Dr. Goodyear

Growth hormone treatment of abdominally obese men reduces abdominal fat mass, improves glucose and lipoprotein metabolism, and reduces diastolic blood pressure.

nice review of the complexity of metabolic syndrome

Case study of 1 of a man with remote history of anabolic steroid use and current azoospermia.  HCG therapy for 3 months led to resolution of infertility.

very nice case review and discussion of the treatment of low T and low sperm count in men desiring preservation of fertility.  Clomid and HCG are viable options to increase endogenous Testosterone production, though both work via different mechanisms.

I can't say I agree with the premise of the study design.  In this study, HCG at 500 IU every other day was used to aid Testosterone therapy.  

HCG used to stimulated endogenous Testosterone production and treat azoospermia.  The treatment protocol called for 5,000 IU 3 x weekly.  Even elevated LH/FSH levels decreased as endogenous Testosterone levels increased.

The costs of MetS increase with each MetS criteria.

prevalence of MetS in children in US is high.

metabolic syndrome incidence in Europe far below that of the US.  One of the primary driving forces of MetS is obesity.

multiple concussions result in hypopituitarism in 14 year old young man.

One of the main instances for which women need Testosterone, is post-hysterectomy.  This study confirms that.  This study found benefit in those with and without the removal of the ovaries.

Men with type II diabetes found to have Lower free Testosterone levels.  This same association was also found in Left ventricular diastolic dysfunction.

Enclomiphen, a clomid isomer, stimulates FSH and LH to preserve spermatogenesis and Testosterone production.

Low free and Total Testosterone levels found to be associated with premature CAD in men.  Some confounders were present, which they tried to account for--this should leave some healthy questioning of this study results.  That being said, this is not the first time low T has been found to be associated with CAD in men.  This study found a statistical significant association with Free and Total Testosterone levels in young men.  Another point to consider is the Low T a cause or a biomarker and an effect of poor/declining health?  I would so more to the biomarker point.

The DHT metabolite 3beta-androstanediol found to increase proliferation of endometrial tissue in women with PCOS.  In contrast, Testosterone repressed proliferation.  

Review, only abstract available--Testosterone therapy does not affect prostate size, intraprostatic Testosterone levels, or prostate cancer progression.  Carcinogenesis of the prostate is not a androgen driven process.  It is an aromatase process.  DHT metabolites can promote tumor growth via Estrogen receptors later, but initiation, via all accounts, occurs through aromatase expression and production of estrogen in the prostate.

Testosterone levels appear to be more of a biomarker of poor health in older men that are obese with diabetes.  More of these men had low free Testosterone (calc) versus Total Testosterone.  Using QOL questionnaires, weak correlation (not statistically significant) with androgen deficiency symptoms and ED were found.

Only the abstract available in this publication.  Good study design.  No improvement in insulin resistance, glycemic control or visceral adiposity in obese men with type II diabetes.  The levels of inclusion were TT < 346, which would not meet the criteria put forth by other studies.  This study appeared to look at border line "low T" men with obesity and type II diabetes and found no direct glycemic control improvement.  An increase in lean muscle mass and decrease in subcutaneous fat was found.

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.  

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.