Older men who take testosterone and growth hormone to build up muscle mass and strength lose fat and become fitter. If they stop taking the drugs, then three months later they’ll have lost about half of the muscle mass and strength they’d accumulated, nearly all the fat that had been lost will have returned and hardly any of the increase in fitness will be noticeable. Researchers at the University of Southern California draw this conclusion in Clinical Endocrinology.
A quarter to a fifth of all men over the age of sixty have so little testosterone in their blood that they are at risk of developing the disease of aging called sarcopenia. [Mech Ageing Dev. 1999; 107(2): 123–136.] That’s why researchers are looking at whether administration of testosterone can help the over sixties to maintain strength in their muscles.
The trials have not always been a success. In 2010 the New England Journal of Medicine reported about an experiment in which men used testosterone gel, and which had to be broken off abruptly when the participants got heart attacks and strokes and some even died. The men were not actually very healthy: they were overweight, many had chronic diseases, such as diabetes type-2, and others had high blood pressure.
The 112 men aged from 65-90 that Fred Sattler of the University of Southern California used for his Hormonal Regulators of Muscle and Metabolism in Aging [HORMA] trial were all healthy, apart form their relatively low levels of testosterone and IGF-1. Sattler got them to rub 5 or 10 g Solvay testosterone gel [testosterone concentration: 1 percent] into their bodies every day for 16 weeks, and to inject themselves every evening with 0.3 or 5 micrograms of Genentech’s Nutropin.
Sattler measured the effects of the hormones during the supplementation, but he also looked at what remained of these effects three months after finishing the hormone course. It was nothing to write home about.
Of all lean body mass [Total LBM] that the man had built up during the course [Week 17], only half was left three months later [Week 28]. The same was true for the muscle mass in the limbs [ASMM].
Of the maximal strength that the men had built up [they didn’t train by the way] only a third was left three months later. The Margaria Power – in other words the speed with which the men could climb stairs – increased during the supplementation, but none of this was visible three months later.
During the course of supplementation the men lost fat mass, but three months after finishing the course nearly all the fat had returned.
So the positive effects of taking growth hormone and using testosterone gel are not very lasting. The same was fortunately also true for the side effects. Three months after the course had ended the men produced the same amount of testosterone and IGF-1 as they had before the course started. The hormone course didn’t have a lasting negative effect on the body’s own hormone production.
The figure above shows that blood viscosity increased during the hormone course, but returned to normal after it ended. The same was true for the PSA level, a marker of the likelihood of developing prostate cancer. What happened to the blood pressure and cholesterol levels was less encouraging, although there’s no need to exaggerate the effects.
The researchers are above all concerned about the short shelf life of the desirable effects of the hormone administration. “Additional strategies such as nutritional support or exercise may be needed to sustain the gains in muscle mass and strength achieved during short term administration of such combination therapies”, they write.
Durability of the Effects of Testosterone and Growth Hormone Supplementation in Older Community Dwelling Men: The HORMA Trial.
Sattler FR, Bhasin S, He J, Yarasheski K, Binder E, Todd Schroeder E, Castaneda-Sceppa C, Kawakubo M, Roubenoff R, Dunn M, Hahn C, Stewart Y, Martinez C, Azen SP.
From the Department of MedicineDivision of BiokinesiologyDepartment of Preventive MedicineDepartment of Urology, of the University of Southern California, Los Angeles, CASection of Endocrinology, Diabetes, and Nutrition, Boston University, Boston, MA Boston, MADepartment of Medicine, Washington University, St. Louis, MOJean Mayer USDA Human Nutrition Research Center on Aging of Tufts University.
Objectives:? Determine the durability of anabolic effects and adverse events (AEs) after stopping testosterone and growth hormone supplementation in older men. Design:? Secondary analysis of a double-masked, randomized controlled trial of testosterone gel (5g or 10g/daily) plus rhGH (0, 3, or 5ug/kg/day) with follow-up of outcomes 3-months later. Participants:? 108 community-dwelling 65-90 year-old-men. Measurements:? Testosterone and IGF-1 levels, body composition (DEXA), 1-repetition maximum (1-RM) strength, stair-climbing power, quality-of-life (QOL) and activity questionnaires, AEs. Results:? Despite improvements in body composition during treatment, residual benefits 3-months later (week-28) were variable. For participants with improvements exceeding their week-17 median changes, benefits were sustained at week 28 for lean body mass (LBM, 1.45±1.63kg, 45% of week-17 values, p<0.0001-vs-baseline), appendicular skeletal muscle mass (ASMM, 0.71±1.01kg, 42%, p<0.0001), total fat (-1.06±2.18kg, 40%, p<0.0001,), and trunk fat (-0.89±1.42kg, 50%, p<0.0001,); retention of ASMM was associated with greater week-16 protein intake (p=0.01). For 1-RM strength, 39%-43% of week-17 improvements (p?0.05) were retained and associated with better week-17 strength (p<0.0001), change in testosterone from week-17-to-28 (p=0.004) and baseline PASE (p=0.04). Framingham 10-year cardiovascular risks were low (?14%), didn’t worsen, and improved by week-28 (p=0.0002). The hypothalamic-pituitary-gonadal axis recovered completely. Conclusions:? Durable improvements in muscle mass, strength, and fat mass were retained 3-months after discontinuing hormone supplementation in participants with greater than median body composition changes during treatment, but not in others with smaller gains. AEs largely resolved after intervention discontinuation. Additional strategies may be needed to sustain or augment muscle mass and strength gains achieved during short-term hormone therapy.
PMID: 21521283 [PubMed – as supplied by publisher]