The impact of serum testosterone level to reflect age-related multi-organ functions.

The aim of this study is to examine the correlation between aging, serum total testosterone and biomarkers of multiple organ functions in men. The participants consisted of 12,547 outpatients, whose serum testosterone level was measured. A multiple regression analysis was conducted to determine whether biomarkers including hemoglobin (Hb), hematocrit (Hct), luteinizing hormone (LH), follicle stimulating hormone (FSH), alkaline phosphatase (ALP), albumin (ALB), creatinine (Cre), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glucose (Glu), C-reactive protein (CRP), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) values were associated with serum total testosterone concentration. Significant correlations (p < 0.05) were found between total testosterone and Hb, Hct, LH, FSH, ALP, ALB, TG, HDL-C, AST, ALT, Glu, and CRP. In addition, significant correlations (p < 0.05) were found between Hb, Hct, LH, FSH, ALP, ALB, TG and HDL-C associated with [age × testosterone]. This large-scale study provided new insights into correlations between serum testosterone and biomarkers associated with age-related diseases, suggesting that testosterone is especially important for maintaining homeostasis in aging males. Thus, hypogonadism in elderly patients may be associated with multiple organ dysfunctions.

Management of Male Fertility in Hypogonadal Patients on Testosterone Replacement Therapy.

Testosterone is crucial in regulating several body functions in men, including metabolic, sexual, and cardiovascular functions, bone and muscle mass, and mental health. Therefore, optimizing testosterone levels in men is an important step to maintaining a healthy body and mind, especially as we age. However, traditional testosterone replacement therapy has been shown to lead to male infertility, caused by negative feedback in the hypothalamic-pituitary-gonadal (HPG) axis. Recent advances in research have led to the discovery of many new methods of administration, which can have more or less suppressive effects on the HPG axis. Also, the usage of ancillary medications instead of or after testosterone administration might help maintain fertility in hypogonadal patients. The goal of this narrative review is to summarize the newest methods for optimizing fertility parameters in patients undergoing treatment for hypogonadism and to provide the necessary information for healthcare providers to make the right treatment choices.

Mobility and Biomechanical Functions in the Aging Male: Testosterone and the Locomotive Syndrome.

In the current aging society, the occurrence of the locomotive syndrome, a condition in which the locomotive organs are impaired, is increasing. The locomotive system includes support (bones), mobility and impact absorption (joints and intervertebral disks), drive and control (muscles, nerves), and network (blood vessels). The impairment of any of those systems can lead to a major decrease in quality of life. In recent years, several studies on methods to improve and prevent conditions impairing the locomotive syndrome have been conducted. Almost in parallel with the structure supporting mobility and body functions, testosterone levels decrease with age. Testosterone is a hormone-regulating several pathways affecting each aspect of the locomotive syndrome. Testosterone is regulated by the pituitary gland triggering several processes in the body through genomic and non-genomic pathways, affecting muscles, bones, nerves, joints, intervertebral discs, and blood vessels. The purpose of this review is to investigate the role of testosterone in each of the systems involved in the locomotive syndrome.

Acute and Long-term Responses to Different Rest Intervals in Low-load Resistance Training.

We investigated the effects of low-load resistance training to failure performed with different rest intervals on acute hormonal responses and long-term muscle and strength gains. In the acute study, 14 participants were assigned to either a short rest (S, 30 s) or long rest (L, 150 s) protocol at 40% one-repetition maximum. Blood samples were taken before and after the workout. Both groups showed significant (p<0.05) increases in growth hormone and insulin-like growth factor 1 immediately post-workout. In the longitudinal study, the same protocol as in the acute study was performed 2 times per week for 8 weeks by 21 volunteers. Both groups showed significant increases in triceps (S: 9.8±8.8%, L: 10.6±9.6%, p<0.05) and thigh (S: 5.7±4.7%, L: 8.3±6.4%, p<0.05) cross-sectional area. One-repetition maximum also significantly increased for the bench press (S: 9.9±6.9%, L: 6.5±5.8%, p<0.05) and squat (S: 5.2±6.7%, L: 5.4±3.5%, p<0.05). In conclusion, our results suggest that acute hormonal responses, as well as chronic changes in muscle hypertrophy and strength in low-load training to failure are independent of the rest interval length.

Novel methods for the treatment of low testosterone.

INTRODUCTION: Testosterone replacement therapy is a promising and growing field in modern healthcare. Several novel testosterone preparations aiming at providing an efficient drug without side effects have been developed in recent years. Several oral, nasal, gel, and self-injection preparations are now available, providing a wide variety of options customized to each individual's needs. AREAS COVERED: We searched Google Scholar for keywords related to the different types of testosterone replacement therapy. This review provides information about the benefits and side effects of the newest testosterone preparations, aiming at giving a summary of the options with regard to testosterone replacement therapy to healthcare professionals. EXPERT OPINION: As testosterone replacement therapy is increasing in popularity, the development of novel ways of administration minimizing side effects associated with testosterone replacement therapy is growing. Nowadays, hypogonadal patients have several options to treat their conditions and can choose the most beneficial method for their individual condition.

Application of Passive Head Motion to Generate Defined Accelerations at the Heads of Rodents.

Exercise is widely recognized as effective for various diseases and physical disorders, including those related to brain dysfunction. However, molecular mechanisms behind the beneficial effects of exercise are poorly understood. Many physical workouts, particularly those classified as aerobic exercises such as jogging and walking, produce impulsive forces at the time of foot contact with the ground. Therefore, it was speculated that mechanical impact might be implicated in how exercise contributes to organismal homeostasis. For testing this hypothesis on the brain, a custom-designed ''passive head motion'' (hereafter referred to as PHM) system was developed that can generate vertical accelerations with controlled and defined magnitudes and modes and reproduce mechanical stimulation that might be applied to the heads of rodents during treadmill running at moderate velocities, a typical intervention to test the effects of exercise in animals. By using this system, it was demonstrated that PHM recapitulates the serotonin (5-hydroxytryptamine, hereafter referred to as 5-HT) receptor subtype 2A (5-HT2A) signaling in the prefrontal cortex (PFC) neurons of mice. This work provides detailed protocols for applying PHM and measuring its resultant mechanical accelerations at rodents' heads.

Human chorionic gonadotropin treatment: a viable option for management of secondary hypogonadism and male infertility.

Introduction: Low testosterone and its symptoms is a condition affecting many males with severe repercussions on health. Testosterone affects metabolism, bones, joints, and ligaments, the cardiovascular system, liver, sexual functions, muscle mass, and the nervous system. Nowadays, due to recent research showing the benefits of testosterone replacement therapy, this treatment is gaining in popularity among aging men. However, testosterone replacement can increase the risk of infertility. Areas covered: Human chorionic gonadotropin (HCG) is used in the treatment of male infertility due to its luteinizing hormone (LH)-like action triggering testosterone and sperm production. Due to these positive effects on testosterone production, HCG has also been used to treat secondary hypogonadism. In this review, based on a literature review for the years 1977-2020 via Google Scholar, we summarize the current research on HCG as treatment for patients suffering from low testosterone and provide an overview of the pros and contras for HCG therapy as compared to testosterone replacement therapy for the treatment of secondary hypogonadism. Expert opinion: The testosterone and sperm production triggering effects of HCG without the side effects on fertility seen in testosterone replacement therapy make HCG therapy a prime candidate for patients suffering from secondary hypogonadism.

Anabolic-androgenic steroids: procurement and administration practices of doping athletes.

Performance enhancing substances are becoming increasingly popular amongst bodybuilders and people who want to enhance their physiques. However, due to the rise of the Internet and laws prohibiting sales of these substances without prescription, the route of procurement and administration practices have become more and more dangerous. Prior to the mid-1970's, anabolic steroids were not regulated and easily available from physicians and pharmacies in several countries. In 1990, the United States enacted the Anabolic Steroid Control Act, leading to the proliferation of black markets and underground laboratories. The shift from pharmacy to underground online sites for the procurement of anabolic steroids led to an increase of fake products with low purity and the ability to potentially endanger the health of anabolic steroid users. Underground laboratories emerged both locally and in countries with lax legal regulations. 'Anabolic steroid tourism' and large networks of online resellers emerged, leading to the banalisation of the illegal procurement of anabolic steroids. Furthermore, the increase of anecdotal information spreading on the internet among anabolic steroid user forums nourishes the rampant misinformation and dangerous practices that currently exist. The dosages and ways of administration recommended on these forums can be false and misleading to those who lack a medical background and cannot go to their physician to seek advice because of the fear of repercussions. This review aims to elucidate and describe current practices of the anabolic-androgenic steroids black market and draw attention to potential dangers for users.

Effects of rest intervals and training loads on metabolic stress and muscle hypertrophy.

We investigated the effects of volume-matched resistance training (RT) with different training loads and rest intervals on acute responses and long-term muscle and strength gains. Ten subjects trained with short rest (30 s) combined with low load (20 RM) (SL) and ten subjects performed the same protocol with long rest (3 min) and high load (8 RM) (LH). Cross-sectional area (CSA) of the upper arm was measured by magnetic resonance imaging before and after 8 weeks of training. Acute stress markers such as growth hormone (GH) and muscle thickness (MT) changes have been assessed pre and post a single RT session. Only the SL group demonstrated significant increases in GH (7704·20 ± 11833·49%, P<0·05) and MT (35·2 ± 16·9%, P<0·05) immediately after training. After 8 weeks, the arm CSA s in both groups significantly increased [SL: 9·93 ± 4·86% (P<0·001), LH: 4·73 ± 3·01% (P<0·05)]. No significant correlation between acute GH elevations and CSA increases could be observed. We conclude that short rest combined with low-load training might induce a high amount of metabolic stress ultimately leading to improved muscle hypertrophy while long rest with high-load training might lead to superior strength increases. Acute GH increases seem not to be directly correlated with muscle hypertrophy.

The role of hormones in muscle hypertrophy.

Anabolic-androgenic steroids (AAS) and other hormones such as growth hormone (GH) and insulin-like growth factor-1 (IGF-1) have been shown to increase muscle mass in patients suffering from various diseases related to muscle atrophy. Despite known side-effects associated with supraphysiologic doses of such drugs, their anabolic effects have led to their widespread use and abuse by bodybuilders and athletes such as strength athletes seeking to improve performance and muscle mass. On the other hand, resistance training (RT) has also been shown to induce significant endogenous hormonal (testosterone (T), GH, IGF-1) elevations. Therefore, some bodybuilders employ RT protocols designed to elevate hormonal levels in order to maximize anabolic responses. In this article, we reviewed current RT protocol outcomes with and without performance enhancing drug usage. Acute RT-induced hormonal elevations seem not to be directly correlated with muscle growth. On the other hand, supplementation with AAS and other hormones might lead to supraphysiological muscle hypertrophy, especially when different compounds are combined.

Potential application of testosterone replacement therapy as treatment for obesity and type 2 diabetes in men.

Sedentary lifestyle and over-nutrition are the main causes of obesity and type 2 diabetes (T2D). However, the same causes are major triggers of hypogonadism. Many T2D patients show low testosterone levels while hypogonadal men seem to be prone to become diabetic. Testosterone plays a major role in the regulation of muscle mass, adipose tissue, inflammation and insulin sensitivity and is therefore indirectly regulating several metabolic pathways, while T2D is commonly triggered by insulin resistance, increased adipose tissue and inflammation, showing a negative correlation between testosterone levels and T2D. Testosterone replacement therapy (TRT) is widely used in patients with symptoms of hypogonadism, however it is not commonly used as preventive intervention or treatment for T2D patients even though hypogonadal patients share many common symptoms (obesity, insulin insensitivity, increased inflammation, decrease in muscle mass and strength) with T2D patients. Even though TRT is often associated with side effects such as prostatic hypertrophy or cancer, cardiovascular risks due to increase in the number of red blood cells and infertility, several studies have shown that TRT remains a potent intervention improving metabolic functions such as glycated haemoglobin, blood sugar, total cholesterol and visceral fat. The purpose of this review is to discuss the possible benefits and risks of TRT in the prevention and treatment of obesity and T2D and assess the health risks and benefits of common T2D medications and testosterone.

Effects of drop set resistance training on acute stress indicators and long-term muscle hypertrophy and strength.

BACKGROUND: We investigated the effects of 2 different resistance training (RT) protocols on muscle hypertrophy and strength. The first group (N.=8) performed a single drop set (DS) and the second group (N.=8) performed 3 sets of conventional RT (normal set, NS). METHODS: Eight young men in each group completed 6 weeks of RT. Muscle hypertrophy was assessed via magnetic resonance imaging (MRI) and strength via 12 repetition maximum tests before and after the 6 weeks. Acute stress markers such as muscle thickness (MT), blood lactate (BL), maximal voluntary contraction (MVC), heart rate (HR) and rating of perceived exertion (RPE) have been measured before and after one bout of RT. RESULTS: Both groups showed significant increases in triceps muscle cross-sectional area (CSA) (10.0±3.7%, effect size (ES) =0.47 for DS and 5.1±2.1%, ES=0.25 for NS). Strength increased in both groups (16.1±12.1%, ES=0.88 for DS and 25.2±17.5%, ES=1.34 for NS). Acute pre/post measurements for one bout of RT showed significant changes in MT (18.3±5.8%, P<0.001) and MVC (-13.3±7.1, P<0.05) in the DS group only and a significant difference (P<0.01) in RPE was observed between groups (7.7±1.5 for DS and 5.3±1.4 for NS). CONCLUSIONS: Superior muscle gains might be achieved with a single set of DS compared to 3 sets of conventional RT, probably due to higher stress experienced in the DS protocol.

Impact of high versus low fixed loads and non-linear training loads on muscle hypertrophy, strength and force development.

BACKGROUND: In this study, we investigated the effects of resistance training protocols with different loads on muscle hypertrophy and strength. METHODS: Twenty-one participants were randomly assigned to 1 of 3 (n = 7 for each) resistance training (RT) protocols to failure: High load 80 % 1RM (8-12 repetitions) (H group), low load 30 % 1RM (30-40 repetitions) (L group) and a mixed RT protocol (M group) in which the participants switch from H to L every 2 weeks. RT consisted of three sets of unilateral preacher curls performed with the left arm 3 times/week with 90 s rest intervals between sets. The right arm served as control. Maximum voluntary contraction (MVC) of the elbow flexors (elbow angle: 90°) and rate of force development (RFD, 0-50, 50-100, 100-200 and 200-300 ms) were measured. Cross-sectional area (CSA) of the elbow flexors was measured via magnetic resonance imaging (MRI). All measurements were conducted before and after the 8 weeks of RT (72-96 h after the last RT). Statistical evaluations were performed with two-way repeated measures (time × group). RESULTS: After 8 weeks of 3 weekly RT sessions, significant increases in the left elbow flexor CSA [H: 9.1 ± 6.4 % (p = 0.001), L: 9.4 ± 5.3 % (p = 0.001), M: 8.8 ± 7.9 % (p = 0.001)] have been observed in each group, without significant differences between groups. Significant changes in elbow flexor isometric MVC have been observed in the H group (26.5 ± 27.0 %, p = 0.028), while no significant changes have been observed in the M (11.8 ± 36.4 %, p = 0.26) and L (4.6 ± 23.9 %, p = 0.65) groups. RFD significantly increased during the 50-100 ms phase in the H group only (p = 0.049). CONCLUSIONS: We conclude that, as long as RT is conducted to failure, training load might not affect muscle hypertrophy in young men. Nevertheless, strength and RFD changes seem to be load-dependent. Furthermore, a non-linear RT protocol switching loads every 2 weeks might not lead to superior muscle hypertrophy nor strength gains in comparison with straight RT protocols.