Comparison of American Urological Association and Endocrine Society guidelines on testosterone replacement

2021 ◽  
Author(s):  
Isaac Jake Zucker ◽  
Thomas A. Masterson
Keyword(s):  
Testosterone Replacement ◽  
Endocrine Society ◽  
American Urological Association

scholarly journals Update: Hypogonadotropic Hypogonadism in Type 2 Diabetes and Obesity

2011 ◽  
Vol 96 (9) ◽  
pp. 2643-2651 ◽  
Author(s):  
Paresh Dandona ◽  
Sandeep Dhindsa
Keyword(s):  
Type 2 Diabetes ◽  
Glycosylated Hemoglobin ◽  
Hypogonadotropic Hypogonadism ◽  
Phosphodiesterase Inhibitors ◽  
Free Testosterone ◽  
Testosterone Replacement ◽  
C Reactive Protein ◽  
Endocrine Society ◽  
Reactive Protein

Abstract Studies over the last few years have clearly established that at least 25% of men with type 2 diabetes have subnormal free testosterone concentrations in association with inappropriately low LH and FSH concentrations. Another 4% have subnormal testosterone concentrations with elevated LH and FSH concentrations. The Endocrine Society, therefore, now recommends the measurement of testosterone in patients with type 2 diabetes on a routine basis. The subnormal testosterone concentrations are not related to glycosylated hemoglobin or duration of diabetes, but are associated with obesity, very high C-reactive protein concentrations, and mild anemia. In addition, subnormal testosterone concentrations in these men are associated with a two to three times elevated risk of cardiovascular events and death in two early studies. Short-term studies of testosterone therapy in hypogonadal men with type 2 diabetes have demonstrated an increase in insulin sensitivity and a decrease in waist circumference. However, the data on the effect of testosterone replacement on glycemic control and cardiovascular risk factors such as cholesterol and C-reactive protein concentrations are inconsistent. As far as sexual function is concerned, testosterone treatment increases libido but does not improve erectile dysfunction and thus, phosphodiesterase inhibitors may be required. Trials of a longer duration are clearly required to definitively establish the benefits and risks of testosterone replacement in patients with type 2 diabetes and low testosterone.

scholarly journals Prostate-Specific Antigen Concentrations in Response to Testosterone Treatment of Severely Hypogonadal Men

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Saachi Sachdev ◽  
Andrew J Cucchiara ◽  
Peter J Snyder
Keyword(s):  
Prostate Specific Antigen ◽  
Clinical Guidelines ◽  
Medical Center ◽  
Academic Medical Center ◽  
Specific Antigen ◽  
Testosterone Replacement ◽  
Endocrine Society ◽  
Testosterone Treatment ◽  
Psa Response ◽  
Testicular Disease

Abstract Context Clinical guidelines recommend measurement of the serum prostate-specific antigen (PSA) concentration during testosterone treatment of hypogonadal men to determine whether the increase is sufficiently high to warrant urologic referral. Prior studies of the effect of testosterone treatment on PSA concentrations have been conducted in men who were mildly to moderately hypogonadal. Objective The objective of this work is to determine the PSA response to testosterone treatment of men who are severely hypogonadal. Design and Setting This retrospective cohort study was conducted at a single academic medical center. Participants Eighty-five men participated who were severely hypogonadal as a result hypothalamic-pituitary or testicular disease. Main Outcome Measure Changes in serum PSA concentrations were measured during testosterone treatment for up to 18 months. Results Testosterone treatment increased the median serum testosterone concentration from 36 ng/dL (interquartile range [IQR], 20-91 ng/dL) at baseline to 395 ng/dL (IQR, 266-542 ng/dL) at 6 to 18 months. This treatment resulted in a median increment in PSA above baseline of 0.70 ng/mL (IQR, 0.10-1.85 ng/mL) at 6 to 18 months. Apropos current Endocrine Society clinical guidelines, 31% of the men experienced a PSA increase above baseline greater than 1.4 ng/mL, and 13% reached an absolute PSA concentration of greater than 4.0 ng/mL. Four men were diagnosed with prostate cancer. Conclusions The PSA response to testosterone replacement in men who are severely hypogonadal as a result of pituitary or testicular disease is greater than that previously reported in men with mild to moderate hypogonadism. These results suggest the magnitude of the PSA response to testosterone replacement is related to the degree of hypogonadism.

Testosterone Replacement Therapy

2006 ◽  
Vol 39 (13) ◽  
pp. 16
Author(s):  
WILLIAM E. GOLDEN ◽  
ROBERT H. HOPKINS
Keyword(s):  
Replacement Therapy ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy

Vitamin D Treatment in Patients with Hashimoto’s Thyroiditis may Decrease the Development of Hypothyroidism

2016 ◽  
Vol 86 (1-2) ◽  
pp. 9-17 ◽  
Author(s):  
Bekir Ucan ◽  
Mustafa Sahin ◽  
Muyesser Sayki Arslan ◽  
Nujen Colak Bozkurt ◽  
Muhammed Kizilgul ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Hashimoto’S Thyroiditis ◽  
Healthy Control Group ◽  
Hashimoto's Thyroiditis ◽  
Control Group ◽  
Endocrine Society ◽  
Thyroid Autoantibody ◽  
Healthy Control ◽  
The Mean

Abstract.The relationship between Hashimoto’s thyroiditis and vitamin D has been demonstrated in several studies. The aim of the present study was to evaluate vitamin D concentrations in patients with Hashimoto’s thyroiditis, the effect of vitamin D therapy on the course of disease, and to determine changes in thyroid autoantibody status and cardiovascular risk after vitamin D therapy. We included 75 patients with Hashimoto’s thyroiditis and 43 healthy individuals. Vitamin D deficiency is defined as a 25-hydroxy vitamin D (25(OH)D3) concentration less than 20ng/mL. Vitamin D deficient patients were given 50.000 units of 25(OH)D3 weekly for eight weeks in accordance with the Endocrine Society guidelines. All evaluations were repeated after 2 months of treatment. Patients with Hashimoto’s thyroiditis had significantly lower vitamin D concentrations compared with the controls (9.37±0.69 ng/mL vs 11.95±1.01 ng/mL, p < 0.05, respectively). Thyroid autoantibodies were significantly decreased by vitamin D replacement treatment in patients with euthyroid Hashimoto’s thyroiditis. Also, HDL cholesterol concentrations improved in the euthyroid Hashimoto group after treatment. The mean free thyroxine (fT4) concentrations were 0.89±0.02 ng/dL in patients with Hashimoto’s thyroiditis and 1.07±0.03 ng/dL in the healthy control group (p < 0.001). The mean thyroid volumes were 7.71±0.44 mL in patients with Hashimoto’s thyroiditis and 5.46±0.63 mL in the healthy control group (p < 0.01). Vitamin D deficiency is frequent in Hashimoto’s thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

Informationen und Stellungnahme zu bariatrisch-chirurgischen Maßnahmen bei Jugendlichen mit extremer Adipositas

2012 ◽  
Vol 06 (02) ◽  
pp. 99-103
Author(s):  
M. Wabitsch ◽  
Keyword(s):  
Chirurgische Therapie ◽  
Wird Eine ◽  
Endocrine Society

ZusammenfassungKürzlich wurden mehrere Empfehlungen zur Adipositaschirurgie bei Jugendlichen durch verschiedene Fachgruppen publiziert (2). In einigen dieser Empfehlungen wird eine relativ großzügige Indikationsstellung zu einer bariatrisch-chirurgischen Maßnahme bei Jugendlichen empfohlen und es wird relativ unkritisch mit den dadurch ausgelösten potenziellen Langzeitrisiken und Folgeerkrankungen umgegangen. Parallel dazu wird in den letzten Jahren ein deutlicher Anstieg der Zahl von Jugendlichen, die sich einem bariatrisch-chirurgischen Eingriff unterzogen haben, berichtet. Aufgrund dieser Entwicklungen wurde die vorliegende Stellungnahme durch eine interdisziplinär besetzte Expertengruppe der Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalter formuliert. Die Stellungnahme ergänzt das Kapitel 3.1.10 Chirurgische Therapie der im Jahr 2009 publizierten evidenzbasierten Leitlinien zur Therapie der Adipositas im Kindes- und Jugendalter (6) und entspricht in wesentlichen Inhalten der Expertenleitlinie der Endocrine Society aus dem Jahr 2008 (3).

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