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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Testosterone supplementation associated with development of DVT-PE-osteonecrosis
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<blockquote data-quote="cjg" data-source="post: 29025" data-attributes="member: 12633"><p>We have published two new original data manuscripts which focus on deep venous thrombosis-pulmonary emboli-osteonecrosis which occur when testosterone is given to men or women with previously undiagnosed thrombophilia. We have provided new data which shows that when testosterone is continued in men with thrombophilia, despite adequate anticoagulation, recurrent deep venous thrombosis-pulmonary emboli occur. We are glad to provide free consultation to any man or woman who has sustained DVT-PE-osteonecrosis after testosterone therapy or HCG therapy to increase endogenous testosterone. Contact us at Cholesterol Center, Jewish Hospital, Cincinnati OH (CJ Glueck MD)</p><p></p><p></p><p>Thrombophilia in 67 Patients With</p><p>Thrombotic Events After Starting</p><p>Testosterone Therapy</p><p></p><p>Charles J. Glueck, MD1, Marloe Prince, MD1,</p><p>Niravkumar Patel, MD1, Jaykumar Patel, MD1, Parth Shah, MD1,</p><p>Nishi Mehta, MD1, and Ping Wang, PhD1 </p><p></p><p>Clinical and Applied Thrombosis/Hemostasis, 2015, pages 1-6</p><p>DOI: 10.1177/1076029615619486 Abstract</p><p></p><p>We compared thrombophilia in 67 cases (59 men and 8 women) with thrombotic events after starting testosterone therapy (TT) versus 111 patient controls having unprovoked venous thrombotic events without TT. In the 67 patients, thrombosis (47 deepvenous thrombosis–pulmonary embolism, 16 osteonecrosis, and 4 ocular thrombosis) occurred 6 months (median) after starting TT. Cases differed from controls for factor V Leiden heterozygosity (16 of the 67 [24%] vs 13 [12%] of the 111, P . .038) and forlupus anticoagulant (9 [14%] of the 64 vs 4 [4%] of the 106, P . .019). After a first thrombotic event and continuing TT, 11 caseshad a second thrombotic event, despite adequate anticoagulation, 6 of whom, still anticoagulated, had a third thrombosis.Screening for thrombophilia before starting TT should identify men and women at high risk for thrombotic events with an adverserisk–benefit ratio for TT. When TT is given to patients with familial and acquired thrombophilia, thrombosis may occur and recur</p><p>in thrombophilic men despite anticoagulation.</p><p><strong></strong></p><p><strong></strong></p><p><strong>Testosterone Therapy Can Interact With Thrombophilia, Leading to Osteonecrosis </strong></p><p>Charles J. Glueck, MD; RashidRiaz, MD; Marloe Prince, MD; RichardA. Freiberg, MD; PingWang, PhD </p><p><em>The authors are from the Cholesterol, Metabolism, and Thrombosis Center (CJG, PW), Jewish Hospital of Cincinnati, Cincinnati; and the Internal Medicine Resident Training Program (RR, MP) and the Department of Orthopedics (RAF), VA Hospital, Cincinnati, Ohio. </em></p><p><em>The authors have no relevant financial relationships to disclose. </em></p><p><em>This study was supported by the Lipoprotein Research Fund, Jewish Hospital of Cincinnati. </em></p><p><em>Correspondence should be addressed to: Charles J. Glueck, MD, Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Ste 430, 2135 Dana Ave, Cincinnati, OH 45207</em></p><p>Although this effect is not widely recognized, testosterone therapy can interact with thrombophilia, causing osteonecrosis. In 12 men and 4 women who had idiopathic osteonecrosis a median of 6 months after the onset of testosterone therapy, the authors examined the interaction between testosterone therapy and previously undiagnosed thrombophilia. The authors hypothesized that patients who had osteonecrosis after starting testosterone therapy were more likely than 110 normal control subjects or 48 patients who had osteonecrosis and were not receiving testosterone therapy to have thrombophilia. Measures of thrombophilia included Factor V Leiden, prothrombin, PAI-1 gene mutations, Factor VIII, Factor XI, anticardiolipin antibody immunoglobulin G or immunoglobulin M, and homocysteine values. In 10 cases, osteonecrosis occurred 6 months or less after the onset of testosterone therapy, and in all 16 cases, it occurred after a median of 6 months of testosterone therapy. Of the 16 cases, 5 (31%) were Factor V Leiden heterozygotes vs 2 of 109 (2%) healthy control subjects (<em>P</em>=.0003) and 4 of 48 patients who had osteonecrosis and were not receiving testosterone therapy (<em>P</em>=.04). Of the 16 cases, 4 (25%) had high (>150%) Factor VIII levels vs 7 of 103 (7%) healthy control subjects (<em>P</em>=.04), and 3 (19%) had high (>150%) Factor XI levels vs 3 of 101 (3%) healthy control subjects (<em>P</em>=.03). Of the 16 patients with osteonecrosis, 14 (88%) had at least 1 abnormal procoagulant value (of the 8 measured) vs 47 of 110 (43%) healthy control subjects (<em>P</em>=.0009). Of the 5 men whose serum estradiol level was measured while they were receiving testosterone therapy, this level was high (≥42.6 pg/mL) in 4. When testosterone therapy is given to patients with thrombophilia, they are at increased risk for osteonecrosis. [<em>Orthopedics. </em>2015; 38(12):e1073-e1078.]</p></blockquote><p></p>
[QUOTE="cjg, post: 29025, member: 12633"] We have published two new original data manuscripts which focus on deep venous thrombosis-pulmonary emboli-osteonecrosis which occur when testosterone is given to men or women with previously undiagnosed thrombophilia. We have provided new data which shows that when testosterone is continued in men with thrombophilia, despite adequate anticoagulation, recurrent deep venous thrombosis-pulmonary emboli occur. We are glad to provide free consultation to any man or woman who has sustained DVT-PE-osteonecrosis after testosterone therapy or HCG therapy to increase endogenous testosterone. Contact us at Cholesterol Center, Jewish Hospital, Cincinnati OH (CJ Glueck MD) Thrombophilia in 67 Patients With Thrombotic Events After Starting Testosterone Therapy Charles J. Glueck, MD1, Marloe Prince, MD1, Niravkumar Patel, MD1, Jaykumar Patel, MD1, Parth Shah, MD1, Nishi Mehta, MD1, and Ping Wang, PhD1 Clinical and Applied Thrombosis/Hemostasis, 2015, pages 1-6 DOI: 10.1177/1076029615619486 Abstract We compared thrombophilia in 67 cases (59 men and 8 women) with thrombotic events after starting testosterone therapy (TT) versus 111 patient controls having unprovoked venous thrombotic events without TT. In the 67 patients, thrombosis (47 deepvenous thrombosis–pulmonary embolism, 16 osteonecrosis, and 4 ocular thrombosis) occurred 6 months (median) after starting TT. Cases differed from controls for factor V Leiden heterozygosity (16 of the 67 [24%] vs 13 [12%] of the 111, P . .038) and forlupus anticoagulant (9 [14%] of the 64 vs 4 [4%] of the 106, P . .019). After a first thrombotic event and continuing TT, 11 caseshad a second thrombotic event, despite adequate anticoagulation, 6 of whom, still anticoagulated, had a third thrombosis.Screening for thrombophilia before starting TT should identify men and women at high risk for thrombotic events with an adverserisk–benefit ratio for TT. When TT is given to patients with familial and acquired thrombophilia, thrombosis may occur and recur in thrombophilic men despite anticoagulation. [B] Testosterone Therapy Can Interact With Thrombophilia, Leading to Osteonecrosis [/B] Charles J. Glueck, MD; RashidRiaz, MD; Marloe Prince, MD; RichardA. Freiberg, MD; PingWang, PhD [I]The authors are from the Cholesterol, Metabolism, and Thrombosis Center (CJG, PW), Jewish Hospital of Cincinnati, Cincinnati; and the Internal Medicine Resident Training Program (RR, MP) and the Department of Orthopedics (RAF), VA Hospital, Cincinnati, Ohio. [/I] [I]The authors have no relevant financial relationships to disclose. [/I] [I]This study was supported by the Lipoprotein Research Fund, Jewish Hospital of Cincinnati. [/I] [I]Correspondence should be addressed to: Charles J. Glueck, MD, Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Ste 430, 2135 Dana Ave, Cincinnati, OH 45207[/I] Although this effect is not widely recognized, testosterone therapy can interact with thrombophilia, causing osteonecrosis. In 12 men and 4 women who had idiopathic osteonecrosis a median of 6 months after the onset of testosterone therapy, the authors examined the interaction between testosterone therapy and previously undiagnosed thrombophilia. The authors hypothesized that patients who had osteonecrosis after starting testosterone therapy were more likely than 110 normal control subjects or 48 patients who had osteonecrosis and were not receiving testosterone therapy to have thrombophilia. Measures of thrombophilia included Factor V Leiden, prothrombin, PAI-1 gene mutations, Factor VIII, Factor XI, anticardiolipin antibody immunoglobulin G or immunoglobulin M, and homocysteine values. In 10 cases, osteonecrosis occurred 6 months or less after the onset of testosterone therapy, and in all 16 cases, it occurred after a median of 6 months of testosterone therapy. Of the 16 cases, 5 (31%) were Factor V Leiden heterozygotes vs 2 of 109 (2%) healthy control subjects ([I]P[/I]=.0003) and 4 of 48 patients who had osteonecrosis and were not receiving testosterone therapy ([I]P[/I]=.04). Of the 16 cases, 4 (25%) had high (>150%) Factor VIII levels vs 7 of 103 (7%) healthy control subjects ([I]P[/I]=.04), and 3 (19%) had high (>150%) Factor XI levels vs 3 of 101 (3%) healthy control subjects ([I]P[/I]=.03). Of the 16 patients with osteonecrosis, 14 (88%) had at least 1 abnormal procoagulant value (of the 8 measured) vs 47 of 110 (43%) healthy control subjects ([I]P[/I]=.0009). Of the 5 men whose serum estradiol level was measured while they were receiving testosterone therapy, this level was high (≥42.6 pg/mL) in 4. When testosterone therapy is given to patients with thrombophilia, they are at increased risk for osteonecrosis. [[I]Orthopedics. [/I]2015; 38(12):e1073-e1078.] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Testosterone supplementation associated with development of DVT-PE-osteonecrosis
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