Six-Week Improvements in Muscle Mass and Strength During Androgen Therapy in Older Men

Schroeder, E. Todd; Vallejo, Alberto F.; Zheng, Ling; Stewart, Yolanda; Flores, Carla; Nakao, Susie; Martı́nez, Carmen; Sattler, Fred R.

doi:10.1093/gerona/60.12.1586

Cited by 34 publications

(17 citation statements)

References 35 publications

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“…This may also explain why participants in the placebo group showed a non-significant reduction in muscle strength parameters, while those in the L-Carnitine group maintained and those in the L-Carnitine-combination group improved muscle strength. In addition, clinical muscle function studies involving older men and women have observed that participants in the placebo group show declines in muscle strength over the course of the study [40, 41], relative to baseline, similar to this current report.…”

Section: Discussionsupporting

confidence: 85%

Efficacy of a novel formulation of L-Carnitine, creatine, and leucine on lean body mass and functional muscle strength in healthy older adults: a randomized, double-blind placebo-controlled study

et al. 2017

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BackgroundProgressive decline in skeletal muscle mass and function are growing concerns in an aging population. Diet and physical activity are important for muscle maintenance but these requirements are not always met. This highlights the potential for nutritional supplementation. As a primary objective, we sought to assess the effect of a novel combination of L-Carnitine, creatine and leucine on muscle mass and performance in older subjects.MethodForty-two healthy older adults aged 55–70 years were randomized to receive either a novel L-Carnitine (1500 mg), L-leucine (2000 mg), creatine (3000 mg), Vitamin D3 (10 μg) (L-Carnitine-combination) product (n = 14), L-Carnitine (1500 mg) (n = 14), or a placebo (n = 14) for eight weeks. We evaluated body mass by DXA, upper and lower strength by dynamometry, and walking distance by a 6-min walk test at baseline and after eight weeks of intervention. These measures, reflecting muscle mass, functional strength and mobility have been combined to generate a primary composite score. Quality of life, blood safety markers, and muscle biopsies for protein biomarker analysis were also conducted at baseline and the end of the study.ResultsThe primary composite outcome improved by 63.5 percentage points in the L-Carnitine-combination group vs. placebo (P = 0.013). However, this composite score did not change significantly in the L-Carnitine group (P = 0.232), and decreased slightly in the placebo group (P = 0.534). Participants supplemented with the L-Carnitine-combination showed a 1.0 kg increase in total lean muscle mass (P = 0.013), leg lean muscle mass (0.35 kg, P = 0.005), and a 1.0 kg increase in lower leg strength (P = 0.029) at week 8. In addition, these increases were significant when compared to the placebo group (P = 0.034, P = 0.026, and P = 0.002, respectively). Total mTOR protein expression was increased in participants in the L-Carnitine-combination group at the end of the study compared to the baseline (P = 0.017). This increase was also significant when compared to the placebo (P = 0.039), suggesting that the increase in muscle mass and strength was due to new protein synthesis and mTOR pathway activation.ConclusionsThe trial did reach its primary objective. L-Carnitine combined with creatine and L-leucine significantly improved the composite score which reflects muscle mass and strength, at the end of the study compared to placebo. The combination showed an increase in mTOR protein level, a driver for increased muscle mass which translated to an improvement in muscle strength. This new combination may provide a potential nutritional intervention to promote muscle growth and improved physical functioning in older adults.Electronic supplementary materialThe online version of this article (doi:10.1186/s12986-016-0158-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 85%

Efficacy of a novel formulation of L-Carnitine, creatine, and leucine on lean body mass and functional muscle strength in healthy older adults: a randomized, double-blind placebo-controlled study

et al. 2017

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“…Indeed, in a prior report from members of our group, treatment of older men with oxandrolone resulted in 90% of the gains in lean mass, reductions in adipose tissue, and improvements in muscle strength being achieved by 6 weeks in a 12-week treatment study (Schroeder et al 2005). Likewise, in the present study significant reductions in total and trunk fat (data not shown) occurred at week 8 and the changes were greater at week 17 supporting a time-dependent effect of the anabolic hormone combination on other tissues.…”

Section: Discussionmentioning

confidence: 93%

Value of measuring muscle performance to assess changes in lean mass with testosterone and growth hormone supplementation

Schroeder

Yarasheski

et al. 2011

Eur J Appl Physiol

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We hypothesized that treatment with testosterone (T) and recombinant human growth hormone (rhGH) would increase lean mass (LM) and muscle strength proportionally and an in a linear manner over 16 weeks. This was a multicenter, randomized, controlled, double-masked investigation of T and rhGH supplementation in older (71 ± 4 years) community-dwelling men. Participants received transdermal T at either 5 or 10 g/day as well as rhGH at 0, 3.0 or 5.0 µg/kg/day for 16 weeks. Body composition was determined by dual-energy X-ray absorptiometry (DEXA) and muscle performance by composite one-repetition maximum (1-RM) strength and strength per unit of lean mass (muscle quality, MQ) for five major muscle groups (upper and lower body) at baseline, week 8 and 17. The average change in total LM at study week 8 compared with baseline was 1.50 ± 1.54 kg (P < 0.0001) in the T only group and 2.64 ± 1.7 (P < 0.0001) in the T + rhGH group and at week 17 was 1.46 ± 1.48 kg (P < 0.0001) in the T only group and 2.14 ± 1.96 kg (P < 0.0001) in the T + rhGH group. 1-RM strength improved modestly in both groups combined (12.0 ± 23.9%, P < 0.0001) at week 8 but at week 17 these changes were twofold greater (24.7 ± 31.0%, P < 0.0001). MQ did not significantly change from baseline to week 8 but increased for the entire cohort, T only, and T + rhGH groups by week 17 (P < 0.001). Despite sizeable increases in LM measurements at week 8, tests of muscle performance did not show substantive improvements at this time point.

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“…The number of participants in intervention groups ranged from 7 to 113 and in placebo groups from 5 to 110. The drug used was testosterone enanthate (SheffieldMoore et al 2011;Page et al 2005;Ferrando et al 2003;Blackman et al 2002), oxandrolone (Schroeder et al 2005;Schroeder et al 2004;Schroeder et al 2003a), testosterone undecanoate (Emmelot-Vonk et al 2008;Wittert et al 2003), oxymetholone (Schroeder et al 2003b), and Androgel (Kenny et al 2010). The administration method used was oral (6 articles), injection (4 articles), and transdermal gel (1 article).…”

Section: Selected Studiesmentioning

confidence: 99%

Effects of testosterone on lean mass gain in elderly men: systematic review with meta-analysis of controlled and randomized studies

Neto

Gama

Rocha

et al. 2015

AGE

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The objective of this study was to evaluate the effects of steroid anabolic androgenic hormones use on lean mass gain in elderly men through a systematic review with a meta-analysis of randomized controlled studies. We systematically searched PubMed database until 4th October 2013. We included randomized placebo-controlled trials (RCT) that studied testosterone replacement therapy in men over 60 years of age, with total testosterone levels ≤550 ng/dl, observing gains in weight, lean mass tissue and fat mass as outcome. We excluded duplicated studies, studies which mixed men and women, and studies using weak androgens such as dehydroepiandrosterone or androstenedione. The initial search yielded 2681 articles, of which 26 were selected for full text analysis. In the end, 11 studies were included. However, 3 studies were not included in the metaanalysis. Meta-analysis showed that mean weight increased (lean mass), ranging from 1.65 (95 % CI, AGE (2015) ) kg, although it was heterogeneous (I 2 =98 %). Effect estimate was 3.59 [2.38-4.81]. Androgen therapy decreased fat mass; effect estimate was −1.78 [−2.57, −0.99] that analysis had also a high level of heterogeneity (I 2 =81 %). The results suggest that testosterone replacement therapy is able to increase muscle mass in elderly men and that is affected by the time that the treatment is carried out and the method of administration of the drug.

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Six-Week Improvements in Muscle Mass and Strength During Androgen Therapy in Older Men

Abstract: Treatment with a potent anabolic androgen may produce significant increases in muscle mass and strength after only 6 weeks in healthy older men. However, such treatment did not improve leg muscle power or walking speed.

Cited by 34 publications

References 35 publications

Efficacy of a novel formulation of L-Carnitine, creatine, and leucine on lean body mass and functional muscle strength in healthy older adults: a randomized, double-blind placebo-controlled study

Efficacy of a novel formulation of L-Carnitine, creatine, and leucine on lean body mass and functional muscle strength in healthy older adults: a randomized, double-blind placebo-controlled study

Value of measuring muscle performance to assess changes in lean mass with testosterone and growth hormone supplementation

Effects of testosterone on lean mass gain in elderly men: systematic review with meta-analysis of controlled and randomized studies

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