Health knowledge made personal
Join this community!
› Share page:
Go
Search posts:

Testosterone Supplements in Frail Elderly Men

Posted Feb 22 2010 6:24pm
 

 

Weekly Health Update:

 

Testosterone Supplements in Frail Elderly Men

 



"A critical weekly review of important new research findings for health-conscious readers..."

 

By, Robert A. Wascher, MD, FACS



Photo of Dr. Wascher


Updated:  02/21/2010

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


Welcome to Weekly Health Update


“A critical weekly review of important new research findings for health-conscious readers”

TESTOSTERONE SUPPLEMENTS IN FRAIL ELDERLY MEN

As we age, we tend to lose both muscle mass and bone density. These adverse effects of aging often lead to an increased risk of generalized weakness, early fatigue, imbalance and falls, bone fractures, long-term disability, and hospitalization or other forms of chronic institutionalization. In turn, these complications of frailty in the elderly are significantly associated with an increased risk of death.

While an elixir of eternal youth has not yet been discovered (despite many claims to the contrary over the centuries), some of the causes of aging-related frailty can be treated. Sex hormone replacement therapy in the elderly has been a major focus of clinical intervention, in both men and women, in an effort to reverse many of the debilitating effects of aging, including declines in muscle mass, bone density, and sexual function. However, the true risks and benefits of sex hormone replacement therapy have not always been well understood. Indeed, within the past decade, old assumptions about the safety of hormone replacement therapy have been called into question by high-level prospective, randomized, placebo-controlled, blinded clinical research trials, including the recent and disturbing (but not altogether surprising) findings that long-term combination hormone replacement therapy in postmenopausal women is associated with a significant increase in the risk of both breast cancer and cardiovascular disease.

Although aging men do not experience an abrupt and total loss of testicular function, unlike the complete loss of ovarian function that occurs in women following menopause, testicular function does dramatically and progressively decline with advancing age. Significant decreases in the levels of testosterone (and other “androgens”) in the blood often leads to decreased muscle mass and bone density which, in turn, can result in reduced strength and balance, and an increased risk of falls and serious injuries. 

Testosterone replacement therapy has been shown to be effective in improving muscle mass and bone density (and sexual function) in older men with very low testosterone levels (hypogonadism). However, the role of testosterone replacement therapy in men with borderline-low circulating levels of androgen hormones has been much less clear.   As with sex hormone replacement therapy in postmenopausal women, there are known side effects associated with male sex hormone replacement therapy. These include enlargement of the prostate gland (benign prostatic hypertrophy, or BPH), liver disease (especially with oral testosterone supplements), fluid retention, decreased fertility, breast enlargement and pain (gynecomastia), and a potential increase in the risk of prostate cancer, among others.

A newly published research study, in the Journal of Clinical Endocrinology & Metabolism, evaluated 274 men who were 65 years of age or older, and who were determined, by validated clinical criteria, to be either “intermediate-frail” or “frail.” All of these men were also confirmed to have “borderline-low” levels of testosterone in their blood. 

In this randomized, prospective, placebo-controlled, double-blind study (which is the “gold standard” method of performing clinical research), these older men were randomly assigned to receive either transdermal testosterone therapy (50 mg per day) or a placebo gel that appeared identical to the testosterone gel. These treatments were continued for 6 months. The researchers then assessed both groups of men in terms of their muscle strength, muscle mass, body fat, overall level of physical function, and self-reported quality-of-life.

At the end of 6 months, the men who had been secretly randomized to the testosterone gel group were found to have experienced significant improvements in both muscle mass and muscle strength, as well as a decrease in total body fat. Overall physical function in the “intermediate-frail” and “frail” older men also significantly improved. Finally, and not surprisingly, self-reported physical health and sexual health satisfaction scores were substantially improved among the men who, unknown to them at the time, had received the testosterone gel.

Thus, the findings of this prospective, randomized, controlled clinical research trial certainly suggest a potential role for transdermal testosterone supplementation in frail older men with borderline-low testosterone levels. At the same time, continued follow-up of the men in this study who elected to continue receiving testosterone supplementation is indicated, as the rather short duration of this study (6 months) is not long enough to identify the long-term benefits and risks of androgen replacement therapy.

If you are an older man who is experiencing significant frailty and disability due to progressive muscle mass and bone density loss, and you have borderline-low or low testosterone levels, then you might wish to discuss the potential benefits of a monitored testosterone supplementation regimen with your physician, or with an Endocrinologist who specialize in male endocrinology (Andrology).

On a related topic, please also see my recent column on the use of Vitamin D to decrease the risk of falls and fractures in the elderly:

http://doctorwascher.com/Archives/10-11-09.htm


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg


 

(Anticipated Publication Date:  March 2010)

Link to TV36 Interview with Dr. Wascher

(Click above image for TV36 interview of Dr. Wascher)


Bookmark and Share
 



Send your feedback to Dr. Wascher at:
 

rwascher@doctorwascher.net


Dr. Wascher's Biography


Links to Other Health & Wellness Sites


http://doctorwascher.com


Copyright 2007 - 2010

Robert A. Wascher, MD, FACS

All rights reserved


Dr. Wascher's Archives:

1-31-2010:  Concord Grape Juice Improves Memory

1-24-2010:   Mozart, Music, Babies & Health

1-17-2010:  Breast Cancer, Physical Therapy & Lymphedema

1-10-2010:  Prevention of Surgical Site Infections (SSIs) after Surgery

1-3-2010:    Ginkgo Biloba, Memory & Cognitive Health

12-20-2009: CT Scans & Cancer Risk

12-13-2009: Soy Isoflavones Decrease Breast Cancer Recurrence Risk

12-6-2009:  Salt (Sodium) Intake, Stroke & Cardiovascular Disease

11-29-2009: Exercise & Prostate Cancer Risk

11-22-2009: Genistein (Soy Isoflavone) & Prostate Cancer

11-15-2009: Breast Cancer Treatment & Chronic Pain

1-8-2009:     Vitamin D & Breast Cancer Risk

11-1-2009:  Exercise & Prostate Cancer Risk

10-25-2009: HPV Virus & Risk of Breast Cancer

10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009:Vitamin D & Falls in the Elderly

10-4-2009:   Surgery, NSQIP, Complications & Death

9-27-2009    Stress, Heart Disease, Exercise & Death

9-20-2009:   Vitamin D & Colorectal Cancer Survival

9-13-2009:   H1N1 Swine Flu Update

9-7-2009:     Green Tea, Aging & Lifespan

8-30-2009:   Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009:  Update on Prostate Cancer and Cryotherapy

8-16-2009:   Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009:   Breast Cancer Recurrence, Death & Vitamin D

8-2-2009:   Honesty, Dishonesty & Brain Function

7-26-2009:   Coronary Artery CT Scans & Cancer Risk

7-19-2009:   Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009:   Breast Cancer & Metformin (Glucophage)

7-5-2009:     Prostate Cancer & Green Tea

6-28-2009:    Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009:    Red Yeast Rice, Statins & Cholesterol

6-14-2009:    Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009:    Diet, Soy & Breast Cancer Risk

5-31-2009:   Diet and Prostate Cancer Risk

5-24-2009:   Diabetes, Glucose Control & Death

5-17-2009:   Drug Company Marketing & Physician Prescribing Bias

5-10-2009:   Hemorrhoids & Surgery

5-3-2009:     Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009:    Are We Really Losing the War on Cancer?

4-19-2009:    Exercise in Middle Age & Risk of Death

4-12-2009:   Can Chronic Stress Harm Your Heart?

4-5-2009:     Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009:   CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009:   Depression, Stress, Anger & Heart Disease

3-8-2009:    Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009:    Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009:   Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009:  Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009:   Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008:   Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008:    Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008:    Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008:   Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008:   Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008:   Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:    Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:    Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:  Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


Post a comment
Write a comment:

Related Searches