Bioavailable Testosterone and Depressed Mood in Older Men: The Rancho Bernardo Study

Abstract

A cross-sectional population-based study examined the association between endogenous sex hormones and depressed mood in community-dwelling older men. Participants included 856 men, ages 50-89 yr, who attended a clinic visit between 1984-87. Total and bioavailable testosterone, total and bioavailable estradiol, and dihydrotestosterone levels were measured by radioimmunoassay in an endocrinology research laboratory. Depressed mood was assessed with the Beck Depression Inventory (BDI). Levels of bioavailable testosterone and bioavailable estradiol decreased with age, but total testosterone, dihydrotestosterone, and total estradiol did not. BDI scores increased with age. Low bioavailable testosterone levels and high BDI scores were associated with weight loss and lack of physical activity, but not with cigarette smoking or alcohol intake. By linear regression or quartile analysis the BDI score was significantly and inversely associated with bioavailable testosterone (both Ps = 0.007), independent of age, weight change, and physical activity; similar associations were seen for dihydrotestosterone (P = 0.048 and P = 0.09, respectively). Bioavailable testosterone levels were 17% lower for the 25 men with categorically defined depression than levels observed in all other men (P = 0.01). Neither total nor bioavailable estradiol was associated with depressed mood. These results suggest that testosterone treatment might improve depressed mood in older men who have low levels of bioavailable testosterone. A clinical trial is necessary to test this hypothesis.

Age-Related Alterations in Endocrine Markers Do Not Match Changes in Psychosocial Measures: Findings From the Men’s Health 40+ Longitudinal Study

“…To increase the validity and reliability, it can be beneficial to employ a design with more than one hormone sample for each time point. Reliable and valid results can also be obtained with single or two-time measurements while controlling for sampling time and presample behavior, as also applied within the current study (Barrett-Connor et al, 1999;Clifton et al, 2016;Feldman et al, 2002). Similarly, the assessment of more than two time points within the 4 years of the study duration, or even expanding the study with a study design of more than 4 years would increase the potential conclusions that could be derived.…”

Investigation of the Plausibility of 5-Alpha-Reductase Inhibitor Syndrome

“…Other possible mechanisms involve reduction in levels of DHT. A study by Barrett-Connor et al [24 ]showed that BDI survey scores for measuring depression were inversely associated with bioavailable DHT levels and genetic predisposition. Two polymorphisms (CAG) rs4045402 and (GGN) rs3138869 in the gene encoding for the androgen receptor have been hypothesized to play a role in finasteride sensitivity [25].…”

Aging and sex hormones in males

“…Metabolic syndrome was associated to low serum T and/ or low SHBG in the BLSA, 41 HIMS, 108,109 InChianti, 68,67 Tromsø, 110,111,112 and RBS. 65,105,106 studies, but not in the CHAMP study, the latter showing an association between lower SHBG levels, but not T, and the development of metabolic syndrome 76 ( Table 3). The EMAS study showed that weight loss is associated to an increase, while weight gain to a decrease in both total and free serum T, with the same association persisting by considering waist circumference 82 As previously reported, obesity probably determines an impairment of the hypothalamic-pituitary function, leading to lower LH incretion and finally to hypogonadotropic hypogonadism.…”