This is a short interview of the author on a recent retrospective review that revealed no increase in cardiovascular events in men. The author rightly points out his data, which is quite different than the previous JAMA and PLOSone publications which showed an increase in cardiovascular events.
However, the lead author points out the main problem with comparisons: his study group was younger and healthier. So, the comparison is apples to oranges. Studies still point to increased risk of Testosterone therapy in men with pre-existing CVD. This new study does not refute this point at all.
Another serious flaw here, is that only Testosterone was followed. This logic is seriously flawed as I have previously documented. The author points out the flaw in the levels in the JAMA study post treatment. But he fails to account for the the lack of adequate pathway assessment i.e.aromatazation. Also, no inflammatory cytokine evaluation was performed in that study. Both of these should have been highlighted.
In contrast, a positive was the length of follow.
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.
vitamins/minerals shown to reduce all-cause mortality. this study also warns of "sick-user effect" that is on of the many flaws in the recently released, flawed Iowa Health Study
rebuttal to seriously flawed study recently released about vitamin/mineral supplements. Much of scientific research published today is a rush to manipulate public opinion, rather than a rush to publish truth.
24 week study of 71 women post-hysterectomy finds no increase in cardiovascular biomarkers. Several problems with this study. First, there was a large drop out--24%. Second and most important, the women were pretreated with estrogen prior to Testosterone therapies were initiated. Other studies have proposed that this protects cardiovascular risk in women on Testosterone. Previous studies show increasing endogenous Testosterone is associated with increasing cardiovascular disease in women.
This study would be much better if no estradiol was prescribed. That would give an unbiased view of Testosterone in post-hysterectomy women.
Not much can be taken from this study.
If you doctor doesn't know this, find another doctor. Inherent bias in this study as ties to the manufacturer of the Testosterone was disclosed. This study point to the inherent flaws in so much of the medical literature today. Most would read the headlines and read no further, but the "further" dispels the headline as flawed.
This letter to the editor points out how much of "reported science" today is merely propaganda to push $$. This letter points out, scientifically, many of the flawed assumptions and problems with the Gardisil vaccine. Science is about data and evidence. The data and evidence on Gardisil is suspect at best.
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.
study finds that HRT given as women transition through menopause has benefiical effect in people with Alzheimer's. However, when given years later, after menopause, no benefit is found. In fact, rates increased. Several flaws with this study. First, they used synthetic hormones, particularily progestins. Second, there seems to be no thought that the interpretation of the signal has changed. For example, we know that when men have low T, their estrogen receptor status changes from ER beta to ER alpha, which is more proinflammatory. Third, use bioidentical hormones and compare these to synthetic hormones.
somewhat flawed study in that they looked at serum sex hormones to evaluate men with gynecomastia compared to controls. A better eval would have been of saliva or blood spot. Free levels will show more subtle changes physiologically than will serum as to the sex hormones. The study did find decreased sexual function in the men with gynecomastia--indicating hormone issues not picked up by the serum.
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
There are alot of problems with evidence-based medicine. Don't for one minute think that a "study" can be without major flaws and biases. In fact, alot of the studies reported by the press are based on poorly designed and manipulated studies. Probably 50% of the studies that I read I disgard after evaluating the study design and statistics.
Recent publication slams varicella vaccine as not cost effective, poorly effective in the prevention of chicken pox, based on flawed assumptions, CDC promoted 2 poorly designed studies, actually increased the incidence of shingles, and is less effective than natural immunity. So, what is the reason to get the chicken pox vaccine again???
Several flaws with this study. First, the majority of testing done in the meta-analysis was serum--unreliable. Second, this study flies in the face of many other studies that have shown elevated estrogens contribute to low testosterone in men. Third, this flies in the face of observation. I see over and over again, by lowering a male's estrogen level, he in turn will start producing more Testosterone. And finally, the environmental xenoestrogens have helped to contribute to a all time low of testosterone/infertility rate in men today.
this study revealed increased breast cancer risk in women on "estrogen" and "testosterone" therapy. Now, several problems here: first, are these synthetic hormone or bioidentical. Second, the dosages appear, in what is written, to be supra physiologic. Third, giving supra physiologic estradiol and testosterone will obviously create imbalances and growth potential. Fourth, how were the women evaluated prior to starting hormone therapy and then were they remonitered (unlikely), fifth, were hormone metabolites evaluated (too, also unlikely). This study has serious flaws and very little can be extrapolated other than: don't take supra physiologic hormone levels without appropriate evaluation. Enough said
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.
Study finds that "midrange" Testosterone and DHT associated with a reduced ischemic heart disease and death rate. No association was found with Estradiol. One flaw of this study is in their use of serum.
Excellent review of the current literature on Testosterone and cardiovascular disease as well as a brief discussion of the flaws in the recent published articles pointing to increased CVD with Testosterone therapy.
Androgen deprivation therapy is associated with increased diabetes, metabolic syndrome, insulin resistance, and cardiovascular mortality. The longer the duration of therapy, the more the progression of metabolic dysfunction. This process seems similar to chemotherapy i.e. secondary cancer due to chemotherapy. The treatment of one disease, prostate cancer in this case, leads to an increase in the risk of the #1 killer in men--logic seems severely flawed there.
Insulin has a stimulatory effect on the sympathetic system resulting in elevated B/P. There is a movement by some to put every diabetic on insulin early. This is seriously flawed and will only contribute to further complications.