Testosterone Replacement

Data from the Baltimore Longitudinal Study on Aging (890 men), suggested that 20% of the men over 60 years of age, 30% over 70 years, and 50% over 80 years were hypogonadal, as defined by a total testosterone level < 325 ng/dl (11.3 nmol/l), [46]. It is widely believed that total testosterone declines 1% per year after the age of 50 years [4]. Thus, the decline in testosterone follows a time course similar to the decline in muscle strength and muscle mass. Many individuals believe that it is the decline in testosterone over time that results in a reduction in muscle mass and muscle strength, and that by administering replacement doses of testosterone these parameters can be restored.

Morley et al. [47] studied 37 men aged 69-89 years old. Twenty-six of the men had a mean total testosterone level of < 272 ng/dl. They were administered 200 mg of testosterone enanthate every 2 weeks for 3 months. Alternating cases was the method used to assign subjects to treatment or placebo groups. The authors reported a nine-fold increase in bioavailable testosterone and a significant increase in right-hand muscle strength. Sih et al. [48] reported that 12 months of testosterone replacement (biweekly injections of 200 mg) in hypogonadal elderly men resulted in a significant increase in bilateral grip strength. Bhasin et al. [49] examined the effects of 10 weeks of testosterone replacement (100 mg/week) on body composition and strength in seven hypogonadal men aged 19-47 in an open-labelled non-randomised study. By day 15, serum testosterone had increased from 71.9 to 509 ng/ml. After 10 weeks, there was an 8.8 % increase in fat-free mass, an 11% increase in triceps cross-sectional area, and a 7% increase in thigh cross-sectional area. Strength on the bench press increased by 22% and that on the squat exercise by 45%. The caveat from the study of Bhasin et al. [49] is that these men had extremely low testosterone concentrations (mean = 71.9 ng/ml). As described above, the investigators from the Baltimore Longitudinal Study on Aging used a testosterone concentration of < 325 ng/l as the cut off for hypogonadism [46]. Thus, because the testosterone concentration was so low in the study of Bhasin et al. [49], and presumably muscle mass and muscle strength were extremely low, the response of these parameters to the administration of 100 mg testosterone/week may have been greater than that seen in other investigations. Brodsky et al. [50] studied testosterone replacement (3 mg/kg every 2 weeks) in hypogonadal men (total testosterone < 200 ng/ml). They reported a 15% increase in fat-free mass and a 13% increase in appendicular muscle mass. Tenover [51] used a double-blind randomised controlled trial to study the effects of testosterone replacement (100 mg/week; 3 months) in men age 57-76

who had low or borderline low serum testosterone (< 13.9 nmol/l; 400 ng/dl). A small (3%) increase in lean body mass and no change in grip strength were reported. In an open-labelled trial without a control group, Urban et al. [52] administered 100 mg of testosterone per week over 4 weeks to elderly men with a serum testosterone concentration of < 480 ng/dl. Significant increases in strength in the hamstrings and quadriceps of both legs were observed. In contrast to the positive benefits observed in most studies, Snyder et al. [53] reported that, despite a 70% increase in testosterone concentration over 36 months in men over the age of 65 (using a testosterone patch), there was no significant improvement in muscle strength despite a significant increase in lean body mass. Thus, from these data it appears that testosterone replacement is likely an effective intervention for reversing sar-copenia. However, whether it is a better and/or safer alternative than resistance training remains to be determined.

Supplements For Diabetics

Supplements For Diabetics

All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.

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