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Old 10-23-18, 09:50 AM
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Androgens Are Not Evil!

The field of androgen physiology is as fascinating as it is frustrating. Not only do mainstream journalists get the “facts” wrong, but also many of my own science colleagues are more than willing to sacrifice “scientific fact” for political correctness. God forbid you actually tell the truth about the potential benefits of androgen use. Let’s instead stick to the tried-and-stupid method of agreeing with the masses that have the science training of a pixie stick. It reminds me of the classic line uttered by the great actor Jack Nicholson in the movie “A Few Good Men”… “You can’t handle the truth!”

What is it about androgens that scares the bejesus out of Congressmen, makes my science colleagues run like castrated rabbits, and makes journalists’ IQ drop to a level comparable to a mole rat? Mmm. Things to ponder.

Meanwhile, we’re left with a volume of science that points to one very powerful direction. And that’s the notion that using certain androgens, for a specific duration and dose, can indeed have beneficial and healthy effects on various populations that may include but are not be limited to the elderly, HIV patients, normal healthy individuals, and even pediatric populations.

If we go back to a seminal study published in the New England Journal of Medicine showing that when normal, healthy men were administered IM shots of 600 mgs of testosterone enanthate weekly for a period of 10 weeks, not only did they get bigger and stronger— but they didn’t experience any untoward side effects. In fact, the authors of the study stated, “Neither mood nor behavior was altered in any group. Supraphysiologic doses of testosterone, especially when combined with strength training, increase fat-free mass and muscle size and strength in normal men.”1 And then you have a follow-up study from the same lab debunking the myth of “roid rage.”

Now mind you, there are plenty of guys who act like complete a-holes who self-adminster androgens. However, there are plenty of jerks who also do not use androgens. As with all drugs, the dose you take and the duration of treatment will have highly individualized effects. There may be individuals who have idiosyncratic effects. Nonetheless, the data on androgens is growing faster than the waistline of an overweight suburbanite eating corn dogs at the Texas state fair. Here are some cool new facts that I’d like to share.

Testosterone Versus 3-alpha-diol

Not all androgens have the same effects. For instance, we know that testosterone (T) is aromatized to estrogen, and reduced to dihydrotestosterone (DHT), which then is converted to 5alpha-androstane, 3alpha, 17alpha-diol (3alpha-diol). Scientists determined the extent to which some age-related decline in hippocampally-influenced (a part of the brain) behaviors may be due to androgens. Interestingly, they found that 3alpha-diol, but not T, improved performance in the inhibitory avoidance, water maze, forced swim, and defensive freezing tasks, irrespective of age. Thus, age is associated with a decrease in 3alpha-diol production, and 3alpha-diol administration reinstates cognitive and affective performance of aged male rats.4 So here you have one of the “downstream” molecules of T having an effect that is better than T itself with regard to brain function.

T, Women, and Heart Failure

Now, despite many of the potential side effects of T administration in women, there may be clinical reasons for administering this powerful hormone. Patients with chronic heart failure (CHF) show decreased exercise capacity and insulin sensitivity. Testosterone supplementation improves these variables in men with CHF. But what happens in women?

Thirty-six elderly female patients with stable CHF were randomly assigned (2:1 ratio) to receive a testosterone transdermal patch or placebo— both on top of optimal medical therapy— for six months. Distance walked as well as peak oxygen consumption significantly improved in the T group. Also, maximal voluntary contraction and peak torque increased significantly in the T group, but did not change in the P group. No side effects requiring discontinuation of T were detected. So in this particular study, testosterone supplementation improved functional capacity, insulin resistance, and muscle strength in women with advanced CHF. Testosterone seems to be an effective and safe therapy for elderly women with CHF.5

T and Coronary Heart Disease

But I thought T was supposed to be lethal? Result in heart attacks? Ha! Right. Here’s an interesting twist. Eighty-seven diabetic male subjects (mean age: 74 years) with proven coronary artery disease (CAD) were randomized to a 12-week treatment with either T undecanoate (40 mgs administered three times daily) or placebo (P) in a double-blind protocol. Compared to P, T significantly reduced the number of anginal attacks/weeks by 34 percent; the silent ischemic episodes by 26 percent, and the total ischemic burden by 21 percent on ambulatory ECG monitoring. After 12 weeks, total cholesterol and plasma triglycerides were significantly reduced in the T group, compared to P group.3 Pretty nifty, eh? Another study showed that testosterone replacement therapy appears to improve metabolism and endurance in patients with chronic heart failure. Physicians who regularly treat patients with CHF may consider testosterone therapy.7

Sensation-Seeking and T

Apparently, the more T you have, the more you are apt to be “sensation-seeking.” And this trait has a genetic component. Besides that, I’m not sure what else to say. Other than it explains why men are more apt to jump out of airplanes, get into a cage and beat the crap outta each other, and watch movies with gratuitous violence. Thank god! Who needs a world where there are more TV shows like “The View.”2

T and HIV

Sixty-one HIV-infected men with weight loss were randomized to receive weekly intramuscular injections of 300 mgs of testosterone enanthate or placebo for 16 weeks. Men receiving testosterone demonstrated significantly greater improvements in mental health and quality-of-life scores than those receiving placebo, and improvements in fatigue/energy and mood scores that were not significantly different from those receiving placebo. In HIV-infected men with weight loss, a supraphysiological dose of testosterone significantly increased fat free mass, but did not improve self-reported or performance-based measures of physical function. Improvements in mood, fatigue, and quality-of-life measures in the testosterone group are pretty important, though.6
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