Summary
Patients with chronic liver disease usually exhibit low plasma levels of testosterone with loss of libido and potency; this is also valid in male patients suffering from idiopathic hemochromatosis (IHC), in whom nowadays the diagnosis is made at an earlier age. Therefore, the effect of testosterone treatment was studied in 10 patients with IHC. After the application of 250 mg testosterone enanthate i.m., the plasma testosterone (from 2.4±1.9 to 20.1±7.4 ng/ml) and estradiol (from 17.4±6.3 to 38.5±14.2 pg/ml) levels increased significantly. The rise of estradiol was in the range of controls and smaller than reported in other chronic liver diseases. In a long-term study, 250 mg testosterone enanthate was given 4-weekly for 33–96 months to 5 patients with IHC. General well-being, libido, and potency recovered almost immediately. Over a treatment period of 27.3 patient years, symptoms of hyperestrogenism (gynecomastia) or (portal vein) thrombosis were not seen, both of which had been described in patients with alcoholic liver cirrhosis. There was no deterioration of liver function. The effect of testosterone treatment on the patients' well-being and plasma hormone concentrations remained unchanged over the whole period of testosterone treatment. Thus, in male patients with IHC and lowered plasma testosterone, treatment with testosterone enanthate may be instituted. Because of the positive effects on general well-being, liver regeneration capacity, and potency, testosterone should especially be administered to younger subjects suffering from IHC.
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Abbreviations
- IHC:
-
idiopathic hemochromatosis
- LH:
-
luteinizing hormone
- SHBG:
-
sexual hormone binding globulin
References
Charbonnel B, Chupin M, LeGrand A, Guillon J (1981) Pituitary function in idiopathic haemochromatosis: hormonal study in 36 male patients. Acta Endocrinol (Copenh) 98:178–181
Chopra IJ, Tulchinsky D, Greenway FL (1973) Estrogen-androgen imbalance in hepatic cirrhosis. Ann Intern Med 79:198–203
Doe RP, Mellinger GT, Swaim WR, Seal US (1967) Estrogen dosage effects on serum proteins: a longitudinal study. J Clin Endocrinol Metab 27:1081–1088
Dorfmann H, Solnica J, Mitrovic D, Dreyfuß P (1969) Veränderungen an Knochen und Gelenken bei der Hämochromatose. Münch Med Wochenschr 11:1396–1399
Gluud C, Bennett P, Dietrichson O, Johnsen SG, Ranek L, Svendsen LB, Juhl E (1981) Short-term parenteral and peroral testosterone administration in men with alcoholic cirrhosis. Scand J Gastroenterol 16:749–755
Gordon GG, Olivo J, Rafii F, Southren AL (1975) Conversion of androgens to estrogens in cirrhosis of the liver. J Clin Endocrinol Metab 40:1018–1026
Henke F, Lubarsch O (1966) Drüsen mit innerer Sekretion. (Handbuch der Speziellen Pathologischen Anatomie und Histologic, vol 8) Springer, Berlin Heidelberg New York, pp 950–961
Jabbari M, Leevy CM (1967) Protein anabolism and fatty liver of the alcoholic. Medicine (Baltimore) 46:131–139
Johnson FL, Feagler JR, Leber KG (1972) Association of androgenic-anabolic steroid therapy with the development of hepatocellular carcinoma. Lancet II: 1273–1276
Johnson SG, Kampmann JP, Bennett EP, Schonau-Jorgensen F (1976) Enzyme induction by oral testosterone. Clin Pharmacol Ther 20:233–237
Kley HK, Krüskemper HL (1977) Leber und Steroid-hormone. Med Klin 71:231–239
Kley HK, Herrmann J, Morgner KD, Kruskemper HL (1973) Effects of testosteroneoenanthate on plasma concentrations of thyroxine, cortisol, testosterone and hormone binding proteins in patients with hypogonadism. Horm Metab Res 5:271–275
Kley HK, Nieschlag E, Bidlingmaier F, Kruskemper HL (1974) Possible age-dependent influence of oestrogens on the binding of testosterone in plasma of adult men. Horm Metab Res 6:213–216
Kley HK, Nieschlag E, Wiegelmann W, Kruskemper HL (1975) Steroid hormones and their binding in plasma of male patients with fatty liver, chronic hepatitis and liver cirrhosis. Acta Endocrinol (Copenh) 79:275–285
Kley HK, Keck E, Kruskemper HL (1976) Estrone and estradiol in patients with cirrhosis of the liver: effects of ACTH and dexamethasone. J Clin Endocrinol Metab 43:557–560
Kley HK, Strohmeyer G, Kruskemper HL (1979) Effect of testosterone application on hormone concentrations of androgens and estrogens in male patients with cirrhosis of the liver. Gastroenterology 76:235–241
Kley HK, Solbach HG, McKinnan JC, Kruskemper HL (1979) Testosterone decrease and oestrogen increase in male patients with obesity. Acta Endocrinol (Copenh) 91:553–563
Kley HK, Stremmel W, Niederau C, Hehrmann R, Shams O, Strohmeyer G, Kruskemper HL (1985) Androgen and estrogen response to adrenal and gonadal stimulation in idiopathic hemochromatosis: evidence for decreased estrogen formation. Hepatology 5:251–256
Kley HK, Niederau C, Stremmel W, Lax R, Strohmeyer G, Krüskemper HL (1985) Conversion of androgens to estrogens in idiopathic hemochromatosis: comparison with alcoholic liver cirrhosis. J Clin Endocrinol Metab 61:1–6
Leevy CM (1967) Clinical diagnosis, evaluation and treatment of liver disease in alcoholics. Fed Proc 26:1474–1481
Lester R, Eagon PK, Van Thiel DH (1979) Feminization of the alcoholic: the estrogen/testosterone ratio. Gastroenterology 76:415–417
Mendenhall CL, Anderson S, Garcia-Pont P (1984) Shortterm and long-term survival in patients with alcoholic hepatitis treated with oxandrolone and prednisolone. N Engl J Med 311:1464–1470
Niederau C, Fischer R, Sonnenberg A, Stremmel W, Trampisch HJ, Strohmeyer G (1985) Survival and causes of death in cirrhotic and noncirrhotic patients with primary hemochromatosis. N Engl J Med 313:1256–1262
Stocks AE, Powell LW (1972) Pituitary function in idiopathic haemochromatosis and cirrhosis of the liver. Lancet 11:298–300
The Copenhagen Study Group for Liver Diseases (1986) Testosterone treatment of men with alcoholic cirrhosis: a double-blind study. Hepatology 6:807–813
Van Thiel DH, Lester R, Sherins RJ (1974) Hypogonadism in alcoholic liver disease: evidence for a double defect. Gastroenterology 67:1188–1199
Walsh CH, Wright AC, Williams JW, Holder G (1976) A study of pituitary function in patients with idiopathic hemochromatosis. J Clin Endocrinol Metab 43:866–872
Wardle EW, Patton JT (1969) Bone and joint changes in haemochromatosis. Ann Rheum 28:15–21
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Kley, H.K., Stremmel, W., Kley, J.B. et al. Testosterone treatment of men with idiopathic hemochromatosis. Clin Investig 70, 566–572 (1992). https://doi.org/10.1007/BF00184793
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DOI: https://doi.org/10.1007/BF00184793