A Compilation of Articles Written by Nelson Vergel

For several articles written by Nelson Vergel on testosterone, please visit:

http://www.mesomorphosis.com/blog/author/nelsonvergel/

and the facebook page

http://www.facebook.com/groups/325872205815/

Those who start at low baseline testosterone had the largest PSA increases. That makes sense since low levels of testosterone reduce prostate volume and prostatic specific antigen to levels under the expected median for a specific age. PSA levels normalized after the first month on the gel.

J Urol. 2011 Jul 23. [Epub ahead of print]

Changes in Prostate Specific Antigen in Hypogonadal Men After 12 Months of Testosterone Replacement Therapy: Support for the Prostate Saturation Theory.

Khera M, Bhattacharya RK, Blick G, Kushner H, Nguyen D, Miner MM.

Source

Scott Department of Urology, Baylor College of Medicine, Houston, Texas.

Abstract

PURPOSE:

We measured prostate specific antigen after 12 months of testosterone replacement therapy in hypogonadal men.

MATERIALS AND METHODS:

Data were collected from the TRiUS (Testim® Registry in the United States), an observational registry of hypogonadal men on testosterone replacement therapy (849). Participants were Testim naïve, had no prostate cancer and received 5 to 10 gm Testim 1% (testosterone gel) daily.

RESULTS:

A total of 451 patients with prostate specific antigen and total testosterone values were divided into group A (197 with total testosterone less than 250 ng/dl) and group B (254 with total testosterone 250 ng/dl or greater). The groups differed significantly in free testosterone and sex hormone-binding globulin, but not in age or prostate specific antigen. In group A but not group B prostate specific antigen correlated significantly with total testosterone (r = 0.20, p = 0.005), free testosterone (r = 0.22, p = 0.03) and sex hormone-binding globulin (r = 0.59, p = 0.002) at baseline. After 12 months of testosterone replacement therapy, increase in total testosterone (mean ± SD) was statistically significant in group A (+326 ± 295 ng/dl, p <0.001; final total testosterone 516 ± 28 ng/dl) and group B (+154 ± 217 ng/dl, p <0.001; final total testosterone 513 ± 20 ng/dl). After 12 months of testosterone replacement therapy, increase in prostate specific antigen was statistically significant in group A (+0.19 ± 0.61 ng/ml, p = 0.02; final prostate specific antigen 1.26 ± 0.96 ng/ml) but not in group B (+0.28 ± 1.18 ng/ml, p = 0.06; final prostate specific antigen 1.55 ± 1.72 ng/ml). The average percent prostate specific antigen increase from baseline was higher in group A (21.9%) than in group B (14.1%). Overall the greatest prostate specific antigen was observed after 1 month of treatment and decreased thereafter.

CONCLUSIONS:

Patients with baseline total testosterone less than 250 ng/dl were more likely to have an increased prostate specific antigen after testosterone replacement therapy than those with baseline total testosterone 250 ng/dl or greater, supporting the prostate saturation hypothesis. Clinicians should be aware that severely hypogonadal patients may experience increased prostate specific antigen after testosterone replacement therapy.

Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

The Effect of Antihypertensive Drugs on Erectile Function: A Proposed Management Algorithm - By Michael Doumas MD, Stella Douma

Blood pressure medications are one of the main culprits of erectile dysfunction in men who are aging. This is a great review of medications and algorithm . Too bad that it does not include the use of testosterone in that algorithm!

CLICK HERE

Testosterone improves memory in women

Too bad most doctors do not check testosterone blood levels in women, and if they do...they do not know how to supplement it.  Right now, there is no FDA approved option for women. Libigel will be approved soon , though.   Doctors can prescribe gels from compounding pharmacies.  The best for women in 

http://www.womensinternational.com/

http://www.endocrinetoday.com/view.aspx?rid=84459

How should doctors monitor men receiving testosterone replacement therapy?

Very good short paper that summarizes what several guidelines say about following up men on testosterone replacement. I suggest you print it out and give your doctor a copy since it is simple and short. The summary table is great!

http://stg.jfponline.com/pdf/5912/5912JFP_ClinInq3.pdf

stg.jfponline.com

Low testosterone predicts increased mortality and testosterone replacement therapy improves survival in men with type 2 diabetes

Endocrine Abstracts (2011) 25 P163

Low testosterone predicts increased mortality and testosterone replacement therapy improves survival in men with type 2 diabetes

Vakkat Muraleedharan^1,2, Hazel Marsh¹ & Hugh Jones^1,2

¹Barnsley Hospital NHS Foundation Trust, Barnley, UK; ²University of Sheffield, Sheffield, UK.

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Background: Low testosterone in men is associated with increase in all-cause and cardiovascular mortality. There is a high prevalence of hypogonadism in men with type 2 diabetes and testosterone replacement therapy (TRT) improves cardiovascular risk. However there is no published data regarding mortality in these patients in relation to testosterone levels, and the long term effect of TRT on mortality.

Aim: We report a 6 year follow-up study examining the effect of baseline testosterone and TRT in hypogonadal men with type 2 diabetes on all-cause mortality.

Methods: Five hundred eighty-seven patients with type 2 diabetes had total testosterone (TT) performed between 2002 and 2005 and were followed up for 5.8±1.3 years.

Deaths during the first 6 months were excluded. Patients were then analysed in three groups. i) normal TT (>10.4 nmol/l) ii) low TT (≤10.4 nmol/l) without TRT. iii) low TT receiving TRT for 2 years or more.

Results: Of 580 patients analysed, 338 had normal TT (58%) and 240 low TT (42%). In the low TT group 58 patients received TRT. Mean age 61±11 S.D. and similarly matched in all three groups. Total deaths 72 (12.4%). Mortality rates – low TT without treatment (36/182-20%), normal TT (31/338-9%) and low TT with TRT (5/58-8.6%). Survival was significantly decreased in patients with low TT without TRT (P=0.001 log rank) compared to normal. The treated group had improved survival (P=0.049 log rank). In the Cox Regression model multi-variate (age, weight, HbA1c, pre existing cardiovascular disease, smoking, statin and ACEi/ARB use) adjusted hazard ratio for all-cause mortality was 2.2 (95% CI 1.3–3.7 P=0.001) for low TT.

Conclusions: This study shows that men with type 2 diabetes and low testosterone have a significant increased mortality. TRT improved survival compared to those untreated, recording a similar mortality rate to the normal TT group.

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Endocrine Abstracts (2011) 25 P163

Men who regularly take pain relievers such as ibuprofen and aspirin may be at increased risk for erectile dysfunction

Men who regularly take pain relievers such as ibuprofen and aspirin may be at increased risk for erectile dysfunction, new research suggests.

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  By PhotoDisc
  More than 30 million people a day take prescription and over-the-counter pain relievers.

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By PhotoDisc

More than 30 million people a day take prescription and over-the-counter pain relievers.

Men who use non-steroidal anti-inflammatory drugs (NSAIDs) three times a day for more than three months are at a 22% increased risk of erectile dysfunction, reports Steve Jacobsen, director of research for Kaiser Permanente Southern California, in this week's Journal of Urology.

http://yourlife.usatoday.com/health/story/2011/03/New-study-links-pain-relievers-to-erectile-dysfunction/44363996/1

Latest Advances in Men's Health- Lecture in New York City on May 24

http://menshealthnyc.eventbrite.com/