Can Testosterone Induce Blood Clots and Thrombosis? Interview with Dr Charles Glueck

JPB

Member
Age 58, I am not on TRT. My therapy for hormones the last several years consisted of Clomid and growth hormone peptides. Approx. 1 year ago I had injured my leg and subsequently developed a clot (popliteal vein). I was put on Xarelto, three months later the clot was gone and I got off the Xarelto. I had got off the Clomid when clot was diagnosed. When the clot cleared at some point I resumed Clomid and growth peptides. This past week I rapidly developed symptoms in the same spot and was diagnosed again with a DVT in the popliteal vein and was started on Eliquis, since I did not want the Xarelto again. Will be talking to my doc about more detailed testing. At this point I am blaming things on the original injury and the Clomid. I'm not telling my doc about the Clomid since he told me to stay off it. But I do think the estrogens it produces are probably partly at blame. Hopefully can get the tests recommended by Dr. Glueck to help figure this out.
 
Looking at studies post 2014 shows no correlation between trt use and thrombosis. Texas study in 2015, u.s. chest physicians study, etc etc. I feel like one study showing it's true is not enough to warrant such anxiety and fear. Technically there are more studies showing no correlation then there are showing correlation. Reminds me of the studies on weather trt induces heart attacks, there were one or two which led to fear in the media, later those studies were shown to be inconclusive.
 

Nelson Vergel

Founder, ExcelMale.com
Aging (Albany NY). 2018 May 2;10(5):902-929. doi: 10.18632/aging.101438.

Testosterone and dihydrotestosterone reduce platelet activation and reactivity in older men and women.

Karolczak K1, Konieczna L2, Kostka T3, Witas PJ1, Soltysik B3, Baczek T2, Watala C1.

Author information
1
Department of Haemostatic Disorders, Medical University, Lodz, Poland.
2
Department of Pharmaceutical Chemistry, Medical University of Gdansk, Gdansk, Poland.
3
Department of Geriatrics, Healthy Ageing Research Centre (HARC), Medical University, Lodz, Poland.

Abstract

The cardiovascular effects of testosterone and dihydrotestosterone are generally attributed to their modulatory action on lipid and glucose metabolism. However, no ex vivo studies suggest that circulating androgen levels influence the activation and reactivity of blood platelets - one of the main components of the haemostasis system directly involved in atherosclerosis. The levels of testosterone, dihydrotestosterone and oestradiol in plasma from men and women aged from 60 to 65 years were measured by LC-MS; the aim was to identify any potential relationships between sex steroid levels and the markers of platelet activation (surface membrane expression of GPII/IIIa complex and P-selectin) and platelet reactivity in response to arachidonate, collagen or ADP, monitored with whole blood aggregometry and flow cytometry. The results of the ex vivo part of the study indicate that the concentrations of testosterone and its reduced form, dihydrotestosterone are significantly negatively associated with platelet activation and reactivity. These observations were confirmed in an in vitro model: testosterone and dihydrotestosterone significantly inhibited platelet aggregation triggered by arachidonate or collagen. Our findings indicate that testosterone and dihydrotestosterone are significant haemostatic steroids with inhibitory action on blood platelets in older people.
 

Nelson Vergel

Founder, ExcelMale.com
More from Glueck

J Investig Med. 2018 Apr;66(4):733-738. doi: 10.1136/jim-2017-000637. Epub 2017 Dec 15.


Thromboembolism peaking 3 months after starting testosterone therapy: testosterone-thrombophilia interactions.

Glueck CJ1, Goldenberg N1, Wang P1.

Abstract

We assessed time of thrombotic events (venous thromboembolism (VTE)) after starting testosterone therapy (TT) in 21 men who sustained 23 VTE. The density of thrombotic events was greatest at 3 months after starting TT, with a rapid decline in events by 10 months. The 21 cases with VTE on TT differed from 110 patient controls with unprovoked VTE, not taking TT (VTE-no TT) for Factor V Leiden heterozygosity (FVL) (33 per cent vs 13 per cent, P=0.037), for high lipoprotein (a) (Lp(a)) (55 per cent vs 17 per cent, P=0.012), and for the lupus anticoagulant (33 per cent vs 4 per cent, P=0.003). These differences between cases and VTE-no TT controls were independent of age and gender. TT can interact with underlying thrombophilia-hypofibrinolysis promoting VTE. We suggest that TT should not be started in subjects with known thrombophilia. Coagulation screening, particularly for the FVL , Lp(a), and the lupus anticoagulant should be considered before starting TT, to identify men at high VTE risk who have an adverse risk/benefit ratio for TT.



KEYWORDS:
pulmonary embolism; testosterone; thromboembolism; thrombophilia; thrombosis
 
More from Glueck

J Investig Med. 2018 Apr;66(4):733-738. doi: 10.1136/jim-2017-000637. Epub 2017 Dec 15.


Thromboembolism peaking 3 months after starting testosterone therapy: testosterone-thrombophilia interactions.

Glueck CJ1, Goldenberg N1, Wang P1.

Abstract

We assessed time of thrombotic events (venous thromboembolism (VTE)) after starting testosterone therapy (TT) in 21 men who sustained 23 VTE. The density of thrombotic events was greatest at 3 months after starting TT, with a rapid decline in events by 10 months. The 21 cases with VTE on TT differed from 110 patient controls with unprovoked VTE, not taking TT (VTE-no TT) for Factor V Leiden heterozygosity (FVL) (33 per cent vs 13 per cent, P=0.037), for high lipoprotein (a) (Lp(a)) (55 per cent vs 17 per cent, P=0.012), and for the lupus anticoagulant (33 per cent vs 4 per cent, P=0.003). These differences between cases and VTE-no TT controls were independent of age and gender. TT can interact with underlying thrombophilia-hypofibrinolysis promoting VTE. We suggest that TT should not be started in subjects with known thrombophilia. Coagulation screening, particularly for the FVL , Lp(a), and the lupus anticoagulant should be considered before starting TT, to identify men at high VTE risk who have an adverse risk/benefit ratio for TT.



KEYWORDS:
pulmonary embolism; testosterone; thromboembolism; thrombophilia; thrombosis
I can't believe that after 5 years, his assessments remain a one-way ticket to another dead end: staying hypogonadal which is no better option. Also, T reduces Lp(a): Testosterone-induced suppression of lipoprotein(a) in normal men; relation to basal lipoprotein(a) level. - PubMed - NCBI
To the contrary:
https://www.sciencedirect.com/science/article/pii/S0090429518312007
 
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