An endocrinologist with 24 years of experience talks about the latest study by Russian scientists
Obesity never one disease. It is always accompanied by inflammation of adipose tissue and metabolic syndrome. metabolic syndrome, to simplify, this is a whole bunch of painful conditions - hypertension, elevated levels of glucose and cholesterol in the blood, etc. In men, in most cases, added testosterone deficiencyand are often prescribed testosterone replacement therapy (TRT).
And there is one interesting point.
How obesity affects testosterone
Obesity increases the activity of the aromatase enzyme (CYP19A1). This enzyme converts testosterone to estradiol (conditionally the main male hormone to the main female hormone). And when the activity of aromatase increases, then testosterone begins to be processed excessively into estradiol.
That is a person can have normal testosterone production, but it is not enough, as this hormone “runs away” to another hormone. It could also be testosterone deficiency.
In any case, if you use testosterone from the outside, then we add resources to aromatase, which, with increasing activity, will distill it into the conditionally female hormone estradiol.
It would seem a vicious circle.
How to choose a testosterone drug
What to do?
Look for testosterone replacement therapy that will significantly increase testosterone and not so much raise estradiol levels.
We at the Moscow State University clinic decided to see how different forms of testosterone work.
We took 60 case histories and conducted a retrospective analysis.
Patients used the following testosterone preparations:
- testosterone gel 1%-50 mg (green on the graphs),
- injections of an oily solution of testosterone undecanoate 25%-1000 mg in 4 ml (blue),
- human chorionic gonadotropin (hCG), on average at a dose of 2000 IU-2 times a week (blue).
What did we see?
1. All drugs led to a significant increase in total testosterone levels, but supraphysiological (i.e., much greater than natural) numbers were achieved in the hCG injection groups and to a greater extent in the testosterone injection group. undecanoate.
It can be concluded that the most physiological and gentle is the use of the gel.
2. The level of estradiol (which, as we remember, is converted from testosterone through aromatase) was also the highest in the testosterone undecanoate group - 1000 mg. It was expected.
Can High Doses of Testosterone Help Treat Obesity?
We also decided to confirm or refute the widespread theory that high doses of testosterone lead to weight loss, primarily due to a decrease in the amount of adipose tissue.
We assessed the changes that occurred in patients taking TRT within 6 months.
During this time, all groups experienced:
- weight changes
- body mass index (BMI),
- waist circumference (OT),
- hip circumference (OB),
But these changes were significant and positive only in the 1% testosterone gel group.
Other drugs have not confirmed that high testosterone somehow affects the treatment of obesity.
From the author
I must say that we had no commercial interest in this study.
I use all variants of TRT in my practice and it is extremely important for me, as for other scientists and clinicians, to have objective information, even if it differs from the opinion of other researchers.
Of course, 60 patients is not the largest sample, but this information deserves attention, and it would be great to conduct such an analysis on a large group of people.
Because - see above: in obesity, the more testosterone, the less testosterone ...
This is such a sad paradox...
Your Doctor Pavlova
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