Administration of testosterone to elderly hypogonadal men with Crohn's disease improves their Crohn's Disease Activity Index: a pilot study

Both elevated and depressed testosterone (T) levels have been reported in Crohn's disease (CD). In this pilot study, effects of T administration on CD were assessed.A total of 13 men with CD, aged 45–67 years, had subnormal plasma T (mean±SD=9.0±1.4 nmol/L) (reference >12.0); they were compared to a group of 110 men of similar age with sexual and urological problems whose plasma T was also subnormal: 10.4±1.4 nmol/L (p=0.02). All received treatment with parenteral T undecanoate for 24 months. The Crohn's Disease Activity Index (CDAI) was assessed as an indicator of the severity of the disease every 3 months. Levels of T and C-reactive protein (CRP) were compared between the 13 men with CD and the other men in this study. Values of CDAI and CRP were followed-up.CRP levels were 22.7 mg/dL (95% confidence interval of the mean: 14.9–34.3) in the 13 men with CD vs. 3.5 (2.9–4.1) in 107 control men (p=0.001). Upon normalization of serum T, there was a significant decline of CDAI (from 243±19 to 89±9), CRP levels from 22.7±8.1 to 6.9±2.9 mg/dL, and white blood cell count. Hemoglobin/hematocrit increased significantly.Upon normalization of plasma T the CDAI and CRP levels decreased in hypogonadal patients with CD. The mechanism of this improvement could be through immunosuppressive effects of T, reducing chronic inflammation of the intestinal wall in CD.