Thomas Cangiano MD

Hello! I am Dr Thomas Cangiano. Since my medical school and residency training in Urology at the University of Pennsylvania and subsequent Urologic Oncology education at the University of California at Los Angeles, I have been treating patients with a wide variety of urologic conditions in the Orlando area for over 21 years. About 10 years ago I found myself with a noticeable lack of energy, decreased libido and generally in a mental fog. It was hard to explain I just knew something was wrong. At that time very little was known about testosterone and its impact on the male. In fact, the range of testosterone considered normal was a whopping 200 to almost 900! So the scientific community was way behind the times and really unsure what was “normal” or even acceptable. All of our training as urologists and even endocrinologists was rigid and behind the times. The anti- aging community had discovered benefits of testosterone and other hormonal balances which we as urologists viewed as alternative unproven medicine since there was no real scientific proof with carefully structured studies. The problem was again that the science lagged behind the clinical conditions and many patients weren’t being optimized or simply ignored when they had complaints of low libido, poor erections, reduced muscle mass, depression, moodiness, and lack of energy. Through a friend, I met an anti-aging specialist who took the time to educate me on what some of the cutting edge techniques they used to maximize hormones and make life more fulfilling. In fact, when my blood level was tested, my testosterone was considered “normal” by all standards but I knew I was not optimized. I knew I just was not feeling right. I would exercise and eat right and was getting nowhere. I tried low carbohydrate diet, you name it and just could not lose weight or gain muscle mass. I was also not necessarily in a mental fog but certainly not on my game or on point mentally. All I wanted to do was come home (sure after a stressful day) and lay on the couch and watch tv. I had lost my motivation to workout and just seemed to have lost my sharpness and creativity.

So I started a journey of being treated over 10 years ago when there was little data, little science to back all of this up. Some of it was street science. Some of it trial and error. I became my own experiment and had to learn as I went. I researched and searched for answers. The journey was long and initially it was frustrating because I could not find data to support what I felt, how I felt or how I managed myself. I would go to conferences and lectures only to find the old teachings. Our Urological Association was behind the times as was our endocrinology colleagues. So through trial and error and personal experience I was able to get ahead of the curve. I was pleased when I saw more and more studies corroborating what I knew and felt and saw first hand the advancement in the study of male aging and low T. Many of my colleagues would call me with questions but wouldn’t prescribe the medication because they were afraid to. I guided them, through personal experience into uncharted waters but as the science caught up as the field evolved and our knowledge matured; we as Urologists became more aggressive in treating this condition. Billboards and radio ads began to pop up. Morning talk shows are openly discussing the topic. The most attended lectures in our annual meeting are the ones on Testosterone and the aging male. In fact, I went to one of these lectures recently and it was standing room only, probably a fire hazard for people in a closed door lecture hall.

I looked at the educational literature out there and was not satisfied. I wanted to set the record straight. I wanted to dispel the many myths I hear everyday and update you on the salient points of the current literature. I wanted something anyone and everyone could understand. Lastly, I wanted to try to simplify the nebulous and most complex male hormonal issues into simple terms.