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Journal of Clinical Endocrinology & Metabolism, Vol 75, 1092-1098, Copyright © 1992 by Endocrine Society

ARTICLES

Effects of testosterone supplementation in the aging male

JS Tenover
Division of Gerontology and Geriatric Medicine, University of Washington, Seattle 98104.

Serum androgen levels decline with aging in normal males, such that a significant number of men over 60 yr of age will have a mean serum total testosterone (T) level near the low end of the normal adult range. It is not known whether lower T levels in older men have an effect on androgen-responsive organ systems, such as muscle, bone, bone marrow, and prostate, nor are there data to evaluate the relative benefits and risks of T supplementation in older men. We assessed the physiological and biochemical effects of T therapy in 13 healthy men, 57-76 yr old, who had low or borderline low serum T levels (< or = 13.9 nmol/L). Intramuscular testosterone enanthate (TE; 100 mg weekly) and placebo injections were given for 3 months each. Before treatment and at the end of both 3-month treatment regimens, lean body mass, body fat, biochemical parameters of bone turnover, hematological parameters, lipoprotein profiles, and prostate parameters [such as prostate- specific antigen (PSA)] were evaluated. Serum T levels rose in all subjects with TE treatment, such that the lowest level of T during a week's period was 19.7 +/- 0.7 nmol/L (mean +/- SE). After 3 months of TE treatment, lean body mass was significantly increased, and urinary hydroxyproline excretion was significantly depressed. With TE treatment, there was a significant increase in hematocrit, a decline in total cholesterol and low density lipoprotein cholesterol, and a sustained increase in serum PSA levels. Placebo treatment led to no significant changes in any of these parameters. We conclude that short term (3 months) TE supplementation to healthy older men who have serum T levels near or below the lower limit of normal for young adult men results in an increase in lean body mass and possibly a decline in bone resorption, as assessed by urinary hydroxyproline excretion, with some effect on serum lipoproteins, hematological parameters, and PSA. The sustained stimulation of PSA and the increase in hematocrit that occur with physiological TE supplementation suggest that older men should be screened carefully and followed periodically throughout T therapy.


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Andropause: Clinical Implications of the Decline in Serum Testosterone Levels With Aging in Men
J. Gerontol. A Biol. Sci. Med. Sci., February 1, 2002; 57(2): M76 - 99.
[Full Text]

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A. B. Singh, S. Hsia, P. Alaupovic, I. Sinha-Hikim, L. Woodhouse, T. A. Buchanan, R. Shen, R. Bross, N. Berman, and S. Bhasin
The Effects of Varying Doses of T on Insulin Sensitivity, Plasma Lipids, Apolipoproteins, and C-Reactive Protein in Healthy Young Men
J. Clin. Endocrinol. Metab., January 1, 2002; 87(1): 136 - 143.
[Abstract] [Full Text] [PDF]

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 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
C. Christmas, K. G. O'Connor, S. M. Harman, J. D. Tobin, T. Munzer, M. F. Bellantoni, C. St. Clair, K. M. Pabst, J. D. Sorkin, and M. R. Blackman
Growth Hormone and Sex Steroid Effects on Bone Metabolism and Bone Mineral Density in Healthy Aged Women and Men
J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2002; 57(1): M12 - 18.
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S. Basaria, J. T. Wahlstrom, and A. S. Dobs
Anabolic-Androgenic Steroid Therapy in the Treatment of Chronic Diseases
J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5108 - 5117.
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L. P. Ly, M. Jimenez, T. N. Zhuang, D. S. Celermajer, A. J. Conway, and D. J. Handelsman
A Double-Blind, Placebo-Controlled, Randomized Clinical Trial of Transdermal Dihydrotestosterone Gel on Muscular Strength, Mobility, and Quality of Life in Older Men with Partial Androgen Deficiency
J. Clin. Endocrinol. Metab., September 1, 2001; 86(9): 4078 - 4088.
[Abstract] [Full Text] [PDF]

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 NeurologyHome page
M.M. Cherrier, S. Asthana, S. Plymate, L. Baker, A.M. Matsumoto, E. Peskind, M.A. Raskind, K. Brodkin, W. Bremner, A. Petrova, et al.
Testosterone supplementation improves spatial and verbal memory in healthy older men
Neurology, July 10, 2001; 57(1): 80 - 88.
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A. Vermeulen
Androgen Replacement Therapy in the Aging Male--A Critical Evaluation
J. Clin. Endocrinol. Metab., June 1, 2001; 86(6): 2380 - 2390.
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S. A. Stoch, R. A. Parker, L. Chen, G. Bubley, Y.-J. Ko, A. Vincelette, and S. L. Greenspan
Bone Loss in Men with Prostate Cancer Treated with Gonadotropin-Releasing Hormone Agonists
J. Clin. Endocrinol. Metab., June 1, 2001; 86(6): 2787 - 2791.
[Abstract] [Full Text] [PDF]

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 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
A. M. Kenny, K. M. Prestwood, C. A. Gruman, K. M. Marcello, and L. G. Raisz
Effects of Transdermal Testosterone on Bone and Muscle in Older Men With Low Bioavailable Testosterone Levels
J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2001; 56(5): 266M - 272.
[Abstract] [Full Text]

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A. S. Dobs, P. S. Bachorik, S. Arver, A. W. Meikle, S. W. Sanders, K. E. Caramelli, and N. A. Mazer
Interrelationships among Lipoprotein Levels, Sex Hormones, Anthropometric Parameters, and Age in Hypogonadal Men Treated for 1 Year with a Permeation-Enhanced Testosterone Transdermal System
J. Clin. Endocrinol. Metab., March 1, 2001; 86(3): 1026 - 1033.
[Abstract] [Full Text]

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 J. Clin. Endocrinol. Metab.Home page
S. M. Harman, E. J. Metter, J. D. Tobin, J. Pearson, and M. R. Blackman
Longitudinal Effects of Aging on Serum Total and Free Testosterone Levels in Healthy Men
J. Clin. Endocrinol. Metab., February 1, 2001; 86(2): 724 - 731.
[Abstract] [Full Text]

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 ANN INTERN MEDHome page
S. Amin, Y. Zhang, C. T. Sawin, S. R. Evans, M. T. Hannan, D. P. Kiel, P. W.F. Wilson, and D. T. Felson
Association of Hypogonadism and Estradiol Levels with Bone Mineral Density in Elderly Men from the Framingham Study
Ann Intern Med, December 19, 2000; 133(12): 951 - 963.
[Abstract] [Full Text] [PDF]

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 QJMHome page
P.J. Pugh, K.M. English, T.H. Jones, and K.S. Channer
Testosterone: a natural tonic for the failing heart?
QJM, October 1, 2000; 93(10): 689 - 694.
[Full Text] [PDF]

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A. W. van den Beld, F. H. de Jong, D. E. Grobbee, H. A. P. Pols, and S. W. J. Lamberts
Measures of Bioavailable Serum Testosterone and Estradiol and Their Relationships with Muscle Strength, Bone Density, and Body Composition in Elderly Men
J. Clin. Endocrinol. Metab., September 1, 2000; 85(9): 3276 - 3282.
[Abstract] [Full Text]

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 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
A. M. Kenny, K. M. Prestwood, K. M. Marcello, and L. G. Raisz
Determinants of Bone Density in Healthy Older Men With Low Testosterone Levels
J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2000; 55(9): 492M - 497.
[Abstract] [Full Text]

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 J. Clin. Endocrinol. Metab.Home page
C. Wang, R. S. Swerdloff, A. Iranmanesh, A. Dobs, P. J. Snyder, G. Cunningham, A. M. Matsumoto, T. Weber, and N. Berman the Testosterone Gel Study Group
Transdermal Testosterone Gel Improves Sexual Function, Mood, Muscle Strength, and Body Composition Parameters in Hypogonadal Men
J. Clin. Endocrinol. Metab., August 1, 2000; 85(8): 2839 - 2853.
[Abstract] [Full Text]

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 J Geriatr Psychiatry NeurolHome page
H. C. Margolese
The Male Menopause and Mood: Testosterone Decline and Depression in the Aging Male--Is There a Link?
J Geriatr Psychiatry Neurol, July 1, 2000; 13(2): 93 - 101.
[Abstract] [PDF]

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 Eur Heart JHome page
G.M.C. Rosano
Androgens and coronary artery disease. A sex-specific effect of sex hormones?
Eur. Heart J., June 1, 2000; 21(11): 868 - 871.
[PDF]

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 Eur Heart JHome page
K.M English, O Mandour, R.P Steeds, M.J Diver, T.H Jones, and K.S Channer
Men with coronary artery disease have lower levels of androgens than men with normal coronary angiograms
Eur. Heart J., June 1, 2000; 21(11): 890 - 894.
[Abstract] [PDF]

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 EndocrinologyHome page
D. Vanderschueren, L. Vandenput, S. Boonen, E. Van Herck, J. V. Swinnen, and R. Bouillon
An Aged Rat Model of Partial Androgen Deficiency: Prevention of Both Loss of Bone and Lean Body Mass by Low-Dose Androgen Replacement
Endocrinology, May 1, 2000; 141(5): 1642 - 1647.
[Abstract] [Full Text] [PDF]

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 BMJHome page
D. C Gould, R. Petty, and H. S Jacobs
For and against: The male menopause---does it exist? • For • Against
BMJ, March 25, 2000; 320(7238): 858 - 861.
[Full Text]

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 J. Clin. Endocrinol. Metab.Home page
C. Longcope, H. A. Feldman, J. B. McKinlay, and A. B. Araujo
Diet and Sex Hormone-Binding Globulin
J. Clin. Endocrinol. Metab., January 1, 2000; 85(1): 293 - 296.
[Abstract] [Full Text]

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R. Bross, M. Javanbakht, and S. Bhasin
Anabolic Interventions for Aging-Associated Sarcopenia
J. Clin. Endocrinol. Metab., October 1, 1999; 84(10): 3420 - 3430.
[Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
A. S. Dobs, A. W. Meikle, S. Arver, S. W. Sanders, K. E. Caramelli, and N. A. Mazer
Pharmacokinetics, Efficacy, and Safety of a Permeation-Enhanced Testosterone Transdermal System in Comparison with Bi-Weekly Injections of Testosterone Enanthate for the Treatment of Hypogonadal Men
J. Clin. Endocrinol. Metab., October 1, 1999; 84(10): 3469 - 3478.
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P. J. Snyder, H. Peachey, P. Hannoush, J. A. Berlin, L. Loh, D. A. Lenrow, J. H. Holmes, A. Dlewati, J. Santanna, C. J. Rosen, et al.
Effect of Testosterone Treatment on Body Composition and Muscle Strength in Men Over 65 Years of Age
J. Clin. Endocrinol. Metab., August 1, 1999; 84(8): 2647 - 2653.
[Abstract] [Full Text]

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 J. Clin. Endocrinol. Metab.Home page
M. Sheffield-Moore, R. J. Urban, S. E. Wolf, J. Jiang, D. H. Catlin, D. N. Herndon, R. R. Wolfe, and A. A. Ferrando
Short-Term Oxandrolone Administration Stimulates Net Muscle Protein Synthesis in Young Men
J. Clin. Endocrinol. Metab., August 1, 1999; 84(8): 2705 - 2711.
[Abstract] [Full Text]

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 Clin. Chem.Home page
H. M. Perry III
The Endocrinology of Aging
Clin. Chem., August 1, 1999; 45(8): 1369 - 1376.
[Abstract] [Full Text] [PDF]

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P. J. Snyder, H. Peachey, P. Hannoush, J. A. Berlin, L. Loh, J. H. Holmes, A. Dlewati, J. Staley, J. Santanna, S. C. Kapoor, et al.
Effect of Testosterone Treatment on Bone Mineral Density in Men Over 65 Years of Age
J. Clin. Endocrinol. Metab., June 1, 1999; 84(6): 1966 - 1972.
[Abstract] [Full Text]

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 Am. J. Respir. Crit. Care Med.Home page
Skeletal Muscle Dysfunction in Chronic Obstructive Pulmonary Disease . A Statement of the American Thoracic Society and European Respiratory Society
Am. J. Respir. Crit. Care Med., April 1, 1999; 159(4): S2 - 40.
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 J. Clin. Endocrinol. Metab.Home page
J. J. Zachwieja, S. R. Smith, J. C. Lovejoy, J. C. Rood, M. M. Windhauser, and G. A. Bray
Testosterone Administration Preserves Protein Balance But Not Muscle Strength during 28 Days of Bed Rest
J. Clin. Endocrinol. Metab., January 1, 1999; 84(1): 207 - 212.
[Abstract] [Full Text]

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 Am. J. Physiol. Endocrinol. Metab.Home page
A. A. Ferrando, K. D. Tipton, D. Doyle, S. M. Phillips, J. Cortiella, and R. R. Wolfe
Testosterone injection stimulates net protein synthesis but not tissue amino acid transport
Am J Physiol Endocrinol Metab, November 1, 1998; 275(5): E864 - E871.
[Abstract] [Full Text] [PDF]

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 Arterioscler. Thromb. Vasc. Bio.Home page
E. J. Giltay, J. M. H. Elbers, L. J. G. Gooren, J. J. Emeis, T. Kooistra, H. Asscheman, and C. D. A. Stehouwer
Visceral Fat Accumulation Is an Important Determinant of PAI-1 Levels in Young, Nonobese Men and Women : Modulation by Cross-Sex Hormone Administration
Arterioscler Thromb Vasc Biol, November 1, 1998; 18(11): 1716 - 1722.
[Abstract] [Full Text] [PDF]

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 J. Clin. Endocrinol. Metab.Home page
C. J. Bagatell and W. J. Bremner
V. The Effects of Aging and Testosterone on Lipids and Cardiovascular Risk
J. Clin. Endocrinol. Metab., October 1, 1998; 83(10): 3440 - 3441.
[Full Text]

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S. Bhasin
VIII. Conclusion--Research Design Issues in Examining the Effects of Testosterone Supplementation in Older Men
J. Clin. Endocrinol. Metab., October 1, 1998; 83(10): 3445 - 3448.
[Full Text]

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 J. Clin. Endocrinol. Metab.Home page
S. Bhasin, T. W. Storer, N. Asbel-Sethi, A. Kilbourne, R. Hays, I. Sinha-Hikim, R. Shen, S. Arver, and G. Beall
Effects of Testosterone Replacement with a Nongenital, Transdermal System, Androderm, in Human Immunodeficiency Virus-Infected Men with Low Testosterone Levels
J. Clin. Endocrinol. Metab., September 1, 1998; 83(9): 3155 - 3162.
[Abstract] [Full Text]

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 J. Clin. Endocrinol. Metab.Home page
K. Miller, C. Corcoran, C. Armstrong, K. Caramelli, E. Anderson, D. Cotton, N. Basgoz, L. Hirschhorn, R. Tuomala, D. Schoenfeld, et al.
Transdermal Testosterone Administration in Women with Acquired Immunodeficiency Syndrome Wasting: A Pilot Study
J. Clin. Endocrinol. Metab., August 1, 1998; 83(8): 2717 - 2725.
[Abstract] [Full Text]

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 J. Clin. Endocrinol. Metab.Home page
S. Khosla, L. J. Melton III, E. J. Atkinson, W. M. O’Fallon, G. G. Klee, and B. L. Riggs
Relationship of Serum Sex Steroid Levels and Bone Turnover Markers with Bone Mineral Density in Men and Women: A Key Role for Bioavailable Estrogen
J. Clin. Endocrinol. Metab., July 1, 1998; 83(7): 2266 - 2274.
[Abstract] [Full Text]

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 J. Nutr.Home page
D. N. Proctor, P. Balagopal, and K. S. Nair
Age-Related Sarcopenia in Humans Is Associated with Reduced Synthetic Rates of Specific Muscle Proteins
J. Nutr., February 1, 1998; 128(2): 351 - 351.
[Abstract] [Full Text]


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