title: Effects of various modes of androgen substitution therapy on erythropoiesis.
abstract: In order to investigate differential effects of androgens on erythropoiesis, 55 men with clincally and biochemical confirmed hypogonadism were randomly assigned to 4 groups receiving different forms of androgen substitution: Mesterolone (MES) 100 mg/d, testosterone undecanoate (TU) 160 mg/d, testosterone enanthate (TE) 250 mg i.m./21 days or 1200 mg crystalline testosterone (TPEL) subcutaneously implanted at study begin. Previous testosterone medication had been suspended at least 3 months prior to study begin. Testosterone (T), dihydrotestosterone (DHT), hemoglobin (HB) and hematocrit (HC) were assessed before, during and after substitution of androgens. MES did not increase serum T and TU raised average T levels during substitution to 5.7 +/- 0.3 nmol/l, thereby doubling baseline concentrations. TE resulted in a 6fold increase of baseline T yielding 13.5 +/- 0.7 nmol/l and TPEL increased serum T 8.5fold to 23.2 +/- 1.1 nmol/l. Average DHT levels during substitution were 4.3 +/- 0.2 (MES), 3.3 +/- 0.2 (TU), 4.0 +/- 0.4 (TE) and 5.5 +/- 0.4 (TPEL) nmol/l. The groups receiving TPEL, TU or TE showed a significant rise of HB and HC compared to baseline, whereas in the MES group these parameters did not change significantly. MES increased HB by 5.6 +/- 1.8 g/l, TU by 12.7 +/- 2.8 g/l, TE by 21.1 +/- 2.6 g/l and TPEL by 21.7 +/- 4.0 g/l. HC was raised by 1.8 +/- 0. 4% in the MES group, 3.9 +/- 1.1% in the TU group and 6.4 +/- 0.9% and 6.5 +/- 1.6% in the TE and TPEL groups, respectively. Except for 1 subject in the TPEL group, the HB and HC stayed within the normal limits. We conclude that, T, but not DHT, stimulates erythropoiesis in a dose dependent manner. T levels within the low normal range for men are required for maximal stimulation of erythropoiesis.
authors.affiliation: Klinik II und Poliklinik für Innere Medizin, Universität zu Köln, Köln D-50924, Germany. fjockenhoevel@uni-koeln.de
authors.forename: F
authors.initials: F
authors.lastname: Jockenhövel
authors.forename: E
authors.initials: E
authors.lastname: Vogel
authors.forename: W
authors.initials: W
authors.lastname: Reinhardt
authors.forename: D
authors.initials: D
authors.lastname: Reinwein
mesh_terms: D000328:Adult; D013196:Dihydrotestosterone / Q000097:blood; D004343:Drug Implants; D004920:Erythropoiesis / Q000187:drug effects*; D005293:Ferritins / Q000097:blood; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007006:Hypogonadism / Q000097:blood* / Q000188:drug therapy; D007501:Iron / Q000097:blood; D008297:Male; D008655:Mesterolone / Q000008:administration & dosage / Q000627:therapeutic use*; D012044:Regression Analysis; D013739:Testosterone / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood / Q000627:therapeutic use*; D045165:Testosterone Congeners / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D004343:Drug Implants; D006454:Hemoglobins; D045165:Testosterone Congeners; D013196:Dihydrotestosterone; D008655:Mesterolone; D013739:Testosterone; C004648:testosterone enanthate; D005293:Ferritins; D007501:Iron; C010792:testosterone undecanoate