TheOldFart
New Member
Seems like a very responsibly written article to me. It does not discourage the use of TRT in older men or in men in general. I think that the following conclusion is reasonable from the outcome of the study.
"Although this result sounds a note of caution in general concerning testosterone administration in older men, it certainly should not deter investigators from proceeding with additional, larger studies of testosterone administration in well-characterized groups of older men to more clearly outline benefits and risks. Similarly, it should not prevent clinicians from prescribing testosterone replacement for well-established late-onset hypogonadism, although it should provide some new caution about the administration of testosterone in older men who have an extensive history of cardiovascular disease and immobility."
The thing that I see wrong with all studies is what they recommend as the cutoff point for hypogonadism, that being somewhere between 250 and 350, depending on the study. I believe that is too low of a cutoff for men with multiple symptoms. My doctor believes that a more reasonable value is 500 ng/dL, which I think is reasonable. Perhaps the men mentioned in the following quote had values of total T in the range of 350 to 500, but were written off as having normal T.
"The difficulty with using symptoms alone to define late-onset hypogonadism was highlighted by the finding that more than 25% of men with normal testosterone levels had similar sexual symptoms."
While one 65 year old might feel fine with a level of 350, another might feel lousy and have several typical symptoms with a level of 450. The guy who is 350 and feels fine does not need TRT and taking a chance of screwing up his hormones, while the guy who is 450 and has multiple symptoms should be given TRT to see if it solves his problems, after ruling out other possible causes.
"Although this result sounds a note of caution in general concerning testosterone administration in older men, it certainly should not deter investigators from proceeding with additional, larger studies of testosterone administration in well-characterized groups of older men to more clearly outline benefits and risks. Similarly, it should not prevent clinicians from prescribing testosterone replacement for well-established late-onset hypogonadism, although it should provide some new caution about the administration of testosterone in older men who have an extensive history of cardiovascular disease and immobility."
The thing that I see wrong with all studies is what they recommend as the cutoff point for hypogonadism, that being somewhere between 250 and 350, depending on the study. I believe that is too low of a cutoff for men with multiple symptoms. My doctor believes that a more reasonable value is 500 ng/dL, which I think is reasonable. Perhaps the men mentioned in the following quote had values of total T in the range of 350 to 500, but were written off as having normal T.
"The difficulty with using symptoms alone to define late-onset hypogonadism was highlighted by the finding that more than 25% of men with normal testosterone levels had similar sexual symptoms."
While one 65 year old might feel fine with a level of 350, another might feel lousy and have several typical symptoms with a level of 450. The guy who is 350 and feels fine does not need TRT and taking a chance of screwing up his hormones, while the guy who is 450 and has multiple symptoms should be given TRT to see if it solves his problems, after ruling out other possible causes.
