If you’re the typical middle-aged, TV-watching male, most of what you know about testosterone probably comes from the Nugenix commercials featuring Hall of Fame first baseman Frank Thomas.

One from 2019 begins with a woman in an airport recognizing Thomas. She says, “Wowza,” to her husband, and then “You look like you could still be playing,” to Thomas, who last played in the major leagues in 2008 and is now 53.

When Thomas admits, “I am feeling stronger, leaner with a lot more energy and drive,” the husband asks his secret. It’s Nugenix Total-T. The announcer explains Total-T is Nugenix’s “most powerful man-boosting formula ever” because it “boosts your free testosterone and total testosterone levels” and if you’re a man over 40, you should text for a free bottle right now.

Thomas then hands the hubby a bottle, taps his shoulder, and says, “Trust me. She’ll like it too.”

Over-the-counter products such as Total-T strive to counteract the decreasing testosterone levels that lead to the subsequent loss of muscle, energy, and sex drive, but there is another benefit to males over 40 doing so. Study author Dr. Bu Yeap writes in an article published in the February 2021 issue of Hypertension: “The endothelium [the lining of the blood vessels and heart] is integral to the maintenance of vascular health in humans, and advancing age and low testosterone levels are associated with endothelial dysfunction in men.”

That’s why he and four colleagues at the University of Australia, Perth set out to determine the impact of something a bit more powerful than Total-T on blood vessel functioning. The study used doctor-prescribed testosterone therapy, 78 men between the ages of 55 and 70 who had never smoked or had heart disease, and one other thing.

Exercise.

After the study’s publication, it was the efficacy of the exercise, not the testosterone therapy, making headlines.

In “Guys, Exercise Helps Aging Hearts, Testosterone Won’t,” Alan Mozes’s article about the study for WebMD.com, Yeap declares: “To improve the health of arteries, exercise is better than testosterone.”

The 78 subjects in the study were divided into four groups. “One group did aerobic and strength exercise two to three times per week while receiving testosterone therapy; a second got testosterone alone; a third was given placebo therapy; and a fourth got placebo therapy with an exercise routine.”

After 12 weeks, the men who had received testosterone therapy averaged a hormone-level increase of 62 percent, and the group who exercised but received no testosterone also recorded a bit of a rise. No surprises here, but there was one when blood vessel functioning was tested.

Exercise improved it more than testosterone therapy.

While those who received testosterone and exercised averaged a 19-percent improvement in blood vessel functioning, those who only exercised improved 28 percent. The subjects who received the therapy and did no exercise at all recorded no improvement.

Since publishing this paper from the University of Australia, Perth study, the journal Hypertension has run another of note linking exercise and heart health. “Physical Activity as a Critical Component of First-Line Treatment for Elevated Blood Pressure or Cholesterol” is a collaborative effort between the American Heart Association and the American College of Cardiology and its title says it all.

Both high blood pressure and high cholesterol increase your odds of developing heart problems and having a stroke or heart attack. In this position paper, using drugs to attack either problem is no longer seen as the first line of defense.

“For patients with mildly or moderately elevated blood pressure and blood cholesterol, lifestyle-only approaches are [now] the first line of therapy.”

And amongst the lifestyle-only approaches, exercise “has extensive benefits ... that are comparable, superior, or complementary to other healthy lifestyle changes.”

To close, I will admit to feeling uneasy about how you’ll perceive this column. I fear you’ll dismiss it as more of “the same old same old” from that old exercise eccentric. After all, you’ve read about the multitude of health benefits from exercise many times before.

But the two studies highlighted here do that and more. Mainstream medicine has always praised exercise as a proactive measure, but in these cases exercise is being used after the fact and in lieu of what Americans use far too much of.

Prescribed drugs.

While it’s easy to blame doctors for that, it now seems more of them are prescribing exercise instead of pills when the situation warrants it.

But don’t wait for your doctor to write the new script. Do it yourself.

Make it a point to exercise regularly. Study upon study has found it strengthens muscles, reduces stress and inflammation, decreases blood pressure, helps control body weight, and slows or even stops type 2 diabetes. For those hooked on the ugly habit, it actually makes quitting smoking easier.