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This version published online on December 26, 2007
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2007-1692
A more recent version of this article appeared on March 1, 2008
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Right arrow Male Endocrinology

Submitted on July 30, 2007
Accepted on December 18, 2007

Effects of Graded Doses of Testosterone on Erythropoiesis in Healthy Young and Older Men

Andrea D. Coviello*, Beth Kaplan, Kishore M. Lakshman, Tai Chen, Atam B. Singh, and Shalender Bhasin

Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA 02118; Charles R. Drew University, Los Angeles, CA, 90059

* To whom correspondence should be addressed. E-mail: andrea.coviello{at}bmc.org.

CONTEXT: Erythrocytosis is a dose limiting adverse effect of testosterone therapy, especially in older men.

OBJECTIVE: To compare the dose-related changes in hemoglobin and hematocrit in young and older men and determine whether age-related differences in erythropoietic response to testosterone can be explained by changes in erythropoietin and soluble transferring receptor (sTfR) levels.

DESIGN: Secondary analysis of a testosterone dose-response study in young and older men who received long acting GnRH agonist monthly plus one of five weekly doses of testosterone enanthate (25, 50, 125, 300 or 600 mg IM) for 20 weeks.

SETTING: General Clinical Research Center

PARTICIPANTS: 60 older men aged 60–75 years and 61 young men aged 19–35 years

OUTCOME MEASURES: Hematocrit and hemoglobin, and serum erythropoietin and sTfR levels.

RESULTS: Hemoglobin and hematocrit increased significantly in a linear, dose-dependent fashion in both young and older men in response to graded doses of testosterone (P < 0.0001). The increases in hemoglobin and hematocrit were significantly greater in older than young men. There was no significant difference in percent change from baseline in erythropoietin or sTfR levels across groups in either young or older men. Changes in erythropoietin or sTfR levels were not significantly correlated with changes in total or free testosterone levels.

CONCLUSIONS: Testosterone has a dose-dependent stimulatory effect on hematopoiesis in men that is more pronounced in older men. Testosterone-induced rise in hemoglobin and hematocrit and age-related differences in response to testosterone therapy may be mediated by factors other than erythropoietin and sTfR.
Key words: Testosterone • polycythemia • soluble transferrin receptor • erythropoietin






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