Testosterone therapy benefits elusive, major studies find


Snyder says scientists followed up by sending a letter to all 788 participants, informing of them of their iron levels at the start of the trial as well as at the end. When it comes to men's health, it is considered to be essential.

All of the men in the United States trials were 65 or older and had moderately low testosterone levels, but with no obvious medical cause.

Some studies that mine medical records - including one in Tuesday's JAMA Internal Medicine - have found men taking it have fewer heart problems.

-Testosterone had no effect on memory or mental function, based on tests given before, halfway and at the end of treatment to almost 500 men with age-related memory decline.

"Our study finds benefits of testosterone treatment in improving bone density and anaemia".

The results are from the final four studies in a seven-part project mostly funded by the National Institute on Aging, involving almost 800 US men aged 65 and older with low testosterone levels. Hemoglobin levels climbed markedly in those treated with a testosterone gel at doses normal for a young man, compared with those treated with a placebo gel. In addition to low testosterone, the presence of complaints such as low sexual function, difficulty in walking or low vitality was required for eligibility to participate in the trials.

What recommendations do you have for future research as a result of this study?

A fifth study, not part of the TTrials, looked at the link between testosterone replacement therapy and cardiovascular effects. One of the groups was assigned with a testosterone gel for over year, while the other was granted with a placebo. Efficacy was then evaluated at months three, six, nine and 12. The trials were double-blinded, meaning neither the experimenters nor the participants knew which group was a placebo and which received the treatment. Another thing that was found out due to bone imaging tests is that 200 men which are on testosterone have shown results with increased bone density and strength after the tests.

To test cognition, researchers administerd a delayed paragraph recall test.

In the cardiovascular trial, researchers assessed coronary artery plaque buildup by CT angiography. These included acute myocardial infarction, angina, stroke, transient ischemic attack, as well as sudden cardiac death.

Older men on TRT versus placebo for 1 year had improved hemoglobin levels and volumetric bone mineral density and estimated bone strength. And other drugs may be more effective at treating anemia and improving bone mass than testosterone.

"The T Trials were created to determine if testosterone treatment might help alleviate these symptoms and conditions". The improvement was similar to bone changes seen with treatment for osteoporosis, although most men studied did not have that bone-thinning condition, which can lead to fractures. Over a roughly three-year follow-up period, these men actually had a lower risk of cardiovascular issues than men who hadn't been given a testosterone prescription, researchers report. Those treated had a greater increase in the volume of noncalcified plaque than the control group. A larger and longer trial is needed to establish the clinical significance of these findings.

Dr. Peter J. Snyder, a professor of Medicine in the Division of Endocrinology, Diabetes, and Metabolism at the University of Pennsylvania, cautions that the findings suggest the treatment may pose a cardiovascular risk. The trials were conducted at 12 sites across the country and involved 790 men age 65 and older with low levels of testosterone. The total number of major cardiovascular negative health outcomes in testosterone-treated men was comparable with those observed in the control group. It ordered drugmakers to revise product labeling to stress the approved use, and to warn that the drug may increase the risk of heart attacks and stroke.