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Testing Testosterone Replacement

Posted by moddoctor On January - 3 - 2008

The new issue of the Journal of the American Medical Association has published a Dutch study on the use of testosterone in aging men. This is interesting because the study itself comes to some interesting conclusions. The Dutch researchers concluded that oral testosterone replacement in men improves lean body mass but did not result in weight loss as seen in other studies of the hormone. They also used a quality of life measurement scale that resulted in no measurable quality of life improvement. The study also showed no improvement in cognitive function amongst those in the study. The study is followed by a lengthy comment and literature review.

Several problems with the study appear on even the first reading. While the Dutch researchers checked for low testosterone in the men in the study before starting medication they did not monitor the testosterone levels through the study. It is entirely possible that the doses of testosterone were inadequate to see the kinds of results that have been documented for testosterone before. Also, the study used oral testosterone for supplementation. Oral testosterone is not considered by those in the know to be acceptable for testosterone replacement. Even the Endocrine Society notes that there are risks of negative effects on the liver from oral testosterone only in their clinical guidelines. Additionally, the paper in JAMA refers to itself as being a “large study” despite the fact there were only 237 test subjects. I personally don’t consider anything less 1000 large, but clearly JAMA differs with me on this. Really, there are statistical rules for analyzing data from numbers as small as 30 and extrapolating to larger populations but this is a dangerous game which is also why so many studies are done over and over again.

The AMA also has a history with anti-aging medicine that’s not good. The American Academy of Anti-Aging Medicine (A4M) has on several occasions made official responses to JAMA articles on hormone replacement because JAMA coverage is universally negative despite what makes it into the endocrinology journals. The responses include this one from 2002 and this one from early 2007. JAMA and the AMA have demonstrated what appear to me to be a political bias against hormone replacement as demonstrated by their ongoing choice to publish only negative studies of hormone replacement.

Since JAMA is very widely read by physicians and covered heavily in the mainstream media, it’s important to make sure you find a physician that reads more than just JAMA if you intend to age against the machine.

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