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closeThis and the recently VA study point at the need to revise testosterone treatment guidelines
Posted by nelsonvergel on 30 Jan 2014 at 14:14 GMT
What this and the previous study at the VA show is that it is WRONG to give testosterone to older men and not provide phlebotomies for lowering hematocrit or anastrozole for lowering estradiol. High hematocrit and estradiol are more common in older men on testosterone since testosterone related aromatization and erythrocytosis are worse in that population. Both variables have been linked to cardiovascular risks in older men. None of these studies manage either.
Many clinics are managing hematocrit by recommending blood donation or phlebotomies to men with hematocrit over 53. They are also recommending treatment with low dose anastrozole for men with estradiol over 50 pg/mL. However, most medical practices follow recommendations for the 4 current guideline groups (neither mentions ways to manage high hematocrit and estradiol).
It is time to change the current guidelines for testosterone treatment in men to include the management of those two variables.
Nelson Vergel