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Can Testosterone Induce Blood Clots and Thrombosis? Interview with Dr Charles Glueck
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<blockquote data-quote="Marco N Cognito" data-source="post: 7328" data-attributes="member: 13"><p>Here are the main takeaways I gleaned from Glueck's emails: </p><p></p><p><strong>1. On the basis of our published data, when a patient has a major gene familial thrombophilia like V Leiden or Prothrombin gene heterozygosity, or familial high Factors VIII or XI, or acquired thrombophilia (lupus anticoagulant, anti phospholipid antibody syndrome), exogenous testosterone appears to be contraindicated absolutely, irrespective of the E2 level, although most events occurr when E2 is >42.6. </strong></p><p><strong></strong></p><p><strong>2. We have 10 cases with major gene thrombophilia fully anticoagulated with warfarin who had second or even third thrombotic events when exogenous T therapy was continued.</strong></p><p><strong></strong></p><p><strong>3. We have one case (not yet published but soon in Blood Coag Fibrinolysis) where arimidex by itself caused thrombosis in a V Leiden heterozygote. </strong></p><p><strong></strong></p><p><strong>4. All of the anti-estrogens are reported to be thrombogenic. Tamoxifen is the most thrombogenic, but all of the others are clearly thrombogenic, but only confer about half of the thrombogenic risk of tamoxifen. </strong></p><p><strong></strong></p><p><strong>5. Clomid and hCG are known to increase thrombotic events, both in men and women. </strong></p><p><strong></strong></p><p><strong>6. Several studies (Svartbarg, Tromso) have shown that endogenous T throughout its distribution (particularly on the high end) is NOT associated with thrombotic events. </strong></p><p><strong></strong></p><p><strong>7. T increases platelet aggregation and increases viscosity. As T is aromatized to E2 , E2 then increases resistance to activated protein C and increases clotting. In patients with hypogonadotrophic hypogonadism, plasminogen activator inhibitor is low, and is modestly increased by TT </strong></p><p><strong></strong></p><p><strong>8. In our cases with thrombosis, NONE of them had high rbc hct hgb; the thrombogenic effects of TRT in our research are theorized to be predominantly E2-mediated and is entirely independent of the added risk of polycythemia.</strong></p></blockquote><p></p>
[QUOTE="Marco N Cognito, post: 7328, member: 13"] Here are the main takeaways I gleaned from Glueck's emails: [B]1. On the basis of our published data, when a patient has a major gene familial thrombophilia like V Leiden or Prothrombin gene heterozygosity, or familial high Factors VIII or XI, or acquired thrombophilia (lupus anticoagulant, anti phospholipid antibody syndrome), exogenous testosterone appears to be contraindicated absolutely, irrespective of the E2 level, although most events occurr when E2 is >42.6. 2. We have 10 cases with major gene thrombophilia fully anticoagulated with warfarin who had second or even third thrombotic events when exogenous T therapy was continued. 3. We have one case (not yet published but soon in Blood Coag Fibrinolysis) where arimidex by itself caused thrombosis in a V Leiden heterozygote. 4. All of the anti-estrogens are reported to be thrombogenic. Tamoxifen is the most thrombogenic, but all of the others are clearly thrombogenic, but only confer about half of the thrombogenic risk of tamoxifen. 5. Clomid and hCG are known to increase thrombotic events, both in men and women. 6. Several studies (Svartbarg, Tromso) have shown that endogenous T throughout its distribution (particularly on the high end) is NOT associated with thrombotic events. 7. T increases platelet aggregation and increases viscosity. As T is aromatized to E2 , E2 then increases resistance to activated protein C and increases clotting. In patients with hypogonadotrophic hypogonadism, plasminogen activator inhibitor is low, and is modestly increased by TT 8. In our cases with thrombosis, NONE of them had high rbc hct hgb; the thrombogenic effects of TRT in our research are theorized to be predominantly E2-mediated and is entirely independent of the added risk of polycythemia.[/B] [/QUOTE]
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Expert Interviews
Can Testosterone Induce Blood Clots and Thrombosis? Interview with Dr Charles Glueck
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