That is higher than the national average, and that is only representative of those that have been diagnosed,” said Quatiba Davis, chief clinical officer
for ABA Centers. “Our organization aims to remove children off wait lists and get them that diagnosis and then treatment.”

Headquarted in Fort Lauderdale, ABA Centers of Florida plans to add centers in Broward County in 2025.

HCA Florida University Hospital in Davie gets technology for patients with abnormal heartbeats

HCA Florida University Hospital in Davie has opened a new electrophysiology (EP) lab to perform advanced procedures for patients with abnormal heartbeats and other heart-related conditions. HCA says this lab is the first in the country to adopt new electrophysiology technology, which uses precise and predictable motion through its laser-guided positioning.

The hospital’s new EP lab also has a catheterization lab and an interventional radiology lab. The hospital said its first procedure in the new EP lab was done on May 23 by cardiac electrophysiologist Dr. Awais Humayun and the hospital’s electrophysiology team.

Patients also can get procedures such as the implantation of pacemakers and defibrillators, as well as cardiac ablation treatments to reduce arrhythmia episodes.

“The opening of our EP Lab marks a significant milestone in the expansion of our cardiology services,” said Dr. Veronica McCloskey, chief medical officer at HCA Florida University Hospital. “In this new lab, our cardiologists will be able to perform a variety of diagnostic tests and procedures to treat heart conditions caused by abnormal heart rhythms. This is an exciting time for HCA Florida University Hospital, as our patients can now receive advanced cardiac electrophysiology care close to home and will not have to travel far to get these services.”

Holy Cross unveils newly renovated surgical suites

Holy Cross Health in Fort Lauderdale has just unveiled the newly renovated Harry T. Mangurian Jr. Foundation Surgical Suites.

A $5 million gift from the Harry T. Mangurian Jr. Foundation funded the renovation of seven operating rooms, a storage room and a portion of the area where instruments get sterilized.

The operating rooms on the third floor of the hospital have been outfitted with state-of-the-art equipment including new monitors and booms.

Renovations began in 2021; five rooms were renovated and two rooms were added.  All operating rooms are open and being used for surgeries.

Holy Cross, is a member of Trinity Health and is a not-for-profit, Catholic teaching hospital. It opened in Fort Lauderdale in 1955.