Dr. Goodyear

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

Startling statistic--25% of men started on Testosterone therapy have had not diagnostic evaluation of Testosterone levels.

Increasing mercury exposure associated with increasing tics in children.

severe hypogonadism was associated with a 5 fold increase risk of cardiovascular mortality and all cause mortality in men ages 40-79 in European study.

Elderly individuals with the lowest normal TSH values were found to be associated with increased depressive symptoms.  These patients were clearly not hyperthyroid.  This fits with other data that points to increased inflammation and reduced TSH levels.  Increased inflammation is associated with increased depression.

Study found no significant effect of subclinical hypothyroidism on weight in the elderly.  However, higher free T4 levels were associated with lower baseline weight and weight loss in women. TSH and free T3 were not. associated.

IN men with low Testosterone, Testosterone therapy improved trabecular bone, but not cortical bone.  Growth hormone provided no additional benefit.  This study looked at men with panhypopituitarism.

Study found that men who carry cell phones in their pants for > 4 hours have increased sperm fragmentation.  

Severe sleep apnea associated with lower Testosterone levels and fatigue.  The low level of Testosterone was the only factor predictive of fatigue and reduced activity in sleep apnea.  This was only found in severe sleep apnea, not mild cases.

Here is where science and particularly conclusions fail the public.  The authors conclusions are that tadalifl improves ED and sexual function irrespective of Testosterone levels.  However, the results say something different.  The group with normal Testosterone responded better versus the low Testosterone group.  This difference didn't reach statistical significance though.  This lack of statistical significance does not exclude the fact that there indeed was a difference.  The authors conlcusions take no part in reporting the whole truth, just that which supports their hypothesis. The diagnosis of low T in this study was < 300 ng/dl

Not clear in its association here, but lower Testosterone was associated with increased mortality in men with chronic kidney disease not on dialysis.  This was found in the 2nd lowest quintile only.  What the authors did find was that diabetes and increasing BMI are were associated with increasing incidence of low T.  This studies definition of low Testosterone was <350 ng/dl.  This differs from other definitions.

This study's conclusion is to evaluate clotting factor i.e. factor V leiden, Factor VIII, and prothrombin prior to giving Testosterone.  This small study found increased clotting in some men on Testosterone. The problem here is the dosing of Testosterone in these men was 50-160 mg.  Physiologic dosing is 5-10 mg.  The problem is doping.  One wonders if physiologic dosing was undertaken if any of the men in this study would develop clotting problems, even though they had undiagnosed hypercoagulabitliy.

Colitis as a result of K. oxytoca

Very disturbing trend.  Study finds that opioid addicted infants are on a dramatic risk in the US.  This study looked at Neionatal abstinence syndrome from 2000 to 2009.  This follows the significant increase in maternal opioid prescription use.  We physicians must do better.  Patients must demand better.  This study just focused on hospital costs directly associated with the Neonatal period.  No cost estimates are evaluated for long-term care.

low levels of SHBG associated with increasing incidence of metabolic syndrome in men ages 40-70.

Increased strength training associated with increased Total Testosterone and 3-alpha androstane idol  levels in trained athletes.  This was not found in free Testosterone levels.

Higher base-line Testosterone levels associated with longer overall survival in men with prostate cancer.  The comparison was 32.7 months with higher T levels versus 22.4 months with lower T levels.  Anemia was also a poor prognostic variable.  Whether exogenous Testosterone therapy will change this is still unclear, but the authors suggest that this should play a role in whether to use salvage hormone therapy.

No significant statistical significance was found with vitamin D therapy and insulin sensitivity.  However, improved outcomes were found in 2 hour insulin and 2 hour glucose levels after a 75 gram OGTT.

Meta-analysis finds that low vitamin D is more associated with mortality in women with breast cancer than increased incidence.

Another review study.  Low Testosterone is associated with increased CVD in men.  However, some studies have suggested an increase in CVD with men using exogenous Testosterone therapy.  Is Testosterone the cause of CVD in men?  Likely, low T is a