Testosterone Replacement in Men with Opioid-Induced Androgen Deficiency
Plasma Testosterone and Risk of Ischemic Arterial Event in Elderly Men: The French 3C Cohort Study
Soisson et al. of the Center for Research in Epidemiology and Population Health, Hormones and Cardiovascular Disease Team, University of Paris-Sud (France), concluded that “Optimal range of plasma testosterone may confer cardiovascular protection and these results may have clinical implications in the management of testosterone deficiency.”
Maturitas. 2013 Jul;75(3):282-8.
Testosterone: The Key to Male Vitality?
Kaplan and Hu of the Department of Urology, David Geffen School of Medicine at UCLA, note that “up to 25% of older men experience hypogonadism [low testosterone levels]. Prevalence is higher in men with comorbid disease and increases with age starting in the fourth decade. Hypogonadal men have lower muscle mass, bone mineral density, and hemoglobin, and are in poorer general health. During the past decade, there has been increasing awareness of the health benefits conferred by testosterone replacement therapy (TRT). TRT for hypogonadism increases muscle mass and bone mineral density, decreases fat mass, and improves mood, libido, and sexual performance. Despite these benefits, there is an historical fear that administration of exogenous testosterone may increase the risk of developing prostate cancer or an aggressive form of the disease.
Urology. 2013 Aug;82(2):321-6.
“Goodbye Androgen Hypothesis, Hello Saturation Model”
Observations in humans, animals, and PCa cell lines have led to the Saturation Model, ie, that “androgens have a finite, limited ability to stimulate prostate tissue, malignant or benign. This refinement is simple yet profound. Yes, prostate tissue requires androgens for optimal growth. However, it can only use a relatively small amount, beyond which additional androgen is merely excess. The saturation point is well below physiologic concentrations, which explains why manipulation of serum T into or out of the castrate range produces large changes in prostate biology, whereas normal prostate and PCa appear completely indifferent to variations in serum T from the near-physiologic to supraphysiologic range.”
Eur Urol. 2012 Nov;62(5):757-64
Serum testosterone and dihydrotestosterone and prostate cancer risk
Muller et al. of Department of Surgery, Duke University School of Medicine found that “baseline serum testosterone and DHT levels were unrelated to PCa detection or grade. Our findings of the lowest testosterone levels being associated with the lowest PCa risk with no further changes with higher testosterone support a saturation model but must be confirmed in future studies…” After the exclusion criteria were applied, their study consisted of 149,354 men with prostate cancer.
Eur Urol. 2012 Nov;62(5):757-64. doi: 10.1016/j.eururo.2012.05.025. Epub 2012 May 18.
High estradiol levels can suppress testosterone production, and play a role in Metabolic Syndrome. Aromatase inhibitors such as anastrozole can reduce estradiol and increase serum bioavailable and total testosterone levels to the youthful normal range in older men with mild hypogonadism. Suppression of estradiol in men using low-dose anastrozole has been shown to have a positive effect on testosterone production without adverse effects during short term administration.
J Clin Endocrinol Metab. 2004 Mar;89(3):1174-80.
In this case study anastrozole was used to restore fertility in a 29-year-old obese man who presented with a low sperm count in the setting of morbid obesity. Roth et al report "Treatment with an aromatase inhibitor, anastrozole, led to normalisation of the patient's testosterone, luteinising hormone and follicle-stimulating hormone levels, suppression of serum estradiol levels, and to normalisation of spermatogenesis and fertility."
Nat Clin Pract Endocrinol Metab. 2008 Jul;4(7):415-9.
Testosterone Replacement Therapy for Men and Treatment of Depression
J Clin Psychiatry. 2009 Jul;70(7):1009-16.
Low Free Testosterone as a Potentially Treatable Cause of Depression in Older Men
Low Testosterone Increases Mortality Risk in Men
Administration of a transdermal testosterone (T) gel formulation to hypogonadal men provided dose-proportional increases in serum T levels to the normal adult male range. Testosterone 1% gel (50 or 100 mg/day) was compared to the permeation-enhanced T patch. After 180 days, skin irritation was reported in 5.5% of subjects treated with T gel and in 66% of subjects in the permeation-enhanced T patch group. This research at UCLA concluded that T gel replacement improved sexual function and mood, increased lean mass and muscle strength (principally in the legs), and decreased fat mass in hypogonadal men with less skin irritation and discontinuation compared with the recommended dose of the permeation-enhanced T patch.
J Clin Endocrinol Metab. 2000 Aug;85(8):2839-53
The following study concluded that replacing testosterone in hypogonadal men increases bone mineral density of the spine and hip, fat-free mass, prostate volume, erythropoiesis, energy, and sexual function. The full effect of testosterone on bone mineral density took 24 months, but the full effects on the other tissues took only 3-6 months.
J Clin Endocrinol Metab 2000 Aug;85(8):2670-7
Am J Med 2001 May;110(7):563-72
Drugs Aging 1999 Aug;15(2):131-42
The findings below suggest that low levels of testosterone and SHBG play some role in the development of insulin resistance and subsequent type 2 diabetes.
Diabetes Care 2000 Apr;23(4):490-4
Manifestations of testosterone deficiency have included depression, anxiety, irritability, insomnia, weakness, diminished libido, impotence, poor memory, reduced muscle and bone mass, and diminished sexual body hair. Although testosterone levels decline with age, there is great interindividual variability.
Am J Psychiatry 1998 Oct;155(10):1310-8
Med Hypotheses 1999 Jan;52(1):49-51
J Clin Endocrinol Metab 1999 Feb;84(2):573-7
Urology 2000 May;55(5):755-8
- Hormone Replacement Therapy for Men
- Hormone Replacement Therapy for Women
- Athlete’s Foot
- Chemical Peels
- Diaper Rash/Incontinence
- Head Lice and Scabies
- Molluscum Contagiosum
- Nail Infection/Removal
- Pigmentation Abnormalities
- Plantar Warts/Warts
- Scarring and Keloids
- Topical Anesthetics
- Sun Protection/Photoaged Skin/Wrinkles
- Examples of Compounded Medications
- Pain Management
- Palliative Care
- Sports Medicine
- Veterinary Compounding
- Wound Care
- PHYSICIANS ONLY
- SCHOLARSHIP INFO