Hypogonadism may be defined either as serum concentration of T (either total T, bioavailable T or free T) or as low T plus symptoms of hypogonadism
The Baltimore Longitudinal Study on Aging reported the incidence of total serum T < 325 ng/dL to be 20% for men in their 60s, 30% for men in their 70s and 50% for men over 80
The Massachusetts Aging Male Study reported that 12.3% of men aged 40 to 70 had a total serum T of < 200 ng/dL with 3 or more symptoms of hypogonadism
The Boston Area Community Health Study reported that 5.6% of men aged 30 to 70 were hypogonadal, as defined by total serum T < 300 ng/dL; or, free serum T < 5 ng/dL plus 3 or more symptoms of hypogonadism
In a health screening project among 819 men in Taiwan, the prevalence of hypogonadism (total serum T < 300 ng/dL) ranged from 16.5% for men in their 40s, 23.0% for men in their 50s, 28.9% for men in their 60s, and 37.2% for men older than 70 years of age
The prevalence of hypogonadism among men in Taiwan is higher than the prevalence reported in the Massachusetts Male Aging Study
CAG repeat sequence, within the androgen receptor (AR). Rajender et al[12] reviewed over 30 studies on the AR trinucleotide repeat and infertility
suggestion that CAG repeat length may determine androgen responsiveness, this issue is not clearly settled
reported prevalence of low T in older men range from 5.6% to 50%
Those in the hypogonadal group (n = 4269) had direct health care costs, that exceeded the eugonadal group (n = 4269) by an average of $7100 over the course of the observation window
higher economic burden and presence of co-morbidities for hypogonadism
minor to moderate improvements in lean mass and muscle strength
increased bone mineral density
modest enhancement in sexual function
reduced adiposity
lessening of depressive symptoms
Meta-analyses of clinical TRT trials as of 2010 have identified three major adverse events resulting from TRT: (1) polycythemia; (2) an increase in prostate-related events; and (3) and a slight reduction in serum high-density lipoprotein (HDL) cholesterol
polycythemia (> 3.5-fold increase in risk
TRT produced a 40% prostate enlargement in older hypogonadal male Veterans over 12 mo
no published analysis has reported measurable increases in prostate cancer risk or Gleason score in men undergoing TRT, or in hypogonadal men with a history of prostate cancer undergoing TRT
the prostate which highly expresses the type II 5α-reductase enzyme. Inhibition of this enzyme via finasteride (a type II 5α-reductase inhibitor) or dutasteride (a dual type I and II 5α-reductase inhibitor) reduces circulating DHT 50%-75% and > 90%, respectively[47], and reduces prostate mass[48] and prostate cancer risk
Normally estradiol partially regulates testosterone levels, at the hypothalamus, blunting LH and FSH release from the pituitary. As a selective estrogen receptor modulator, CC interrupts this pathway, and consequently there is a greater stimulation for the production of testosterone in Leydig cells
The benefits of restoring serum testosterone in men with LOH were not significantly different between men older than 65 years of age and younger men. There were no indications that side effects were more severe in elderly men. The effects on prostate and urinary function and hematocrit were within safe margins.
obesity, but also impaired general health, are the more common causes of low testosterone in aging men
Severe LOH is associated with substantially higher risks of all-cause and cardiovascular mortality,
advanced age, obesity, a diagnosis of metabolic syndrome, and poor general health status were predictors of LOH
Diabetes mellitus was correlated with hypogonadism in most studies
coronary heart disease, hypertension, stroke, and peripheral arterial disease did not predict hypogonadism, they did correlate with the incidence of low testosterone
LOH can be defined by the presence of at least three sexual symptoms associated with a total testosterone level of less than 11 nmol/L (3.2 ng/mL) and a free testosterone level of less than 220 pmol/L (64 pg/mL)
the European Male Aging study defined low T as total < 320 ng/dl and free < 64 pg/ml.
Mean weight decreased
Waist circumference decreased
Total cholesterol decreased
Low-density lipoprotein decreased
Triglycerides decreased
High-density lipoprotein (HDL) increased
ratio of total cholesterol to HDL improved
Prostate volume increased
PSA increased
The benefits for men older than 65 years of age were compared with those of younger men, and the improvements in body weight, metabolic factors, psychological functioning, and sexual functioning were of the same magnitude in both age groups
weight loss was progressive over the 6-year period, effects of testosterone on lipids and on psychological and sexual functioning reached a plateau after approximately 3 years and these effects were sustained
Effects of testosterone on hematopoiesis, on the prostate, and on bladder function were not more severe in older men than in younger men
observe a mild increase in prostate volume and serum PSA over time, which is a normal finding in aging men. Maybe somewhat surprising, postvoiding residue and the IPSS did not deteriorate with aging but showed a degree of improvement
the severity of the metabolic syndrome is associated with the severity of lower urinary tract symptoms
The symptoms of the metabolic syndrome improve upon testosterone treatment and testosterone may thus have a favorable effect on lower urinary tract symptoms
it seems reasonable to conclude that the risks of testosterone administration to elderly men are not disproportionately higher in elderly men than in younger men.
Despite evidence to the contrary, physicians still harbor a wrongful association between testosterone and the development of prostate pathology (prostate cancer and benign prostate hyperplasia)
Not surprisingly, the incidence of prostate cancer was higher in older men; however, it was lower than expected in both groups
These observations suggest that the incidence of prostate cancer in patients receiving testosterone therapy, both in the younger and in the older group, was not greater than in the general population not receiving testosterone treatment
The historical fear that raising testosterone levels will result in more prostate cancer has been dispelled, particularly by the work of Abraham Morgentaler
Higher serum testosterone levels fail to show an increased risk of prostate cancer, and supraphysiological testosterone does not increase prostate volume or PSA in healthy men
This apparent paradox is explained by the "saturation model,"
Recent studies indicate no increased risk of prostate cancer among men with serum testosterone in the therapeutic range
In the present observational study, no cases of major adverse cardiovascular events occurred.
the benefits of testosterone therapy are fully achieved only by long-term treatment
To achieve maximal benefits, good patient adherence is a prerequisite
In the relatively uncommon circumstance of vaccine matching the viral circulating strain and high circulation, 4% of unvaccinated people versus 1% of vaccinated people developed influenza symptoms (risk difference (RD) 3%
The corresponding figures for poor vaccine matching were 2% and 1% (RD 1, 95% CI 0% to 3%).
Vaccination had a modest effect on time off work and had no effect on hospital admissions or complication rates
Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.
exhaustive review of the flu vaccine data reveals VERY poor matching of vaccine, poor prevention of flu symptoms, and only modest effect on reduction in hospital admission or complication rates.
Final conclusion: "There is no evidence that they affect complications, such as pneumonia, or TRANSMISSION.
New study finds Testosterone therapy provides less than statistical significant improvement in constitutional/sexual symptoms, in obese men with type II diabetes with symptoms classified as mild-moderate with modest reductions in Total Testosterone. This study highlights that low Testosterone is a biomarker of poor health and multiple comorbidities and that simply adding in Testosterone therapy will not cure all male woes. The authors did state that ED and low T are separate issues and I will differ with them on this--they are in fact link. This association may vary between individuals, but to flatly state they are completely separate issues is devoid of the fact that testosterone has been shown to reduce inflammatory cytokines and improve PDE5 therapy.
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Testosterone therapy aids symptoms of Parkinson's disease. Whether low T is an associated finding or plays a role has yet to be determined. However, we do know that androgens play an anti-inflammatory role in men and we know that inflammation plays a role in the neurodegenerative disease that is Parkinson's disease.
low free Testosterone, though calculated in this study, found to be associated with low T symptoms despite normal total Testosterone. Though the "normal" total Testosterone in this study is abnormal low in other studies. Only abstract available.
A Sore Throat is a painful feeling in the throat aggravated by swallowing. A sore throat can also feel dry and scratchy and makes it hard to talk. A sore throat is a frequent symptom of the common cold or other acute respiratory tract ...
A Sore Throat is a painful feeling in the throat aggravated by swallowing. A sore throat can also feel dry and scratchy and makes it hard to talk. A sore throat is a frequent symptom of the common cold or other acute respiratory tract ...