T Nation

Test is Good for Your Heart

For the HRT guys:

"Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life
C J Malkin1, P J Pugh1, P D Morris1, K E Kerry2, R D Jones2, T H Jones2,* and K S Channer1
1 Department of Cardiology, Royal Hallamshire Hospital, Sheffield S10 2JF, UK
2 Academic Unit of Endocrinology, Hormone and Vascular Biology Group, Division of Genomic Medicine, University of Sheffield, Sheffield, UK

Correspondence to:
Dr K S Channer
M131, Cardiology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK; email: kevin.channer@sth.nhs.uk

Background: Low serum testosterone is associated with several cardiovascular risk factors including dyslipidaemia, adverse clotting profiles, obesity, and insulin resistance. Testosterone has been reported to improve symptoms of angina and delay time to ischaemic threshold in unselected men with coronary disease.

Objective: This randomised single blind placebo controlled crossover study compared testosterone replacement therapy (Sustanon 100) with placebo in 10 men with ischaemic heart disease and hypogonadism.

Results: Baseline total testosterone and bioavailable testosterone were respectively 4.2 (0.5) nmol/l and 1.7 (0.4) nmol/l. After a month of testosterone, delta value analysis between testosterone and placebo phase showed that mean (SD) trough testosterone concentrations increased significantly by 4.8 (6.6) nmol/l (total testosterone) (p = 0.05) and 3.8 (4.5) nmol/l (bioavailable testosterone) (p = 0.025), time to 1 mm ST segment depression assessed by Bruce protocol exercise treadmill testing increased by 74 (54) seconds (p = 0.002), and mood scores assessed with validated questionnaires all improved. Compared with placebo, testosterone therapy was also associated with a significant reduction of total cholesterol and serum tumour necrosis factor with delta values of ?0.41 (0.54) mmol/l (p = 0.04) and ?1.8 (2.4) pg/ml (p = 0.05) respectively.

Conclusion: Testosterone replacement therapy in hypogonadal men delays time to ischaemia, improves mood, and is associated with potentially beneficial reductions of total cholesterol and serum tumour necrosis factor."

This is good news, and supported by my own experience.
I would like to see a long term study showing effect on hematocrit levels and PSA as well, but maybe this is all too new for that.

And your bones too:


Increases in bone density during treatment of men with idiopathic hypogonadotropic hypogonadism

JS Finkelstein, A Klibanski, RM Neer, SH Doppelt, DI Rosenthal, GV Segre and WF Crowley Jr
Department of Medicine, Massachusetts General Hospital, Boston 02114.

To assess the effects of gonadal steroid replacement on bone density in men with osteoporosis due to severe hypogonadism, we measured cortical bone density in the distal radius by 125I photon absorptiometry and trabecular bone density in the lumbar spine by quantitative computed tomography in 21 men with isolated GnRH deficiency while serum testosterone levels were maintained in the normal adult male range for 12-31 months (mean +/- SE, 23.7 +/- 1.1). In men who initially had fused epiphyses (n = 15), cortical bone density increased from 0.71 +/- 0.02 to 0.74 +/- 0.01 g/cm2 (P less than 0.01), while trabecular bone density did not change (116 +/- 9 compared with 119 +/- 7 mg/cm3). In men who initially had open epiphyses (n = 6), cortical bone density increased from 0.62 +/- 0.01 to 0.70 +/- 0.03 g/cm2 (P less than 0.01), while trabecular bone density increased from 96 +/- 13 to 109 +/- 12 mg/cm3 (P less than 0.01). Cortical bone density increased 0.03 +/- 0.01 g/cm2 in men with fused epiphyses and 0.08 +/- 0.02 g/cm2 in men with open epiphyses (P less than 0.05). Despite these increases, neither cortical nor trabecular bone density returned to normal levels. Histomorphometric analyses of iliac crest bone biopsies demonstrated that most of the men had low turnover osteoporosis, although some men had normal to high turnover osteoporosis. We conclude that bone density increases during gonadal steroid replacement of GnRH-deficient men, particularly in men who are skeletally immature.

I’ve read similar articles in the past. All of those who think T leads to doom are hurting for quality information.

Thanks for posting this.

Low Testosterone Linked to Many Men’s Health Problems
Wednesday, July 05, 2006

By Jennifer Warner

Older men with common health problems such as obesity, diabetes, and high blood pressure may be twice as likely as other men their age to have low testosterone levels, according to a new study.

Researchers found more than a third of men aged 45 and over had low testosterone levels, and the odds of having low testosterone was much higher among those with chronic health problems.

They say the results suggest that common, age-related, chronic health problems in older men may mask underlying low testosterone levels and negatively affect their quality of life.

Low testosterone is also known as hypogonadism and affects an estimated 13 million men in the U.S. Symptoms of low testosterone in men include decreased libido, erectile dysfunction, loss of body and facial hair, weakened bones, increased body fat, and fatigue.

Men Say Sex Lives Better at 50 Than 30

Low Testosterone Common Among Older Men

In the study, published in the International journal of Clinical Practice, researchers looked at the prevalence of low testosterone levels among more than 2,100 men aged 45 and over who visited one of 130 different primary care practices in the U.S. for any reason during a two-week period."

Dec. 1, 2004

Diabetes and Low Testosterone:
The Two Go Hand and Hand, With Possibly Serious Consequences

A third of men with type 2 diabetes have low testosterone levels, a new study suggests.

Testosterone helps men reduce body fat and improves the way their bodies handle insulin. So low testosterone levels may have serious consequences for men with diabetes, suggests Sandeep Dhindsa, MD, of State University of New York at Buffalo.

“We are describing a new complication of type 2 diabetes. We are saying that the largest group of people who have [low testosterone] are diabetics,” Dhindsa tells WebMD. “It means your pituitary gland, which controls all the other hormones in your body, is not working very well. We are talking about one-third of men with diabetes being at risk of high fat mass, low muscle mass, low bone density, depression, and erectile dysfunction.”

[quote]e-loo wrote:

Dec. 1, 2004

Diabetes and Low Testosterone:
The Two Go Hand and Hand, With Possibly Serious Consequences

A third of men with type 2 diabetes have low testosterone levels, a new study suggests.

Testosterone helps men reduce body fat and improves the way their bodies handle insulin. So low testosterone levels may have serious consequences for men with diabetes, suggests Sandeep Dhindsa, MD, of State University of New York at Buffalo.

“We are describing a new complication of type 2 diabetes. We are saying that the largest group of people who have [low testosterone] are diabetics,” Dhindsa tells WebMD. “It means your pituitary gland, which controls all the other hormones in your body, is not working very well. We are talking about one-third of men with diabetes being at risk of high fat mass, low muscle mass, low bone density, depression, and erectile dysfunction.”

[/quote]

Another slant on the same issue: Men loose T with age, belly fat increases, the added fat changes more and more T --> E and the E competes for T receptors. Insulin resistance occurs which creates more fat and then there is more E. E become dominant. Increasing blood sugars start to degrade proteins by creating non functional gluco-proteins products. This vicious circle is known as syndrome-X or metabolic disorder. Treatment requires dietary changes and supplements to address cellular health and insulin resistance. But vitamin T is probably the most important intervention.

Lack of T is a strong predictor for belly fat, insulin resistance and then type II diabetes.

“It means your pituitary gland, which controls all the other hormones in your body, is not working very well.” - well… that is not really true. The pituitary gland is working the way it is designed to work… it regulates the combined amount of E and T in the system. If a man becomes estrogen dominant, LH and T will drop. So it is working correctly. This action could however be considered a design weakness, error or flaw. Or the system is unstable and the trigger for this switch-over is fat tissue that changes T --> E. Many medical folks who are aware of these issues now consider fat tissue to be the largest organ in the body. Fat tissue is not a passive fat storage, it is part of the hormone game. Fat wants to change men into women. And in harmony with this viewpoint: The profile of the typical diabetic used to be the 3F’s. Fat, Female and over Forty. Now our lifestyle has more and more men taking on plump estrogen dominant body forms… FAT, estrogen dominant and over Forty. Maybe the FFF should now be FEF.

Men who drink a lot also are known to automatize more T --> E which helps explain the beer-gut. That is in many cases reinforced by bar-food with the wrong fats that degrade cell walls and receptor function - contributing to insulin resistance.

[quote]Headhunter wrote:
For the HRT guys:

"Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life
C J Malkin1, P J Pugh1, P D Morris1, K E Kerry2, R D Jones2, T H Jones2,* and K S Channer1
1 Department of Cardiology, Royal Hallamshire Hospital, Sheffield S10 2JF, UK
2 Academic Unit of Endocrinology, Hormone and Vascular Biology Group, Division of Genomic Medicine, University of Sheffield, Sheffield, UK

Correspondence to:
Dr K S Channer
M131, Cardiology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK; email: kevin.channer@sth.nhs.uk

Background: Low serum testosterone is associated with several cardiovascular risk factors including dyslipidaemia, adverse clotting profiles, obesity, and insulin resistance. Testosterone has been reported to improve symptoms of angina and delay time to ischaemic threshold in unselected men with coronary disease.

Objective: This randomised single blind placebo controlled crossover study compared testosterone replacement therapy (Sustanon 100) with placebo in 10 men with ischaemic heart disease and hypogonadism.

Results: Baseline total testosterone and bioavailable testosterone were respectively 4.2 (0.5) nmol/l and 1.7 (0.4) nmol/l. After a month of testosterone, delta value analysis between testosterone and placebo phase showed that mean (SD) trough testosterone concentrations increased significantly by 4.8 (6.6) nmol/l (total testosterone) (p = 0.05) and 3.8 (4.5) nmol/l (bioavailable testosterone) (p = 0.025), time to 1 mm ST segment depression assessed by Bruce protocol exercise treadmill testing increased by 74 (54) seconds (p = 0.002), and mood scores assessed with validated questionnaires all improved. Compared with placebo, testosterone therapy was also associated with a significant reduction of total cholesterol and serum tumour necrosis factor with delta values of ?0.41 (0.54) mmol/l (p = 0.04) and ?1.8 (2.4) pg/ml (p = 0.05) respectively.

Conclusion: Testosterone replacement therapy in hypogonadal men delays time to ischaemia, improves mood, and is associated with potentially beneficial reductions of total cholesterol and serum tumour necrosis factor."
[/quote]

Studies of blood samples of men who arrive at the hospital with strokes or heart attacks show that both higher testosterone and DHEA levels correlate with higher survival rates or time to repeat events. Double blind and random supplementation with DHEA of heart attack admissions also showed higher survival rates with DHEA supplementation. Otherwise, low levels of T and DHEA predict mortality.