Discussion
Anemia, hypogonadism, anemia, fatigue
CVD, HYPOGONADISM, ANEMIA, SECONDARY, ANEMIA
Anemia is a common health problem among older men that is associated with fatigue, functional limitations, a reduced ability to carry out activities of daily living, increased risk of falls, exacerbation of existing CVD, and increased risk of hospitalizations and mortality.The magnitude of increase in hemoglobin in testosterone-treated men with anemia was not dissimilar from that reported with other erythropoiesis-stimulating agents and inhibitors of hypoxia-inducible factor prolyl hydroxylase that are approved for the treatment of anemia.Testosterone likely increases hemoglobin and red cell number by multiple mechanisms. Testosterone stimulates erythropoietin transcription, increases iron availability for erythropoiesis by suppressing hepcidin transcription, increases the numbers of common myeloid progenitors, and improves red cell survival.The TRAVERSE Anemia Study is the largest testosterone trial to date in older men with hypogonadism and anemia in which correction of anemia was a prespecified primary end point. A secondary analysis of 129 men with unexplained anemia in the testosterone trials also found correction of anemia in a greater proportion of testosterone-treated men than placebo-treated men.