Bioidentical Hormones 101
The Book, by Jeffrey Dach MD
Testosterone Diabetes
 Testosterone Found Beneficial For Diabetes by Jeffrey Dach MD At the 2011 Society for Endocrinology Meeting, Dr. Jones presented data on men with low testosterone and type two diabetes (elevated blood sugar). (1,2) The authors studied 587 diabetic men over 6 years. About 40% of the men had low testosterone (below 300 ng/DL), and in this group, 58 men received Testosterone Replacement. The men were followed for 6 years and mortality rates reported. Above Left Image: Applause courtesy of Wikimedia Commons. Mortality rates over 6 years were as follows– Group 1) Low Testosterone without treatment (36/182-20% mortality), Group 2) Normal Testosterone Level (31/338-9% mortality) Group 3) low Testosterone Level with Testosterone Replacement (5/58-8.6% mortality). A Large Reduction in Mortality For Testosterone Treated Group Mortality in the testosterone treatment men was reduced from 20% mortality to 11 % mortality over 6 years. This is a 2% per year mortality reduction. Compare This to Statin Drugs - 2% vs. 0.5% Compare this 2% per year mortality reduction with testosterone to the 0.5% annual mortality reduction with Statin Drug Treatment in the average secondary prevention trial such as the 4S or LIPID studies, which found a 0.5% per year reduction in mortality for statin treatment in men with known heart disease.(3,4,5) Conclusion The shocking conclusion is that testosterone replacement in diabetic men is a far better treatment with more robust reduction in mortality and fewer adverse effects when compared to statin drug treatment. Articles with Related Interest: Low Testosterone Diagnosis and Treatment HCG in Males with Low Testosterone Testosterone Benefits, PSA and Prostate Part One Hormone Disruption From Pain Pills Testosterone Reduces Mortality Increased Mortality from Testosterone Blockade Testosterone Found Beneficial For Diabetes Links and References 1) www.endocrine-abstracts.org/ea/0025/ea0025p163.htm Endocrine Abstracts (2011) 25 P163 Low testosterone predicts increased mortality and testosterone replacement therapy improves survival in men with type 2 diabetes Vakkat Muraleedharan1,2, Hazel Marsh1 & Hugh Jones1,2 1 Barnsley Hospital NHS Foundation Trust, Barnley, UK; 2University of Sheffield, Sheffield, UK. Background: Low testosterone in men is associated with increase in all-cause and cardiovascular mortality. There is a high prevalence of hypogonadism in men with type 2 diabetes and testosterone replacement therapy (TRT) improves cardiovascular risk. However there is no published data regarding mortality in these patients in relation to testosterone levels, and the long term effect of TRT on mortality. Aim: We report a 6 year follow-up study examining the effect of baseline testosterone and TRT in hypogonadal men with type 2 diabetes on all-cause mortality. Methods: Five hundred eighty-seven patients with type 2 diabetes had total testosterone (TT) performed between 2002 and 2005 and were followed up for 5.8±1.3 years. Deaths during the first 6 months were excluded. Patients were then analysed in three groups. i) normal TT (>10.4 nmol/l) (300 ng/dL) ii) low TT (≤10.4 nmol/l) without TRT. (300 ng/dL) iii) low TT receiving TRT for 2 years or more. 1nmol/L = 28.843 ng/dL Results: Of 580 patients analysed, 338 had normal TT (58%) and 240 low TT (42%). In the low TT group 58 patients received TRT. Mean age 61±11 S.D. and similarly matched in all three groups. Total deaths 72 (12.4%). Mortality rates – low TT without treatment (36/182-20%), normal TT (31/338-9%) and low TT with TRT (5/58-8.6%). Survival was significantly decreased in patients with low TT without TRT (P=0.001 log rank) compared to normal. The treated group had improved survival (P=0.049 log rank). In the Cox Regression model multi-variate (age, weight, HbA1c, pre existing cardiovascular disease, smoking, statin and ACEi/ARB use) adjusted hazard ratio for all-cause mortality was 2.2 (95% CI 1.3–3.7 P=0.001) for low TT. Conclusions: This study shows that men with type 2 diabetes and low testosterone have a significant increased mortality. TRT improved survival compared to those untreated, recording a similar mortality rate to the normal TT group. Brooke J. Poster 152. Muraleedharan V. Poster 163. Both presented at: Society for Endocrinology BES 2011; April 11-14, 2011; Birmingham, United Kingdom. 2) http://www.endocrinology.org/press/pressreleases/2011-04-13_Testosterone.pdf Society for Endocrinology – Media Release Embargoed until 00:01 BST, Wednesday 13 April 2011 Increase in deaths in men with type 2 diabetes and testosterone deficiency may be prevented by testosterone replacement 4S Study Seconday Prevention 3) http://www.ncbi.nlm.nih.gov/pubmed/7572690 Am J Cardiol. 1995 Sep 28;76(9):64C-68C. Reducing the risk of coronary events: evidence from the Scandinavian Simvastatin Survival Study (4S). Kjekshus J, Pedersen TR. National Hospital, Department of Medicine, Oslo, Norway. The Scandinavian Simvastatin Survival Study (4S) was designed to evaluate the effects of cholesterol reduction with simvastatin on mortality and morbidity in patients with coronary artery disease (CAD). A total of 4,444 patients with angina pectoris or previous myocardial infarction and serum cholesterol levels of 213-310 mg/dl (5.5-8.0 mmol/liter) while treated with a lipid-lowering diet were randomly assigned to double-blind treatment with simvastatin or placebo. Over the 5.4 years of median follow-up, simvastatin produced changes in total cholesterol, low density lipoprotein (LDL) cholesterol, and high density lipoprotein (HDL) cholesterol of -25%, -35%, and +8%, respectively, with minimal adverse effects. A total of 256 patients (12%) in the placebo group died compared with 182 (8%) in the simvastatin group, a risk reduction of 30% (p = 0.0003) attributable to a 42% reduction in the risk of coronary death. Noncardiovascular causes accounted for 49 and 46 deaths in the placebo and simvastatin groups, respectively. Major coronary events were experienced by 622 patients (28%) in the placebo group and 431 patients (19%) in the simvastatin group, corresponding to a risk reduction of 34% (p < 0.00001). 4) http://www.ncbi.nlm.nih.gov/pubmed/9576425 Circulation. 1998 Apr 21;97(15):1453-60. Lipoprotein changes and reduction in the incidence of major coronary heart disease events in the Scandinavian Simvastatin Survival Study (4S) Pedersen TR, Olsson AG, Faergeman O, Kjekshus J, Wedel H, Berg K, Wilhelmsen L, Haghfelt T, Thorgeirsson G, Pyörälä K, Miettinen T, Christophersen B, Tobert JA, Musliner TA, Cook TJ. Aker Hospital, Oslo, Norway. 5) LIPID STUDY http://www.nejm.org/doi/full/10.1056/NEJM199811053391902 Prevention of Cardiovascular Events and Death with Pravastatin in Patients with Coronary Heart Disease and a Broad Range of Initial Cholesterol Levels The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group N Engl J Med 1998; 339:1349-1357November 5, 1998 ----------------------------- onlinelibrary.wiley.com/doi/10.1002/pdi.1544/pdf P ractical Diabetes InternationalVolume 28, Issue 1, Article first published online: 4 FEB 2011 Every obese male with type 2 diabetes should be screened for hypogonadism’ FOR Professor T Hugh Jones Consultant Physician & Endocrinologist, Robert Hague Centre for Diabetes and Endocrinology, Barnsley Hospital NHS Foundation Trust, and Hon. Professor of Andrology, Academic Unit of Diabetes, Endocrinology and Metabolism, School of Medicine and Biomedical Sciences, University of Sheffield, UK updated clinical practice guideline of the American Endocrine Society does say that they suggest measurement of testosterone in men with type 2 diabetes.22 jcem.endojournals.org/content/95/6/2536.long The Journal of Clinical Endocrinology & Metabolism June 1, 2010 vol. 95 Testosterone Therapy in Men with Androgen Deficiency Syndromes: An Endocrine Society Clinical Practice Guideline Shalender Bhasin, Glenn R. Cunningham, Frances J. Hayes, Alvin M. Matsumoto, Peter J. Snyder, Ronald S. Swerdloff and Victor M. Montori Boston University School of Medicine (S.B.), Boston, Massachusetts 02118; Baylor College of Medicine/Veterans Affairs Medical Center (G.R.C.), Houston, Texas 77030; St. Vincent’s University Hospital (F.J.H.), Dublin 4, Ireland; University of Washington/Veterans Affairs Puget Sound Health Care System (A.M.M.), Seattle, Washington 98108; University of Pennsylvania School of Medicine (P.J.S.), Philadelphia, Pennsylvania 19104; Harbor University of California, Los Angeles Medical Center (R.S.S.), Torrance, California 90502; and Mayo Clinic (V.M.M.), Rochester, Minnesota 55905 Jeffrey Dach MD 7450 Griffin Road, Suite 190 Davie, Fl 33314 954-792-4663 Serving Hollywood, Miami, Fort Lauderdale, Pembroke Pines, Miramar, Davie, Coral Springs, Cooper City, Sunshine Ranches, Hallandale, Surfside, Miami Beach, Sunny Isles, Normandy Isles, Coral Gables, Hialeah, Golden Beach ,Kendall,sunrise, coral springs, parkland,pompano, boca raton, palm beach, weston, dania beach, tamarac, oakland park, boynton beach, delray,lake worth,wellington,plantation www.drdach.com www.naturalmedicine101.com www.bioidenticalhormones101.com www.truemedmd.com Click Here for: Dr Dach's Online Store for Pure Encapsulations Supplements Click Here for: Dr Dach's Online Store for Nature's Sunshine Supplements Web Site and Discussion Board Links: jdach1.typepad.com/blog/ disc.yourwebapps.com/Indices/244124.html disc.yourwebapps.com/Indices/244066.html disc.yourwebapps.com/Indices/244067.html disc.yourwebapps.com/Indices/244161.html disc.yourwebapps.com/Indices/244163.html Disclaimer click here: www.drdach.com/wst_page20.html The reader is advised to discuss the comments on these pages with his/her personal physicians and to only act upon the advice of his/her personal physician. 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