Testosterone in the Management of Cirrhosis of the Liver- A Controlled Study

Testosterone therapy increases muscle mass in men with cirrhosis and low testosterone: A randomised controlled trial

“…The inclusion of women and eugonadal men in previous studies likely underestimated the beneficial effects of testosterone (10,11). The single trial to assess the effects of testosterone on muscle strength in hypogonadal cirrhotic men demonstrated an increase in handgrip strength (12), but there was no control group for comparison.…”

“…Previous studies investigating the potential therapeutic effects of testosterone therapy in men with cirrhosis have been limited by such issues as inclusion of women and eugonadal men, variable follow-up durations, and inappropriate drug delivery such as oral administration, with inconclusive findings (10)(11)(12)(13). A Cochrane review of testosterone therapy in men with liver disease included a high proportion of non-cirrhotic subjects with alcoholic hepatitis who ceased alcohol ingestion during the study period, and thus the failure to identify benefit is uninterpretable (14).…”

Hypothalamic‐pituitary‐testicular function in end‐stage non‐alcoholic liver disease before and after liver transplantation

“…The physiological consequences of chronically lowered testosterone levels are unclear but suggest that the effects of androgen supplementation warrant a controlled clinical study either in men unsuitable for or awaiting liver transplantation or where liver transplantation does not normalize HPT function. Testosterone administration improves sense of well-being, increases serum proteins and reduces oedema without serious adverse effects (Gluud et al, 1981;Kley et al, 1979;Puliyel et al, 1977) but long-term benefits remain to be demonstrated.…”

Testosterone in men with advanced liver disease: Abnormalities and implications

“…Most trials were conducted many years ago, and despite promising early results the possible health benefits of T in men with cirrhosis have been little explored in recent years. While no trial revealed an increase in significant adverse events from T therapy in cirrhosis, even in those with advanced disease, larger trials are needed to conclusively demonstrate safety . Table provides a summary of existing trials of T therapy in cirrhosis.…”

“…A smaller study enrolled 21 patients with biopsy‐proven cirrhosis of any etiology, including one‐third female participants . Twelve patients received intramuscular T and nine controls received standard of care.…”