Dave Bostick, a patient in the clinical trial testing.
Dave Bostick of Park Place poses for a portrait inside his home. Bostick was a patient in a clinical trial testing the benefits of a testosterone treatment.
By David Templeton / Pittsburgh Post-Gazette
Most afternoons Dave Bostick would slump into a chair and doze off. He thought it was normal for someone 71 years old with arthritis in his knees and type 2 diabetes.
But then he joined a randomized double-blind clinical trial at the University of Pittsburgh Graduate School of Public Health to test the impact of testosterone treatments on men 65 and older. He didn’t get official results for three years, but soon after the trial began he had good reason to believe he was receiving testosterone in the gel he was rubbing into his upper arm and shoulder area.
Mr. Bostick of Park Place was one of 790 men with low testosterone levels who participated in trials at seven sites nationwide, including Pittsburgh.
“Once on testosterone, the naps during the day were considerably fewer,” he said. “I felt different. I felt I had fuel in the tank.”
Indeed, boosting testosterone levels in older men to levels typical for 19- to 40-year-olds not only bolstered sexual interest and activity but also improved their mood. So says the study funded by the National Institutes of Health and published Wednesday in the New England Journal of Medicine.
Testosterone treatments increased sexual activity and desire in men receiving the treatment, with improvements in erectile function, said Jane A. Cauley, the principal investigator for the Pittsburgh trial. Some benefits were shown in walking, with those receiving the treatment also generally feeling better.
There weren’t enough participants to show any health risks from the treatments, but adverse health events were equal in the two groups, said Ms. Cauley, who holds a Ph.D. in epidemiology. “Those interested in exploring treatment can see if this would be beneficial for symptoms related to low testosterone” that include lack of energy and decline in libido, among others
Abraham Morgentaler, director and founder of Men’s Health Boston and author of “Testosterone for Life,” said “the study confirms what clinicians and patients have know for many years — that testosterone treatment works for men who have low testosterone levels.”
“The importance of this study is that until today critics have claimed the benefits were unproven because there hadn’t been a large NIH-funded study that demonstrated this. Those claims can no longer be considered credible,” said Dr. Morgentaler, who’s also an associate clinical professor of urology at the Harvard University Medical School. He was not involved in the study.
One case of prostate cancer was documented among the 790 participants — a tiny number considering the men’s ages. For those receiving testosterone, there was a slight increase in prostate-specific antigen, or PSA, which often is elevated because of prostate cancer and other prostate disorders. But Dr. Morgentaler said research largely has discounted any link between elevated testosterone levels and prostate cancer.
“I’ve been using this treatment in patients for 25 years and everything described in the study is what we’ve seen in treatment of several thousand men,” he said. “That doesn’t mean every man gets every one of those benefits, but testosterone works on lots of areas of the body, including muscles, brain, fat, bones and sex organs. It makes sense as levels of testosterone decline that there may be biological effects that can be reversed by normalizing testosterone.”
Men in the study had testosterone blood levels of 275 nanograms per deciliter or lower, with 410 ng/dL being the average for the age group. Those on the treatment experienced levels ranging between 500 and 800 ng/dL for a year, followed by a year without treatment. They also were divided into three groups to determine testosterone’s specific impacts on sexual and physical function and vitality.
The study found no boosts in vitality but noted that “men who received testosterone reported slightly better mood and lower severity of depressive symptoms than those who received placebo.”
Mr. Bostick said soon after the trial began he no longer needed his aftenoon naps but did need those naps when treatments ended. So he received a prescription of testosterone gel from his own physician. It also can be administered as a pellet under the skin or through injection.
“There were benefits with the libido, but for me the main benefit was not running out of gas in the afternoon,” he said. “Now, if only I could get my knees back.”
David Templeton: firstname.lastname@example.org.
Clarification, added Feb.19: An earlier version of the story inaccurately stated where the brand of the testosterone gel that Dave Bostick used was applied.
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