Testosterone: A Man's Guide- Introductory Lecture by Author Nelson Vergel

Testosterone therapy increases risk of red blood cell disorder for men with HIV

Nothing new that we did not know.

However, it bothers me how they do not mention therapeutic phlebotomy as a solution. Instead, they mention cessation of therapy. 

It also surprised me to see that they do not mention smoking as a risk factor for polycythemia.

http://www.aidsmap.com/Testosterone-therapy-increases-risk-of-red-blood-cell-disorder-for-men-with-HIV/page/2114719/

New Genetic Associations For Testosterone Levels in Men

A study in male twins showed that genetics accounts for up to 65% of the variation in blood testosterone between individuals. However, up until this month, very little was known about the genetic factors responsible for this variation.
Read more:
http://spittoon.23andme.com/2011/10/24/snpwatch-new-genetic-associations-for-testosterone-levels-in-men/

FDA Approves Cialis to Treat Benign Prostatic Hyperplasia

October 6, 2011 -- The U.S. Food and Drug Administration today approved Cialis (tadalafil) to treat the signs and symptoms of benign prostatic hyperplasia (BPH), a condition in which theprostate gland becomes enlarged, and for the treatment of BPH and erectile dysfunction (ED), when the conditions occur simultaneously. Cialis was approved in 2003 for the treatment of ED.

Common symptoms of BPH include difficulty in starting urination and a weak urine stream; a sudden urge to urinate; and more frequenturination including at night.

The severity of symptoms of BPH can be measured using the International Prostate Symptom Score (IPSS). In two clinical trials, men with BPH who took 5 milligrams (mg) of Cialis once daily experienced a statistically significant improvement in their symptoms of BPH compared to men who were treated with placebo. The trials based their findings on a reduction in total IPSS scores.

In a third study, men who experienced both ED and BPH and who took 5 mg of Cialis once daily had improvement in both their symptoms of BPH and in their ED compared to men who were treated with placebo. The improvement in ED was measured using the Erectile Function domain score of the International Index of Erectile Function.

“BPH can have a big impact on a patient’s quality of life,” said Scott Monroe, director of the Division of Reproductive and Urologic Products in the FDA’s Center for Drug Evaluation and Research. “A large number of older men have symptoms of BPH. Cialis offers these men another treatment option, particularly those who also have ED, which is also common in older men.”

Cialis should not be used in patients taking nitrates, for example nitroglycerin, because the combination can cause an unsafe decrease in blood pressure. Also, the use of Cialis in combination with alpha blockers for the treatment of BPH is not recommended because the combination has not been adequately studied for the treatment of BPH, and there is a risk of lowering blood pressure.

The FDA has approved eight other drugs to treat symptoms of BPH: Proscar, (finasteride), Avodart (dutasteride), Jalyn (dutasteride plus tamsulosin), and the alpha blockers: Hytrin (terazosin), Cardura (doxazosin), Flomax (tamsulosin), Uroxatral (alfuzosin) and Rapaflo (silodosin).

Cialis is manufactured by Indianapolis-based Eli Lilly and Co.

Source: FDA

Posted: October 2011

What Should Men Over 60 Be Aware of When Taking Testosterone?

Ask the Experts  >  Forum on Nutrition and Exercise  >  Q & A

		testosterone Sep 24, 2011 well it happened, i was on anti depress, anixety meds, and then my doctoc check my testy, and it was as low as it gets according to doc, went on once a month, then biweekly and raised it to 730 now back to once a month..68 yrs of age, woodys galore, depression gone, muscle up, fat gone..overall feeling better..no side effects from this med and feel much better..i think all older men should get their testy checked..i take maximum dose and does this increase my chances for anything serious..i am type two di and take glipizide, metform, but to keep this lean body and muscle, i'm willing to take the possible severe side effects, any responses??
		Response from Mr. Vergel Good to hear that you are doing well on testosterone. Testosterone replacement therapy improves insulin response in diabetic patients. Three warnings for you since you are over 60 years of age (some studies have reported some red flags on testosterone replacement in older men): 1- Make sure that your hematocrit is never over 52. If it is, you need to have 3-4 units of blood drawn every 2-4 months (you should check hematocrit monthly if you have this side effect). High hematocrit can dramatically increase cardiovascular risks. 2- Get your prostatic specific antigen checked every 6 months to ensure that it is OK. If you see a sharp increase, then there may be an issue with prostatic cancer if hidden cancer was present when you started testosterone. An annual digital rectal exam if also advisable. 3- Have your estradiol checked every few months during the first year to ensure it is not much over 30 picograms. High estradiol can cause water retention, mood issues, and increased breast size. I have provided detailed information on these issues in Testosterone: A Man's Guide I think that men who start testosterone without reading about potential side effects and how to manage them are a little naive. Yes, your doctor should be looking out for you, but many doctors are too busy and may not be following guidelines. I hope this email did not bring you down from your excitement. Many men have the benefits you report without side effects. But the only way to find out early if you are one of those lucky ones is to follow the advise that I provided here. Short term benefits are great but not at the expense of long term problems. Nelson

Do You Need Testosterone?

Click here for article

Testosterone Replacement and Anabolic Steroids- Side Effect Management- Interview With Dr. Michael Scally- Part 1

How to Manage Testosterone Side Effects- Interview with Dr Michael Scally- Part 1

Endogenous Testosterone and Mortality in Men: A Systematic Review and Meta-Analysis

Men with low blood levels of testosterone had higher risk of mortality

From: The Journal of Clinical Endocrinology & Metabolism. August 3, 2011 jc.2011-1137

Clinical Review: Endogenous Testosterone and Mortality in Men: A Systematic Review and Meta-Analysis

1. Andre B. Araujo, 
2. Julia M. Dixon, 
3. Elizabeth A. Suarez, 
4. M. Hassan Murad, 
5. Lin T. Guey and
6. Gary A. Wittert

-Author Affiliations

1. Department of Epidemiology (A.B.A., J.M.D., E.A.S., L.T.G.), New England Research Institutes, Inc., Watertown, Massachusetts 02472; Division of Preventative Medicine (M.H.M.), Mayo Clinic, Rochester, Minnesota 55905; and Department of Medicine (G.A.W.), University of Adelaide, Adelaide, South Australia 5005, Australia

1. Address all correspondence and requests for reprints to: Andre B. Araujo, Ph.D., Vice President, Epidemiology, New England Research Institutes, Inc., 9 Galen Street, Watertown, Massachusetts 02472. E-mail: aaraujo@neriscience.com.

Abstract

Context: Low testosterone levels have been associated with outcomes that reduce survival in men.

Objective: Our objective was to perform a systematic review and meta-analysis of published studies to evaluate the association between endogenous testosterone and mortality.

Data Sources: Data sources included MEDLINE (1966 to December 2010), EMBASE (1988 to December 2010), and reference lists.

Study Selection: Eligible studies were published English-language observational studies of men that reported the association between endogenous testosterone and all-cause or cardiovascular disease (CVD) mortality. A two-stage process was used for study selection. 1) Working independently and in duplicate, reviewers screened a subset (10%) of abstracts. Results indicated 96% agreement, and thereafter, abstract screening was conducted in singlicate. 2) All full-text publications were reviewed independently and in duplicate for eligibility.

Data Extraction: Reviewers working independently and in duplicate determined methodological quality of studies and extracted descriptive, quality, and outcome data.

Data Synthesis: Of 820 studies identified, 21 were included in the systematic review, and 12 were eligible for meta-analysis [n = 11 studies of all-cause mortality (16,184 subjects); n = 7 studies of CVD mortality (11,831 subjects)]. Subject mean age and testosterone level were 61 yr and 487 ng/dl, respectively, and mean follow-up time was 9.7 yr. Between-study heterogeneity was observed among studies of all-cause (P < .001) and CVD mortality (P = 0.06), limiting the ability to provide valid summary estimates. Heterogeneity in all-cause mortality (higher relative risks) was observed in studies that included older subjects (P = 0.020), reported lower testosterone levels (P = 0.018), followed subjects for a shorter time period (P = 0.010), and sampled blood throughout the day (P = 0.030).

Conclusion: Low endogenous testosterone levels are associated with increased risk of all-cause and CVD death in community-based studies of men, but considerable between-study heterogeneity, which was related to study and subject characteristics, suggests that effects are driven by differences between cohorts (e.g. in underlying health status).