Fwd: [BULK] Mainstream Doctors’ Ineptitude Put on Display

[Guest guest]

For all those guys (and women wiht guys) needing Testosterone, this is

an excellent article showing how twisted medical studies have become.

And why our OWN research is so very important.

http://www.nthadrenalsweb.org/

http://www.health.groups.yahoo.com/group/NaturalThyroidHormonesADRENALS/

http://www.faqhelp.webs.com/

http://www.health.groups.yahoo.com/group/RT3_T3/

http://www.thyroid-rt3.com/

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[bULK] Mainstream Doctors’ Ineptitude Put on Display

Date:

Fri, 30 Jul 2010 21:12:12 -0400

From:

Life Extension

Reply-To:

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To:

artisticgroomer@...

Mainstream Doctors Ineptitude Put on Display

in The New England Journal of Medicine

A study published in the June 30, 2010

edition of The New England Journal of Medicine

confirms how little conventional doctors know about prescribing testosterone

to aging men.

The Life Extension Foundation® (and

its medical advisors) long ago recognized that maturing men have a

propensity to convert (aromatize) testosterone into estrogen.

When you see an overweight man growing breasts, it is not directly

because he eats too much. This phenomenon is instead caused by the

testosterone he converts to breast-enlarging estrogen.

When men are prescribed testosterone gels or creams,

they sometimes have to take an aromatase-inhibiting drug (like

Arimidex®) to prevent their estrogen (measured as estradiol in the

blood) from climbing to dangerous levels.

Optimal estradiol blood levels in men

are between 20-30 pg/mL. Elderly males can have much higher

estradiol levels that place them at substantial risk for developing coronary

atherosclerosis and thrombotic stroke.

If elderly men are prescribed large doses of

topical testosterone gel or cream, their estradiol

blood levels have to be tested and properly controlled. Failure

to manage estradiol in men receiving high-dose testosterone gel or

cream can result in a catastrophic estrogen surge

that increases vascular disease risk and premature death.

Enormous tax dollars squandered on flawed

testosterone study

The Federal government provided a financial grant to an

armada of doctors to evaluate the effects of high-dose testosterone on

men that were so severely debilitated that they struggled to climb more

than 10 stairs or walk the equivalent of two city blocks.

These men suffered numerous risk factors such as

obesity, diabetes, hypertension, and elevated blood lipids that placed

them at higher risk for cardiovascular events. Obese men tend to

produce loads of estrogen in their abdominal fat and typically have

higher estradiol levels than thinner men.

The men with the worst vascular risk factors

(such as highest triglyceride levels) were placed on a dose of topical

testosterone that is TWICE the standard starting dose. These

debilitated men were given testosterone in a way that is more likely to

aromatize through the skin into estrogen.

Men with fewer vascular risk factors were given a

placebo gel.

It should be no surprise to learn that this study was

halted prematurely because the debilitated men given the high-dose

testosterone (with no aromatase inhibitor) suffered more

atherosclerosis-related events such as heart attack, stroke, and

sudden death.

The official title of this study is Adverse Events

with Testosterone Administration. A more accurate title may have been:

"Elevated Estrogen

Leads to Cardiovascular Events in Older Men."

Click here to read Life Extension®s recent review about

the dangers of estrogen imbalance in aging men, click

here

Life Extension writes a letter to these doctors

The day this study was published, Life

Extension wrote the doctors who conducted the study

asking if there was any data regarding baseline and post-baseline blood

estradiol levels. We have waited over four

weeks, and the authors of The New England Journal of

Medicine study have not responded to our repeated

requests as to whether estradiol levels were ever

measured.

From what was written in the paper, it does not

appear that any attention was paid to the estrogen levels in these

debilitated men. The authors wrote in the discussion section of the

paper, Testosterone and associated increases in estradiol

may promote inflammation, coagulation and platelet aggregation.

Yet these doctors dont appear to have done anything to evaluate estradiol

levels in the unfortunate study subjects given double-dose

testosterone with no aromatase inhibitor to suppress

the expected estrogen surge.

This study had numerous other flaws

Leaving aside the failure to manage estradiol

levels in men given high-dose testosterone gel, there were numerous

design flaws that call into question any conclusion that can be drawn

from this study.

As mentioned earlier, the testosterone group at

baseline was at greater risk for cardiovascular events as manifested by

a greater proportion of men in the testosterone group with dyslipidemia

who were undergoing statin and antihypertensive drug treatment.

In addition, triglyceride levels (higher) and HDL

levels (lower) were trending against the testosterone group. Clearly,

the baseline cardiovascular risk for the testosterone group was

higher than the placebo group. The authors claim that a sensitivity

analysis, as well as controlling for cardiovascular risk factors, did

not change the results, but the small sample size and relatively short

trial duration serve to magnify, not minimize, differences due to

chance.

The study was not designed to systematically assess for

cardiovascular events, and given the small sample size, lack of

consistent pattern of events, diversity of serious events, and small

number of serious adverse cardiac events (10 vs. 1) in the two

treatment groups before study stoppage in this short duration trial

strongly suggest that the results are due to chance. Another

explanation of course is that the adverse vascular events were caused

by the uncontrolled conversion of the topically-applied testosterone to

estradiol in men who were already likely to have dangerously high

estradiol blood levels to begin with.

Fodder for the media

The published scientific data documents low

testosterone as being an independent risk factor for heart attack and a

host of other age-related ailments.

The authors of this study acknowledge the benefits the

testosterone group obtained from the drug and openly admitted the

limitations of this study in providing guidance about the effects of

testosterone on different population groups.

The media, however, has a propensity to publicize one

negative study while ignoring hundreds of positive ones. We will not be

surprised to see this horrifically flawed study used for decades to

discredit the safety and efficacy of properly prescribed testosterone

cream and aromatase-inhibition therapy.

Importance of blood testing in men supplementing

with testosterone

In response to overwhelmingly favorable studies, record

numbers of aging men are rubbing testosterone creams or gels on to

their skin each day to restore this vital hormone to youthful levels.

Within 45-60 days of initiating testosterone replacement

therapy, the following blood tests should be done to ensure safety and

efficacy:

PSA (prostate specific antigen) To

rule out prostate cancer

Estradiol To make sure

testosterone is not converting to estrogen

Free & Total Testosterone To

make sure enough testosterone is being absorbed

CBC/Chemistry To make sure liver

enzymes are normal and red blood production has not increased too much

These tests can be done at your doctors office, or you

can order them all directly from Life Extension by calling 1-

(24 hours a day) and asking for the Male Testosterone Panel

(item LC100001).

These tests can retail for over $500.00 at commercial labs, but Life

Extension members pay only $125.00. Order

your blood tests now!

To review Life Extension articles describing

benefits of testosterone replacement in aging men, click here: Optimizing

Testosterone Levels in Aging Men, Vindication.

Summary of 5 recent

peer-reviewed studies noting adverse cardiovascular effects associated

with elevated estrogen in aging men:

1) After adjustment for age, hypertension, diabetes,

adiposity, cholesterol, atrial fibrillation, and other characteristics

were made in a group of 2,197 men aged 71 to 93 years of age, men with

the highest blood levels of estradiol had a 2.2-fold greater risk of

stroke compared with those whose estradiol levels were lower. {Reference:

Abbott RD, Launer LJ, BL, et al. Serum estradiol and risk of

stroke in elderly men. Neurology. 2007 Feb 20;68(8):563-8.}

2) In a study of 313 men whose average age was 58,

carotid artery intima-media thickness was measured at baseline and then

three years later. After adjusting for other confounding risk factors,

higher levels of estradiol were associated with thickening of the

carotid artery wall. Researchers concluded, Circulating estradiol is a

predictor of progression of carotid artery intima-media thickness in

middle-aged men. {Reference: Tivesten A, Hulthe J,

Wallenfeldt K, et al. Circulating estradiol is an independent predictor

of progression of carotid artery intima-media thickness in middle-aged

men. J Clin Endocrinol Metab. 2006 Nov;91(11):4433-7.}

3) In an angiographic trial of coronary atherosclerosis

in a group of men with stable coronary artery disease, significant

positive correlations between estradiol levels and other known

atherosclerotic risk factors was observed. Researchers concluded, "Our

results indicate a possible role of estradiol in promoting the

development of atherogenic lipid milieu in men with coronary artery

disease. {Reference: Wranicz JK, Cygankiewicz I, Rosiak M, et

al. The relationship between sex hormones and lipid profile in men with

coronary artery disease. Int J Cardiol. 2005 May

11;101(1):105-10.}

4) In another angiographic trial of coronary

atherosclerosis in men aged 40-60 years, compared with healthy

age-matched controls, men with coronary atherosclerosis had higher

levels of estrone and a low level of testosterone in the presence of a

high level of estradiol. Researchers concluded, "Low levels of total

testosterone, testosterone/estradiol ratio and free androgen index and

higher levels of estrone in men with coronary artery disease appear

together with many features of metabolic syndrome and may be involved

in the pathogenesis of coronary atherosclerosis. {Reference:

Dunajska K, Milewicz A, Szymczak J, et al. Evaluation of sex hormone

levels and some metabolic factors in men with coronary atherosclerosis.

Aging Male. 2004 Sep;7(3):197-204.}

5) In a study of men having suffered an acute

myocardial infarction (heart attack), a prior heart attack, and

patients with normal coronary arteries, the results showed

significantly higher levels of estradiol in both groups of heart attack

patients compared with those without coronary disease. {Reference:

Mohamad MJ, Mohammad MA, Karayyem M, Hairi A, Hader AA. Serum levels of

sex hormones in men with acute myocardial infarction. Neuro

Endocrinol Lett. 2007 Apr;28(2):182-6.}

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