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A study by scientists in a UK university has shown the scale of the prevalence of a condition that can lead to various cardiometabolic diseases. The study published in the Annals of Internal Medicine journal on Tuesday (January 4) has prompted calls for changes to healthcare policy after researchers revealed, for the first time, the scale of the impact of the condition associated with benign tumours that can lead to type 2 diabetes and high blood pressure. Up to 10 per cent of adults have a benign tumour, or lump, known as an 'adrenal incidentaloma' in their adrenal glands which can be associated with the overproduction of hormones including the stress steroid hormone cortisol that can lead to type 2 diabetes and high blood pressure. Previous small studies suggested that one in three adrenal incidentalomas produce excess cortisol, a condition called mild autonomous cortisol secretion (MACS). An international research team led by the University of Birmingham carried out the largest ever prospective study of over 1,305 patients with adrenal incidentalomas to assess their risk of high blood pressure and type 2 diabetes and their cortisol production by comparing patients with and without MACS.

This study looked at those with previous MIs.  This study found a reduction in recurrent events in those receiving EDTA chelation versus placebo.  The authors of this study looked at the Hazard ratio, which was reduced in every end point that this study was designed to evaluate.

Nice review of all the sex hormones and their relationship to CVD in men.  

Article highlights the problems with the definition of low T.  This article finds consistent decline in Total Testosterone and FAI with increasing age groups, with a significant portion of men > 60 meeting the required levels for "low T".  This study found a decrease in total T and FAI at a consistent rate independent of variables, such as BMI.    This study did find a decrease in SHBG and total T with obesity; in contrast to other studies.

A systemic review of Testosterone benefit in men stirs the pot.  I can't say that I agree with the majority of their conclusions.  What I do agree with them on is that the majority of men on Testosterone therapy likely don't need it and are simply using Testosterone as a drug.

Exercise alters gene expression via methylation--the power of epigenetics.  Interestingly, the majority of the methylation was outside the CPG island regions.  This 3 month study found methylation of 5,000 sites across the genome resulting in altered expression of apps 4,000 genes.  The altered muscle changes of the endurance training was linked to DNA methylation changes.

This study found that in longitudinal studies, testosterone decline accelerated compared to cross sectional studies.  They concluded that decreasing health could be the explanation.  But, what if the decline in testosterone explained the decreasing health?

First long-term study on GMO effects on rats. The majority of studies on GMO have been on animals with the end point at < 90 days.  This study followed the rats for 2 years.  Increased mammary tumors were found.  Is this definitive?  Of course not, but this is the first study to look at long term effects.

Good deep look into the testosterone and CVD link.

This study found that high serum testosterone associated with a reduction of cardiovascular events in elderly men.  Studies have shown that low T is associated with increased cardiovascular mortality and in cardiovascular events, but this study takes it one step further: testosterone reduces those risks. 

This study looked at long term therapy with GH in adults with GH deficiency.  This study found the long-term therapy to be "well-tolerated".  Though there are limited studies, this study showed good patient tolerability.

this study looked at salivary testosterone to serum testosterone and found poor correlation.  One major problem with this study is the significantly smaller amount (10 fold) of testosterone in women than men in healthy individuals.  This study took place in postmenopausal women, which would have significantly lower levels than healthy women.  They also don't discuss the pitfalls of equilibrium dialysis of serum free testosterone.  Another major flaw is the mere logic of looking at serum for tissue activity.   What is the correlation between serum levels and tissue activity.  There is tremendous assumptions being undertaken that serum levels of testosterone whether total or free translate to genomic or non-genomic signaling.  I also wonder if newer techniques using Mass Spec can better detect the typically pico levels of testosterone in women's saliva?  This study does nothing to dissuade the use of salivary testing.

this study states that progesterone promotes breast growth and has implications of breast cancer.  However, this study looked at progestins not progesterone.  Studies have shown a reduction of breast cancer risk with progesterone and an increase with progestins.  It would have been nice to have looked at "progesterone" metabolites.  This study shows the flaw that many have: the intermix progesterone and progestins as if they are one in the same and they are clearly not

Nice editorial response to "does testosterone treatment reduce mortality in men?"  This response points out the flaws with the study.   The point to be taken with all studies, is there will never be a study to end all studies that provides unequivocal results.  We as scientists must view the risks/benefits of all therapies from within the prism that is each person sitting in front of us.  First, and foremost, do no harm.

Progesterone metabolites and breast cancer

prospective study of almost 9,000 men and women followed for 30 + years.  The study found that there was a significant increased risk of early death after diagnosis of cancer with higher levels of Testosterone.  The risk was increased by up to 80%.  The incidence of cancer was unchanged.  The study looked at total Testosterone via serum.  The study is limited due to its limited look at hormones.  Full Testosterone metabolism needs to be evaluated--including conversion to estrogens.  Inflammatory cytokines need to be assessed and men and women need to be assessed separately as their reactions to hormones are quite different.

I find this study a good example of the distortion in medical science.  This study looked at lifestyle changes as its effect on hormones and glucose regulation.  This study found a decrease in estrogen, decrease in DHEA, and an increase in SHBG.  However, they included metformin therapy in the lifestyle arm of the study.  What about metformin is "lifestyle"?

Life extesnsions rebuttal to recent JAMA study.  There was several significant flaws in that study and thus limited evidence can be gained by that study.  In fact, I find no useful clinical information from that study. In the rebuttal, there are flaws. The reference the low serum T after treatment and correctly discuss aromatase activity.  But they fail the mention that the less than optimal serum T is likely the result of the high aromatase activity in these men.  Age, stress, and weight are primary causes of increases estrogen production in these men.  These would be why likely high estrogen production occurred and less than optimal serum T resulted.   And, increased E2 will cause an increase in CRP which can precipitate CVD events.

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.