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Nathan Goodyear

Testosterone and benign prostatic hyperplasia Jarvis TR, Chughtai B, Kaplan SA, - Asian... - 0 views

www.ajandrology.com/preprintarticle.asp

Testosterone BPH low T low Testosterone prostate cancer men male hormone hormones

shared by Nathan Goodyear on 01 Dec 14 - No Cached
  • The prevalence of hypogonadism (often defined as serum testosterone < 300 ng dl−1 ) ranges from 6% [10] to as high as 38%
  • The process of BPH, however, continues as men age and despite the fact their serum testosterone decreases
  • Liu et al. [12] demonstrated that in a group of older males (mean age 59.8 years) that there was not a significant correlation of serum testosterone levels (total, free or bioavailable) with either prostate volume or International Prostate Symptom Score (IPSS)
  • ...11 more annotations...
  • in eugonadal men, studies have demonstrated that the prostate can increase in volume by approximately 12%
  • There seems to be little doubt that the treatment with testosterone of a young hypogonadal male leads to significant growth of the prostate
  • Behre et al. [22] demonstrated increased prostate volume and prostate-specific antigen (PSA) levels in hypogonadal men
  • Most studies, however, have shown no effect of exogenous androgens on PSA or prostate volume for older hypogonadal males
  • saturation model
  • They argue that the prostate is relatively insensitive to changes in androgen concentration at normal levels or in mild hypogonadism because the AR is saturated by androgens and therefore maximal androgen-AR binding is achieved. Conversely, the prostate is very sensitive to changes in androgen levels when testosterone is low
  • visceral obesity (one of the most significant components of metabolic syndrome) is associated with prostate volume and influences prostate growth during TRT.
  • This hypothesis of inflammation induced LUTS is also argued to be a mechanism for improvement of LUTS with PDE5I
  • The concept, therefore, that treatment with TRT of hypogonadal males with metabolic syndrome might lead to improvement/stabilization of their LUTS, appears to be confirmed in recent work by Francomano et al.
  • There was also an improvement in components of the patient's metabolic syndrome (such as BMI, waist circumference, hemoglobin A1c [HbA1c], insulin sensitivity, and lipid profile) as well as inflammatory markers and C-reactive protein.
  • They concluded that TRT was safe in this group of men, and hypothesize that TRT mitigates the pro-inflammatory factors associated with metabolic syndrome.
  • Nathan Goodyear on 01 Dec 14
     
    Authors review the literature behind Testosterone and BPH.  The authors highlight the 4 proposed theories behind BPH: Testosterone, Estrogen, inflammation, and metabolic.   The conclusion is mixed: pointing out that no high level of evidence exists on either side of the debate of Testosterone and BPH.
Nathan Goodyear

Testosterone Deficiency, Cardiac Health, and Older Men - 0 views

www.hindawi.com/...143763

low T Testosterone obesity type II diabetes diabetes health wellness metabolic syndrome lipids cholesterol hypogonadism TDS testicular dysgenesis syndrome men male hormone hormones prostate cancer

shared by Nathan Goodyear on 12 May 14 - No Cached
  • Studies have shown pharmacological doses of testosterone to relax coronary arteries when injected intraluminally [39] and to produce modest but consistent improvement in exercise-induced angina and reverse associated ECG changes [40]. The mechanism of action is via blockade of calcium channels with effect of similar magnitude to nifedipine
    • Nathan Goodyear
      Nathan Goodyear on 12 May 14
       
      This directly refutes the recent studies (3) that Testosterone therapy increases cardiovascular events.
    • Nathan Goodyear
      Nathan Goodyear on 13 May 14
       
      Testosterone acts as a calcium channel blocker inducing vasodilation.
  • men with chronic stable angina pectoris, the ischaemic threshold increased after 4 weeks of TRT and a recent study demonstrates improvement continuing beyond 12 months [
  • Exercise capacity in men with chronic heart failure increased after 12 weeks
  • ...36 more annotations...
  • Studies have shown an inverse relationship between serum testosterone and fasting blood glucose and insulin levels
  • Medications such as chronic analgesics, anticonvulsants, 5ARIs, and androgen ablation therapy are associated with increased risk of testosterone deficiency and insulin resistance
  • Women with T2D or metabolic syndrome characteristically have low SHBG and high free testosterone
    • Nathan Goodyear
      Nathan Goodyear on 12 May 14
       
      This stands in polar opposite of that with men.
  • Hypogonadism is a common feature of the metabolic syndrome
  • The precise interaction between insulin resistance, visceral adiposity, and hypogonadism is, as yet, unclear but the important mechanisms are through increased aromatase production, raised leptin levels, and increase in inflammatory kinins
  • levels of testosterone are reduced in proportion to degree of obesity
  • Men should be encouraged to combine aerobic exercise with strength training. As muscle increases, glucose will be burned more efficiently and insulin levels will fall. A minimum of 30 minutes exercise three times weekly should be advised
  • Testosterone increases levels of fast-twitch muscle fibres
  • By increasing testosterone, levels of type 2 fibres increase and glucose burning improves
  • Weight loss will increase levels of testosterone
  • studies now clearly show that low testosterone leads to visceral obesity and metabolic syndrome and is also a consequence of obesity
  • In the case of MMAS [43], a baseline total testosterone of less than 10.4 nmol/L was associated with a greater than 4-fold incidence of type 2 diabetes over the next 9 years
  • There is high level evidence that TRT improves insulin resistance
  • Low testosterone predicts increased mortality and testosterone therapy improves survival in 587 men with type 2 diabetes
  • A similar retrospective US study involved 1031 men with 372 on TRT. The cumulative mortality was 21% in the untreated group versus 10% ( ) in the treated group with the greatest effect in younger men and those with type 2 diabetes
  • the presence of ED has been shown to be an independent risk factor, particularly in hypogonadal men, increasing the risk of cardiac events by over 50%
  • A recent online publication on ischaemic heart disease mortality in men concluded optimal androgen levels are a biomarker for survival
  • inverse associations between low TT or FT (Table 2) and the severity of CAD
  • A recent 10 year study from Western Australia involving 3690 men followed up from 2001–2010 concluded that TT and FT levels in the normal range were associated with decreased all-cause and cardiovascular mortality, for the first time suggesting that both low and DHT are associated with all-cause mortality and higher levels of DHT reduced cardiovascular risk
  • TDS is associated with increased cardiovascular and all-cause mortality
  • The effect of treatment with TRT reduced the mortality rate of treated cohort (8.4%) to that of the eugonadal group whereas the mortality for the untreated remained high at 19.2%
  • hypogonadal men had slightly increased triglycerides and HDL
  • Men with angiographically proven CAD (coronary artery disease) have significantly lower testosterone levels [29] compared to controls ( ) and there was a significant inverse relationship between the degree of CAD and TT (total testosterone) levels
  • TRT has also been shown to reduce fibrinogen to levels similar to fibrates
  • men treated with long acting testosterone showed highly significant reductions in TC, LDL, and triglycerides with increase in HDL, associated with significant reduction in weight, BMI, and visceral fat
  • Low androgen levels are associated with an increase in inflammatory markers
  • In the Moscow study, C-reactive protein was reduced by TRT at 30 weeks versus placebo
  • In some studies, a decline in diastolic blood pressure has been observed, after 3–9 months [24, 26] and in systolic blood pressure
  • A decline was noted in IL6 and TNF-alpha
  • No studies to date show an increase in LUTS/BPH symptoms with higher serum testosterone levels
  • TRT has been shown to upregulate PDE5 [65] and enhance the effect of PDE5Is (now an accepted therapy for both ED and LUTS), it no longer seems logical to advice avoidance of TRT in men with mild to moderate BPH.
    • Nathan Goodyear
      Nathan Goodyear on 12 May 14
       
      What about just starting with normalization of Testosterone levels first.
  • Several meta-analyses have failed to show a link between TRT and development of prostate cancer [66] but some studies have shown a tendency for more aggressive prostate cancer in men with low testosterone
    • Nathan Goodyear
      Nathan Goodyear on 12 May 14
       
      And if one would have looked at their estrogen levels, I guarantee they would have been found to be elevated.
  • low bioavailable testosterone and high SHBG were associated with a 4.9- and 3.2-fold risk of positive biopsy
  • Current EAU, ISSAM, and BSSM guidance [1, 2] is that there is “no evidence TRT is associated with increased risk of prostate cancer or activation of subclinical cancer.”
  • Men with prostate cancer, treated with androgen deprivation, develop an increase of fat mass with an altered lipid profile
  • Erectile dysfunction is an established marker for future cardiovascular risk and the major presenting symptom leading to a diagnosis of low testosterone
Nathan Goodyear

Elevated androgens and prolactin in aromatase-... [Endocrinology. 2001] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...11356695

prostate cancer hormone hormones androgens Testosterone DHT estrogens male men BPH

shared by Nathan Goodyear on 21 Jan 14 - No Cached
  • Nathan Goodyear on 21 Jan 14
     
    aromatase knockout mice, thus elevated androgens without estrogen production, develop BPH but not prostate cancer.  This points to estrogen as the important hormone in carcinogenesis of the prostate. Granted this is a animal model.
Nathan Goodyear

Analysis of Relations between serum levels of Epitestosterone, Estradiol, Testosterone,... - 0 views

www.biomed.cas.cz/...49_S113.pdf

PSA hormone hormones BPH Prostate cancer prostate cancer Epitestosterone men male aromatase Estradiol IGF-1

shared by Nathan Goodyear on 21 Aug 13 - No Cached
  • Nathan Goodyear on 21 Aug 13
     
    Great confusion exists in the medical profession about Testosterone and PSA and the health of the prostate. The conversion of Estrogen, whether E2 or E1, and other variables are responsible for increases in PSA while on Testosterone therapy. This study points out that Estradiol in men stimulates cell line growth of prostate cancer. In contrast, Epitestosterone, an androgen metabolite, has antiandrogen, inhibits this estrogen activity. Epitestosterone exists in an inverse relationship to Estradiol and IGF-1.
Nathan Goodyear

Long-term effects of finasteride on prostate specific antigen levels: results from the ... - 0 views

www.ncbi.nlm.nih.gov/...16093979

5 alpha reductase finasteride 5 alpha reductase inhibitors PSA BPH prostate disease cancer men male hormones

shared by Nathan Goodyear on 14 Oct 15 - No Cached
  • Nathan Goodyear on 14 Oct 15
     
    PSA increased more in men with prostate cancer compared to no disease in men on finasteride therapy. This supports the idea that finasteride has a greater PSA reduction in benign prostate disease compared to prostate cancer.
Nathan Goodyear

Hormonal Signaling in Prostatic Hyperplasia and Neoplasia - 0 views

jcem.endojournals.org/...3463.full

men male BPH prostate cancer hormone hormones

shared by Nathan Goodyear on 19 Sep 12 - No Cached
  • Nathan Goodyear on 19 Sep 12
     
    older study on the underlying biochemistry of BPH and prostate cancer.  Some of this data presented is outdated
Nathan Goodyear

Aromatase and regulating the estrogen:androgen ratio in the prostate gland - 0 views

www.sciencedirect.com/...S0960076009002696

estrogen estradiol Testosterone T:E2 prostate cancer prostate BPH male men hormone hormones cancer health ER alpha ER beta aromatase activity aromatase

shared by Nathan Goodyear on 21 Aug 13 - No Cached
  • Nathan Goodyear on 21 Aug 13
     
    This article summarizes it all.  With age, Testosterone declines and estrogen production, through elevated aromatase activity, increases.  This results in a decline in the Testosterone:estradiol ratio.  This has been clearly implicated in both benign and disease states of the prostate.  The evidence points to aromatase activity and estrogen in the prostate to poor prostate health.  Additionally, this article points out the impact of ER alpha and ER beta on the translation of the message of Estrogen.
Nathan Goodyear

Effect of Finasteride on the Sensitivity of PSA for Detecting Prostate Cancer - 0 views

jnci.oxfordjournals.org/...1128.long

PSA prostate BPH prostate cancer 5 alpha reductase finasteride male hormones men

shared by Nathan Goodyear on 14 Oct 15 - No Cached
  • Nathan Goodyear on 14 Oct 15
     
    Finasteride more likely to lower PSA associated with benign prostate conditions compared to cancer of prostate.
Nathan Goodyear

Prostate-specific antigen (PSA) concentrations in hy... [BJU Int. 2013] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...23294726

Testosterone PSA DHT prostate cancer men male hormone hormones

shared by Nathan Goodyear on 06 Feb 14 - No Cached
  • Nathan Goodyear on 06 Feb 14
     
    Study finds negligible effect of Testosterone therapy (4.8 mg) on PSA.  The study consisted of several phases, the longest being 6 years.  However, each phase the parcipitants significantly declined.  The long held belief that Testosterone and DHT promote an increase in PSA is just not supported in the science.  In fact, aromatase knockout mice don't develop prostate cancer, only BPH.
Nathan Goodyear

Tissue and serum levels of principal androgens in benign prostatic hyperplasia and pros... - 0 views

www.sciencedirect.com/...S0039128X07000293

prostate cancer BPH Testosterone DHT androgens men male hormone hormones saliva

shared by Nathan Goodyear on 20 Jan 14 - No Cached
  • Nathan Goodyear on 20 Jan 14
     
    Serum evaluation of Testosterone and DHT poorly correlates with intraprostatic hormone levels.  Must look to saliva to get better clinical picture.
Nathan Goodyear

In Vitro Anticancer Activity of Plant-Derived Cannabidiol on Prostate Cancer Cell Lines - 0 views

file.scirp.org/...5-2500510_47691.htm

CBD medical marijuana THC prostate BPH male men VEGF hormone hormones cancer PSA CSC cancer stem cells

shared by Nathan Goodyear on 13 Feb 19 - No Cached
  • Nathan Goodyear on 13 Feb 19
     
    High CBD downregulates prostate CBD1, CBD2, chemosensitizes CSCs, suppressed cancer cell formation, down regulated IL-6 and IL-8, decreased PSA, and VEGF.
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