Saturday, 22 September, 2018

Anemia, Bone Density Improve With Testosterone Replacement

Ron Matthews | 24 February, 2017, 00:15

While testosterone use for one year appeared to strengthen bones and reduce anemia, it also showed signs of worsening artery disease and questions remain about other potential risks.

Now, with a clearer scorecard on benefits, Snyder would like to see the government fund a study to tease out the risks - an effort that would take 5,000 men, five years of treatment, and $500 million.

Cognition trial - This trial sought to determine if testosterone treatment improved cognition in older men with age-associated memory impairment (AAMI), a mild form of impairment, distinct from dementia. That includes many men with testosterone levels on the borderline between low and normal, men who don't actually meet clinical guidelines for treatment, Alexander says. This therapy is usually implemented through gels, injections or mouth patches.

In addition to LA BioMed, the TTrials were conducted at Albert Einstein College of Medicine, Baylor College of Medicine, Brigham and Women's Hospital, University of Alabama at Birmingham, Northwestern University Feinberg School of Medicine, Puget Sound Health Care System, University of California at San Diego School of Medicine, University of Florida School of Medicine, University of Minnesota School of Medicine, University of Pennsylvania Perelman School of Medicine, University of Pittsburgh School of Public Health and Yale School of Medicine.

The four 12-month, placebo-controlled studies won't resolve the long-standing medical debate over the usefulness of testosterone replacement therapy. New research investigates the side effects of testosterone replacement therapy. They were conducted in 12 USA teaching medical centers across the country for a year and were mainly funded by a grant from the National Institutes of Health. Additional funding, and the study drug and placebo, were provided by AbbVie Pharmaceuticals. This study aimed to determine whether testosterone administation in older men with low testosterone levels increased volumetric BMD (vBMD) and estimated bone strength. After the research had ended, the investigators followed several cases for another year, to have a more specific body of results.

At the end of that study, compared to men using the placebo, men using testosterone gel had a greater increase in coronary artery plaque, which is tied to poor heart health.

The first trial conducted was the Cognition Trial, and it was the only one in which all the participants were involved.

However, the treatment did not improve memory or any other measure of cognitive function.

One of the studies found that the testosterone gel improved bone density in some men.

In the Cardiovascular trial, results showed how this therapy is not exclusively positive for the patients.

Among the 8,808 men ever prescribed the hormone given by injection, orally or topically, cardiovascular outcomes over a median follow-up of 3.2 years, the composite adjusted hazard ratio for acute MI, coronary revascularization, unstable angina, stroke, transient ischemic attack (TIA), and sudden cardiac death was 0.67 with any testosterone prescription (95% CI 0.62-0.73). And the most recent data does show some benefits: 54% of men with unexplained anemia, for example, had clinically significant increases in red blood cell levels, compared with 15% of men with the disease who took a placebo.

Anemia Trial - Treatment helped correct anemia without identifiable cause as well as anemia stemming from iron deficiency. Testosterone gel and other supplements and their efficacy still varies.

"Looking globally at testosterone therapy, the strongest evidence is for sexual function", said Dr. Thomas Gill, the Humana Foundation Professor of Medicine and a lead author. Getting old naturally lowers testosterone in the body.

"I think this will help men and their physicians decide whether this is a reasonable treatment for them", she said.


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