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Nathan Goodyear

Testosterone for secondary prevention in men with ischaemic heart disease? - 0 views

qjmed.oxfordjournals.org/...521.full

CAD coronary artery disease men low testosterone prevention fibrinogen

shared by Nathan Goodyear on 25 Apr 12 - No Cached
  • Androgens and in particular testosterone have an inverse relationship with fibrinogen such that low endogenous testosterone is associated with elevated fibrinogen
  • testosterone administration causes a significant fall in fibrinogen
  • Nathan Goodyear on 25 Apr 12
     
    this article looks at the use of normalization of testosterone levels in men with CAD.  This study presents the data that low T is associated with increased CAD, yet says more studies needed.  This study should have used salivary testing and been more definitive in their conclusion
Nathan Goodyear

Prognostic Influence of Increased Fibrinogen and C-Reactive Protein Levels in Unstable ... - 0 views

circ.ahajournals.org/...4204.full

fibrinogen CRP CAD coronary artery disease

shared by Nathan Goodyear on 28 Apr 12 - No Cached
  • Nathan Goodyear on 28 Apr 12
     
    fibrinogen and CRP associated with poor outcome in those individuals with CAD.
Nathan Goodyear

Testosterone does not adversely affect fibrinogen or tissue plasminogen activator (tPA)... - 0 views

eje-online.org/...285.long

Testosterone therapy low T cardiovascular risk men male hormone hormones disease coagulation fibrinogen PAI-1 tPA

shared by Nathan Goodyear on 29 Jul 14 - No Cached
  • Nathan Goodyear on 29 Jul 14
     
    Thrombosis and cardiovascular risk is a hot topic in Testosterone therapy in men.  This study showed that topical "physiologic" Testosterone therapy provided no negative effects on the coagulation system.  No changes were documented in tPA, PAI-1, and fibrinogen levels in men with chronic stable angina.  This stands in contrast to supra-physiologic therapy of Testosterone that leads to hypofibrinogenemia.
Nathan Goodyear

Residual adverse changes in arterial endothelial fun... [Ann Med. 2007] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/pubmed

flu vaccine LDL oxidation CRP fibrinogen inflammation

shared by Nathan Goodyear on 07 Nov 12 - No Cached
  • Nathan Goodyear on 07 Nov 12
     
    could the flu vaccine cause a short-term increase in cardiovascular event risk?  According to this study yes.  So, with a recent study showing no benefit in children and adults, then with this finding of increased arterial dysfunction, increased CRP and fibrinogen, and increased LDL oxidation...why would an adult get the flu vaccine??? The focus should be on what the science shows, not an individuals bias!
Nathan Goodyear

Chronic Subclinical Inflammation as Part of the Insulin Resistance Syndrome - 0 views

circ.ahajournals.org/...42.full

inflammation insulin resistance CRP fibrinogen

shared by Nathan Goodyear on 17 Oct 12 - No Cached
  • Nathan Goodyear on 17 Oct 12
     
    All 3 inflammatory markers used in this study (CRP, fibrinogen, wbc)  all correlated with insulin resistance
Nathan Goodyear

Relation between markers of inflammation and e... [Med Sci Monit. 2010] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...21119577

estradiol aromatase testosterone inflammation CRP fibrinogen men male markers

shared by Nathan Goodyear on 24 Apr 12 - No Cached
  • Nathan Goodyear on 24 Apr 12
     
    Estradiol found to be associated with elevated CRP and fibrinogen with men.  This association was not found between Testosterone and the same inflammatory markers.  This points to the conversion of Testosterone to estrogen as a contributor to inflammation and CVD in men.
Nathan Goodyear

Adherence to the Mediterranean diet attenuates inflammation and coagulation process in ... - 0 views

www.ncbi.nlm.nih.gov/...15234425

mediterranean diet CVD cardiovascular disease nutrition diet inflammation CRP IL-6 homocysteine fibrinogen

shared by Nathan Goodyear on 27 Oct 15 - No Cached
  • Nathan Goodyear on 27 Oct 15
     
    Mediterranean diet reduced IL-6, homocysteine and CRP; as well as WBCs and fibrinogen.
Nathan Goodyear

Preventing Chronic Disease | Plasma Vitamin D and Biomarkers of Cardiometabolic Disease... - 0 views

www.cdc.gov/...12_0230.htm

vitamin D CRP cardiovascular disease CVD vitamin D

shared by Nathan Goodyear on 18 Jun 13 - No Cached
  • Nathan Goodyear on 18 Jun 13
     
    Higher vitamin D levels associated with lower cardio biomarkers: insulin, insulin resistance, triglycerides, TC, LDL and TC:HDL.  Not found to be associated: glucose, apoliporotein A1 and B, CRP, fibrinogen, and homocysteine.
Nathan Goodyear

The effects of compounded bioident... [Int J Pharm Compd. 2013 Jan-Feb] - PubMed - NCBI - 1 views

www.ncbi.nlm.nih.gov/...23627249

bioidentical hormone hormones menopause peri-menopause progesterone Bi-est DHEA Testosterone women

shared by Nathan Goodyear on 03 Feb 14 - No Cached
Nan Sprouse liked it
  • Nathan Goodyear on 03 Feb 14
     
    3 year study finds improvement in classic menopausal symptoms for women in perimenopause and menopause with improvement in other parameters: fasting glucose, cholesterol, MMP-9, CRP, fibrinogen and other clotting factors.  This study used bioidentical Bi-est, progesterone, and in some DHEA and Testosterone.
Nathan Goodyear

High Estrogen in Men After Injectable Testo... [Am J Mens Health. 2014] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...24928451

aromatase estrogen aromatase inhibition aromatase inhibitor men's health libido low T Testosterone Estradiol men male hormone hormones

shared by Nathan Goodyear on 16 Jun 14 - No Cached
  • Nathan Goodyear on 16 Jun 14
     
    Again, Testosterone and here Estradiol are merely there for libido and sex.  What tunnel vision?!  What about hsCRP?  What about fibrinogen?  What about IL-1beta?  What about TNF-alpha?  These inflammatory cytokines have all been reported to elevate as a result of estrogen production in men.   And PSA?  No mention of it here.   This linear, tunnel vision thinking on hormones has got to stop! The study points out that all clients were using AIs and SERMs irregardless of whether they had elevated estrogens or not.  That is not a well designed study.  One group should have had AI's if elevated estrogens were present and another group should not--this would compare the effects of aromatase activity.  Second, this was simply a retrospective chart review.  Third, a 50% conversion of 34,000 + men is very high when you look at the literature.  Fourth, they point to gynecomastia as a means of negative?  The cardiovascular implications are more significant.  These studies just seem to focus on superficial things.  Fifth, did libido problems exist before?  What were the free levels?   This falls in the paucity of data (2 studies) that point to excessive lowering of estradiol effecting libido and sexual performance.
Nathan Goodyear

Changes in inflammatory biomarkers acros... [J Gastrointest Surg. 2009] - PubMed - NCBI - 0 views

www.ncbi.nlm.nih.gov/...19415399

CRP fibrinogen obesity overweight weight-gain diabetes hypertension

shared by Nathan Goodyear on 20 Dec 11 - No Cached
  • Nathan Goodyear on 20 Dec 11
     
    obesity leads to inflammatory marker elevations and associated inflammatory disease states. These results come from the NHANES 1999-2004.
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

ScienceDirect - The American Journal of Cardiology : Relation Between C-Reactive Protei... - 0 views

www.sciencedirect.com/...S0002914909029208

homocysteine CAD cardiovascular disease

shared by Nathan Goodyear on 03 Aug 11 - No Cached
  • these findings indicate that low-grade systemic inflammation and hyperhomocysteinemia were present in participants with high 10-year risk for CAD.
  • Nathan Goodyear on 03 Aug 11
     
    elevated homocysteine helps to identify patients with high CAD over 10 years
Nathan Goodyear

The implication of obesity and central fat on markers of chronic inflammation: The ATTI... - 0 views

www.atherosclerosis-journal.com/...abstract

obesity inflammation CRP fibrinogen IL-6

shared by Nathan Goodyear on 14 Aug 11 - No Cached
  • Nathan Goodyear on 14 Aug 11
     
    obesity increases inflammation
Nathan Goodyear

The relation of body fat mass and distribution to markers of chronic inflammation - 0 views

www.nature.com/...0801792a.html

Fat obesity inflammation CRP fibrinogen IL-6

shared by Nathan Goodyear on 14 Aug 11 - No Cached
  • Nathan Goodyear on 14 Aug 11
     
    Increased body fat = increased inflammation
Nathan Goodyear

Obesity Is a Major Determinant of the Association of C-Reactive Protein Levels and the ... - 0 views

diabetes.diabetesjournals.org/...2357.full

CRP fibrinogen obesity inflammation metabolic syndrome

shared by Nathan Goodyear on 14 Aug 11 - No Cached
  • Nathan Goodyear on 14 Aug 11
     
    obesity increases inflammation and Metabolic syndrome factors
Nathan Goodyear

Obesity - Systemic Inflammation, Adipose Tissue Tumor Necrosis Factor, and Leptin Expre... - 0 views

www.nature.com/...oby200374a.html

IL-6 CRP Fibrinogen inflammation obesity leptin TNF-alpha

shared by Nathan Goodyear on 14 Aug 11 - No Cached
  • Nathan Goodyear on 14 Aug 11
     
    fat increases inflammation.  
Nathan Goodyear

Comparisons of normal saline and lactated Ringer's resuscitation on hemodynamics, metab... - 0 views

www.ncbi.nlm.nih.gov/...PMC4029282

IV fluids lactated ringers normal saline LR NS

shared by Nathan Goodyear on 03 Jul 18 - No Cached
  • NS contains 154 mM Na+ and Cl-, with an average pH of 5.0 and osmolarity of 308 mOsm/L.
  • LR solution has an average pH of 6.5, is hypo-osmolar (272 mOsm/L), and has similar electrolytes (130 mM Na+, 109 mM Cl-, 28 mM lactate, etc.) to plasma
  • hyperchloremic acidosis
  • ...26 more annotations...
  • LR’s acid base balance is superior to that of NS’s
  • There were no significant differences between LR and NS groups in fibrinogen concentrations or platelet count
  • Total protein dropped
  • no significant differences in Hct (Table  1) or total protein between LR and NS groups
  • Bicarbonate HCO3- levels were decreased by hemorrhage but returned to pre-hemorrhage values by 3 h after LR resuscitation, whereas no return was observed with NS resuscitation
  • Na+ was increased after NS resuscitation
  • No changes in Na+ or K+ were observed
  • K+ did not change initially after NS resuscitation but was elevated at 6 h afterwards
  • Ca++ was similarly decreased
  • Cl- was elevated for 6 h after NS resuscitation, with no changes shown after LR resuscitation
  • PT was similarly prolonged by resuscitation with LR (from 11.2 ± 0.2 sec at baseline to 12.1 ± 0.2 sec at 6 h) and NS
  • Plasma aPTT was also similarly prolonged by resuscitation with LR (from 17.1 ± 0.5 sec baseline to 20.1 ± 1.2 sec at 6 h) or NS
  • NS resuscitation resulted in better oxygen delivery and oxygen delivery-to-oxygen demand ratio as an index of oxygen debt
  • NS had better tissue perfusion and oxygen metabolism than LR
  • LR resuscitation returned BE and bicarbonate to pre-hemorrhage levels within 3 h, but no return of BE or bicarbonate was observed for 6 hr with NS resuscitation
  • current blood bank guidelines state that LR should not be mixed with blood to prevent the risk of clot formation from calcium included in LR
  • LR resuscitation should not be given with blood through the same iv-line and crystalloids should be avoided in patients with blood transfusion
  • PT and aPTT were prolonged for 6 h after hemorrhage and resuscitation, suggesting a hypocoagulable states
  • potential thrombotic risk from LR resuscitation is unlikely.
  • we suspected that the blood pressure after NS resuscitation would be lower than that of LR due to its vasodilator effects
  • NS required a larger resuscitation volume and was associated with poor acid base status and elevated serum potassium in this model
  • NS required 50% more volume and was associated with a higher cardiac output and lower peripheral resistance, as compared to LR resuscitation
  • These differences are possibly due to the vasodilator effects from NS
  • an elevation of K+ was observed at 6 h post NS resuscitation, while no change of K+ was observed after LR resuscitation
  • The mechanism for the increase of K+ from NS is not fully known
  • NS is associated with vasodilator effects and the risks of metabolic acidosis and hyperkalemia
  • Nathan Goodyear on 03 Jul 18
     
    LR vs NS crystalloid.
Nathan Goodyear

High D-dimer levels are associated with poor prognosis in cancer patients - 0 views

www.ncbi.nlm.nih.gov/...PMC3409812

cancer D-dimer

shared by Nathan Goodyear on 10 Jul 18 - No Cached
  • a systemic activation of blood coagulation and procoagulant changes in the hemostatic system have frequently been observed in cancer patients, even in the absence of venous thromboembolism
  • Thrombin is a pivotal enzyme in the process of blood coagulation and leads to the conversion of fibrinogen to fibrin, which is the end product of blood coagulation and finally results in the formation of a fibrin clot
  • deposition of fibrin, which has an important role in the formation of tumor stroma and hematogenous spread of tumor cells.
  • ...5 more annotations...
  • The interaction of fibrin, platelets and tumor cells leads to the formation of platelet-fibrin-tumor-cell aggregates that promote endothelial adhesion and metastatic spread, as well as tumor cell growth and tumor cell survival
  • fibrin degradation products have been shown to display strong angiogenic properties
  • D-dimer is a biomarker that globally indicates the activation of hemostasis and fibrinolysis
  • It is a degradation product of fibrin
  • high D-dimer levels were reported to be predictive of the occurrence of VTE in cancer patients
  • Nathan Goodyear on 10 Jul 18
     
    elevated D-Dimer associated with poor prognosis in cancer. Good review of cancer and ehmostasis.
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