Important note: Information in this article was accurate in October 2000. The state of the art may have changed since the publication date.
Researchers in Boston compared the effect of weekly testosterone injections versus regular exercise versus a combination of testosterone and exercise on the build-up of muscle in men with HIV-related weight loss. Testosterone injections helped increase muscle mass, though the effect of testosterone combined with exercise was even greater. Generally there were no serious side effects, although there were changes to some hormonal levels. As well, there were some unfavourable changes in levels of certain blood lipids among testosterone users. Testosterone injections had no impact on CD4+ cell counts or viral load.
Researchers recruited 54 HIV+ males who had lost at least 10% of their weight and who also had normal levels testosterone. None of the subjects had prostate disorders, serious kidney damage or depressive illness. Researchers randomly assigned subjects to receive weekly injections of testosterone 200 mg or fake testosterone (placebo). They further randomly selected subjects to receive progressive strength training exercises or no training for three months. About 3/4 of all subjects were taking anti-HIV therapy, 72% of whom were using highly active antiretroviral therapy or HAART. Before entering the study, about 75% of subjects had previously experienced a life-threatening AIDS-related complication. At the start of the study subjects who received testosterone had on average the following lab values:
For subjects who received placebo, their average values were as follows:
Subjects who received testosterone lost more fat and gained more muscle than did subjects on placebo. Not surprisingly, subjects who exercised and took testosterone gained the most muscle and lost the most fat.
Subjects who received testosterone developed the following changes in their hormonal levels:
Subjects who received testosterone had their levels of "good" cholesterol (HDL - high density lipoprotein) fall significantly. By itself this change does not greatly increase the risk of cardiovascular disease. In people with the lipodystrophy syndrome, whose levels of "bad" cholesterol and triglycerides are probably higher-than-normal, such a change in HDL may raise concerns. In those subjects who received placebo and who also exercised, levels of "good" cholesterol (HDL) increased during the study.
There were no major side effects such as increased prostate size or mood swings reported by subjects who received testosterone. Three subjects who received testosterone developed tender breasts and/or increased breast size during the study.
1. Grinspoon S, Corcoran C, Parlman K, et al. Effects of testosterone and progressive resistance training in eugonadal men with AIDS wasting: a randomized, controlled trial. Ann Intern Med 2000 Sep 5;133(5):348-55.
2. Périard D, Telenti A, Sudre P, et al. Atherogenic dyslipidemia in HIV-infected individuals treated with protease inhibitors. Circulation 1999 Aug 17;100(7):700-5.
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