Table 1414

Testosterone Characteristics

Endogenous anabolic hormone

Produced mainly by the testes in males and the adrenal gland in females Acts on androgenic receptors found mainly in muscle, skin, and sex glands Has modest anabolic activity compared to its analogs

Androgenic activity includes male sex gland development, male pattern of hair, mood Rapidly metabolized by the liver Levels decrease with increasing age Levels decrease with injury/infection

Decreased testosterone causes lean mass loss in healthy and injured man itself.97-99 The anabolic properties were defined in the 1930s. These included an increase in muscle size, synthesis, and strength. Increased skin thickness has also been noted with administration to hypogonadal men. The importance of testosterone is evidenced by the complications seen with low testosterone levels, which include sarcopenia or lost lean mass, increased rate of development of osteoporosis, anemia, thinning of skin, and weakness and impaired wound healing98-100 (Table 14.15 and Table 14.16).

The native molecule was first used in the 1950s to correct a debilitated state, correct anemia, and increase calcium deposition in bone as well as to treat hypogonadal states.93-96 The testosterone molecule is rapidly metabolized by the liver such that the half-life is only about 20 min. Adjustments were made to the molecule to increase its time of action, the most popular being testosterone enthanate.

Decreased production, leading to a hypogonadal state, occurs with increasing age as well as with injury or infection, especially severe trauma and chronic illness such as HIV infection and chronic wounds.

As seen in Table 14.16, a hypogonadal state is seen in many patient populations, including an acute severe injury state, infection, or more chronic states such as aging, chronic obstructive pulmonary disease (COPD), and other chronic illnesses.96-99

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