Testosterone; the good, the bad and the ugly

Testosterone is a subject that comes up quite often in the KDA chat rooms. Most men with Kennedy’s Disease have lower than normal levels as the condition progresses. Doctors who are unfamiliar with Spinal Bulbar Muscular Atrophy might recommend testosterone supplements to boost their patient’s levels. Most neurologists familiar with the disease are cautious whenever these type supplements are considered.

Over the years there have been a few studies trying to determine if there are any benefits in using testosterone injections. These studies were inconclusive. One study showed testosterone had a negative effect while another did not show any harm nor any benefit in taking supplements.

Yahoo Health News recently had an article, “Thirteen Surprising Facts about Testosterone” that I found interesting. I have shown six of the facts below.
 

• It's hard to measure accurately

  Men are often diagnosed with low testosterone after a single test. This is a big problem, says Neil Goodman, MD, an endocrinologist and professor of medicine at the University of Miami School of Medicine. "If I take blood on a guy and I send it to three labs, I'm going to get three different levels," he says. Efforts are underway to standardize blood tests. In the meantime, testosterone should be checked more than once, Dr. Goodman says, and done in the morning when testosterone is highest. Men whose levels of testosterone are below normal may lose their spare tire when treated with testosterone. "Most of the studies show there's a reduction of abdominal obesity in men who are given testosterone," says Adrian Dobs, MD, a professor of medicine and oncology at Johns Hopkins University School of Medicine, in Baltimore.

• It can shrink your belly

  Because the long-term effects of testosterone therapy have not been well studied, however, it is generally only recommended in men with below-normal testosterone levels and symptoms such as fatigue, muscle or bone-mass loss, or sexual dysfunction.

• Fat can lower testosterone

  Obese men tend to have lower testosterone than thinner men, Dr. Dobs says. It's not clear why, she adds, although one possible reason is that obesity promotes a state of widespread inflammation in the body. "When there's fat cells, there's a lot of inflammatory factors," she says. "These inflammatory factors have been associated with suppression of testosterone synthesis."

• Too much may kill brain cells

  It's only known to happen in a petri dish, but Yale researchers showed that nerve cells exposed to high levels of testosterone were more likely to self-destruct. The hormone boosted a "cell suicide" mechanism known as apoptosis, which, under normal circumstances, is supposed to help the body wipe out cancerous or otherwise abnormal cells. And the higher the testosterone level in the dish, the shorter lived the cells were. Exposure to low levels of testosterone, however, had no effect on the cells.

• It may hurt men's hearts

  In 2010, researchers halted a study of testosterone therapy in older men because of a higher rate of cardiovascular problems such as heart attack in the group taking testosterone instead of placebo. The reason isn't clear, but caution should be used in prescribing testosterone to older men in poor health, Dr. Goodman says. Declining testosterone in men is associated with health problems, but this doesn't mean giving older men testosterone will extend lifespans, he says.

• Low levels of testosterone are linked to sleep apnea

  Men with sleep apnea are more likely to have low testosterone, and treating sleep apnea can help return it to normal. But if a man with sleep apnea is diagnosed with low testosterone alone, taking the supplemental hormone can worsen sleep apnea. That's why it's crucial for men with low testosterone to get a thorough workup by an endocrinologist so underlying conditions that can cause low testosterone, such as sleep apnea or pituitary-gland tumors, don't go undiagnosed, Dr. Goodman says.

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If you or your doctor is considering testosterone supplements, I would recommend that you discuss it first with a neurologist familiar with Kennedy’s Disease and then monitor the effect closely.

Source: Thirteen Surprising Facts about Testosterone