Testosterone Lecture by Author Nelson Vergel
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Transcript of Testosterone Lecture by Author Nelson Vergel
You may be one of the 13 million men in the United States that are suffering from testosterone deficiency but who are suffering needlessly.
There is hope…
Testosterone: Target OrgansTestosterone: Target OrgansTestosterone: Target OrgansTestosterone: Target Organs
brainbrainlibido, moodlibido, moodskinskin
hair growth, balding, sebum production
musclemuscleincrease in strength and volume
liverliversynthesis of serum proteins kidneykidney
stimulation of erythropoietin production
male sexual male sexual organsorganspenile growthspermatogenesisprostate growth and function
bone marrowbone marrowstimulation of stem cells
boneboneaccelerated linear growthclosure of epiphyses
Albumin-bound T38%
Free T2%
SHBG-bound T60%T = testosterone
Only 2% is free testosteroneand 98% is bound
Testosterone Fractions in the Blood
Hourly Testosterone Blood Levels in Healthy Young and Older Men in
a Day
Source: Bremner WJ, Vitiello MV, Prinz PN., J Clin Endocrinol Metab 1983;56:1278-1281
000020001600120008000400
0000
Testosterone Deficiency Testosterone Deficiency (Hypogonadism)(Hypogonadism)
Normal levels in blood:Normal levels in blood: Men... Total test. 300-1100 ng/dL, Men... Total test. 300-1100 ng/dL,
Free test. 5 - 21 ng/dLFree test. 5 - 21 ng/dL
Women... Total test. 10-50 ng/dLWomen... Total test. 10-50 ng/dL
Free test. 0.10-0.85 ng/dLFree test. 0.10-0.85 ng/dL Symptoms of testosterone deficiency:Symptoms of testosterone deficiency:
Fatigue, low or lack of sex drive, Fatigue, low or lack of sex drive, poor appetite, loss of muscle mass & poor appetite, loss of muscle mass & strength, depressionstrength, depression
Signs and Symptoms of Low Testosterone
Loss of muscle mass and strength Loss of muscle mass and strength Loss of libido and erectile dysfunctionLoss of libido and erectile dysfunction Depression Depression Lethargy (fatigue, lack of focus)Lethargy (fatigue, lack of focus) Osteoporosis (bone loss)Osteoporosis (bone loss) Some regression of secondary sexual Some regression of secondary sexual
characteristics (body hair loss, etc)characteristics (body hair loss, etc) Oligospermia or azoospermia (low or no Oligospermia or azoospermia (low or no
sperm count)sperm count)
Tenover JL. Endocrinol Metab Clin North Am. 1998;27:969-987Petak SM, et al. AACE Clinical Practice Guidelines. Available at: http://www.aace.com/clin/guides/hypogonadism.html
Causes of Hypogonadism Causes of Hypogonadism (Low Testosterone Blood (Low Testosterone Blood
Level)Level) Congenital hypogonadismCongenital hypogonadism Primary testicular failurePrimary testicular failure Hypogonadotropic hypogonadismHypogonadotropic hypogonadism Severe systemic disease, including HIV infectionSevere systemic disease, including HIV infection Normal agingNormal aging Medications: ketoconazole, glucocorticoids, Medications: ketoconazole, glucocorticoids,
spironolactone, cimetidine, phenytoin, spironolactone, cimetidine, phenytoin, flutamide, megesterolflutamide, megesterol
Testosterone Metabolites and Their Functions
Testosterone5-7
mg/day
Androgen
Receptor
Androgen
Receptor
EstrogenReceptor
Dehydro Testosterone(DHT) (by 5α-reductase)
Estradiol (by aromatase)
Direct Effect
LH
Oxidation by LiverElimination by Kidneys
Skin, Prostate
Hair, Brain, Bone
Muscle, Brain