Testosterone and the aging male: to treat or not to treat?

[Larrybird]

Found an interesting study with great information I'd like to share with those that are debating TRT.

It is well-established that total testosterone (TT) in men decreases with age and that bioavailable testosterone (bio-T) falls to an even greater extent. The clinical relevance of declining androgens in the aging male and use of testosterone replacement therapy (TRT) in this situation is controversial. Most studies have been short term and there are no large randomized placebo-controlled trials. Testosterone has many physiological actions in: muscles, bones, hematopoietic system, brain, reproductive and sexual organs, adipose tissue. Within these areas it [Testosterone] stimulates: muscle growth and maintenance, bone development while inhibiting bone resorption, the production of red blood cells to increase hemoglobin, libido, enhanced mood and cognition, erectile function and lipolysis. Anabolic deficits in aging men can induce: frailty, sarcopenia, poor muscle quality, muscle weakness, hypertrophy of adipose tissue and impaired neurotransmission. The aging male with reduced testosterone availability may present with a wide variety of symptoms which in addition to frailty and weakness include: fatigue, decreased energy, decreased motivation, cognitive impairment, decreased self-confidence, depression, irritability, osteoporotic pain and the lethargy of anemia. In addition, testosterone deficiency is also associated with type-2 diabetes, the metabolic syndrome, coronary artery disease, stroke and transient ischemic attacks, and cardiovascular disease in general. Furthermore, there are early studies to suggest that testosterone replacement therapy (TRT) in men with low testosterone levels may improve metabolic status by: lowering blood sugar and HbA1C in men with type-2 diabetes, reducing abdominal girth, ameliorating features of the metabolic syndrome, all of which may be protective of the cardiovascular system . The major safety issue is prostate cancer but there is no evidence that supports the idea that testosterone causes the development of a de novo cancer. So on balance in a man with symptoms of hygonadism and low or lowish levels of testosterone with no evidence of prostate cancer such as a normal PSA a therapeutic (4-6 months) trial of testosterone replacement therapy (TRT) is justified. Treatment and monitoring of this duration will determine whether the patient is responsive.

Source:

Bain, J. (2010). Testosterone and the aging male: to treat or not to treat?. Maturitas, 66(1), Retrieved from Testosterone and the aging male: to treat or not t... [Maturitas. 2010] - PubMed result

 

[Bullseye Forever]

good read man,thanks for posting

 

[1134bigo]

very good post bro....

 

[Mr. Humdiddly]

It is well-established that total testosterone (TT) in men decreases with age and that bioavailable testosterone (bio-T) falls to an even greater extent. The clinical relevance of declining androgens in the aging male and use of testosterone replacement therapy (TRT) in this situation is controversial. Most studies have been short term and there are no large randomized placebo-controlled trials.

I agree with the majority of the study however, I disagree on the bolded text. Which leads me to believe the publisher may not have done adequate research. Also the author lacks sources.

Not saying he is wrong just prefer more competent sources.

 

[Irentat]

He uses the word "controversial" but does not go on to explain what makes it so. Maybe in the full report he does.

Does anyone know of older men, say over 80, that have taken up testosterone replacement therapy (TRT)? It seems to be an obvious route based on my knowledge. It would be interesting to hear about some of these older folks taking levels beyond common prescriptions of 100mg/EW.

Even the isitlowt.com commercial focuses on middle age people.

 

[cjw2021]

Like anything, there is a proper way to do it. If done improperly, it may yield a high estrogen conversion. But come on what old man don't you see that doesn't have a spare tire nowadays from the synthetic estrogen in our non organic meat? Estrogen stress is EVERYWHERE.

 

[Larrybird]

He uses the word "controversial" but does not go on to explain what makes it so. Maybe in the full report he does.

Does anyone know of older men, say over 80, that have taken up testosterone replacement therapy (TRT)? It seems to be an obvious route based on my knowledge. It would be interesting to hear about some of these older folks taking levels beyond common prescriptions of 100mg/EW.

Even the isitlowt.com commercial focuses on middle age people.

I found a study that described testosterone replacement therapy (TRT) in men over 60, but not over 80:

Testosterone supplementation therapy for older men... [J Am Geriatr Soc. 2003] - PubMed result

 

[Irentat]

Larry,
Thanks for this.

I read that abstract. Here is the only negative they state:

...but hematocrit and prostate specific antigen levels often increased. Based on these results, testosterone supplementation cannot be recommended at this time for older men with normal or low-normal testosterone levels and no clinical manifestations of hypogonadism.

Hematocrit is a non-issue, just give blood regularly and for prostate, that can be alleviated with diet and OTC supplementation, if not extreme but we aren't talking BB levels of test here. So for the 10+ sentences of positives and potentially only 2 stated negatives, they don't reccomend test for those with "normal" levels. WTF is this?

Again, this is why I do my own research and go against the norm all the time.

 

[Larrybird]

Larry,
Thanks for this.

I read that abstract. Here is the only negative they state:

...but hematocrit and prostate specific antigen levels often increased. Based on these results, testosterone supplementation cannot be recommended at this time for older men with normal or low-normal testosterone levels and no clinical manifestations of hypogonadism.

Hematocrit is a non-issue, just give blood regularly and for prostate, that can be alleviated with diet and OTC supplementation, if not extreme but we aren't talking BB levels of test here. So for the 10+ sentences of positives and potentially only 2 stated negatives, they don't reccomend test for those with "normal" levels. WTF is this?

Again, this is why I do my own research and go against the norm all the time.

I think what they're saying here, though, is because of those two problems, it's not a 'perfect' drug. Doesn't mean the other benefits don't outweigh those risks.

Also, I read some where, in the research, that Supraphysiologic doses (250+) can actually do cardiac damage in the long term. I'm sure @ normal levels you'd be fine.

I hear ya though. Way to keep an eye out. Always read things with a grain of salt.