Feb. 8, 2000 (Baltimore) -- Use of the male hormone testosterone helps HIV-positive men who have low testosterone levels and loss of muscle mass -- called muscle wasting -- rebuild muscle and increase strength, according to a study in the Feb. 9 issue of the Journal of the American Medical Association.
"This is the first [study] to clearly show that testosterone replacement in physiologic doses increases muscle mass and muscle strength, and that it is useful in the treatment of muscle wasting associated with chronic disease," says lead author Shalender Bhasin, MD, professor of medicine at Charles R. Drew University of Medicine and Science in Los Angeles, in an interview with WebMD. Testosterone is one type of hormone called an anabolic steroid, which, among other functions, helps the body build muscle mass.
Bhasin and colleagues studied 49 men who were HIV-positive and had both low testosterone levels and muscle wasting for 16 weeks. The men were divided into four groups: those who received a placebo; those who did resistance exercise alone; those who received testosterone alone; and those who both received testosterone and did resistance training (combination group).
Body weight and lean muscle mass increased by approximately 6 pounds in men who either exercised or received testosterone. Those in the testosterone-only, exercise-only, and combination groups realized significant increases in their maximum muscle strength and thigh muscle size. The men receiving placebo did not have any significant change in strength or muscle mass.
"Our study suggests that the use of testosterone in men who have low testosterone levels and chronic muscle wasting will possibly increase muscle mass and strength," Bhasin says. "The question is: Will this reduce disability and improve function? These data do look promising, however, and the increased mass and strength are seen without any tedious adverse effects."
"This study shows a benefit from testosterone replacement in HIV-infected men who have low testosterone levels," Adrian Dobbs, MD, tells WebMD in an interview seeking objective comment on the study. "With the initiation of early [anti-HIV] therapy, only about 5-10% of HIV-infected men will experience low testosterone levels, so potential benefit in this group of patients may be limited. However, in other chronic diseases where muscle wasting is common, such as [emphysema,] this therapy might be quite effective. In fact, we're recruiting patients with [emphysema] and lung cancer for such a study right now, where we're using an inhaled anabolic steroid." Dobbs is an associate professor of medicine at Johns Hopkins School of Medicine in Baltimore.
"Another group who might benefit from the use of anabolic steroids for muscle wasting is women," she says. According to Dobbs, she and some colleagues performed a study on the use of testosterone in women, and it was difficult to formulate a dose that would produce beneficial effects on muscle mass but not make the women more masculine. "It's possible some of the other anabolic steroids will be less risky," she says. "One group I most certainly do not want to see using these drugs is normal men who feel they would like to increase their lean body mass. While there may be many reasons to be treated if one is experiencing muscle wasting due to chronic illness, there are no good reasons to treat normal men."
- HIV-positive men who suffer from loss of muscle can increase muscle mass and strength by taking the hormone testosterone, according to a recent study.
- The next question for researchers is whether this muscle improvement translates into reduced disability and improved function.
- Researchers believe treatment with testosterone may also be useful to treat muscle loss in patients with other diseases, such as emphysema.