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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
Age-Specific Serum Total and Free Estradiol Concentrations in Healthy Men in US Nationally Representative Samples
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<blockquote data-quote="madman" data-source="post: 159649" data-attributes="member: 13851"><p><strong>One purpose of our report is to inform the monitoring of serum estrogen in men receiving testosterone supplementation. </strong><span style="color: rgb(184, 49, 47)"><strong>Although the literature on the influence of testosterone supplementation on estrogen levels is not extensive, the influence of testosterone supplementation on estradiol levels is supported by the fact that some men who receive testosterone therapy develop estrogen-related symptoms such as gynecomastia and by direct measurements of their serum estradiol concentrations.</strong></span> <strong><span style="color: rgb(44, 130, 201)">For example, in a 2015 study by Tan et al. [19], of 34,016 men treated for low testosterone across 35 US sites, </span><span style="color: rgb(251, 160, 38)">20.2% had high estradiol levels, defined as .42.6 pg/mL </span><span style="color: rgb(44, 130, 201)">as measured by electrochemiluminescence immunoassay. </span></strong></p><p></p><p></p><p><strong><span style="color: rgb(184, 49, 47)">Risks of supplemental testosterone, including estrogen-associated symptoms, have been discussed extensively in the literature and summarized in consensus practice guidelines [5]. </span></strong><span style="color: rgb(184, 49, 47)"><strong>However, other possible consequences of increased estrogen levels, whether caused by testosterone supplementation or other factors, have been not been discussed in the same depth.</strong></span> <strong><span style="color: rgb(26, 188, 156)">Some studies have reported that estrogen influences carcinogenesis via genomic and nongenomic processes. For example, estrogens can produce DNA damage after being metabolized to catechols [20, 21]. Of particular interest for older men, evidence from animal studies suggests a synergistic role for estrogens in prostate carcinogenesis [6, 22]. In rats, although prostate cancer can be induced by androgens alone, a higher chance of inducing prostate cancer occurs when the combination of androgens and estrogen is administered [6, 22].</span><span style="color: rgb(44, 130, 201)"> However, a large, pooled analysis of epidemiologic studies on circulating estrogens measured once in middle or older age and prostate cancer risk does not support a link [23]. </span>Nevertheless, elevated estrogens, irrespective of the cause, <span style="color: rgb(184, 49, 47)">could generate chronic, systemic inflammation;</span> men with higher estrogens have<span style="color: rgb(184, 49, 47)"> higher white blood cell counts and C-reactive protein concentrations and consequent adverse effects on health in general [7].</span> Although it remains unknown whether circulating estradiol levels influence intraprostatic inflammation in men, as has been observed in rodents [24], such a possibility is concerning given that intraprostatic inflammation has been associated with an elevated risk of prostate cancer [25, 26].</strong></p><p></p><p></p><p><span style="color: rgb(184, 49, 47)"><strong>We reported medians and distributions of estradiol concentrations in healthy men who participated in the morning sessions of phase I of NHANES in 1988 to 1991 or in continuous NHANES in 1999 to 2004.</strong></span><strong> Although the medians were different, patterns of total and free estradiol concentrations were similar at these two time points. We reported data separately by time point because members of our team previously published that estradiol concentrations, adjusted for BMI, WC, and smoking, decreased between the years of these two surveys among non-Hispanic white and Mexican American men [11]. These declines could be the result of secular changes in the prevalences of factors that directly or indirectly influence serum estradiol, although we could not rule out time differences. </strong><span style="color: rgb(26, 188, 156)"><strong>However, the samples were assayed in the same laboratory by the same method. As noted above, a small number of the NHANES III samples were reanalyzed when the NHANES 1999 to 2004 samples were assayed, and there was a </strong></span><span style="color: rgb(184, 49, 47)"><strong>CV of 15.3%, which was not unexpected for this analyte, which has a low concentration in men [11]. </strong></span></p></blockquote><p></p>
[QUOTE="madman, post: 159649, member: 13851"] [B]One purpose of our report is to inform the monitoring of serum estrogen in men receiving testosterone supplementation. [/B][COLOR=rgb(184, 49, 47)][B]Although the literature on the influence of testosterone supplementation on estrogen levels is not extensive, the influence of testosterone supplementation on estradiol levels is supported by the fact that some men who receive testosterone therapy develop estrogen-related symptoms such as gynecomastia and by direct measurements of their serum estradiol concentrations.[/B][/COLOR] [B][COLOR=rgb(44, 130, 201)]For example, in a 2015 study by Tan et al. [19], of 34,016 men treated for low testosterone across 35 US sites, [/COLOR][COLOR=rgb(251, 160, 38)]20.2% had high estradiol levels, defined as .42.6 pg/mL [/COLOR][COLOR=rgb(44, 130, 201)]as measured by electrochemiluminescence immunoassay. [/COLOR][/B] [B][COLOR=rgb(184, 49, 47)]Risks of supplemental testosterone, including estrogen-associated symptoms, have been discussed extensively in the literature and summarized in consensus practice guidelines [5]. [/COLOR][/B][COLOR=rgb(184, 49, 47)][B]However, other possible consequences of increased estrogen levels, whether caused by testosterone supplementation or other factors, have been not been discussed in the same depth.[/B][/COLOR] [B][COLOR=rgb(26, 188, 156)]Some studies have reported that estrogen influences carcinogenesis via genomic and nongenomic processes. For example, estrogens can produce DNA damage after being metabolized to catechols [20, 21]. Of particular interest for older men, evidence from animal studies suggests a synergistic role for estrogens in prostate carcinogenesis [6, 22]. In rats, although prostate cancer can be induced by androgens alone, a higher chance of inducing prostate cancer occurs when the combination of androgens and estrogen is administered [6, 22].[/COLOR][COLOR=rgb(44, 130, 201)] However, a large, pooled analysis of epidemiologic studies on circulating estrogens measured once in middle or older age and prostate cancer risk does not support a link [23]. [/COLOR]Nevertheless, elevated estrogens, irrespective of the cause, [COLOR=rgb(184, 49, 47)]could generate chronic, systemic inflammation;[/COLOR] men with higher estrogens have[COLOR=rgb(184, 49, 47)] higher white blood cell counts and C-reactive protein concentrations and consequent adverse effects on health in general [7].[/COLOR] Although it remains unknown whether circulating estradiol levels influence intraprostatic inflammation in men, as has been observed in rodents [24], such a possibility is concerning given that intraprostatic inflammation has been associated with an elevated risk of prostate cancer [25, 26].[/B] [COLOR=rgb(184, 49, 47)][B]We reported medians and distributions of estradiol concentrations in healthy men who participated in the morning sessions of phase I of NHANES in 1988 to 1991 or in continuous NHANES in 1999 to 2004.[/B][/COLOR][B] Although the medians were different, patterns of total and free estradiol concentrations were similar at these two time points. We reported data separately by time point because members of our team previously published that estradiol concentrations, adjusted for BMI, WC, and smoking, decreased between the years of these two surveys among non-Hispanic white and Mexican American men [11]. These declines could be the result of secular changes in the prevalences of factors that directly or indirectly influence serum estradiol, although we could not rule out time differences. [/B][COLOR=rgb(26, 188, 156)][B]However, the samples were assayed in the same laboratory by the same method. As noted above, a small number of the NHANES III samples were reanalyzed when the NHANES 1999 to 2004 samples were assayed, and there was a [/B][/COLOR][COLOR=rgb(184, 49, 47)][B]CV of 15.3%, which was not unexpected for this analyte, which has a low concentration in men [11]. [/B][/COLOR][COLOR=rgb(26, 188, 156)][B][/B][/COLOR] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
Age-Specific Serum Total and Free Estradiol Concentrations in Healthy Men in US Nationally Representative Samples
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