The putative mechanisms underlying testosterone and cardiovascular risk

[Nelson Vergel]

A very well written short opinion article that summarizes factors that may increase cardiovascular risks of testosterone. All have been reviewed on ExcelMale.com but it is nice to see them summarized in a short paper by Dr Lipshultz' team. They did not include high estradiol as a causative factor, however.




Maganty A, Kovac JR and Ramasamy R (2014)

The putative mechanisms underlying testosterone and cardiovascular risk [v1; ref status: indexed, http://f1000r.es/374] F1000Research 2014, 3:87

Abstract

The use of testosterone supplementation therapy (TST) is increasing primarily in men with symptomatic hypogonadism. While TST has been shown to have numerous benefits, as its use increases, the role on cardiovascular health must be explored. Previous evidence showed no adverse cardiovascular risks associated with TST use; however, more recent studies suggest that there may be an associated risk. The exact mechanism by which TST may contribute to cardiovascular risk has not been elucidated. Numerous mechanisms have been proposed which include testosterone's effect on thromboxane A2 receptors, vascular adhesion molecule 1 receptors, erythropoiesis, and obstructive sleep apnea, all of which can ultimately lead to atherogenesis and increased cardiovascular risk.

Quote:

This study's conclusions were similar to that previously discussed, in that men with a hematocrit greater than 50% were 1.8 times (1.1–2.7) more likely to die from CHD compared with men with a hematocrit of less than 50% after adjusting for coronary risk factors13.

 

[tommyaso]

I have taken testosterone gel for one months, I am under HIV medications, last blood tests showed huge increase in tryglicerids and some increase in bad colesterol end decrease of good colesterol, do you think Testosterone gel and all this very bad lab test results may be linked? Tryglicerides especially are extremely high at 13.60 grams and my doctor said I am at risk of developping a pancreatitis..I don't drink alcohol nor eat sweets or take sugar...Thank you. Tom

 

[Nelson Vergel]

Tommyaso

TRT is not known for increasing triglycerides. In fact, it is known to decrease them. Higher TRT doses can decrease HDL.

There must be something going on in your metabolism. What were your triglycerides before starting TRT. Please provide valid range and units.

 

[Nelson Vergel]

Horm Metab Res. 2002 Feb;34(2):87-92.

Impact on lipoprotein profile after long-term testosterone replacement in hypogonadal men.

Berg G1, Schreier L, Geloso G, Otero P, Nagelberg A, Levalle O.

Abstract

Testosterone serum levels may influence the lipoprotein metabolism and possibly atherogenic risk. Our aim was to investigate the effects of long-term testosterone supplementation in hypogonadal men on multiple lipoprotein markers. 18 Hypogonadal men were studied before and after 3, 6, and 18 (n = 7) months of treatment with testosterone enanthate. During treatment, serum testosterone and estradiol increased, reaching normal levels (p < 0.0001 and 0.003, respectively). This was associated with a decrease in HDL cholesterol (from 1.40 +/- 0.10 mmol/l to 1.22 +/- 0.08 mmol/l, p < 0.001) after six months at the expense of HDL2 cholesterol (p < 0.01), as well as apoprotein A1 (from 139 +/- 3.4 mg/dl to 126 +/- 3.0 mg/dl, p < 0.005). Hepatic lipase activity increased (p < 0.05) and correlated positively with testosterone (r = 0.56, p < 0.02) and negatively with HDL cholesterol (r = - 0.58, p < 0.02). Total and LDL cholesterol, triglycerides, and apoprotein B did not increase. Among the seven patients who completed 18 months of treatment, triglycerides, total cholesterol, LDL and HDL cholesterol, as well as total cholesterol/HDL cholesterol ratio values did not differ from baseline while apoprotein A1 (p < 0.03) and HDL cholesterol (p < 0.015) remained decreased and hepatic lipase unchanged. Restoration of testosterone levels in hypogonadal men in this study did not reveal unfavorable changes based on total cholesterol/HDL cholesterol and LDL cholesterol/apoprotein B ratios, which are both atherogenic risk markers. Whether the changes in light of lipoprotein metabolism will adversely influence cardiovascular risk over time remains to be determined.