Study shows testos­terone has lim­ited ben­e­fits

Older men did not have bet­ter mem­ory, but ane­mia and bone den­sity im­proved

The Hamilton Spectator - - HEALTH - LIND­SEY TAN­NER

CHICAGO — Testos­terone treat­ment did not im­prove older men’s mem­ory or men­tal func­tion in the lat­est re­sults from land­mark govern­ment re­search that chal­lenges the anti-ag­ing claims of pop­u­lar sup­ple­ments.

While testos­terone use for one year ap­peared to strengthen bones and re­duce ane­mia, it also showed signs of wors­en­ing artery dis­ease and ques­tions re­main about other po­ten­tial risks. The re­searchers said more stud­ies are needed to de­ter­mine long-term ef­fects — the kind of re­search the U.S. Food and Drug Ad­min­is­tra­tion has al­ready asked sup­ple­ment mak­ers to con­duct.

“I don’t think any­body would in­ter­pret th­ese re­sults as say­ing, ‘Wow, this is a fountain of youth, this is a mag­i­cal anti-ag­ing po­tion,’” said study coau­thor Su­san El­len­berg, a Univer­sity of Penn­syl­va­nia re­searcher.

The re­sults are from the fi­nal four stud­ies in a seven-part project mostly funded by the Na­tional In­sti­tute on Ag­ing, in­volv­ing nearly 800 U.S. men aged 65 and older with low testos­terone lev­els. The goal was to see if rub­bing testos­terone gel on the skin daily for a year could treat prob­lems linked with low lev­els of the male hor­mone, which de­clines with age. Half the men in each group used the real thing and half used fake gel.

Re­sults pub­lished a year ago from the same re­search linked testos­terone with mostly mod­est im­prove­ment in sex­ual per­for­mance, walk­ing strength and mood. The key new find­ings: • Testos­terone had no ef­fect on mem­ory or men­tal func­tion, based on tests given be­fore, half­way and at the end of treat­ment to nearly 500 men with age-re­lated mem­ory de­cline.

• Among al­most 140 men who un­der­went heart artery imag­ing tests to see if the hor­mone slowed pro­gres­sion of plaque, those who used testos­terone had more plaque buildup and nar­rower ar­ter­ies af­ter a year than the fake gel group. Those changes could sig­nal in­creased chances for heart at­tacks although none oc­curred in the study. Men in this sub-study were al­ready more vul­ner­a­ble for heart prob­lems be­cause of con­di­tions in­clud­ing artery dis­ease, obe­sity and high blood pres­sure.

• Among about 200 men given bone imag­ing tests be­fore and at the end of treat­ment, those on testos­terone showed in­creases in bone den­sity and bone strength, es­pe­cially in the spine, while min­i­mal changes were found in the group that used fake gel. The im­prove­ment was sim­i­lar to bone changes seen with treat­ment for os­teo­poro­sis, although most men stud­ied did not have that bone-thin­ning con­di­tion, which can lead to frac­tures.

• Among 126 men with ane­mia, a fa­tigue-linked con­di­tion in­volv­ing in­ad­e­quate red blood cells, those on testos­terone showed sub­stan­tial im­prove­ment. By the study’s end, ane­mia had van­ished in al­most 60 per cent of men on testos­terone com­pared with 22 per cent of the fake gel group. The hor­mone group also re­ported hav­ing more en­ergy. “The over­all health ben­e­fits, how­ever, re­main to be de­ter­mined,” the re­searchers said.

The stud­ies were pub­lished Tues­day in the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion and JAMA In­ter­nal Medicine. Ab­bVie Phar­ma­ceu­ti­cals pro­vided its gel for the study and helped pay for the re­search but had no other role in the study.

The re­search was not de­signed to look at risks and does not ap­ply to younger men or those with nor­mal lev­els of testos­terone, said study leader Dr. Peter Sny­der, a Univer­sity of Penn­syl­va­nia hor­mone spe­cial­ist. It’s also not known if other forms of testos­terone sup­ple­ments would have sim­i­lar ef­fects in older men with low lev­els.

Pre­scrip­tion testos­terone prod­ucts in­clud­ing gel are approved only for men with low lev­els of the hor­mones caused by var­i­ous med­i­cal con­di­tions. Ben­e­fits and risks are un­known in men whose lev­els are low due only to ag­ing, the agency says. The agency re­quires testos­terone la­bels to in­clude pos­si­ble risks for heart at­tacks and strokes, based on some pre­vi­ous stud­ies.

A sep­a­rate study pub­lished Tues­day in JAMA In­ter­nal Medicine found that men us­ing pre­scrip­tion testos­terone gel, patches or in­jec­tions had fewer heart at­tacks and strokes dur­ing about three years of fol­lowup than non-users. But this was only ob­ser­va­tional data in men aged 40 and up, not rig­or­ous re­search test­ing the hor­mone against a placebo.

Clar­i­fy­ing testos­terone’s ef­fects on heart prob­lems, frac­tures and age-re­lated dis­abil­ity will re­quire larger, longer stud­ies, said Dr. Evan Hadley of the Na­tional In­sti­tute on Ag­ing. He said de­ci­sions about whether to use testos­terone should take into ac­count men’s in­di­vid­ual risks for con­di­tions the hor­mone could af­fect.

DREAM­STIME

Testos­terone treat­ment ap­pears to ben­e­fit some older men who have low lev­els. How­ever, a study showed it in­creased plaque in ar­ter­ies over one year, while help­ing those who are ane­mic.

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