Boosting Testosterone In Men With Low Levels May Reduce Severe Illness

Boosting Testosterone In Men With Low Levels May Reduce Severe Illness

Boosting Testosterone In Men With Low Levels May Reduce Severe Illness

According to a study by researchers from Washington University School of Medicine in St. Louis and Saint Louis University School of Medicine.

The team analyzed the cases of 723 men who tested positive for COVID-19, mostly in 2020 before vaccines were available. The data indicate that low testosterone is an independent risk factor for hospitalization from COVID-19, similar to diabetes, heart disease and chronic lung disease.

They found that men with low testosterone who developed COVID-19 were 2.4 times more likely to be hospitalized than men with hormone levels in the normal range. Furthermore, men who were once diagnosed with low testosterone but were successfully treated with hormone replacement therapy were no more likely to be hospitalized for COVID-19 than men whose testosterone levels were always tested in the normal range.

The findings, published Sept. 2 in JAMA network openedsuggest that treating men with low testosterone could help protect them from serious illness and reduce the burden on hospitals during COVID-19 waves.

“It’s very likely that COVID-19 will stay here,” said co-senior author Abhinav Diwan, MD, a professor of medicine at Washington University. Diwan, who treats patients at Barnes-Jewish Hospital, is also a professor of cell biology and physiology and obstetrics and gynecology. “Hospitalizations with COVID-19 are still a problem and will continue to be a problem as the virus continues to develop new variants that escape immunization-based immunity. Low testosterone is very common; up to a third of men over 30 have it. Our study draws attention to this important risk factor and the need to address it as a strategy to reduce hospitalizations.”

Diwan and co-senior author Sandeep Dhindsa, MD, an endocrinologist at Saint Louis University, had previously shown that men hospitalized with COVID-19 have abnormally low testosterone levels. However, a serious illness or traumatic injury can cause hormone levels to drop temporarily. Data from men already hospitalized with COVID-19 doesn’t really answer the question of whether low testosterone is a risk factor for severe COVID-19 or a consequence of it. For that, the researchers needed to know whether men with chronically low testosterone levels get sicker than men with normal levels.

Diwan, Dhindsa and colleagues — including co-author Cosette Champion, MD, an internal medicine resident at Barnes-Jewish — conducted a survey of patients at SSM Health and BJC HealthCare, two major hospital systems in the St. Louis area. They identified 723 men whose testosterone levels were measured between January 1, 2017 and December 31, 2021, and who had documented cases of COVID-19 in 2020 or 2021. In some cases, testosterone levels were measured after the patient recovered from COVID-19. Because low testosterone is a chronic condition, men who tested low a few months after recovery from COVID-19 likely also had low levels, Dhindsa said.

The researchers identified 427 men with normal testosterone levels, 116 with low levels, and 180 who had previously had low levels but were treated successfully, meaning they were receiving hormone replacement therapy and their testosterone levels were in the normal range at the time of developing COVID- 19.

“Low testosterone has been shown to be a risk factor for hospitalization from COVID, and treatment of low testosterone helped negate that risk,” Dhindsa said. “The risk really decreases below a level of 200 nanograms per deciliter, with a normal range of 300 to 1,000 nanograms per deciliter. This is independent of all the other risk factors that we looked at: age, obesity or other health conditions. But those people those in therapy, their risk was normal.”

Men with low testosterone may experience sexual dysfunction, depressed mood, irritability, difficulty with concentration and memory, fatigue, loss of muscle strength and a general decreased sense of well-being. When a man’s quality of life is markedly reduced, he is usually treated with testosterone replacement therapy. However, when symptoms are mild, doctors and patients may be hesitant to treat.

The two main concerns regarding testosterone therapy are an increased risk of prostate cancer and heart disease. Prostate cancer is common in older men and is often caused by testosterone. Boosting testosterone could potentially accelerate the growth of such cancers, exacerbating the disease. For heart disease, the evidence for risk is more ambiguous. A major clinical study investigating the relationship between heart health and testosterone supplementation is expected to be completed shortly.

“In the meantime, our study would suggest it would be wise to look at testosterone levels, especially in people with low testosterone symptoms, and then individualize care,” said Diwan, whose specialty is cardiology. “If they are at really high risk for cardiovascular events, then the doctor could include the patient in a discussion of the pros and cons of hormone replacement therapy, and perhaps lowering the risk of hospitalization from COVID would be on the list of possible options.” benefits.”

This study is observational, so it only suggests — not proves — that increasing testosterone levels can help men avoid severe COVID-19, Diwan warned. A clinical trial would be needed to conclusively demonstrate whether such a strategy works.

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