Association of Specific Symptoms and Metabolic Risks with Serum Testosterone in Older Men

Zitzmann, Michael; Faber, Stephanie; Nieschlag, Eberhard

doi:10.1210/jc.2006-0401

Cited by 505 publications

(340 citation statements)

References 24 publications

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“…Whether linear dose-response or threshold models apply to other androgen-sensitive tissues, such as bone and prostate, psychosexual and cardiovascular effects remains to be determined. So, from recent studies of elderly men it has become apparent that spectrum of complaints of testosterone deficiency cannot be related to a specific threshold of testosterone concentrations, but that thresholds vary with the various symptoms of testosterone deficiency [22]. In a cohort of men androgen-related loss of libido or vigor became more prevalent when testosterone concentrations fell below [15] nmol per liter, while depression and diabetes mellitus type 2 (also in nonobese men) were significantly more present in men with testosterone concentrations below 10 nmol L -1 .…”

Section: Thresholds and Dose-response Relationships Of Androgen Effectsmentioning

confidence: 99%

“…Patients suffering from one of these three groups exhibit distinct features in terms of androgen levels, age, and body mass index. So, complaints are not only linked to androgen levels but age and body mass index carried weight as well in the manifestation of signs and symptoms of androgen deficiency [22]. To further complicate the matter of the relationship between testosterone levels on the one hand and symptoms of testosterone deficiency on the other, the authors have drawn attention to the multifactorial impact on certain androgen-related functions [22].…”

Section: Thresholds and Dose-response Relationships Of Androgen Effectsmentioning

confidence: 99%

“…So, complaints are not only linked to androgen levels but age and body mass index carried weight as well in the manifestation of signs and symptoms of androgen deficiency [22]. To further complicate the matter of the relationship between testosterone levels on the one hand and symptoms of testosterone deficiency on the other, the authors have drawn attention to the multifactorial impact on certain androgen-related functions [22]. ED may serve as an example of a composite dysfunctionality in which, apart from testosterone concentrations, arterial endothelial function, neuronal integrity and psychological factors play pivotal roles [23,24], almost precluding the establishment of a straightforward relationship between testosterone levels and erectile dysfunction.…”

Section: Thresholds and Dose-response Relationships Of Androgen Effectsmentioning

confidence: 99%

“…ED may serve as an example of a composite dysfunctionality in which, apart from testosterone concentrations, arterial endothelial function, neuronal integrity and psychological factors play pivotal roles [23,24], almost precluding the establishment of a straightforward relationship between testosterone levels and erectile dysfunction. In the study of Zitzmann et al [22] ED was identified as a composite pathology of metabolic risk factors, smoking, and depression, and only testosterone concentrations below 8 nmol L -1 contributed to that symptom. So, the various symptoms of LOH might start at various circulating concentrations of androgens.…”

Section: Thresholds and Dose-response Relationships Of Androgen Effectsmentioning

confidence: 99%

“…There is curvilinear relationship in men (not receiving testosterone administration) between plasma testosterone levels and hemoglobin [22]. Testosterone exerts its effect on erythropoiesis through a number of mechanisms.…”

Section: Polycythemiamentioning

confidence: 99%

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Androgens and male aging: current evidence of safety and efficacy

Gooren¹

2010

Asian J Androl

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Many signs of aging, such as sexual dysfunction, visceral obesity, impaired bone and muscle strength, bear a close resemblance to features of hypogonadism in younger men. The statistical decline of serum testosterone in aging men is solidly documented. It has been presumed that the above features of aging are related to the concurrent decline of androgens, and that correction of the lower-than-normal circulating levels of testosterone will lead to improvement of symptoms of aging. But in essence, the pivotal question whether the age-related decline of testosterone must be viewed as hypogonadism, in the best case reversed by testosterone treatment, has not been definitively resolved. Studies in elderly men with lower-than-normal testosterone report improvement of features of the metabolic syndrome, bone mineral density, of mood and of sexual functioning. But as yet there is no definitive proof of the beneficial effects of restoring testosterone levels to normal in elderly men on clinical parameters. Few of these studies meet as yet rigorous standards of scientific enquiry: double-blind, placebo-controlled design of the study. The above applies also to the assessment of safety of testosterone administration to elderly men. There is so far no convincing evidence that testosterone is a main factor in the development of prostate cancer in elderly men and guidelines for monitoring the development of prostate disease have been developed. It is of note that there are presently no long-term safety data with regard to the prostate. Polycythemia is another potential complication of testosterone treatment. It is dose dependent and can be managed with dose adjustment.

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Section: Thresholds and Dose-response Relationships Of Androgen Effectsmentioning

confidence: 99%

Section: Thresholds and Dose-response Relationships Of Androgen Effectsmentioning

confidence: 99%

Section: Thresholds and Dose-response Relationships Of Androgen Effectsmentioning

confidence: 99%

Section: Thresholds and Dose-response Relationships Of Androgen Effectsmentioning

confidence: 99%

Section: Polycythemiamentioning

confidence: 99%

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Androgens and male aging: current evidence of safety and efficacy

Gooren¹

2010

Asian J Androl

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Clomiphene citrate: A potential alternative for testosterone therapy in hypogonadal males

Huijben

Lock

Kemp

et al. 2023

Endocrino Diabet & Metabol

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Background Hypogonadism is a worldwide problem among men causing sexual, physical and mental problems. Testosterone therapy is the first‐choice treatment for male hypogonadism, with several side effects, that is, subfertility. Clomiphene citrate (CC) is an alternative off‐label therapy for a certain group of hypogonadal males, especially for those with an active or future child wish. There is scarce literature in usage of CC for men with hypogonadism. The aim of this retrospective study was to evaluate the effectiveness and safety of CC for hypogonadal males. Methods In this single‐centre study, men treated with CC for hypogonadism were evaluated retrospectively. Primary outcome was hormonal evaluation including total testosterone (TT), free testosterone (FT), luteinizing hormone (LH) and follicle stimulating hormone (FSH). Secondary outcomes were hypogonadal symptoms, metabolic and lipid parameters, haemoglobin (Hb), haematocrit (Ht), prostate specific antigen (PSA), side effects, the effect of a trial without medication and potential predictors for biochemical and clinical response. Results In total, 153 hypogonadal men were treated with CC. Mean TT, FT, LH and FSH increased during treatment. TT increased from 9 to 16 nmol/L, with a biochemical increase in 89% of the patients. In patients who continued CC treatment, an increased level of TT persisted after 8 years of treatment. With CC treatment, 74% of the patients experienced hypogonadal symptom improvement. LH at the lower normal range before CC treatment was predictive for better TT response. During CC therapy, few side effects were reported and no clinical important changes in PSA, Hb and Ht were found. Conclusion Clomiphene citrate is an effective therapy on short and long term, improving both clinical symptoms and biochemical markers of male hypogonadism with few side effects and good safety aspects.

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The role of androgens in metabolism, obesity, and diabetes in males and females

Navarro

Allard

et al. 2015

Obesity

222

163

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Objectives In men, androgen deprivation contributes to the development of metabolic syndrome and type 2 diabetes (T2D). In women, androgen excess predisposes to insulin resistance and T2D. There is a bidirectional modulation of glucose homeostasis by androgen in males and females that we analyze in this review. Methods We review the literature in both rodents and humans on the role of androgens and the androgen receptor (AR) in the control of glucose and energy metabolism in health, obesity and T2D. Results Sex-specific activation of AR in the hypothalamus, skeletal muscle, liver, adipose tissue and pancreatic islet β cells accounts for maintenance or disruption in energy metabolism and glucose homeostasis. Conclusion We argue that AR is a target to prevent androgen-related metabolic disorders.

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Association of Specific Symptoms and Metabolic Risks with Serum Testosterone in Older Men

Abstract: There is no evidence that a uniform structure of testosterone concentrations and complaints exists within the cohort of elderly male patients. Rather, in aging male patients, psychosomatic complaints and metabolic risk relate to testosterone in a symptom-specific manner.

Cited by 505 publications

References 24 publications

Androgens and male aging: current evidence of safety and efficacy

Androgens and male aging: current evidence of safety and efficacy

Clomiphene citrate: A potential alternative for testosterone therapy in hypogonadal males

The role of androgens in metabolism, obesity, and diabetes in males and females

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