Effects of Graded Doses of Testosterone on Erythropoiesis in Healthy Young and Older Men

Coviello, Andrea D.; Kaplan, Barry; Lakshman, Kishore M.; Chen, Thomas; Singh, Atam B.; Bhasin, Shalender

doi:10.1210/jc.2007-1692

Cited by 325 publications

(264 citation statements)

References 33 publications

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“…61 In another study, testosterone was shown to dose-dependently increase the Hb/haematocrit rate, but did not show a related increase in erythropoietin. 62 A recent study observed increased human erythropoiesis as a result of the acceleration of the conversion of dehydroepiandrosterone sulphate (DHEAS) to testosterone by activation of 3-beta-hydroxysteroid dehydrogenase 2 (3beta-HSD2) and/or 17beta-HSD3, resulting in high serum testosterone levels and high Hb levels. 63 The conversion of testosterone to dihydrotestosterone 64 or to oestradiol 65 is not essential for the mediation of its effects on erythropoiesis.…”

Section: Testosterone and Erythropoiesismentioning

confidence: 99%

Serum testosterone levels and excessive erythrocytosis during the process of adaptation to high altitudes

Gonzales

2013

Asian J Androl

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Populations living at high altitudes (HAs), particularly in the Peruvian Andes, are characterized by a mixture of subjects with erythrocytosis (16 g dl 21 ,haemoglobin (Hb)f21 g dl 21 ) and others with excessive erythrocytosis (EE) (Hb.21 g dl 21 ). Elevated haemoglobin values (EE) are associated with chronic mountain sickness, a condition reflecting the lack of adaptation to HA. According to current data, native men from regions of HA are not adequately adapted to live at such altitudes if they have elevated serum testosterone levels. This seems to be due to an increased conversion of dehydroepiandrosterone sulphate (DHEAS) to testosterone. Men with erythrocytosis at HAs show higher serum androstenedione levels and a lower testosterone/androstenedione ratio than men with EE, suggesting reduced 17beta-hydroxysteroid dehydrogenase (17beta-HSD) activity. Lower 17beta-HSD activity via D4-steroid production in men with erythrocytosis at HA may protect against elevated serum testosterone levels, thus preventing EE. The higher conversion of DHEAS to testosterone in subjects with EE indicates increased 17beta-HSD activity via the D5-pathway. Currently, there are various situations in which people live (human biodiversity) with low or high haemoglobin levels at HA. Antiquity could be an important adaptation component for life at HA, and testosterone seems to participate in this process.

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Section: Testosterone and Erythropoiesismentioning

confidence: 99%

Serum testosterone levels and excessive erythrocytosis during the process of adaptation to high altitudes

Gonzales

2013

Asian J Androl

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“…In a recent study it was convincingly confirmed that npg testosterone has a dose-dependent stimulatory effect on hematopoiesis in men. Remarkably, this effect was more pronounced in older men [121]. Also other studies confirmed the relevance of the dose of testosterone [126] and of age as factors in the stimulation of hematopoiesis [127].…”

Section: Polycythemiamentioning

confidence: 59%

“…Testosterone deficiency results in a 10% to 20% decrease in the blood hemoglobin concentration, which can result in anemia [120,121]. Young hypogonadal men usually have fewer red blood cells and lower hemoglobin levels than age-matched controls, whilst healthy older men also may have lower hemoglobin than normal young men.…”

Section: Improving Anemiamentioning

confidence: 99%

Androgens and male aging: current evidence of safety and efficacy

Gooren¹

2010

Asian J Androl

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Many signs of aging, such as sexual dysfunction, visceral obesity, impaired bone and muscle strength, bear a close resemblance to features of hypogonadism in younger men. The statistical decline of serum testosterone in aging men is solidly documented. It has been presumed that the above features of aging are related to the concurrent decline of androgens, and that correction of the lower-than-normal circulating levels of testosterone will lead to improvement of symptoms of aging. But in essence, the pivotal question whether the age-related decline of testosterone must be viewed as hypogonadism, in the best case reversed by testosterone treatment, has not been definitively resolved. Studies in elderly men with lower-than-normal testosterone report improvement of features of the metabolic syndrome, bone mineral density, of mood and of sexual functioning. But as yet there is no definitive proof of the beneficial effects of restoring testosterone levels to normal in elderly men on clinical parameters. Few of these studies meet as yet rigorous standards of scientific enquiry: double-blind, placebo-controlled design of the study. The above applies also to the assessment of safety of testosterone administration to elderly men. There is so far no convincing evidence that testosterone is a main factor in the development of prostate cancer in elderly men and guidelines for monitoring the development of prostate disease have been developed. It is of note that there are presently no long-term safety data with regard to the prostate. Polycythemia is another potential complication of testosterone treatment. It is dose dependent and can be managed with dose adjustment.

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“…Testosterone increases erythropoetin levels, but the erythropoetin levels return towards baseline with a continued testosterone therapy (23). However, erythropoetin levels are elevated in relation to the increased haemoglobin levels in testosterone-treated men.…”

Section: Discussionmentioning

confidence: 96%

Testosterone replacement therapy (TRT) and its effect on bone marrow. How serious is it and is there a true polyglobulia?

Levcikova¹,

Breza²,

Luha³

et al. 2017

BLL

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INTRODUCTION: TRT in men with testosterone defi ciency syndrome (TDS) had multiple positive effects and restore a quality of life of affected men. Polyglobulia is the most common dose-limiting adverse effect of TRT, but the mechanisms of TRT-mediated erythropoesis remain unclear. In this study, we evaluated long term haematological side effects of TRT: polyglobulia, elevated hemoglobin (Hb) and haematocrit (Ht). METHODS: In a cross-sectional descriptive study, the authors treated 69 men with TDS and the average age 59 years and the follow-up period 81.32 months. The men were treated with three-month i.m. injections of 1000 mg testosterone undecanoate. The elevated values were: Hb above 176 g/l, Ht above 0.52 and erythrocytes (Ery) above 6.0 mil/mcl. RESULTS: 21 out of 69 patients (30.43 %) had an increased Hb, Ht or Ery during treatment. The interesting fact was that only fi ve men (7.24 %) had increased the number of Ery (true polyglobulia). No men with elevated level of Hb, Ht or Ery had other side effects (like thrombosis). CONCLUSION: It is still not clear, why in some men on TRT the feedback does not work and bone marrow production of red blood cells continues even if the upper limit is reached. Authors expect that only 7% of men had true polyglobulia, other men had elevated Hb or Ht. Based on our own experience we recommend a regular check of men on TRT on order to avoid possible serious side-effects (Tab. 1, Fig. 2

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Effects of Graded Doses of Testosterone on Erythropoiesis in Healthy Young and Older Men

Cited by 325 publications

References 33 publications

Serum testosterone levels and excessive erythrocytosis during the process of adaptation to high altitudes

Serum testosterone levels and excessive erythrocytosis during the process of adaptation to high altitudes

Androgens and male aging: current evidence of safety and efficacy

Testosterone replacement therapy (TRT) and its effect on bone marrow. How serious is it and is there a true polyglobulia?

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