Androgen Replacement

[BBC3]

Fair and forward thinking. I like this one as unbiased. I still fear the end result of my TRT with a history of PC in family.

WHAT THEY MAY HAVE LEFT OUT. Is that local "saturation" occurring as due to sufficiently supported testosterone levels MAY in fact protect prostate receptors by keeping plenty of testosterone on hand for action, rather than casual excess E2, or even derivative BASTARD E3 - which might have otherwise involved its self inadvertently by premise of incidental excess availability....

(I'm stockin up on that one)

Polackwich AS, Ostrowski KA, Hedges JC. Testosterone replacement therapy and prostate health. Curr Urol Rep 2013;13(6):441-6. Testosterone Replacement Therapy and Prostate Health - Springer

There is an emerging evolution in the understanding of the relationship between the prostate and testosterone. It has long been generally believed that with testosterone replacement therapy (TRT), increasing serum testosterone levels led to prostatic growth and worsening of voiding dysfunction and associated complications. A new theory, the Saturation Model of Testosterone and its effect on the Prostate has gained attention. This theory suggests that the prostate's response to increasing levels of serum testosterone reaches a limit beyond which there is minimal effect. This model predicts that testosterone replacement therapy occurs above this saturation point, and replacing testosterone to eugonadal levels should not worsen prostate related benign disease. We evaluated the recent published data, with an emphasis on clinical studies done within the last 3 years, for the effects of testosterone supplementation on benign prostatic disease.

 

[Michael Scally MD]

Liao CH, Wu YN, Lin FY, Tsai WK, Liu SP, Chiang HS. Testosterone replacement therapy can increase circulating endothelial progenitor cell number in men with late onset hypogonadism. Andrology. Testosterone replacement therapy can increase circulating endothelial progenitor cell number in men with late onset hypogonadism - Liao - 2013 - Andrology - Wiley Online Library

Circulating endothelial progenitor cells (EPCs) are bone marrow-derived cells required for endothelial repair. A low EPC number can be considered as an independent predictor of endothelial dysfunction and future cardiovascular events. Recent evidence shows that patients with hypogonadal symptoms without other confounding risk factors have a low number of circulating progenitor cells (PCs) and EPCs, thus highlighting the role of testosterone in the proliferation and differentiation of EPCs. Here, we investigate if testosterone replacement therapy (TRT) can increase circulating EPC number in men with late onset hypogonadism. Forty-six men (age range, 40-73 years; mean age, 58.3 years) with hypogonadal symptoms were recruited, and 29 men with serum total testosterone (TT) levels less than 350 ng/dL received TRT using transdermal testosterone gel (Androgel; 1% testosterone at 5 g/day) for 12 months. Circulating EPC numbers (per 100 000 monocytes) were calculated using flow cytometry. There was no significant association between serum TT levels and the number of circulating EPCs before TRT. Compared with the number of mean circulating EPCs at baseline (9.5 +/- 6.2), the number was significantly higher after 3 months (16.6 +/- 11.1, p = 0.027), 6 months (20.3 +/- 15.3, p = 0.006) and 12 months (27.2 +/- 15.5, p = 0.017) of TRT. Thus, we conclude that serum TT levels before TRT are not significantly associated with the number of circulating EPCs in men with late onset hypogonadism. However, TRT can increase the number of circulating EPCs, which implies the benefit of TRT on endothelial function in hypogonadal men.

 

[idmd]

Today show just ran a piece on TRT and of course it was less than balanced. It presented testosterone like it was evil with tons of sides and the only "benefits" were for men who just want to escape natural old age - in other words it's optional and probably unnecessary.

I think there is a real war on masculinity right now. The metrosexual man is now cool - he is by definition a feminized version of a manly man. The media and general public finds it easy to dismiss low T and SD as unimportant and essentially optional. Men who want to feel good and use these therapies are just a bunch of roid-heads who want to escape aging and have unnaturally hard peckers to boof their mistresses.

I think this is due to a combination of how demonized steroids have been in athletics + the rise of the feminist movement which at one point demonized men for simply being different than women. The net result is men who are more like women (metrosexual) and women who are more like men (cigar smoking 7 figure CEOs with a cock bigger than mine).

In the end I think the 1950's difference between men and women, while not entirely equitable, was based on a division of labor set in motion long ago. This division of labor wasn't based on dominance but limited resources - someone had to hunt and someone had to stay with the children.

In modern culture all these lines are blurred....

 

[Michael Scally MD]

Promoting “Low T”: A Medical Writer's Perspective

“Low T” (low testosterone level, aka hypogonadism) is high profile these days. Sales of testosterone replacement therapies (TRTs) for Low T have more than doubled since 2006 and are expected to triple to $5 billion by 2017, according to forecasts by Global Industry Analysts. Driving these sales is a sophisticated marketing effort to define low testosterone level as a disease for which the treatment is TRT. I know this because, as a professional medical writer, I have helped craft that message for transmission in a range of media to both physicians and consumers.

This is hardly the first time that an age-related condition has been spun into a disease state when a new product has been developed that is believed to alleviate or attenuate the condition. In fact, the current situation with TRT eerily echoes the way that hormone therapy was, for years, touted as a safe treatment for menopause-related symptoms and the prevention of cardiovascular disease in women. Only after the Women's Health Initiative study found that older women using hormone therapy had small excesses in the incidence of breast cancer, myocardial infarction, cerebrovascular accident, and venous thrombosis did physicians become more cautious about prescribing it and limit its use to appropriate female patients.

An examination of the current ways that industry is reshaping the paradigm of Low T is warranted now not simply because of the potential public health risks associated with widespread use of TRT in the absence of a Women's Health Initiative–scale study. Efforts have been made in recent years to curtail the abuses of pharmaceutical influence and encourage greater transparency in medical communications. As this article demonstrates, these efforts, although salutary, do not fundamentally alter the influences of drug company funding on the content and tone of messages directed at physicians and consumers.

Braun SR. Promoting “Low T”: A Medical Writer's Perspective. JAMA Intern Med.2013:1-4. JAMA Network | JAMA Internal Medicine | Promoting “Low T”A Medical Writer's PerspectivePromoting “Low T”

 

[Michael Scally MD]

Low “T” as in “Template”: How to Sell Disease: Comment on “Promoting ‘Low T’”

A man on TV is selling me a miracle cure that will keep me young forever. It's called Androgel . . . for treating something called Low T, a pharmaceutical company–recognized condition affecting millions of men with low testosterone, previously known as getting older.
— The Colbert Report, December 2012

The Low T website is part of a broader disease awareness campaign run by Abbott Laboratories, maker of Androgel, the leading testosterone replacement product (>3 million prescriptions and >$1 billion in sales in the United States in 2012).

Whereas traditional drug promotion such as direct-to-consumer ads, physician samples, gifts, and detailing has received much attention, far less is known about disease awareness campaigns—much broader efforts to influence how physicians and the public think about what constitutes disease and when drugs are needed. These well-coordinated campaigns are more subtle than drug-specific campaigns, and they blur the line between public health or professional education and marketing.

The article on the promotion of Low T is a fascinating and troubling first-hand look inside the kitchen of industry disease awareness campaigns. Braun exposes how industry used ghostwritten magazine articles under a celebrity physician's byline. This is on top of educational campaigns, television and magazine ads, and mobilizing industry-funded advocacy groups. The campaigns also target physicians through special journal supplements, consensus statements, and continuing medical education, as Braun also highlights.

The Low T campaign provides a template for understanding how disease awareness campaigns work. Like other campaigns (eg, Bipolar Disorder and Restless Legs Syndrome), the Low T campaign uses 3 basic strategies:
• lower the bar for diagnosis (turning ordinary life experiences into conditions that require medical diagnoses),
• raise the stakes so that people want to get tested, and
• spin the evidence about drug benefits and harms.

We agree with Braun that there is a strong analogy between the marketing of testosterone therapy for men and estrogen therapy for menopausal women. Ignoring the lessons of estrogen therapy is scandalous. Before anyone makes millions of men aware of Low T, they should be required to do a large-scale randomized trial to demonstrate that testosterone therapy for healthy aging men does more good than harm.

Schwartz LM, Woloshin S. Low “T” as in “Template”: How to Sell Disease: Comment on “Promoting ‘Low T’”. JAMA Intern Med.2013:1-3. JAMA Network | JAMA Internal Medicine | Low “T” as in “Template”: How to Sell DiseaseComment on “Promoting ‘Low T’”Low “T” as in “Template”

 

[Michael Scally MD]

There is little evidence to recommend DHEA, pregnenolone, growth hormone, ghrelin, or melatonin to older persons.

Morley JE. Scientific overview of hormone treatment used for rejuvenation. Fertil Steril 2013;99(7):1807-13. ScienceDirect.com - Fertility and Sterility - Scientific overview of hormone treatment used for rejuvenation

A search for a hormonal fountain of youth has been hotly pursued over the last century, predominately by those who wish to market hormones to a gullible public. There is little or no benefit of hormone replacement in persons who do not have a hormone deficiency. Overall, the present state of the art suggests that the findings have been disappointing. In persons who fail to get adequate sunlight, and therefore have low vitamin D levels, vitamin D replacement appears to have positive effects, including decreasing mortality. Testosterone in hypogonadal males has a number of positive effects such as improving libido and erectile capacity, increasing strength and bone mineral density, and perhaps having a small effect on cognition. These effects need to be balanced against long-term side effects, the evidence for which studies are lacking. There is little evidence to recommend DHEA, pregnenolone, growth hormone, ghrelin, or melatonin to older persons. Overall, exercise, adequate exposure to sunlight, and adequate dietary protein appear to have at least as positive an effect as any of the hormones being used to rejuvenate older persons.

 

[cvictorg]

Men's Use of Testosterone on the Rise - NYTimes.com

The number of middle-aged men with prescriptions for testosterone is climbing rapidly, raising concerns that increasing numbers of men are abusing the powerful hormone to boost their libidos and feel younger, researchers reported on Monday.

Testosterone replacement therapy is approved specifically for the treatment of abnormally low testosterone levels, a condition called hypogonadism. The hormone helps build muscle, reduce body fat and improve sex drive. But a study published in the journal JAMA Internal Medicine found that many men who get prescriptions for the hormone have no evidence of a deficiency at all.

The new study is the largest of testosterone prescribing patterns to date, involving nearly 11 million men who were tracked through a large health insurer. The report showed that the number of older and middle-aged men prescribed the hormone has tripled since 2001.

Men in their 40s represent the fastest-growing group of users. About half of men prescribed testosterone had a diagnosis of hypogonadism, and roughly 40 percent had erectile or sexual dysfunction. One third had a diagnosis of fatigue.

The medical group that sets clinical guidelines for testosterone replacement therapy, the Endocrine Society, recommends treatment only in men who have unequivocally low testosterone levels. That finding requires a blood test. But the new report found that a quarter of men did not have their levels tested before they received the hormone. It was also unclear what proportion of men who did undergo testing actually had results showing a deficiency.

Testosterone therapy can cause thickening of the blood, acne and reduced sperm counts. Many doctors worry that it also raises the risk of heart disease and prostate cancer, though some experts say that those concerns are unproved. Jacques Baillargeon, the lead author of the new research, said that the safety of long-term testosterone use had yet to be established in good studies.

“I think these relatively healthy men who are starting testosterone at age 40 are potentially going to be exposed for a very long time, and we don’t know what the risks are,” said Dr. Baillargeon, an associate professor of epidemiology at the University of Texas Medical Branch at Galveston.

In men, testosterone levels normally begin a gradual decline after the age of 30. The average levels for most men range from 300 to 1,000 nanograms per deciliter of blood. But testosterone levels can fluctuate so greatly depending on so many factors — sleep, the time of day, medication — that many men who fall into the hypogonadal range one day will have normal levels the next.

Some studies estimate that up to 30 percent of men ages 40 to 79 have a true deficiency, though only a small percentage actually develop clinical symptoms like depression, hot flashes and erectile dysfunction.

Dr. Ronald S. Swerdloff, an endocrinologist at the University of California, Los Angeles, and an author of the Endocrine Society’s treatment guidelines, said the recommendations were “quite clear” that treatment is for men who have had blood tests showing a testosterone deficiency, as well as symptoms consistent with the disorder. “I don’t think it’s appropriate for patients to be treated for hypogonadism without chemical evidence to support it,” he said.

Dr. Abraham Morgentaler, a professor of urology at Harvard Medical School and the author of “Testosterone for Life,” said the findings were a good sign that more testosterone deficiencies were being diagnosed and treated. While many doctors worry about the side effects of testosterone abuse, he said, there are also studies showing that men with low testosterone levels have shorter life spans and an increased risk of diabetes, heart disease and osteoporosis.

“Aging is associated with bad vision, bad hearing, bad teeth, bad arteries, bad joints and cancer, and we treat all of these things,” Dr. Morgentaler said. “I think it’s an unfair stretch to say that because something is common or natural that we shouldn’t treat it.”

 

[Michael Scally MD]

Virilization In Two Pre-Pubertal Children Exposed To Topical Androgen

With topical formulations, there is a risk of person-to-person transmission if appropriate precautions are not taken. We describe two cases of virilization in pre-pubertal children following passive transfer of paternal topical testosterone.

A 21 month old male was referred with a 6 week history of pubic hair, phallic growth, and linear growth spurt. Genital examination revealed Tanner stage 2 pubic hair and Tanner stage 3 phallic development, which was discordant with the pre-pubertal testicular size (2 mL bilaterally).

A 3 year 8 month old girl was referred for a 2 month history of increasing pubic hair development. Examination revealed Tanner stage 2 pubic hair and Tanner stage 1 breast development.

Both of these patients had fathers who had been diagnosed with hypogonadism and were being treated with topical androgen gel therapy, which they applied to their arms and chest before bed. In addition, both patients often slept with their parents resulting in skin-to-skin contact.

Investigations were consistent with gonadotropin independent virilization with both patients demonstrating elevated testosterone levels. Testosterone levels returned to normal pre-pubertal levels with no further development of secondary sexual characteristics following discontinuation of exposure to topical testosterone.

Precautions must be taken to prevent person-to-person transfer of topical steroids. With the increasing popularity of topical steroids for the treatment of low testosterone, it is imperative that these therapies be prescribed and utilized judiciously to prevent harm, specifically gonadotropin-independent virilization.

Nelson D, Ho J, Pacaud D, Stephure D. Virilization in two pre-pubertal children exposed to topical androgen. J Pediatr Endocrinol Metab 2013:1-5. Virilization in two pre-pubertal children exposed to topical androgen : Journal of Pediatric Endocrinology and Metabolism

 

[Michael Scally MD]

Owen LJ, Macdonald PR, Keevil BG. Is calibration the cause of variation in liquid chromatography tandem mass spectrometry testosterone measurement? Ann Clin Biochem. Is calibration the cause of variation in liquid chromatography tandem mass spectrometry testosterone measurement?

BACKGROUND: Testosterone measurement by liquid chromatography tandem mass spectrometry (LC-MS/MS) is well accepted as the preferred technique for the analysis of testosterone. Variation is seen between assays and this may be due to differences in calibration as commercial calibrators for this assay are not readily available. We investigated the effects calibration in routine clinical LC-MS/MS assays.

METHODS: All LC-MS/MS users that were registered with the UKNEQAS external quality assurance scheme for testosterone were invited to take part in the study. A set of seven serum samples and serum-based calibrators were sent to all laboratories that expressed an interest. The laboratories were instructed to analyse all samples using there own calibrators and return the results and a method questionnaire for analysis.

RESULTS: Fifteen laboratories took part in the study. There was no consensus on supplier of testosterone or matrix for the preparation of calibrators and all were prepared in-house. Also, a wide variety of mass spectrometers, internal standards, chromatography conditions and sample extractions were used. The variation in results did not improve when the results were corrected with a common calibrator.

CONCLUSIONS: The variation in results obtained could not be attributed to variations in calibrators. The differences in methodologies between laboratories must be the reason for this variation.

 

[Michael Scally MD]

Handelsman DJ. Mendelian randomization: loosening the Gordian knot of testosterone and male ageing. Asian J Androl. http://www.nature.com/aja/journal/vaop/ncurrent/full/aja201371a.html

It is unknown whether the reduced blood testosterone among unselected older men (“andropause”) compared to healthy younger men is due to ageing per se or as a non-specific adaptive reaction to chronic diseases accumulating during ageing. A new data analytical technique, Mendelian Randomisation, sheds light on this issue by suggesting that male ageing does not significantly cause lowering of blood testosterone. This shifts the focus from whether treatment of andropause is justified to whether testosterone is safe and effective treatment for the major co-morbidities of ageing such as cardiovascular disease, obesity and chronic organ failure syndromes.

 

[Michael Scally MD]

Do you need to be treated for low testosterone?
Drugmakers spent more than $100 million advertising the drugs last year, but our experts aren't buying it
Low Testosterone | Low T | Risks, Causes, and Advice - Consumer Reports

But our medical experts aren’t sold. They say the benefits of testosterone are overblown and the risks underappreciated. Those risks include breast enlargement, reduced fertility, heart attacks, and possibly faster-growing prostate cancer. Women accidentally exposed to the hormone can develop male characteristics, and children can enter an early puberty. And the drugs can be expensive—up to $570 a month.

The American Urological Association is so concerned by the trend that it recently added testosterone therapy to a list of overused and potentially dangerous medical treatments, as part of campaign called Choosing Wisely.

 

[DTdr2]

From Private MD Labs
Lab tests suggest new benefits for testosterone Updated: 2013-07-30

A study recently published online in the European Journal of Endocrinology suggests a new way to prevent muscles from wasting away: Testosterone replacement therapy. The scientists said that by injecting a small amount of the hormone directly into the liver, they were able to stimulate protein synthesis, which could prevent muscle loss and even promote muscle growth.

Researchers from the Garvan Institute of Medical Research in Sydney found that in post-menopausal women who were free of health-related complications, a restrained dose of testosterone helped keep their protein from wasting. The subjects were given 40 milligrams of crystalline testosterone to take orally per day, which goes directly to the liver. The report noted that it was a small enough dose that the hormone did not spillover to other organs or into the bloodstream.

Because there is no spillover, this new method of preventing muscle loss and promoting growth is free of the usual side effects that testosterone has when given to women. The report listed some of those unwanted results as aggressive behavior and heightened sex drive. Women will also sometimes grow excess facial hair and notice a deepened voice.

"This is really hopeful, because if we can see the same effect on protein metabolism at this stage, we believe it will translate into the same increase in muscle mass that we see from testosterone delivered systemically, yet avoiding all the unpleasant side effects," said Ken Ho, lead author of the study.

The researchers noted that the next step will be to gather healthy male subjects who have below-average testosterone levels and frailer participants who may be experiencing kidney failure. Ho said that should they see similar results, this could be used as a treatment for elderly people to prevent falls and subsequent osteoporotic fractures.

Testosterone therapy and how it is used
The Mayo Clinic reported that testosterone, a hormone produce by men in the testicles, is sometimes used to increase male vitality. In other words, it incites better bone density, fat distribution, muscle mass and strength, more rapid red blood cell and sperm production and a higher sex drive.

Older men whose levels have dropped may experience physical and emotional changes. Men who feel as though their testosterone levels have declined with age can request a lab test to confirm or refute their suspicions before seeking hormone replacement therapy.

 

[Michael Scally MD]

Strategies To Promote Testosterone Deficiency Syndrome: A Paradigm Of Disease Mongering – The so-called «testosterone deficiency syndrome» is a blend of nonspecific symptoms typical of the physiological process of aging. This syndrome has been the subject of intense promotional activity that has presented the phenomenon as highly prevalent and with a major public health impact.

This strategy has been accompanied by the emergence of new and easy to administer testosterone devices into the pharmaceutical market and has generated significant sales for drug companies.

The commercial promotion of testosterone deficiency syndrome and its remedies has exploited cultural stereotypes of aging and sexuality through awareness campaigns promoted by the laboratories involved and has been disseminated by media with the participation of numerous experts and with the support of scientific associations, representing a paradigmatic case of disease mongering.

This example might be of use in the response to disease mongering activities from the clinical and public health fields.

Gavilan E, Jimenez de Gracia L, Gervas J. Estrategias de promoción del síndrome por déficit de testosterona: un caso paradigmático de invención de enfermedad(disease mongering) [Strategies to promote testosterone deficiency syndrome: a paradigm of disease mongering]. Gaceta Sanitaria. Estrategias de promoción del síndrome por déficit de testosterona: un caso paradigmático de invención de enfermedad (disease mongering)

 

[Michael Scally MD]

The growth hormone and testosterone myths
http://www.miamiherald.com/2013/08/28/3592056/the-growth-hormone-and-testosterone.html (The growth hormone and testosterone myths - Other Views - MiamiHerald.com)

Wednesday, 08.28.13
BY THOMAS T. PERLS

thperls@bu.edu

Testosterone and other anabolic steroids and growth hormone are not just about cheating and they’re not just a problem to be dealt with by Major League Baseball and other overseers of professional sports. The sale and prescribing of testosterone and other anabolic steroids and growth hormone are illegal for athletic use, body building and anti-aging, and for good reasons.

These drugs, when marketed and used for medically fallacious reasons, can cause financial, physical and psychological harm.

Many clinics that go by various descriptions ranging from anti-aging, age-management and wellness clinics and spas to life extension and longevity institutes cater to young men looking for drugs for body building and of course professional athletes looking for athletic performance enhancing drugs as well as more middle aged and relatively wealthy individuals succumbing to marketed pitches of youth, virility, and weight loss.

This is a cash only business (except for fraudulent insurance claims) because private and public insurers won’t pay for these treatments that are viewed by endocrinologists as outside the scope of the reasonable, safe and legal practice of medicine.

One of the consequences of this being a cash only business is that the clinics, internet sites and compounding pharmacies are ineffectually regulated. Adverse medical events go unreported and some clinics obtain signed contracts stipulating that patients lose their rights to report adverse events or unprofessional behavior to regulatory agencies.

Testosterone in its various forms, including Androgel, can cause impulsive violent behavior and unpredictable rage and precipitate psychotic behavior and mania. One only needs to recall Charlie Sheen’s recent psychotic meltdown to see the profound and scary side effects of this drug. Chris Benoit, a famous pro-wrestler, killed his wife and son and then himself, while, like most other pro-wrestlers, he was taking what amount to toxic hormone soups or what the anti-aging industry euphemistically calls “hormone replacement therapy”.

There are dangerous physical side effects from testosterone as well, including obstructive sleep apnea, irregular heart beat (called atrial fibrillation, which increases the risk for stroke), and problems that all increase the risk for heart attack, including high blood pressure, increased blood viscosity, and very low good (HDL) cholesterol levels. Anabolic steroids taken by mouth, like Anavar, are additionally associated with markedly increased risk of inflammation of the liver and can lead to liver failure.

Over the past five years or so we have been deluged by pharmaceutical advertisements promoting testosterone injections, gels and creams to baby-boomers as the male fountain of youth. One “anti-aging” doctor states that all men as they get older require testosterone supplementation. According to less conflicted experts, somewhere between 2-18 percent of men have age-related declines in testosterone levels and coexisting clinical problems that merit testosterone supplementation even in the face of testosterone’s significant risk profile.

A study appearing this year in the Journal of Sexual Medicine showed that by 6 months of treatment, only about one third of 15,400 men stuck with their testosterone gel and by one year, the rate was down to only 15 percent. Maybe the vast majority of the men who succumbed to the marketing blitz realized it wasn’t worth it or they sustained adverse effects.

But the expensive television ads keep coming bellying the net profits the pharmaceutical companies are experiencing as a result of their marketing campaigns.

In the case of A-Rod, we have mostly heard about his using human growth hormone. The irony is that there is little or no scientific evidence for anti-aging or athletic benefits from “hGH”. A Stanford study of 27 randomized controlled clinical trials demonstrated no significant improvement in strength and exercise capacity. Furthermore, the risks from hGH far outweigh the little or no benefit. In the Stanford study, nearly half of the healthy people who got this drug experienced swelling, and a quarter developed joint pains. In another evaluation of multiple studies of older people there were even higher rates of these adverse events and 25% developed elevated blood sugars with a subset going on to have diabetes. Numerous laboratory studies show that hGH enhances the ability of cancers to metastasize or spread.

So if the risks of hGH far outweigh the little or no benefit, why do clinics con their clients into buying it? The most likely reason is because hGH has a huge profit margin and it is almost always sold in conjunction with drugs that can help build muscle, namely anabolic steroids like testosterone. That way the patient thinks they are getting a muscle building effect from the growth hormone, but it’s really due to the anabolic steroids.

Recently it was reported that a federal grand jury has been formed to determine if criminal charges are warranted against the South Florida anti-aging clinic. Hopefully, the jury will go beyond the pushers and dealers and determine which doctors wrote prescriptions and what pharmacies and wholesalers participated in the distribution ring.

Effectively tackling the production of these drugs that are destined for illegal distribution across the country via many clinics and compounding pharmacies will be a bigger challenge that must be supported by public and Federal Congressional support and pressure.

None of these actions will bring the many pro-wrestlers, body builders, student athletes, firemen, policemen, military, and unknown numbers of other individuals that have died or suffered as a result of the “being big” cult promotion and hormone replacement scams. We can honor these individuals by taking effective actions to stop these tragedies via effective education and protection of the public.

Thomas Perls MD, MPH, Professor of Medicine at Boston University and Boston Medical Center testified in 2008 as an expert witness for the U.S. Congressional Committee on Oversight and Government Reform about the medical misuse of growth hormone prior to hearings on the Mitchell Report and Steroids in Baseball.

 

[Millard]

Thomas Perls: "Testosterone in its various forms, including Androgel, can cause impulsive violent behavior and unpredictable rage and precipitate psychotic behavior and mania. One only needs to recall Charlie Sheen’s recent psychotic meltdown to see the profound and scary side effects of this drug. Chris Benoit, a famous pro-wrestler, killed his wife and son and then himself, while, like most other pro-wrestlers, he was taking what amount to toxic hormone soups or what the anti-aging industry euphemistically calls “hormone replacement therapy”."

What kind of academic researcher uses Charlie Sheen's meltdown and the Chris Benoit tragedy as "proof" that testosterone causes "violent behavior and unpredictable rage"?!

And to equate Sheen's and Benoit's non-medical use of AAS to HRT?!

 

[MR10X]

Destroying the Myth about Testosterone Replacement and Prostate Cancer - Life Extension

 

[edfriedman]

The reason that androgen replacement in males is so controversial is quite simple - doctors are taught in medical school that testosterone causes prostate cancer. However, what they are not taught is that testosterone must first be converted to estradiol in order for this to happen. This is because estrogen receptor-alpha is absolutely essential in prostate cancer formation as elegantly proved in the 2008 paper at Prostatic hormonal carcinogenesis is mediated by in situ estrogen production and estrogen receptor alpha signaling. Pretty much all of the observed negative effects associated with increasing testosterone levels to the upper limit of the physiological range can be explained by the increased levels of estradiol that result when testosterone is given without an aromatase inhibitor. The only legitimate concern at this time when testosterone is given properly (i.e., accompanied by an aromatase inhibitor) is the increased level of red blood cells that occurs in some individuals.

 

[Michael Scally MD]

Testosterone Boosters Unnecessary?
Testosterone Boosters Unnecessary? | Valley News

 

[edfriedman]

It is interesting that so many doctors seem to think that low levels of testosterone are acceptable, so long as they do not drop below the "normal" low level for their age. Personally, I think that Dr. Abraham Morgentaler of Harvard Medical School is totally correct when he said "Since testosterone values decline with age, it makes no sense to define normal by comparing individuals to populations of similarly aged men who have also experienced a decline in values" in his paper Guideline for Male Testosterone Therapy: A Clinician’s Perspective

Also, any doctor who is unaware of the myriad of health benefits associated with increased levels of testosterone has to be almost totaly blind to the literature. It would take a book to list all of the benefits, which is why I in fact did write a book about it, called "The New Testosterone Treatment".

 

[Michael Scally MD]

It is interesting that so many doctors seem to think that low levels of testosterone are acceptable, so long as they do not drop below the "normal" low level for their age. Personally, I think that Dr. Abraham Morgentaler of Harvard Medical School is totally correct when he said "Since testosterone values decline with age, it makes no sense to define normal by comparing individuals to populations of similarly aged men who have also experienced a decline in values" in his paper at: http://jcem.endojournals.org/content/92/2/416.full (Guideline for Male Testosterone Therapy: A Clinician’s Perspective)

Also, any doctor who is unaware of the myriad of health benefits associated with increased levels of testosterone has to be almost totaly blind to the literature. It would take a book to list all of the benefits, which is why I in fact did write a book about it, called "The New Testosterone Treatment".

The New Testosterone Treatment: How You and Your Doctor Can Fight Breast Cancer, Prostate Cancer, and Alzheimer's
http://www.amazon.com/The-New-Testosterone-Treatment-Alzheimers/dp/1616147237