Bone Density, Anemia Improve With Testosterone in Low-T Men

Study Highlights

• Snyder and colleagues:
  • Study participants were men at least 65 years old with 2 serum testosterone results of less than 275 ng/dL.
  • Men were randomly assigned to receive testosterone gel with titration to maintain serum testosterone levels commensurate with those of a young man, or placebo gel. The treatment period was 12 months.
  • The main study outcome was BMD. Participants underwent BMD testing with quantitative computed tomography and dual energy x-ray absorptiometry of the spine and hip at baseline and at 12 months.
  • 211 men participated in the trial. The mean age of participants was 72.3 years, and the baseline mean testosterone level was slightly more than 230 ng/dL.
  • vBMD increased in the testosterone group by a mean of 7.5%, compared with an increase of only 0.8% in the placebo group ( P <.01).
  • Measurements of hip trabecular and peripheral vBMD were also superior in the testosterone group vs the placebo group.
  • Testosterone appeared more effective in increasing trabecular vs peripheral BMD, and in improving BMD in the spine vs the hip.
  • 19 fractures were reported during the treatment year and 1 year after the treatment period, with no evidence of a difference in fracture rates in comparing the testosterone group vs the placebo group.
• Roy and colleagues:
  • The study was conducted as a double-blind, placebo-controlled trial among men 65 years or older. All participants had a serum testosterone level of less than 275 ng/dL.
  • Men were randomly assigned to receive testosterone gel with titration to maintain serum testosterone levels commensurate with those of a young man, or placebo gel. The treatment period was 12 months.
  • There were 788 men in the study, of whom 126 were anemic, as defined by a hemoglobin level of 12.7 g/dL or lower. Approximately half of men with anemia had no known cause for anemia.
  • The main study outcome was the effect of testosterone therapy on hemoglobin levels among men with anemia.
  • The mean age of participants was 74.8 years, and the mean serum testosterone level among men with anemia was 222 ng/dL at baseline.
  • 54% of men with unexplained anemia who were treated with testosterone experienced an increase in hemoglobin levels of 1.0 g/dL or more, compared with only 15% of men with similar anemia treated with placebo (adjusted OR, 31.5; 95% CI, 3.7-277.8).
  • 58.3% of men treated with testosterone experienced resolution of their anemia, compared with 22.2% of men treated with placebo.
  • Testosterone also raised hemoglobin levels vs placebo among men with a known cause of anemia.
  • Hemoglobin levels increased past 17.5 g/dL in 6 men without anemia at baseline.