Testosterone Therapy: “Significant Reduction” in Heart Attack, Stroke Risks

Large-scale Veterans Affairs database study reaffirms safety and benefits of testosterone replacement, in men.

A US Veterans Affairs database study of more than 83,000 male subjects found that men whose low testosterone was restored to normal through gels, patches, or injections had a lower risk of heart attack, stroke, or death from any cause, versus similar men who were not treated.  Rajat Barua and colleagues analyzed data collected on 83,010 male veterans with documented low total testosterone levels, dividing them into three clinical groups: those who were treated to the point where their total testosterone levels returned to normal (Group 1); those who were treated but without reaching normal (Group 2); and those who were untreated and remained at low levels (Group 3).  Importantly, all three groups were “propensity matched” so the comparisons would be between men with similar health profiles. The researchers took into account a wide array of factors that might affect cardiovascular and overall risk. The average follow-up across the groups ranged from 4.6 to 6.2 years. The sharpest contrast emerged between Group 1 (those who were treated and attained normal levels) and Group 3 (those whose low testosterone went untreated). The treated men were 56% less likely to die during the follow-up period, 24%less likely to suffer a heart attack, and 36%less likely to have a stroke.  The differences between Group 1 and Group 2 (those who were treated but did not attain normal levels) were similar but less pronounced.  The study authors conclude that: “normalization of [total testosterone] levels after [testosterone replacement therapy] was associated with a significant reduction in all-cause mortality, [myocardial infarction], and stroke.”

Sharma R, Oni OA, Gupta K, Chen G, Sharma M, Dawn B, Sharma R, Parashara D, Savin VJ, Ambrose JA, Barua RS. “Normalization of testosterone level is associated with reduced incidence of myocardial infarction and mortality in men.”  Eur Heart J. 2015 Aug 6. pii: ehv346.

Article Source: https://www.worldhealth.net/news/testosterone-therapy-significant-reduction-heart-a/

 

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Got ED?

Are struggling with erectile dysfunction? Impotence is a common problem among men and is characterized by the consistent inability to sustain or maintain an erection. Did you know stress, smoking, poor diet, depression, being overweight, and a sedentary lifestyle can increase your chances of developing ED? Here are some additional facts about ED:

1️⃣It is estimated that half of all men between the ages of 40 and 70 suffer from erectile dysfunction to some degree.
2️⃣Although not exactly defined, failure to achieve an erection more than 50 percent of the time is generally considered by medical professionals as erectile dysfunction.
3️⃣Erectile dysfunction can be caused by a number of issues, including hormonal imbalance, a restriction in the flow of blood to your penis, conditions affecting your nervous system, and psychological causes such as depression and anxiety.
4️⃣Taking certain medications can cause erectile dysfunction.

These may include but not limited to: diuretics, antidepressants, corticosteroids, and antihistamines. Testosterone replacement therapy can be an effective treatment for erectile dysfunction.

Schedule a 100% confidential consultation with one of our Patient Coordinators today!
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What Are Normal Testosterone Levels in Men?

As a society, we tend to place a lot of significance on certain words. The word “normal” is one of them. With that in mind, one of the most often asked questions in the field of men’s health is “what are normal testosterone levels in men?” Both the media and health professionals are capitalizing on this question by talking about “low T” and urging men to turn to hormone replacement therapy to boost their testosterone levels.

But before men should even consider taking steps to raise their testosterone levels (which can be done in a number of natural ways), we return to the basic question: what are normal testosterone levels in men? Here is the not-so-simple answer.

 

What are the forms of testosterone?

First of all, there is more than one form of testosterone:

• One is bonded with sex hormone binding globulin (SHBG), which is the most common type and makes up about 65 percent of total testosterone. The testosterone attached to SHBG typically cannot be separated from the hormone, so this T is not considered to be bioavailable. Testosterone that is bioavailable is the form that is used by the body.
• One is bonded to the protein albumin, making up about 35 percent of your total testosterone. This testosterone is considered to be potentially bioavailable because it can be “coaxed” away from the protein.
• One is free, which means it is not attached to any protein. Free testosterone makes up about 2 percent of total T and is the form that is completely bioavailable to be used by the body. Free testosterone travels throughout the bloodstream and can bind to receptors in the muscles, brain, and other organs.

Getting your testosterone levels checked

After you undergo the simple blood test that measures your testosterone levels, your doctor will give you the results represented by three different numbers:

• Total testosterone. This represents the total amount of testosterone that is circulating throughout your body, so it includes both types of bonded T plus free T
• Bioavailable T, which consists of testosterone attached to albumin plus free T
• Free T

Now comes the complicated part. The definition of “normal” testosterone varies, depending on the expert and the testing lab used. The good news is that there are general guidelines for “normal” testosterone. Here are the generally accepted normal ranges of total, free, and bioavailable T, given in nanograms of testosterone per deciliter (ng/dL) for different age groups:

Total T:

• 240 to 950 ng/dL for men age 19 years and older

Free T:

• 5.05 to 19.8 ng/dL for men 25 to 29
• 4.86 to 19.0 ng/dL for ages 30 to 34
• 4.65 to 18.1 ng/dL for ages 35 to 39
• 4.46 to 17.1 ng/dL for ages 40 to 44
• 4.28 to 16.4 ng/dL for ages 45 to 49
• 4.06 to 15.6 ng/dL for ages 50 to 54
• 3.87 to 14.7 ng/dL for ages 55 to 59
• 3.67 to 13.0 ng/dL for ages 60 to 64
• 3.47 to 13.0 ng/dL for ages 65 to 69
• 3.28 to 12.2 ng/dL for ages 70 to 74

Bioavailable T:

• 83 to 257 ng/dL for men 20 to 29
• 72 to 235 ng/dL for men 30 to 39
• 61 to 213 ng/dL for men 40 to 49
• 50 to 190 ng/dL for men 50 to 59
• 40 to 168 ng/dL for men 60 to 69

No ranges have been determined for men age 70 and older. Clinically low total testosterone levels are recognized as less than 220 to 300 ng/dL.

Bottom line on normal testosterone levels in men

Here is the bottom line when it comes to answering the question, what are normal testosterone levels in men.

• The range of “normal” is wide, which accommodates the fact that every man’s needs are different.
• While men’s total testosterone level can be within the normal range, their free T levels can be low, which can result in symptoms of low T.
• The testosterone level men should be most interested is in the bioavailable number. If men can boost their bioavailable testosterone level, they should expect an increase in energy, sex drive, and muscle strength as well as better mood and well-being.

Article Source: https://www.huffingtonpost.com/entry/what-are-normal-testosterone-levels-in-men_us_5968d687e4b06a2c8edb45e9

Written By: Craig Cooper

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Hormone imbalance may explain higher diabetes rates in sleep-deprived men

Studies have found an association between insufficient sleep and the development of insulin resistance, one of the factors that cause type 2 diabetes, and now researchers have discovered a biological reason for this relationship, at least in men: an imbalance between their testosterone and cortisol hormones. The study results will be presented Sunday at ENDO 2018, the Endocrine Society’s 100th annual meeting in Chicago, Ill.

“Our highly controlled sleep study showed that even one night of restricted sleep can cause insulin resistance and that we can dampen this effect by controlling levels of these two important hormones,” said senior investigator Peter Y. Liu, M.B.B.S., Ph.D., a professor of medicine with the Los Angeles Biomedical (LA BioMed) Research Institute at Harbor-UCLA Medical Center, Torrance, Calif.

Insulin resistance occurs when the body does not properly use the hormone insulin. Testosterone is the main anabolic, or muscle-building, hormone, whereas cortisol—often called the “stress hormone”—helps catabolism, or breaking down energy and fat stores for use, Liu explained. Past research shows that sleep loss reduces a man’s testosterone levels and increases cortisol levels.

Liu and his fellow researchers conducted five nights of sleep studies in 34 healthy men with an average age of 33. They controlled what the subjects ate and how much they slept, giving them 10 hours of sleep the first night and restricting them to four hours of sleep the remaining nights. The study received funding from the National Institutes of Health and the Clinical and Translational Research Center at LA BioMed.

In this “crossover” study, the men served as their own controls. In one series of sleep studies, they received three medications: ketoconazole, which switches off the body’s production of testosterone and cortisol; testosterone gel; and oral hydrocortisone, a synthetic form of cortisol. The doses of testosterone and hydrocortisone were in the midrange of levels that the body normally produces, according to Liu. This arm of the study was called a dual “clamp” because it stopped the body’s production of these two hormones and then gave them a fixed amount of the hormones, thus clamping levels in a normal hormonal balance, he said.

In another set of experiments, the men received inactive placebos that matched the medications. The order of when they received the clamp and the placebo was random, with a two-week interval between the study conditions. The morning after the first and last nights of each part of the study, all men took the oral glucose tolerance test, in which they gave blood samples while fasting and again after drinking a sugary drink. This test result allowed the researchers to calculate each man’s insulin resistance using standard measures, including the Matsuda Index.

After sleep restriction, this index reportedly showed greater insulin resistance with both the clamp and the placebo. However, Liu said this increase was significantly dampened, or less severe, with the dual-clamp, demonstrating that testosterone and cortisol reduced the negative effects of sustained sleep restriction on insulin resistance.

“Maintaining hormonal balance could prevent metabolic ill health occurring in individuals who do not get enough sleep,” he said. “Understanding these hormonal mechanisms could lead to new treatments or strategies to prevent insulin resistance due to insufficient sleep.”

Article Source: https://medicalxpress.com/news/2018-03-hormone-imbalance-higher-diabetes-sleep-deprived.html

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Is testosterone replacement therapy the right thing for aging males?

 

Testosterone (T) is a naturally occurring hormone in men, and most of it is produced in the testicles.

At puberty, T production escalates, bringing about masculinizing changes in muscle mass.  also promotes sex drive, sperm and red blood cell production, bone mass and determines how men store body fat.

It can impact quality of life issues as well, like mood, energy and motivation.

Beginning at about age 30, T production begins to decline on average by about 1 percent per year, plummeting late in life. This causes all sorts of problems, including lack of sex drive, inability to sleep, loss of muscle and bone mass, increased belly fat, the list goes on. Reversing these symptoms and improving the quality of life is the reason T replacement therapy (TRT) clinics supervised by physicians have sprung up around the country.

Although it is considered a male hormone, women also produce a modest amount of T in the ovaries. After menopause, estrogen production declines, which alters the ratio of estrogen to T, explaining why women begin taking on some male characteristics, like storing more fat around the midsection, rather than on the hips, thighs and buttocks as occurs earlier in life.

TESTOSTERONE REPLACEMENT THERAPY

Is TRT a good thing? It can be when managed responsibly. If you are older, and your T level is very low and falls below the normal range, it makes sense to address it with TRT because it can negatively impact health, increasing risks associated with diabetes, obesity and osteoporosis. Low T also may shorten life, but this is controversial because when TRT raises T levels it has not been shown to extend life.

More is not always better, and many TRT clinics are viewed with suspicion because they advertise that it’s possible to feel like you are 25 years old again, even though you are decades older. Perhaps this is possible, but at what price, and if you are taking huge doses of T, could you be damaging your health?

Research studies in 2013 and 2014 indicated that TRT increased the risk of heart disease in men 65 and older, and in younger men with a history of heart disease. However, subsequent studies refute these findings and some show a deceased risk of heart disease. Another area of concern is an increased risk of prostate cancer, but this, too, is controversial. There does appear to be solid evidence that TRT can increase the risk of blood clots and stroke, plus sleep apnea, acne and breast enlargement.

All in all, some experts believe the benefits outweigh the risks, while others are more cautious because TRT hasn’t been around long enough or impacted enough men to draw meaningful conclusions. Time will tell. In the meantime, like most things in life, moderation is the best approach.

ANABOLIC STEROIDS

Anabolic steroids (AS) are synthetic steroid hormones that resemble T. AS require a doctor’s prescription and were developed to promote muscle mass in postsurgical patients, particularly older patients. Unfortunately, AS use spilled over to strength athletes who wanted the advantages associated with increased muscle mass, and AS delivered as promised. This, in turn, inspired gross overdosing with AS as a means to producing freaky muscular proportions and super human strength.

AS can cause a long list of negative side effects, the most serious being growth of tumors in the liver and acceleration of atherosclerosis (clogging of the arteries). AS suppress HDL (good cholesterol) production, which leads to a ratio of bad to good cholesterol that is out of whack, promoting clogged arteries and ultimately leading to a heart attack. Worse, because a doctor’s prescription is required, AS often are obtained illegally from foreign countries through the mail, with no sense of the quality of the product or the dangers involved.

When I was young, I was an enthusiastic weight lifter, working out hours every day. Some of my friends went the AS route and developed amazing physiques. Recently, I have endeavored to track them down to see how they are doing, and I was saddened to learn that too many have died prematurely, in their fifties and sixties, some even earlier. The most likely cause was a heart attack.

THE BOTTOM LINE

TRT has a place and can be beneficial if managed prudently. Just be careful of extreme approaches and promises that seem too good to be true. As for AS, there is no justifiable reason for athletes to be taking them. Ever!

Article Source: https://www.courier-journal.com/story/life/wellness/health/2017/09/07/testosterone-replacement-therapy-aging-males/569708001/?cookies=&from=global

Written BY: Bryant Stamford

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Study: Long-term testosterone therapy improves urinary, sexual function and quality of life

A new study shows a significant improvement in both sexual and urinary function as well as quality of life for hypogonadal men who undergo long-term testosterone replacement therapy.

These findings appear in the Journal of Urology.

Testosterone is a steroid hormone involved in the regulation of sexual function, urinary health and metabolism as well as a number of other critical functions. For most men, testosterone concentration declines slowly with age and may not cause immediate major symptoms. However, some men may experience a host of signs and sumptoms constituting a clinical condition called Testosterone Deficiency (TD), or male hypogonadism, which is attributed to insufficient levels of testosterone. As a result, they experience symptoms as varied as erectile dysfunction, low energy, fatique, depressed mood and an increased risk of diabetes.

Researchers from the Boston University School of Medicine (BUSM) and Public Health (BUSPH) collaborated with a group of urologists in Germany to investigate the effects of long-term testosterone replacement therapy on urinary health and sexual function as well as quality of life in men with diagnosed, symptomatic testosterone deficiency. More than 650 men in their 50s and 60s enrolled in the study, some with unexplained testosterone deficiency and others with known genetic and auto-immune causes for their hypogonadism.

“It is thought that testosterone treatment in men may increase prostate size and worsen lower urinary tract symptoms,” said Abdulmaged Traish, PhD, professor of urology at BUSM.

However, he and Gheorghe Doros, PhD, professor of biostatistics at BUSPH, discovered that despite increased prostate size in the group that received testosterone therapy, there were fewer urinary symptoms such as frequent urination, incomplete bladder emptying, weak urinary stream and waking up at night to urinate.

In addition to these subjective improvements, the researchers conducted objective testing that showed that those men treated with testosterone emptied their bladders more fully. Finally, testosterone treatment also increased the scores patients received on assessments of their erectile/sexual health and general quality of life.

The findings of this study are of great significance to men suffering with symptomatic testosterone deficiency. Traish emphasized the value of this treatment option, stating that, “[Testosterone therapy] is well-tolerated with progressive and sustained improvement in urinary and sexual function and overall improvement in quality of life.”

Article Source: https://www.eurekalert.org/pub_releases/2017-08/bumc-slt081517.php

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How hormone levels might affect your quality of life

Regardless of gender, all humans produce the hormone testosterone. However, men have much higher levels of testosterone than women.

 

Testosterone is a chemical messenger that is responsible for the development of male sexual characteristics. In addition, testosterone helps regulate muscle size and strength, red blood cell production, bone mass, and fat distribution.

 

As men age, their testosterone levels begin to dip. Although a natural result of aging, lower testosterone levels, also called hypogonadism, can contribute to any number of side effects – some of which men can find interrupt their quality of life. The medical resource Healthline says that testosterone starts to decrease after age 30, falling by 1 percent for each year thereafter.

 

Some men may even suffer from low testosterone (called low-T), which is the underproduction or lack of production of this hormone. Typically, this is linked to chronic medical conditions, such as obesity, diabetes and other hormonal conditions. Although not all men will experience low-T, learning to recognize its signs and symptoms can help those who develop the condition address it that much more quickly.

 

Changes in sexual function: Changes in sexual function resulting from low-T can include decreased libido/desire, inability to have or maintain erections, fewer spontaneous erections, and infertility. Since testosterone is linked to healthy sperm production, lower levels may reduce the number of healthy sperm or their mobility.

 

Insomnia and trouble sleeping: Sleep disturbances may be linked to low-T. These can include trouble falling asleep or frequent waking.

 

Weight gain: Men with low-T may suffer from increased body fat coupled with decreased energy levels that can make exercise less appealing. Weight gain — particularly in the abdominal area — may also occur in conjunction with a condition called gynecomastia, which is swollen or tender breasts.

 

Reduced muscle mass: Other physical changes can include reduced muscle bulk and strength. Decreased bone mass or mineral density is also possible.

 

Emotional changes: Emotional changes may be a byproduct of lower testosterone or feelings of helplessness over a seemingly irreversible condition. Fatigue, low self-confidence, sadness, depression, and even trouble concentrating are possible.

The Urinary Care Foundation says that low-T is quite common. Roughly 4 out of 10 men over the age of 45 have low testosterone. Low-T also affects 2 out of 10 men over the age of 60 and 3 out of 10 men over the age of 70.

 

If symptoms of low-T prove bothersome, testosterone replacement therapy, or TRT, may be prescribed. These include skin gels, shots, long-acting pellets, patches, and pills. The American Urological Association suggests discussing the pros and cons of TRT with a doctor who is skilled in diagnosing low-T. TRT should not be used by men planning to become a father anytime soon.

 

It should be noted that, while the Mayo Clinic says there are no definitive studies that point to HRT being effective, the accumulation of anecdotal evidence is undeniable.

Local anti-aging and regenerative medicine expert Dr. Brett Osborn believes that “while HRT is not for everyone — for instance, those with a strong family history of hormone-sensitive cancer — if you and your physician do opt for HRT, use only bio-identical hormones.”

 

Bio-identical hormones are those that are created in a compounding pharmacy and match one’s own specific hormonal needs.

 

In addition, he strongly urges that you “avoid ever using oral testosterone or oral estrogens” because both, when broken down metabolically, have the potential to be carcinogenic.

 

Rather, he suggests that bio-identical transdermal creams or injections are the best options.

 

“Do not underestimate the roles that hormones play in your biochemistry and your overall well-being. I would urge everyone to explore with their doctor the option of hormone replacement therapy. Restoring a youthful hormone profile not only has the potential to make you feel great, but also may slow down the aging process.”

And just in case you need further proof of Dr. Osborn’s belief in HRT, consider this: He checks his own hormone levels every six weeks — and adjusts his HRT accordingly.

Article Source: http://www.palmbeachpost.com/lifestyles/health/how-hormone-levels-might-affect-your-quality-life/sgXf5J82C1ntK2KEdQkM5O/

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Testosterone Therapy Beneficial to Men with Heart Disease

New study finds that testosterone supplementation enables a reduction in the risks of major cardiovascular events, such as strokes, heart attacks, and death.

In a recent study, a research team from the Intermountain Medical Center Heart Institute studied 755 male patients, ranging from 58-78 years, who all had severe coronary artery disease, the most common type of heart disease. They were separated into three different groups, receiving varied doses of testosterone, administered intravenously or by gel. At the end of the first year, 64 patients who weren’t taking any testosterone supplements had serious adverse cardiovascular events, whereas only 12 who were taking medium doses of testosterone and 9 who were taking high doses did. At the end of 3 years, 125 patients who had not received testosterone therapy suffered severe cardiovascular events, whereas only 38 medium-dose and 22 high-patients did. Patients who were given testosterone as part of their follow-up treatment did much better than patients who had not been given testosterone supplementation. The non-testosterone-therapy patients were 80 percent more likely to suffer an adverse event. “Although this study indicates that hypo-androgenic men with coronary artery disease might actually be protected by testosterone replacement, this is an observational study that doesn’t provide enough evidence to justify changing treatment recommendations,” said Dr. Muhlestein, co-director of cardiovascular research at the Intermountain Medical Center Heart Institute. “It does, however, substantiate the need for a randomized clinical trial that can confirm or refute the results of this study.” This new study confirms the findings of a previous study from the Intermountain Medical Center Heart Institute, which found that testosterone therapy did not increase the risk of experiencing a heart attack or stroke for men with low testosterone levels and no prior history of heart disease.

The Intermountain Medical Center research team will presented their study at the American College of Cardiology’s 65th Annual Scientific Session on Sunday, April 3 at 12:15 p.m., CDT.

The Intermountain Medical Center Heart Institute is made up of clinical and research professionals who aim to advance cardiovascular treatment. Intermountain Medical Center is the flagship facility for the Intermountain Healthcare system, which is based in Salt Lake City.

Article Source: https://www.worldhealth.net/news/testosterone-supplementation-beneficial-men-heart-/

 

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How Much Booze Do You Have To Drink To Mess With Your Hormones?

We all love to unwind at the end of the day. Sometimes that’s a great bout of yoga or high-intensity training, and sometimes it’s a glass of wine or a favorite cocktail. Everything in moderation, right?

Or not? Have you ever wondered what impact (if any) alcohol has on your hormones? And just how much is too much? Is any amount “safe”? What is alcohol doing inside our bodies? And what does moderate consumption even mean?

To answer those questions, let’s take it one step at a time.

Alcohol consumption can increase estrogen—but it’s not the same for everyone.

According to clinical studies, moderate alcohol consumption can vary with life stages. What you consume at age 20 may not be the same as what you consume at age 40—and what you drink will affect your hormones really differently as well. As a woman ages, her hormones fluctuate; therefore, less alcohol is needed to have larger hormonal effects over time. For a woman in her 40s or 50s, even “moderate” amounts of alcohol can affect the hormonal system.

Drinking alcohol can cause a rise in estrogen and a decrease in progesterone in premenopausal women. Some studies even suggest that menopause was delayed by moderate alcohol consumption, since “alcohol consumption was significantly correlated with estrogen levels.” Though binge drinking (five or more drinks in one day) is the most detrimental, in terms of hormonal disruption and other health problems, this study suggests that moderate alcohol consumption needs further analysis to determine its health impact.

Alcohol consumption can decrease testosterone—but it depends how much you drink.

According to a study by the Testosterone Centers of Texas, “alcohol is the enemy of testosterone.” Testosterone is important for both men and women (although men have much more)! It’s well-known as the hormone for sex drive and libido, but it is a key player in muscle formation, bone mass, fat distribution, and brain health. Low testosterone (caused by alcohol or something else) in both men and women can result in brain fog, fatigue, irritability, lower muscle mass, and lower motivation.

The Testosterone Centers study goes on to cite that the decrease in testosterone is in direct relation to the amount of alcohol consumed, which poses the question: How much is too much?

In this particular study, the findings suggest that drinking two to three beers a day caused a “slight” reduction in testosterone for men and none for women, a good sign that moderate drinking doesn’t have that huge of an impact. The way in which alcohol affects hormone levels is related to the chemicals alcohol contains. Beer and wine contain chemicals that can increase estrogen, thereby lowering testosterone.

Heavy drinking (more than three drinks a day) is the real culprit for all kinds of health maladies in both men and women: weight gain, lowered testosterone levels in men, and increased testosterone levels in women. Both sexes are affected in terms of fertility. Studies have shown that men who drink in excess suffer from both fertility and “abnormally low testosterone.”

How to balance drinking with a healthy lifestyle.

Though most studies seem to suggest moderate alcohol intake may not cause any health issues in men and women, I’ve found in my years as a practitioner that “moderate” can mean very different things to different people.

The best solution? Consult with your health care provider to:

• Determine a baseline for your health.
• Talk to (and trust) your doctor to let her or him know your accurate alcohol intake on a weekly basis.
• Follow-up, on a regular basis, about how that intake may be or may not be affecting your health.

The bottom line: What’s moderate and appropriate for you might not be the same as what’s moderate and appropriate for me—especially when it comes to hormone balance.

Article Source: https://www.mindbodygreen.com/articles/is-drinking-alcohol-bad-for-hormone-balance

Written By: Dr. Amy Shah

 

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Testosterone decline associated with increased mortality risk

Men experiencing a pronounced, age-related decline in testosterone level are more likely to die of any cause during a 15-year period vs. men who have testosterone levels in the 10th to 90th percentile, according to findings reported in the European Journal of Endocrinology.

Stine A. Holmboe, MSc, a doctoral student in the department of growth and reproduction at the University of Copenhagen, Denmark, and colleagues analyzed data from 1,167 men aged 30 to 60 years participating in the Danish Monitoring Trends and Determinants of Cardiovascular Disease (MONICA1) study, conducted between November 1982 and February 1984, as well as the follow-up examination 10 years later (MONICA10), conducted between 1993 and 1994. Researchers measured levels of testosterone, sex hormone-binding globulin and luteinizing hormone at baseline and follow-up, and then followed the cohort for up to 18 years (mean, 15.2 years) using data from national mortality registries. Researchers used Cox proportional hazard models, with age as the underlying time scale, to assess the association between intra-individual hormone changes and all-cause, CVD and cancer mortality.

During follow-up, 421 men (36.1%) died (106 cancer-related deaths; 119 CVD-related deaths). The estimated mean intra-individual percentage change in hormone levels per year for the cohort were –1.5% for total testosterone, 0.9% for SHBG, –1.9% for free testosterone and 1% for luteinizing hormone. When estimated cross-sectionally, however, mean percentage changes in hormone levels per year were –0.4% for total testosterone, 1.2% for SHBG, –1.1% for free testosterone and 1.1% for luteinizing hormone, according to researchers.

Researchers observed that men who experienced the most pronounced decline in total testosterone — men in the lowest 10th percentile — saw the greatest increased risk for all-cause mortality (HR = 1.6; 95% CI, 1.08-2.38) vs. the reference category. The risk corresponded with an annual total testosterone decline of at least –0.6 nmol/L.

Across tertiles of SHBG levels, researchers found no significant differences in all-cause mortality; however, there was a U-shaped trend observed, with increases in all-cause mortality for those with a change in SHBG levels below the 10th percentile (< –0.7 nmol/L per year) or above the 90th percentile (> 1.1 nmol/L per year) vs. the middle group.

Men with the most pronounced decline in free testosterone also saw an increased risk for all-cause mortality; however, this was significant only in the tertile model (HR = 1.45; 95% CI, 1.09-1.92), according to researchers. There were no disease-specific associations observed, and associations were independent of age, baseline hormone levels and lifestyle factors.

“A possible causal link between an increased tempo in age-related [testosterone] decline and subsequent health is unknown and remains to be investigated,” the researchers wrote. – by Regina Schaffer

Article Source: https://www.healio.com/endocrinology/reproduction-androgen-disorders/news/in-the-journals/%7Bb9ffabec-a385-4c19-b01b-4981f05e01d1%7D/testosterone-decline-associated-with-increased-mortality-risk

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