Firebird Vitality

Author: Andrew J Hewitt

  • A PMHNP’s Perspective: The Role of Testosterone Replacement Therapy in First Responders’ Mental Health

    A PMHNP’s Perspective: The Role of Testosterone Replacement Therapy in First Responders’ Mental Health

    A PMHNP’s Perspective: The Role of Testosterone Replacement Therapy in First Responders’ Mental Health

    As a PMHNP-BC, I am committed to providing evidence-based care. The following blog post is for informational purposes only and does not constitute medical advice. Please consult with a qualified healthcare provider to discuss your individual health needs.

    The men and women who serve as first responders—firefighters, police officers, and EMTs—are our community heroes. They run toward danger when others flee, and they are repeatedly exposed to high-stress, traumatic situations. While their physical courage is often celebrated, the toll this work takes on their mental and emotional well-being is significant. The rates of anxiety, depression, post-traumatic stress disorder (PTSD), and suicide are alarmingly high within this population (UTHealth Houston School of Public Health, 2025).

    As a psychiatric mental health nurse practitioner, I am constantly exploring a holistic approach to care. This means looking beyond traditional psychopharmacology and psychotherapy to consider all factors that influence a person’s mental health, including hormonal balance. In recent years, a growing body of research has highlighted the connection between testosterone levels and mental health, particularly in men. This has led to a crucial conversation about the potential benefits of testosterone replacement therapy (TRT) for first responders.

    The Link Between Testosterone and Mental Health

    Testosterone is a hormone that plays a key role in numerous bodily functions, from muscle mass and energy levels to mood regulation and cognitive function. Research has shown that low testosterone, or hypogonadism, is often associated with symptoms that mimic mental health conditions, including fatigue, irritability, a lack of motivation, and depression (Caliper Wellness, 2025).

    The demanding and often irregular lifestyle of a first responder—characterized by erratic sleep schedules, high stress, and cumulative trauma—can contribute to a decline in testosterone levels (Gameday Men’s Health, 2025). This hormonal imbalance can, in turn, exacerbate the very mental health symptoms that are already prevalent in this population. It’s a vicious cycle: the job can lower testosterone, and low testosterone can make it harder to cope with the mental strain of the job.

    A recent study published in Translational Psychiatry found a U-shaped curve in the relationship between testosterone levels and PTSD symptoms (PsyPost, 2025). The researchers found that individuals with either very low or very high testosterone levels reported higher levels of PTSD symptoms, while those with mid-range levels had the fewest symptoms. While this study does not prove that low testosterone causes PTSD, it does suggest a significant relationship and supports the idea that restoring hormonal balance may have a positive impact on mental health outcomes (PsyPost, 2025).

    The Potential for TRT

    For first responders with clinically low testosterone levels, TRT can be a valuable component of a comprehensive mental health treatment plan. By restoring testosterone to an optimal range, TRT may help to alleviate a number of mental health symptoms. This can include:

    • Improved Mood: Patients often report a significant reduction in symptoms of depression and anxiety, as well as a more stable mood (Mantality Health, 2024).
    • Increased Motivation and Energy: Restored energy and vitality can lead to a greater sense of well-being and a renewed desire to engage in hobbies, exercise, and social activities, all of which are protective factors for mental health (Tactus Health, n.d.).
    • Enhanced Cognitive Function: TRT has been shown to improve memory, focus, and mental clarity, which are essential for first responders working in high-pressure situations (Caliper Wellness, 2025).

    An Individualized Approach is Key

    It’s crucial to understand that TRT is not a one-size-fits-all solution or a magical cure. It is a medical intervention that requires a thorough evaluation, including blood work to confirm a diagnosis of hypogonadism. Treatment should always be monitored by a qualified healthcare professional, with regular follow-up appointments to track hormone levels and adjust dosages as needed. Potential side effects and risks must be carefully discussed with each patient.

    For first responders struggling with their mental health, a holistic and collaborative approach is paramount. This may include a combination of therapy, medication management, and lifestyle changes, with TRT considered as an additional tool for those with a confirmed testosterone deficiency. By addressing the physiological factors that can contribute to mental distress, we can provide our heroes with the comprehensive care they deserve to stay healthy, resilient, and ready to serve.

    Bibliography

    Caliper Wellness. (2025). The mental health benefits of testosterone replacement therapy (TRT) in men over 40 in Pasco County: A PMHNP-BC perspective. Retrieved from https://www.caliperwellness.com/the-mental-health-benefits-of-testosterone-replacement-therapy-trt-in-men-over-40-in-pasco-county-a-pmhnp-bc-perspective/

    Gameday Men’s Health. (2025). The first responder guide: Boost focus and stamina with Gameday TRT. Retrieved from https://gamedaymenshealth.com/trt-first-responders/

    Mantality Health. (2024, May 1). TRT and mental health: Addressing depression with testosterone therapy. Retrieved from https://mantalityhealth.com/blog/trt-mental-health/

    PsyPost. (2025). Testosterone levels linked to PTSD symptoms in both men and women, study finds. Retrieved from https://www.psypost.org/testosterone-levels-linked-to-ptsd-symptoms-in-both-men-and-women-study-finds/

    Tactus Health. (n.d.). #1 Choice for testosterone therapy for first responders. Retrieved from https://tactushealthcare.com/testosterone-therapy-for-first-responders/

    UTHealth Houston School of Public Health. (2025). Mental health conditions in first responders. Retrieved from https://sph.uth.edu/research/centers/dell/legislative-initiatives/docs/Mental%20Health%20Conditions%20in%20First%20Responders_April%202025.pdf

  • The Power of Strong Legs: A Vital Component of Healthy Aging in Men

    The Power of Strong Legs: A Vital Component of Healthy Aging in Men

    By Andrew Hewitt, APRN-BC

    Abstract
    As men age, maintaining leg strength becomes increasingly crucial for preserving mobility, preventing falls, and supporting cognitive health. This article explores the significance of leg strength in aging men, examining its impact on physical function, mental well-being, and overall quality of life. Recent studies highlight the benefits of resistance training and targeted exercises in mitigating age-related muscle loss and promoting longevity [1].

    Introduction
    Aging is accompanied by various physiological changes, including a decline in muscle mass and strength, particularly in the lower extremities. This decline can lead to reduced mobility, increased risk of falls, and diminished independence. Understanding the importance of leg strength and implementing strategies to maintain it are essential for healthy aging in men.

    The Role of Leg Strength in Aging

    Muscle Mass Decline and Sarcopenia
    Sarcopenia, the age-related loss of skeletal muscle mass and strength, typically begins around the age of 50, with an average annual decline of 1–2% in muscle mass [2]. This condition disproportionately affects the lower body, compromising balance and increasing the likelihood of falls [2][3][4].

    Impact on Mobility and Independence
    Strong leg muscles are essential for performing daily activities such as walking, climbing stairs, and rising from a chair. A decline in leg strength can lead to mobility limitations, reducing an individual’s ability to live independently and increasing the risk of hospitalization.

    Cognitive Health and Leg Strength
    Emerging research indicates a connection between leg strength and cognitive function. A study published in Frontiers in Aging Neuroscience found that lower extremity muscle strength mediates the relationship between mobility and cognitive function in older adults [5]. Maintaining leg strength may, therefore, play a role in preserving cognitive abilities and delaying the onset of cognitive decline [5][6].

    Benefits of Resistance Training
    Engaging in resistance training has been shown to counteract the effects of sarcopenia and improve overall health in older adults. A study in BMJ Open Sport & Exercise Medicine demonstrated that one year of heavy resistance training helped older adults maintain isometric leg strength up to four years post-intervention [7]. This suggests that consistent strength training can have long-lasting benefits for leg strength and functional mobility [8][9].

    Practical Recommendations

    Exercise Strategies
    Incorporating specific exercises targeting the lower body can help maintain and improve leg strength. Recommended exercises include:

    • Squats: Engage multiple muscle groups, including the quadriceps, hamstrings, and glutes.
    • Lunges: Improve balance and coordination while strengthening the legs.
    • Leg Presses: Target the quadriceps and glutes, enhancing lower body strength.
    • Step-Ups: Mimic daily activities and improve functional mobility [10].

    Performing these exercises two to three times per week, with appropriate resistance and repetitions, can yield significant benefits [11].

    Nutritional Support
    Adequate nutrition plays a vital role in maintaining muscle mass. Older adults should aim for a protein intake of 0.45 to 0.59 grams per pound of body weight daily to support muscle maintenance and growth [12]. Additionally, ensuring sufficient intake of vitamin D and omega-3 fatty acids can further support musculoskeletal health [12].

    Conclusion
    Maintaining leg strength is paramount for aging men to preserve mobility, prevent falls, and support cognitive health. Incorporating resistance training and ensuring adequate nutritional intake are effective strategies to combat age-related muscle decline. Healthcare providers should encourage older male patients to engage in regular lower body strength training and monitor their nutritional status to promote healthy aging [1][3][9].