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Can Testosterone Induce Blood Clots and Thrombosis? Interview with Dr Charles Glueck
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<blockquote data-quote="Nelson Vergel" data-source="post: 20077" data-attributes="member: 3"><p>Testosterone, thrombophilia, thrombosis.</p><p></p><p>Glueck CJ, et al. Blood Coagul Fibrinolysis. 2014.</p><p></p><p>Authors</p><p>Glueck CJ1, Friedman J, Hafeez A, Hassan A, Wang P.</p><p></p><p>Author information</p><p></p><p>1 Thrombosis Center </p><p></p><p>b Internal Medicine Residency Program, Jewish Hospital of Cincinnati, Cincinnati, Ohio, USA.</p><p>Citation</p><p></p><p>Blood Coagul Fibrinolysis. 2014 Oct;25(7):683-7. doi: 10.1097/MBC.0000000000000126.</p><p></p><p>Abstract</p><p></p><p>We assessed previously undiagnosed thrombophilia-hypofibrinolysis in 11 testosterone (T)-taking men, five of whom developed deep venous thrombosis (DVT), four pulmonary embolism, one spinal cord infarction, and one osteonecrosis 3.5 months (median) after starting T gel (50-160&#8202;mg/day) or T intramuscular (50-250&#8202;mg/week). In the order of referral because of thrombosis after starting T, thrombophilia-hypofibrinolysis was studied in 11 men, and, separately, in two control groups without thrombosis - 44 healthy normal male controls and 39 healthy men taking T. Nine men had DVT or DVT-pulmonary embolism after 3.5 months (median) on T, one spinal cord infarction after 5 days on T, and one had osteonecrosis (knee and then hip osteonecrosis after 6 and 18 months on T). Four of the 11 men (36%) had high factor VIII (&#8805;150%) vs. one of 42 (2%) controls (P&#8202;=&#8202;0.005), and vs. one of 25 (4%) T-controls, (P&#8202;=&#8202;0.023). Of the 11 men, two (18%) had factor V Leiden heterozygosity vs. none of 44 controls, (P&#8202;=&#8202;0.04) and vs. none of 39 T-controls(P&#8202;=&#8202;0.045). Of the 11 men, three had 4G4G plasminogen activator inhibitor-1 homozygosity, one prothrombin G20210A heterozygosity, one low protein S, and one high factor XI. When T was continued, second DVT-pulmonary embolism recurred in three of 11 men despite adequate anticoagulation. T interacts with thrombophilia-hypofibrinolysis leading to thrombosis. Men sustaining DVT-pulmonary embolism-osteonecrosis on T should be studied for thrombophilia. Continuation of T in thrombophilic men appears to be contraindicated because of recurrent thrombosis despite adequate anticoagulation. Before starting T, to prevent T-associated thrombosis, we recommend measures of factor V Leiden, factor VIII, and the prothrombin gene.</p></blockquote><p></p>
[QUOTE="Nelson Vergel, post: 20077, member: 3"] Testosterone, thrombophilia, thrombosis. Glueck CJ, et al. Blood Coagul Fibrinolysis. 2014. Authors Glueck CJ1, Friedman J, Hafeez A, Hassan A, Wang P. Author information 1 Thrombosis Center b Internal Medicine Residency Program, Jewish Hospital of Cincinnati, Cincinnati, Ohio, USA. Citation Blood Coagul Fibrinolysis. 2014 Oct;25(7):683-7. doi: 10.1097/MBC.0000000000000126. Abstract We assessed previously undiagnosed thrombophilia-hypofibrinolysis in 11 testosterone (T)-taking men, five of whom developed deep venous thrombosis (DVT), four pulmonary embolism, one spinal cord infarction, and one osteonecrosis 3.5 months (median) after starting T gel (50-160 mg/day) or T intramuscular (50-250 mg/week). In the order of referral because of thrombosis after starting T, thrombophilia-hypofibrinolysis was studied in 11 men, and, separately, in two control groups without thrombosis - 44 healthy normal male controls and 39 healthy men taking T. Nine men had DVT or DVT-pulmonary embolism after 3.5 months (median) on T, one spinal cord infarction after 5 days on T, and one had osteonecrosis (knee and then hip osteonecrosis after 6 and 18 months on T). Four of the 11 men (36%) had high factor VIII (≥150%) vs. one of 42 (2%) controls (P = 0.005), and vs. one of 25 (4%) T-controls, (P = 0.023). Of the 11 men, two (18%) had factor V Leiden heterozygosity vs. none of 44 controls, (P = 0.04) and vs. none of 39 T-controls(P = 0.045). Of the 11 men, three had 4G4G plasminogen activator inhibitor-1 homozygosity, one prothrombin G20210A heterozygosity, one low protein S, and one high factor XI. When T was continued, second DVT-pulmonary embolism recurred in three of 11 men despite adequate anticoagulation. T interacts with thrombophilia-hypofibrinolysis leading to thrombosis. Men sustaining DVT-pulmonary embolism-osteonecrosis on T should be studied for thrombophilia. Continuation of T in thrombophilic men appears to be contraindicated because of recurrent thrombosis despite adequate anticoagulation. Before starting T, to prevent T-associated thrombosis, we recommend measures of factor V Leiden, factor VIII, and the prothrombin gene. [/QUOTE]
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Can Testosterone Induce Blood Clots and Thrombosis? Interview with Dr Charles Glueck
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