Ageless Forever Anti-Aging News Blog

Low free testosterone levels and loss of muscle mass

 

Hypogonadism, aka testosterone deficiency or low-T, is primarily diagnosed by low total testosterone levels. However, more and more research is showing that free testosterone, which is the active fraction of total circulating testosterone, is independently associated with important health outcomes.

 

Levels of free testosterone decline more steeply than total testosterone as menage.[1-7 In many cases, total testosterone levels can be relatively high, but free testosterone low. Therefore it is important to assess both total and free testosterone levels in order to get a clear picture of the androgen status.

A recent study specifically assessed if baseline testosterone (total and free) levels predict muscle loss in middle-aged and elderly Japanese men over a 10 year period.[8]

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Testosterone Replacement Therapy (TRT) - does it really increase risk of heart attack? Commentaries from medical organizations

We previously posted a commentary on the recently published and notoriously flawed study which concluded that TRT increases risk for heart attack.

Does Testosterone Therapy Really Increase the Risk of Heart Attack?

http://www.agelessforever.net/anti-aging-news-articles/entry/does-testosterone-therapy-really-increase-the-risk-of-heart-attack

This is the study which caused the media debates:

January 29th issue, the Scientific Journal PLOS (Public Library of Science) ONE published the article: 

"Increased Risk of Non-Fatal Myocardial Infarction Following Testosterone Therapy Prescription in Men."

Here we have gathered commentaries from other medical professionals, all in one place:

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Effects of 6-year Long-Term Testosterone Replacement Therapy (TRT) in Patients with ‘‘Diabesity’’

March 6th 2014 FDA approved Aveed for treatment of male hypogonadism, aka testosterone deficiency.[1] Aveed is a long-acting form of injectable testosterone called testosterone undecanoate. In Europe, testosterone undecanoate (under the name Nebido) has a long successful TRT track record for treatment of testosterone deficiency and its consequences (especially obesity, the metabolic syndrome and diabetes).[2-16]

In contrast to shorter acting forms of testosterone (e.g. cypionate), testosterone undecanoate only needs to be injected every 6 to 12 weeks, and thereby offers practical benefits to patients. (Comment: for Nebido (1000 mg per 4 ml) the initial interval is 6 weeks, followed by intervals of 10-14 weeks; for Aveed (750 mg per 3 ml) the initial interval is 4 weeks, followed by 10-week intervals). 

Five days after the FDA approval a notable and impressive 6-year long TRT study was published, confirming the health benefits of TRT that have previously been found in shorter term studies... [44]

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Relationship between Low Levels of Anabolic Hormones and Mortality in Older Men

The anabolic hormones testosterone, IGF-1 and DHEA (a pre-hormone) are receiving more and more attention by health professionals because the anabolic-catabolic imbalance that favors catabolism is a key factor in accelerated physical deterioration aging.[1, 2] Anabolic impairment can speed up the age-related decline in muscle mass and physical performance, increase in fat mass, development of insulin resistance, cardiovascular risk factors, metabolic syndrome and diabetes, conditions that in turn affect mortality.[3-18]

Interestingly, low levels of multiple anabolic hormones, rather than a single one, has a stronger association with age related muscle loss and the frailty syndrome. [19, 20] In men with chronic heart failure, deficiency of more than one anabolic hormone identifies patients with higher mortality rates.[21]

An interesting study sought to investigate the relationship between parallel deficiency of several anabolic hormones and mortality in a general population of older men, regardless of coexisting disease:[22]

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The Androgen Study Group - Cutting Through Misleading Headlines and Exposing the Truth about Testosterone Therapy and Health

Recently several flawed studies, implicating that testosterone replacement therapy increases risk for heart attack and death, created large media headlines. This despite a large body of research evidence showing the contrary, ie. that testosterone replacement therapy decreases risk for heart disease and that higher testosterone levels are associated with reduced death rates. No wonder there is confusion and unnecessary concern and among healthcare providers and their patients.
 
In response to this, The Androgen Study Group was formed. The Androgen Study Group is a multidisciplinary group of androgen researchers and clinicians who are dedicated to education and accurate reporting on the science of testosterone deficiency in men and its treatment. With the media attention that testosterone therapy is attracting it is critical that clinical trials are properly conducted and analyzed, and that results are presented in a way that is not misleading. The mission of the Androgen Study Group is to ensure that the results of research on testosterone deficiency and its treatment is presented accurately and fairly in the medical literature as well as in public media.
 
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Testosterone and Prostate Cancer - Bye Androgen Hypothesis, Welcome Saturation Model

 

A long-held belief is that testosterone stimulates development of prostate cancer and/or accelerates its growth. This fear is the most common reason for doctors' reluctance to prescribe testosterone replacement therapy, even in hypogonadal men [1, 2] , which unnecessarily deprives many hypogonadal men of clinical benefits.
 
This summary gives an overview of an in-depth review of current literature regarding the relationship of testosterone levels and prostate cancer, and the effect of testosterone replacement therapy on prostate cancer progression and recurrence.[3] Key studies which have refuted the old belief that testosterone has harmful effects on the prostate are presented, along the new testosterone-prostate paradigm known as the saturation model.
 
Surprisingly, new research provocatively suggests that it is not high testosterone levels that are problematic for prostate cancer, but to the contrary that it is low serum T that is associated with worrisome cancer features and outcomes...and new experimental research has uncovered mechanisms that explain how low testosterone levels may be detrimental for prostate health, and support the new view that testosterone therapy actually may have beneficial effects with regard to prostate cancer...
 
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Multiple beneficial effects of testosterone replacement therapy in men with testosterone deficiency

Alleged concerns regarding risk of cardiovascular disease with testosterone replacement therapy (TRT) have been promulgated recently. However, a large and growing number of intervention studies show to the contrary that TRT reduces cardiovascular risk factors and confers multiple beneficial health effects. Thus, fears promoted by some recent flawed studies need to be critically re-evaluated. 
 
This article gives an overview of studies that have investigated health effects and safety of TRT.[1] As outlined here, the position that testosterone deficiency (TD) should be regarded as a risk factor for cardiovascular disease is supported by a rapidly expanding body of evidence.[2-4]
 
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Testosterone Treatment and Heart Attack Risk - new study shows testosterone treatment can even be beneficial

Testosterone therapy has been in use for more than 70 years for the treatment of testosterone deficiency, historically called hypogonadism.[1]In the past 30 years there has been a growing body of scientific research demonstrating that testosterone deficiency is associated with increased body weight/adiposity/waist circumference, insulin resistance, type 2 diabetes, hypertension, inflammation, atherosclerosis and cardiovascular disease, erectile dysfunction (ED) and increased risk of mortality [2, 3]. In line with the detrimental health outcomes seen with testosterone deficiency, testosterone therapy has been shown to confer beneficial effects on multiple risk factors and risk biomarkers related to these clinical conditions.[4]
 
Despite these well-documented health benefits, testosterone therapy is still controversial, in large part due to a few flawed studies and media outcry about potential elevated heart attack risk with testosterone therapy. On July 2, 2014, a study was published which demonstrated that testosterone therapy is not associated with an increased risk of MI, and that is actually may protect against heart attack....[5]
 
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Adverse health effects of testosterone deficiency in men

 
Testosterone deficiency, also known as hypogonadism, is a state with sub-optimal circulating levels of testosterone concomitant with clinical signs and symptoms attributed to low physiological testosterone levels.[1-3] 
 
Sexual dysfunction is the most commonly recognized symptom of testosterone deficiency. However, testosterone also plays a broader role in men's health. A growing body of evidence has established associations between low testosterone levels and multiple risk factors and diseases including the metabolic syndrome, obesity, type-2 diabetes, sarcopenia, frailty, mobility limitations, osteoporosis, cognitive impairment, depression, cardiovascular disease, and reduced longevity.[3-12]
 
This summary gives an overview of the detrimental impact of testosterone deficiency on a wide range of health outcomes.[13]
 
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Dr. Pierce's Medical Organization Affiliations

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