Moderate Levels of Testosterone Best for Older Men

Older men with high or low testosterone levels have higher mortality risk as compared to men who have mid-range testosterone levels, a new study finds. The study divided 3,690 elderly, community-dwelling men, between the ages of 70 and 89, into four groups. Follow-up was over 6.7 years, during which there were 974 deaths (26.4%), including 325 of ischemic heart disease (IHD). Men who died had lower mean baseline testosterone (T) (12.8 versus 13.2 nmol/L), dihydrotestosterone (DHT) (1.4 versus 1.5 nmol/L), and estradiol (71.6 versus 74.0 pmol/L). After accounting for other risk factors, researchers found that T and DHT levels were associated with all-cause mortality. Higher DHT was also associated with lower IHD mortality. Estradiol was not associated with either all-cause or IHD mortality. "Our results challenge the concept that lower T is associated with increased mortality in a linear fashion," the researchers wrote. "Instead, an optimal range of circulating total T corresponding to a range of 9.8 to 15.8 nmol/L (282-455 ng/dL) exists for older men, which predicts survival independent of other risk factors." Researchers concluded that optimal androgen levels should be considered a biomarker for survival in older men. Additional research is needed to investigate the impact of natural and therapeutic androgen exposure on overall health and survival as men age, as well as to determine the optimal testosterone level for older men. The complete study is published in the November issue of the Journal of Clinical Endocrinology and Metabolism. References: Yeap BB, Alfonso H, CHubb SAP, Handelsman DJ, et al. In Older Men an Optimal Plasma Testosterone Is Associated With Reduced All-Cause Mortality and Higher Dihydrotestosterone With Reduced Ischemic Heart Disease Mortality, While Estradiol Levels Do Not Predict Mortality. Published online before print November 20, 2013, doi: 10.1210/jc.2013-3272 http://jcem.endojournals.org/content/early/2013/11/20/jc.2013-3272.abstract