A COMPARATIVE STUDY OF THE METABOLIC EFFECTS OF TESTOSTERONE PROPIONATE IN NORMAL MEN AND WOMEN AND IN EUNUCHOIDISM<sup>1</sup>,<sup>2</sup>

Abstract. We describe the clinical and biochemical features of six men with male pseudohermaphroditism due to androgen resistance. Each of the subjects had male-gender behavior but incomplete virilization. The underlying defects in androgen metabolism were defined by studies of the 5a-reductase enzyme and the androgen receptor in fibroblasts cultured from biopsies of genital skin. Four of the six have 5a-reductase deficiency, and two have defects of the androgen receptor (the Reifenstein syndrome).The responses of these men to androgen treatment were assessed by monitoring nitrogen balance, plasma luteinizing hormone (LH) values, and clinical parameters of virilization including penile growth, potency and ejaculatory volume, muscle bulk, and growth of body and facial hair. In all of the subjects with 5a-reductase deficiency and one man with the Reifenstein syndrome significant response occurred, as evidenced by nitrogen retention, lowered plasma LH levels, and improved virilization, with doses of parenteral testosterone esters that raised plasma testosterone levels above the normal male range and brought plasma dihydrotestosterone levels into the normal male range. The subject who did not respond with clinical virilization nevertheless showed nitrogen retention in response to acute testosterone Dr. Price was a Medical

Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 89%

High dose androgen therapy in male pseudohermaphroditism due to 5 alpha-reductase deficiency and disorders of the androgen receptor.

Price¹,

Wass²,

Griffin³

et al. 1984

“…It is apparent, howvever, that both nitrogen and phosphorus were retained and approximately in proportion to their content in muscle, and that under the conditions of these experiments, resistance exercises had a protein anabolic effect similar to testosterone (11).…”

Section: Methodsmentioning

confidence: 66%

The Effects of Resistance Exercises on the Nitrogen, Phosphorus, and Calcium Metabolism of Patients With Rheumatoid Arthritis 12

Clark¹,

Watkins²,

Tonning³

et al. 1954

Muscle weakness and atrophy are common and disabling manifestations of rheumatoid arthritis for which various types of active exercises are usually prescribed. It is well known that active exercises result in substantial increases in muscle mass and power only when performed repeatedly against resistance with considerable physical effort (1). Although physical activity has been reported to have a protein-anabolic effect and cause calcium retention in normal subjects (2, 3), the metabolic responses to exhaustive physical exertion during active rheumatoid arthritis have not been investigated. These studies were undertaken to determine the effects of heavy resistance exercises on nitrogen, phosphorus, and calcium metabolism in patients experiencing exacerbations of this disease. Laboratory studies revealed a normal urine, a corrected sedimentation rate of 1.38 mm. per minute, and a hemoglobin of 12.5 grams per cent. Urinary 17-ketosteroids were 10.8 mg. in twenty-four hours.X-ray studies revealed minimal osteoporosis of the carpal bones and slight spur formation at the margins of the coronoid processes and olecranons. There was marked osteoporosis of the tarsals and metatarsals.2. J. W., a 47-year-old white male, developed rheumatoid arthritis three years before admission with swelling, aching, redness, and heat in the second and third metacarpophalangeal and mid-phalangeal joints of both hands, subsiding in three weeks. Nine months before admission, he developed pain and swelling in the left wrist. This pain subsided within three months but slight swelling remained. Two months before admission he developed pain and swelling in both ankles, the right large toe, right elbow, and left knee. During the two months before admission, he experienced marked fatigue and anorexia and lost twenty-seven pounds.His height was 178.7 cm., weight, 80 Kg., blood pressure, 125/70, and temperature 98.6°F. There was soft tissue swelling of the midphalangeal joints, wrists, left knee, and both ankles. A small effusion was present in the left knee. Motion was limited in the right hand, both wrists, right elbow, and both ankles.Laboratory studies revealed a normal urine, a corrected erythrocyte sedimentation rate of 1.55 mm. per minute, and a hemoglobin of 12.5 grams.X-ray studies revealed considerable osteoporosis of the ends of the long bones of both hands and narrowing of the joint spaces of the right fourth metacarpophalangeal joint and several interphalangeal joints. PROCEDUREThree balance studies were performed in accordance with methods described by Reifenstein, Albright, and Wells (4). Stools were collected in six-day periods and urines in three and six-day periods. Diets, urines, and stools 505

“…Indeed older studies by Kenyon and his coworkers (43) demonstrate a renal "escape" from testosterone-induced sodium retention which could well be mediated by aldosterone. More conclusive evidence of a similar property for estrogens would extend the spectrum of aldosterone antagonism to another class of natural hormones and one which, like progesterone, would have particular relevance to the alterations in ASR seen in pregnant women.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Estradiol and Estriol on Plasma Levels of Cortisol and Thyroid Hormone-Binding Globulins and on Aldosterone and Cortisol Secretion Rates in Man*

Katz¹,

Kappas²

1967

Summary. The effects of estriol and estradiol on the plasma levels of cortisol-and thyroxine-binding globulin activity, and on the secretion rates of aldosterone and cortisol were studied in man. The metabolite estriol had no consistent or significant influence on plasma levels of the hormone-binding globulin activities; the hormone estradiol increased these binding capacities significantly, as expected. Cortisol secretion rate rose slightly after estriol but was unchanged after estradiol. Both compounds induced substantial increases in the aldosterone secretion-rate of most treated subjects. The mechanism of this apparently paradoxical effect of estrogens is not clear; it is suggested that the "salt-retaining" action of estrogens is mediated in part by the rapid enhancement of aldosterone output which follows their administration in man. Balance experiments in four subjects suggest that both estradiol and estriol may induce a transient early natriuresis in man; but other mechanisms for estrogen stimulation of aldosterone secretion may be operative as well. IntroductionEstriol is quantitatively the most important metabolite of estradiol, being derived from this hormone and related precursors such as estrone, via a chemical transformation which is not reversible in vivo (1). Its production is known to increase extraordinarily in pregnancy, reaching levels of