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Nathan Goodyear

Association between endogenous sex steroid hormones and inflammatory biomarkers in US men - 0 views

  • modest statistically significant inverse associations for total and calculated free testosterone, and modest positive associations for total and calculated free estradiol with CRP concentration
  • Estradiol concentrations were also weakly positively associated with WBC count
  • SHBG was weakly inversely associated with WBC
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  • An association between testosterone and WBC count was not observed
  • These findings are consistent with the hypothesis that in men higher androgen concentration is anti-inflammatory, and higher estrogen concentration is pro-inflammatory.
  • the probability of elevated CRP concentrations (≥ 3 mg/L) decreased with higher total and calculated free testosterone concentrations, while the probability increased with higher total and calculated free estradiol concentrations
  • there is ample evidence supporting the immunosuppressive effect of androgens
  • The incidence of autoimmune diseases is higher in androgen-deficient men
  • Studies have shown that the induction of hypogonadism in older men is followed by a significant increase in IL-6 concentrations (Khosla et al. 2002), a potent stimulator of inflammation, and that activation of the androgen receptor exerts a direct anti-inflammatory effect
  • It has been suggested that the mechanisms for the immunosuppressive effect of androgens could be either a direct effect on the expression of inflammatory genes (Bellido et al. 1995; Asirvatham et al. 2006), or an indirect effect through inhibition of nuclear factor-kB activation
  • Estradiol is the major biologically active estrogen, and about 80% is formed in adult men from the aromatization of testosterone primarily in the adipose tissue
  • estrogen can stimulate the transcription factor C/EBP-β, which is involved in CRP transcription
  • Most prior cross-sectional studies have observed inverse associations between androgen concentrations and inflammatory biomarkers
  • A recent study in Chinese men showed that lower concentrations of total and calculated free testosterone were associated with higher CRP concentration
  • Data from the Boston Area Community Health Survey also reported inverse associations between testosterone and CRP concentrations
  • Total testosterone was inversely associated with WBC count (Tang et al. 2007; Schneider et al. 2009; Brand et al. 2012), but calculated free testosterone was not associated with WBC
  • The first trial found a decrease in CRP, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNFα) but no changes in IL-6 and IL-10 concentrations between the active treatment and placebo arms
  • the majority of studies in the literature have not observed statistically significant associations between estradiol and inflammatory biomarkers in men, although several of them observed point estimates in the positive direction
  • total testosterone and estradiol compete for binding to SHBG, and seem to have opposite effects on the concentration of inflammatory biomarkers
  • A small randomized controlled trial of estrogen replacement therapy in prostate cancer patients showed an increase in CRP in the active treatment group versus the comparator group
  • Obese men are known to have lower androgen concentrations compared to their normal-weight counterparts
  • The strongest suggestion of an interaction was the inverse association between androstanediol glucuronide and CRP concentrations in obese participants, while the association was positive in the non-obese
  • A recent Chinese cross-sectional study observed stronger inverse associations between total testosterone and CRP concentrations in individuals with a BMI of 27.5 kg/m2 or greater
  • our results suggest that total and calculated free testosterone are modestly inversely associated with CRP concentrations, and that total and calculated free estradiol are modestly positively associated with CRP and WBC
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    Study results suggest that higher Testosterone and lower Estrogen levels provide anti-inflammatory effects in men.  The inflammatory biomarker assessed here was CRP.  Low total and calculated free Testosterone was associated with an increase in CRP.  In contrast, total and free Estrogen was associated with an increase in CRP.  Estradiol increased WBC count and SHBG was inversely related to WBC count in this study.
Nathan Goodyear

Testosterone Treatment and Sexual Function in Older Men with Low Testosterone Levels: T... - 0 views

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    new study finds that men >65 with low libido and Testosterone levels < 275 increase sexual function with Testosterone therapy.  Only libido was improved; no benefit to erectile function was noted--note that is likely due to depleted NO.  Given time that should improve with he increase in NO synthase and thus NO.  I have a fault with on elf the comments on this study: they point out that increased free Testosterone and estradiol levels were associated with improved sexual activity.  This lacks an understanding of the physiology.  In men with low T > 65, the majority are dealing with inflammation and excess weight; all of which increase aromatase activity and thus estradiol activity.  This does not indicate that an increase in estradiol activity is associated with improved libido in men.  How can elevated estrogen levels lead to low T and then increase levels are associated with improved libido?  This is merely a reflection of the body's dysfunctional physiology.  This observation of increased estradiol by no means shows cause and effect.  Scientists need to due a better job in vetting what they write!
Nathan Goodyear

Gonadal Steroids and Body Composition, Strength, and Sexual Function in Men - NEJM - 0 views

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    This study confirms what we know about Testosterone, but this study finds that Estradiol aids libido and fat loss.  The conclusion on Estradiol I believe to be extremely premature.  First, it flies in the face of all the accumulative data on estradiol, second, what normal physiology is being replicated with goserelin???  Goserelin has been shown to decrease Prolactin which can effect libido also.  What about the potential there?  The men included in the study were described as "healthy".  So, you are taking "healthy" normal funcitoning men, throwing in a monkey wrench and looking at the effects of your monkey wrench.  Sorry, not physiologic.  In all my practice, I have seen one man with low Estradiol levels.  There is no reference to the hormone levels in the men preceding the suppression with goserelin.  This is a study that lacks application.
Nathan Goodyear

17β-ESTRADIOL AND ESTRADIOL FATTY ACYL ESTERS AND ESTROGEN-CONVERTING ENZYME ... - 0 views

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    Interesting study.  Adipose production of Estradiol in both men and women not reflected in serum Estradiol.  Serum Estradiol is just transport hormones.  This same finding has been shown in prostate aromatase activity.  
Nathan Goodyear

Serum oestradiol levels in male partners of infer... [Andrologia. 2014] - PubMed - NCBI - 0 views

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    Study points to association of low Estradiol and spermatogenesis in males in infertile couples.  The authors eluded to the association of low Estradiol with low Testosterone, and BMI which is the likely etiology.  Low BMI will result in low aromatase activity.  For men, the majority of Estradiol production occurs from Testosterone via aromatase activity.  Estradiol likely exists in a "U" shaped pattern of benefit: to low hinders optimal physiologic function and contributes to inflammation and disease in men.
Nathan Goodyear

Testosterone and Estradiol Regulate Free Insulin-Like Growth Factor I (IGF-I), IGF Bind... - 0 views

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    testosterone and Estradiol effect IGF-1 levels.  This small study looked at 8 men and 8 postmenopausal women.  Findings:  low testosterone and high estradiol decrease IGF-1 availability.   Estradiol in postmenopausal women will result in a decrease in IGF-1 through an elevation of IGFBP-1.  In men, testosterone replacement stimulates increased HGH secretion and resultant IGF-1 secretion
Nathan Goodyear

Equine Estrogens Impair Nitric Oxide Production and Endothelial Nitric Oxide ... - 0 views

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    This is the perfect study to compare synthetic, unnatural hormones with bioidentical hormones.  Premarin was compared with bioidentical estradiol.  Premarin reduced the endothelial NO synthase transcription and activity by 30-50% compared to Estradiol.   Thus, premarin results in a lower NO production and thus greater endothelial dysfunction compared to Estradiol.
Nathan Goodyear

Estradiol and Metabolic Syndrome in Older Italian Men: the InCHIANTI Study - 0 views

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    Men with metabolic syndrome found to be associated with higher Estradiol levels.  Thus, Estradiol in "older men", >65 in this study, is associated with metabolic syndrome.
Nathan Goodyear

Selenomethionine and α-Tocopherol Do Not Inhibit Prostate Carcinogenesis in t... - 0 views

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    In this animal study, estradiol is added to Testosterone to increase prostate carcinogenesis.  Previous rat studies have shown that adding estradiol to Testosterone, which occurs naturally, increases prostate cancer risk.  
Nathan Goodyear

Estradiol and Inflammatory Markers in Older Men - 0 views

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    Estradiol found to be associate, though weakly, with IL-6 in men.  This provides a link between estradiol production in men and inflammation.
Nathan Goodyear

Estradiol and Metabolic Syndrome in Older Italian Men: The InCHIANTI Study -- Maggio et... - 0 views

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    Estradiol found to be associated with Metabolic syndrome in men. This was independent of other confounding variables.  Most men, the excess estradiol comes from increased aromatase activity on testosterone.
Nathan Goodyear

Effect of aging on endogenous level of 5 alpha-dihydrotestosterone, testosterone, estra... - 0 views

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    Men with BPH found to have higher levels of stromal Estradiol and Estrone.  This is associated with aging.  This elevation was not found in the prostate epithelium.  No correlation with Testosterone and the stroma and epithelium were found.  So, the point is that what is happening in the prostate appears to be related to increased aromatase activity in the prostate.  Which this has been shown to be evident in the lateral lobes of the prostate in other studies.  But DHT?  The numbers here are slightly elevated.  BUt the balance of DHT to Estradiol may be more important than the individual levels.  This study was done in humans.
Nathan Goodyear

Sex Hormones and Age: A Cross-sectional Study of Testosterone and Estradiol and Their B... - 0 views

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    Older men have Estradiol levels that are 3 x that of a post-menopausal women.  The bioavailable levels of Testosterone and Estradiol showed the greatest precipitous decline.
Nathan Goodyear

Transdermal testosterone replacement therapy in men - 0 views

  • a recent study has suggested that it may sometimes be inaccurate because of abnormal fluctuation of other circulating androgens
    • Nathan Goodyear
       
      The authors are referencing the increase in the suggestions to use other testing techniques i.e. saliva.
  • Testosterone therapy can inhibit hepcidin transcription and is associated with increased iron incorporation into red blood cells and increased erythropoietin concentrations
  • Transdermal TRT has a more favorable adverse effect profile when compared to buccal testosterone formulations
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  • testosterone concentrations should be checked 2–3 months after initiation of therapy and after adjusting the dose
  • the recommendation for injectable testosterone esters is to check the serum concentration midway between injections
  • it is recommended for serum testosterone to be evaluated 3 to 12 hours after application of the transdermal patch
  • Approximately 0.3% of testosterone is converted into estradiol by aromatase (CYP19A1)
  • a study from 1989 utilizing testosterone transdermally containing 5, 10, or 15 mg of testosterone showed that peak concentrations of testosterone were achieved 3 to 8 hours after scrotal application in hypogonadal men
  • measure serum testosterone any time after the patient has been on treatment with gel for at least 1 week
  • evaluate serum testosterone at the end of the dosing interval for testosterone pellets
  • increased amount of fat leads to increased extragonadal aromatase activity, resulting in increased concentrations of estradiol. High circulating concentrations of estradiol down regulate the HPG axis and decrease the amount of circulating testosterone
  • Up to 80% of plasma estradiol originates from aromatization of testosterone and less than 20% of estradiol in the circulation is secreted by the testes
  • A PSA concentration, digital rectal examination, and hematocrit should be performed at baseline and at 3 months, 6 months, then yearly after TRT is initiated.
  • It is used for many medications and has the advantage of high bioavailability, absence of hepatic first pass metabolism, increased therapeutic efficacy, and steadiness of plasma concentrations of the drug
  • If the hematocrit rises above 54%, treatment should be discontinued
  • elderly men having higher estradiol serum concentrations than postmenopausal women
Nathan Goodyear

Salivary estradiol and testosterone in filipin... [Am J Hum Biol. 2014] - PubMed - NCBI - 0 views

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    Study finds association between elevated Estradiol in young men and obesity.  No correlation was found with Testosterone.  This fits other research that points to early increased Estradiol production and late decrease in low T.  The men in this study were "young".  Testing was done in saliva.
Nathan Goodyear

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

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    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

JAMA Network | JAMA | Circulating Estradiol and Mortality in Men With Systolic Chronic ... - 0 views

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    Study of 500 men with CHF and reduced LVEF found that estradiol has a "U" shaped relationship to prognosis.  A low and high estradiol levels are associated with increased poor prognosis.  Other biomarkers in these 2 groups were different, suggesting different physiologic mechanisms.
Nathan Goodyear

Estradiol-induced proliferation of papillary and follicular thyroid cancer ce... - 0 views

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    Estradiol increased thyroid papillary and follicular cancer cells via both ER alpha and ER beta in this study.  What is also interesting is that estradiol did not increase PR expression.
Nathan Goodyear

Estradiol-17β Upregulates Pyruvate Kinase M2 Expression to Coactivate Estroge... - 0 views

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    This is an important study.  Study found that Estradiol increased the transcription of pyruvate kinase M (PKM2)production in endometrial stromal cells.  This increase in PKM2 shifted metabolism to a aerobic glycolysis pattern similar to the Warburg effect described in cancer.  Additionally, increased PKM2 via Estradiol increased ER alpha transcription and functioned as a ER alpha coactivator.
Nathan Goodyear

Urinary Estrogens and Estrogen Metabolites and Subsequent Risk of Breast Cancer among P... - 0 views

  • both 2- and 4-catechol estrogen metabolites bind to the ER with affinities comparable with estradiol, 4-catechol estrogen metabolites have lower dissociation rates than estradiol and an enhanced ability to upregulate ER-dependent processes
  • 2-catechol estrogen metabolites act as either weak mitogens (39) or weak inhibitors of cell proliferation
  • While 16α-hydroxyestrone binds to the ER with lower affinity than estradiol, it binds covalently (41) and leads to a constitutively activated ER
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  • 4-hydroxyestradiol and 16α-hydroxyestrone increasing proliferation and decreasing apoptosis in a manner similar to estradiol; however, these effects were achieved only at concentrations 10-fold higher than estradiol (39). In contrast, 2-hydroxyestradiol did not have substantial proliferative or antiapoptotic effects
  • In our study, the associations with both 2-hydroxyestrone and 16α-hydroxyestrone were nonsignificantly inverse and we did not observe a consistent trend or significant associations between the 2-hydroxyestrone:16α-hydroxyestrone ratio and breast cancer risk
  • Ratios of the 3 hydroxylation pathways were not significantly associated with risk although the 2:16-pathway and 4:16-pathway ratios were suggestively inversely associated
  • a significant inverse association with the ratio of parent estrogens to estrogen metabolites
  • several potentially estrogenic and genotoxic mechanisms
  • Estrogen metabolites also can be genotoxic
  • Catechol estrogens can be oxidized into quinones and induce DNA damage directly through the formation of DNA adducts, or indirectly via redox cycling and generation of reactive oxygen species
  • the oxidized forms of the catechol estrogens differ in their ability to damage DNA through adducts, with oxidized 2-catechols forming stable and reversible DNA adducts and oxidized 4-catechols forming unstable adducts, which lead to depurination and mutations
  • 2- and 4-catechols have been shown to produce reactive oxygen species and induce oxidative DNA damage
  • act independently from the ER
  • 16α-Hydroxyestrone also may be genotoxic
  • While the catechol estrogens have estrogenic and genotoxic potential, the methylated catechol estrogens, which are catechol estrogens with one hydroxyl group methylated, have been hypothesized to lower the risk of breast cancer
  • The suggested mechanisms are indirect, by decreasing circulating levels of catechol estrogens and thereby the opportunity for catechols to exert genotoxic or proliferative effects, or direct, by inhibiting tumor growth and inducing apoptosis
  • the balance between phase I (oxidation) and phase II (methylation) metabolism of estrogen may be important in hormonally related cancer development.
  • Despite the estrogenic and genotoxic potential of many of the estrogen metabolites, we only observed a significantly increased breast cancer risk with one estrogen metabolite, 17-epiestriol, which has particularly strong estrogenic activity and binds to both ERα and ERβ with an affinity comparable with estradiol
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    review of estrogen metabolites and breast cancer risk in premenopausal women.
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