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Part 2 - Hormone Replacement Therapy

This page contains educational resources for hormone replacement therapy. 


Current research for hormone replacement therapy

This page contains treatments details specific to hormone replacement therapy at Peach. This page is not meant to diagnose or recommend. If you have any questions, please contact us at one our facilities. 

Testosterone and depression: systematic review and meta-analysis

Summary: This review concluded that testosterone replacement therapy may have an antidepressant effect, especially for patients who also have hypogonadism or HIV infection. Limitations in the review methods and the evidence base suggest that the conclusions should be treated with caution. The conclusions are unlikely to be applicable to the general population of patients with depression.

Zarrouf, F. A., Artz, S., Griffith, J., Sirbu, C., & Kommor, M. (2009). Testosterone and Depression. Journal of Psychiatric Practice, 15(4), 289-305. doi:10.1097/01.pra.0000358315.88931.fc

A 10-Year, Prospective Study of the Metabolic Effects of Growth Hormone Replacement in Adults

Context: Only a few studies have investigated the effects of GH replacement in adults for more than 5 yr.

Objective/Design/Patients: In a prospective, open-label, single-center study, the effects of 10-yr GH replacement were determined. Eighty-seven consecutive patients (52 men and 35 women), with a mean age of 44.1 (range 22–74) yr with adult-onset GH deficiency (GHD) were included.

Results: The initial mean dose of GH (0.98 mg/d) was reduced during the study and at yr 10 was 0.47 mg/d. The mean IGF-I sd score increased from −1.81 at baseline to 1.29 at study end. The absolute reduction in total body fat was transient. However, after correction for age and sex using a four-compartment model, the reduction in body fat was sustained during the 10-yr study period. There was a sustained improvement in serum lipid profile and after 10 yr, and blood glycosylated hemoglobin level was reduced. The treatment responses in IGF-I sd score, serum high-density lipoprotein cholesterol level, and body composition as measured using dual-energy x-ray absorptiometry were more marked in men, whereas women had a more marked reduction in blood glycosylated hemoglobin level.

Conclusion: The effect on the absolute amount of body fat was seen early and was transient, which could be due to the normal aging of the patients. The effects on metabolic indices were detected later, but they were sustained and even progressive throughout the study period.

Götherström, G., Bengtsson, B., Bosæus, I., Johannsson, G., & Svensson, J. (2007). A 10-Year, Prospective Study of the Metabolic Effects of Growth Hormone Replacement in Adults. The Journal of Clinical Endocrinology & Metabolism,92(4), 1442-1445. doi:10.1210/jc.2006-1487

Ten Years of Growth Hormone (GH) Replacement Normalizes Muscle Strength in GH-Deficient Adults

Context: GH replacement for 1–5 yr improves, but does not fully normalize, muscle strength.

Objective, Design, and Patients: In this single-center, open-labeled, prospective study, the effects of 10 yr of GH replacement on muscle strength and neuromuscular function were followed in 109 consecutive adults (61 men; mean age 50.0 yr; range 22–74 yr) with adult-onset GH deficiency.

Results: The mean initial GH dose of 0.88 mg/d was gradually lowered to 0.47 mg/d. The mean IGF-I sd score increased from −1.54 at baseline to 1.12 at study end. GH replacement induced a sustained increase in lean mass and isometric knee flexor strength (60°). In most other measures of upper leg and handgrip strength, there were transient increases during the first half of the study (0–5 yr), whereas during the second half (5–10 yr), the absolute values of muscle strength decreased and returned to or even below the baseline values. However, after correction for age and gender using observed/predicted value ratios, there were sustained and, until 7 yr, even progressive increases in the measures of muscle strength. At study end, knee flexor strength had increased to 104–110% of predicted, knee extensor strength to 93–108%, and handgrip strength to 88–93%. Measurements of neuromuscular function showed reduced voluntary motor unit activation after 10 yr.

Conclusions: Ten years of GH replacement therapy increased muscle strength during the first half of the study and thereafter partly protected against the normal age-related decline in muscle strength and neuromuscular function, resulting in approximately normalized muscle strength after 10 yr.

Götherström, G., Elbornsson, M., Stibrant-Sunnerhagen, K., Bengtsson, B., Johannsson, G., & Svensson, J. (2009). Ten Years of Growth Hormone (GH) Replacement Normalizes Muscle Strength in GH-Deficient Adults. The Journal of Clinical Endocrinology & Metabolism, 94(3), 809-816. doi:10.1210/jc.2008-1538

Testosterone and growth hormone improve body composition and muscle performance in older men.

Context: Impairments in the pituitary-gonadal axis with aging are associated with loss of muscle mass and function and accumulation of upper body fat.

Objectives:We tested the hypothesis that physiological supplementation with testosterone and GH together improves body composition and muscle performance in older men.

Design, setting, and participants: One hundred twenty-two community-dwelling men 70.8 +/- 4.2 yr of age with body mass index of 27.4 +/- 3.4 kg/m2, testosterone of 550 ng/dl or less, and IGF-I in lower adult tertile (< or =167 ng/dl) were randomized to receive transdermal testosterone (5 or 10 g/d) during a Leydig cell clamp plus GH (0, 3, or 5 microg/kg . d) for 16 wk.

Main outcome measures:Body composition by dual-energy x-ray absorptiometry, muscle performance, and safety tests were conducted.

Results: Total lean body mass increased (1.0 +/- 1.7 to 3.0 +/- 2.2 kg) as did appendicular lean tissue (0.4 +/- 1.4 to 1.5 +/- 1.3 kg), whereas total fat mass decreased by 0.4 +/- 0.9 to 2.3 +/- 1.7 kg as did trunk fat (0.5 +/- 0.9 to 1.5 +/- 1.0 kg) across the six treatment groups and by dose levels for each parameter (P < or = 0.0004 for linear trend). Composite maximum voluntary strength of upper and lower body muscles increased by 14 +/- 34 to 35 +/- 31% (P < 0.003 in the three highest dose groups) that correlated with changes in appendicular lean mass. Aerobic endurance increased in all six groups (average 96 +/- 137 sec longer). Systolic and diastolic blood pressure increased similarly in each group with mean increases of 12 +/- 14 and 8 +/- 8 mm Hg, respectively. Other predictable adverse events were modest and reversible.

Conclusions: Supplemental testosterone produced significant gains in total and appendicular lean mass, muscle strength, and aerobic endurance with significant reductions in whole-body and trunk fat. Outcomes appeared to be further enhanced with GH supplementation.

Sattler, F. R., Castaneda-Sceppa, C., Binder, E. F., Schroeder, E. T., Wang, Y., Bhasin, S., . . . Azen, S. P. (2009). Testosterone and Growth Hormone Improve Body Composition and Muscle Performance in Older Men. The Journal of Clinical Endocrinology & Metabolism, 94(6), 1991-2001. doi:10.1210/jc.2008-2338