Risks of Testosterone Treatment in Elderly Men

Summary: The risks of testosterone supplementation aren't a big deal either.

Interestingness: 1

Paper by Peter J Snyder, MD in the Journal of Anti-Aging Medicine, Volume 1, Issue 4, Winter 1998.

(((This paper is a subset of the previous paper, focusing on risks.)))

Higher testosterone concentration seems to be related to higher probability of having prostate cancer. In one study, testosterone measurements for about 22000 men were taken and those men were tracked for the following ten years. 222 of those men that developed prostate cancer were age matched with 444 non-prostate cancer men. Men with the highest quartile of testosterone concentration were twice as likely to have developed cancer as those in the lowest quartile. Those with the highest quartile of sex hormone binding globulin (SHBG) which binds testosterone were half as likely to have developed as those in the lowest quartile.

Prostate cancer is testosterone dependent (((not shown))). Autopsies of 249 men showed 41% of those in their 50s and 63% of those in their 60s had occult (((unknown))) prostate cancer (((hardcore numbers))).

Prostate size also seems to be dependent on dihydrotestosterone, which is created from testosterone by 5alpha reductase. Blocking of 5alpha reductase with finasteride reduced prostate size, increased maximal urinary flow rate and decreased symptoms of benign prostatic hyperplasia (BPH) (((enlarged prostate))) compared to placebo.

Testosterone probably lowers high density lipoprotein (HDL) concentrations. In one study, inhibiting testosterone release with an antagonist of gonadotropin-releasing hormone (GnRH) raised HDL, but blocking testosterone release and injecting testosterone simultaneously didn't.

Testosterone replacement in hypogonadal men also increased apnea episodes and increased concentration of haemoglobin in small studies.

(((Summary: Testosterone wasn't good to begin with)))


Abstract follows:

As men age, serum testosterone concentrations fall, and they experience decreases in energy, bone mineral density, and muscle strength, which at least in part may be due to the fall in testosterone. Consequently, testosterone treatment has been considered for aging men. The possible benefits of testosterone treatment of aging men should be balanced, however, by its possible deleterious effects, including an increase in the prevalence of prostate cancer, benign prostatic hyperplasia, sleep apnea, lipid abnormalities, erythrocytosis, and hypercoagulability, all of which to some degree are testosterone dependent.