Androgen-induced erythrocytosis: Is it erythropoietin?

Dickerman, Rob D.; Pertusi, Raymond M.; Miller, Jay James R.; Zachariah, N. Y.

doi:10.1002/(sici)1096-8652(199906)61:2<154::aid-ajh17>3.0.co;2-s

Cited by 30 publications

(9 citation statements)

References 8 publications

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“…It is generally known that AAS abuse leads to elevated levels of hematocrit and Hb as has been demonstrated in bodybuilders [20,21,29]. Here we show for the first time that cessation of AAS abuse results in a decrease in Hb, EVF, and erythrocytes count.…”

Section: Discussionsupporting

confidence: 72%

Perturbation of the Hematopoietic Profile by Anabolic Androgenic Steroids

Mullen

Gårevik

Schulze

et al. 2014

Journal of Hormones

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Objective.The aim of this study was to investigate the hematopoietic profile in AAS abusers, during or short after their last abuse and approximately six months later. Moreover, we studied if supraphysiological doses of testosterone influence the concentration of hemoglobin and erythropoietin in healthy volunteers.Design and Methods. Subjects (N=31) were recruited through an antidoping hotline. The hematological profile was measured when the subjects entered the study and approximately 6 months later. Testosterone enanthate (500 mg) was administered to healthy volunteers (N=24). Gene expression was studied in human hek293 cells exposed to 1 μM testosterone.Results.Decreased levels of hemoglobin, erythrocyte volume fraction, and erythrocyte counts were observed after 6 months without the use of AAS. Results in volunteers show that hemoglobin increased 3% four and 15 days after testosterone administration, whereas EPO was significantly increased by 38% four days after dose. Agreeingly,in vitrostudy shows that testosterone induces the mRNA level of EPO with 65% after 24-hour exposure.Conclusion. These results indicate that supraphysiological doses of testosterone may cause a perturbation in the hematopoietic profile. This is of interest in relation to the adverse cardiovascular effects observed in AAS abusers.

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Section: Discussionsupporting

confidence: 72%

Perturbation of the Hematopoietic Profile by Anabolic Androgenic Steroids

Mullen

Gårevik

Schulze

et al. 2014

Journal of Hormones

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“…The erythrocytosis observed in response to TRT seems predominantly due to a direct inhibitory action of T (independent of DHT) on hepcidin transcription/expression and to increased iron incorporation in red blood cells (133, 135). However, it also has been shown that androgens may directly affect erythropoietin concentrations via stimulation of bone marrow hematopoietic stem cells (138, 139), a pathway that involves AR-mediated induction of IGF-1 (140). A direct role of DHT in this pathway has not been investigated.…”

Section: Effects Of Dht On Various Other Biological Processes and Tismentioning

confidence: 99%

Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels

Swerdloff¹,

et al. 2017

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Benefits associated with lowered serum DHT levels after 5α-reductase inhibitor (5AR-I) therapy in men have contributed to a misconception that circulating DHT levels are an important stimulus for androgenic action in target tissues (e.g., prostate). Yet evidence from clinical studies indicates that intracellular concentrations of androgens (particularly in androgen-sensitive tissues) are essentially independent of circulating levels. To assess the clinical significance of modest elevations in serum DHT and the DHT/testosterone (T) ratio observed in response to common T replacement therapy, a comprehensive review of the published literature was performed to identify relevant data. Although the primary focus of this review is about DHT in men, we also provide a brief overview of DHT in women. The available published data are limited by the lack of large, well-controlled studies of long duration that are sufficiently powered to expose subtle safety signals. Nonetheless, the preponderance of available clinical data indicates that modest elevations in circulating levels of DHT in response to androgen therapy should not be of concern in clinical practice. Elevated DHT has not been associated with increased risk of prostate disease (e.g., cancer or benign hyperplasia) nor does it appear to have any systemic effects on cardiovascular disease safety parameters (including increased risk of polycythemia) beyond those commonly observed with available T preparations. Well-controlled, long-term studies of transdermal DHT preparations have failed to identify safety signals unique to markedly elevated circulating DHT concentrations or signals materially different from T.

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“…Various strategies are available to detect this practice (Robinson et al, 2006) although it can be challenging. Erythrocytosis has also been associated with androgen administration (Dickerman et al, 1999).…”

Section: Exogenous Epo Administrationmentioning

confidence: 99%

“…, 2006) although it can be challenging. Erythrocytosis has also been associated with androgen administration (Dickerman et al. , 1999).…”

Section: Acquired Erythrocytosismentioning

confidence: 99%

The classification and diagnosis of erythrocytosis

McMullin

2008

Int J Lab Hematology

102

133

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Summary An absolute erythrocytosis is present when the red cell mass is raised and the haematocrit is elevated above prescribed limits. Causes of an absolute erythrocytosis can be primary where there is an intrinsic problem in the bone marrow and secondary where there an event outside the bone marrow driving erythropoiesis. This can further be divided into congenital and acquired causes. There remain an unexplained group idiopathic erythrocytosis. Investigation commencing with thorough history taking and examination and then investigation depending on initial features is required. Clear simple criteria for polycythaemia vera are now defined. Those who do not fulfil these criteria require further investigation depending on the clinical scenario and initial results. The erythropoietin level provides some guidance as to the direction in which to proceed and the order and extent of investigation necessary in an individual patient. It should thus be possible to make an accurate diagnosis in the majority of patients.

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Androgen-induced erythrocytosis: Is it erythropoietin?

Cited by 30 publications

References 8 publications

Perturbation of the Hematopoietic Profile by Anabolic Androgenic Steroids

Perturbation of the Hematopoietic Profile by Anabolic Androgenic Steroids

Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels

The classification and diagnosis of erythrocytosis

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