NIH Kudzidza Kubatsira Kushandisa Hormone yehutano Hwehutano
Sezvo varume vachikura, mazinga e testosterone muropa ravo anowanzosimuka. Ichi chinodonha mu testosterone chave chichifungidzirwa kutungamirira kune zvinhu zvakasiyana-siyana, zvakadai sokuderera kwebonde, basa rekushaya ropa, uye mapfupa emapfupa.
Testosterone supplementation inoshandiswa nevamwe vanachiremba kuti vabatsire nehutano hwakadaro. Mumakore achangobva kupfuura, kwakave nekuwedzera kuwedzerwa mune kliniki inoshandiswa testosterone supplementation kuvarume vakuru.
Zvisinei, zvidzidzo zvikurusa, kwenguva refu hazvina kuitwa kuti zvione kana mushonga we testosterone unobatsira nemamiriro ezvinhu akadaro.
Muna 2003, imwe Institute of Medicine panel yakagumisa kuti kwakanga kusina uchapupu hwakakwana hunotsigira zvinobatsira zve testosterone kune varume vakwegura uye yakakurudzira kutsvakurudza kwakawedzerwa. Nokudaro, muna 2010, National Institute of Aging, iyo iri chikamu cheNIH, yakatanga Testosterone Trials (T Miedzo) kuti ione kana testosterone inogona kubatsira nezviratidzo zvinosangana nemazinga akaderera e testosterone kuchikoro kusvika kune akwegura (kureva, zviratidzo zvechitendero che hypogonadism ).
I M miedzo ichashanda sepamberi yekuedza kwenguva yakareba uye yakawedzerwa yakasimba mune ramangwana. Zvimwe zvinowanzobva kuT T zviri kuuya iye zvino uye zvizere zvacho zvakasanganiswa, uye kupupurirwa kwe testosterone kunobatanidzwa nezvimwe zvikomborero uye zvimwe njodzi. Kutsvakurudza kwakawanda kunofanirwa kuitwa kuti kuve nekuenzanisa kwezviitiko izvi zvingangobatsira uye njodzi pamwe chete nekodini yakashandiswa ye testosterone kurapwa.
T Mitsva Pfupi
I M miedzo ndiyo yakagadzirwa nemakiriniki emakiriniki anowanikwa munzvimbo 12 dzakapoteredza nyika. Mukati, varume vanomwe 790 vane makore makumi matanhatu nemashanu kana kupfuura vakaderera maitiro e testosterone uye zviratidzo zvakabatanidzwa vakabatanidzwa. Chokutanga, vatori vechikamu vaifanira kukodzera imwe yematatu makuru makuru: Kuita zvepabonde Kuedzwa, Physical Function Trial, kana Vitality Trial.
Zvadaro, vatori vechikamu vanogona kutora chikamu mune imwe yemimwe miedzo yavanokwanisa.
Kunyanya zvakananga, vatori vechikamu vaifanira kunyunyuta nezvekusava nekuita zvepabonde, kusagadzikana kwepanyama, kana kuperevedzwa kwehutano kunotanga kuiswa mumatambudziko E. Uyezve, vatori vechikamu vaisarudzwa avo vaiva nemamwe mamiriro ezvinhu, akadai sekenza yeprotate, zvinetso zvemoyo, zvinetso zveputsvo, nezvakadaro.
Mune miedzo yose, vatori vechikamu vainge vaendeswa kune rimwe boka rekuedza kana kuti placebo. Varume vari muboka rekuedza vakashandisa geri testosterone zuva nezuva (AndroGel) kwemwedzi gumi nemaviri; asi, boka re-placebo rakagamuchira nzvimbo yegelbobo (pasina testosterone). Vaparidzi vaiwanzoongororwa.
Zvinonyanya kukosha, miedzo yakapofumadzwa kaviri, zvinoreva kuti vatsvakurudzi nevatori vechikamu havana kuziva kuti gel raitungamirirwa.
Basa repabonde, Basa reMumuviri, uye Uhu Hunoedza
Migumisiro inobva kumatatu ekutanga maedzo yakataurwa muna February 2016 muNew England Journal of Medicine .
Kubatanidzwa muBasa Rokuita Zvepabonde Kuedza vatori vechidimbu vanodiwa kuti vave nekuderera mu libido pamwe chete nemurume wepabonde anofarira kuita zvepabonde kanomwe pamwedzi.
Kubatanidzwa muMutambo Wemuedzo Kuedza vatori vechidimbu vanodiwa kuti vaite zvishoma nezvishoma gait, kuoma kufamba, uye kuoma kukwira matanho.
Varume vakanga vasingakwanisi kufamba, vaiva nechirwere chakanyanya, kana kuti vane chirwere chakakomba chinonzi neuromuscular chakanga chisina kubviswa.
Kuiswa muUtality Trial inoda kuti vatori vechikamu vave nehutano hwakasimba uye kuneta.
Kurera maitiro e testosterone kubva pasi kusvika kune yakasiyana-siyana yakagadziridzwa kuita zvepabonde basa rakanaka (kureva, kuita zvepabonde, chido chepabonde, uye erectile basa) uye mafungiro uye kuora mwoyo zviratidzo. Zvisinei, testosterone supplementation haina kuwedzera kukwanisa kufamba kana simba.
Kakawanda, vatsvakurudzi vanoratidza kuti pakanga pasina vateveri vakakwana kuti vape mhedziso yakasimba mumatambudziko matatu aya.
Chirwere chekushaya ropa
MunaFebruary 2017, migumisiro inobva kuAriemia Trial yakabudiswa.
Anemia chirwere umo mune kushaya kwemasero matsvuku eropa kana hemoglobin muropa. Muchikamu chetatu chevarume vakwegura vane chirwere chekushaya ropa, vanachiremba havagoni kuita chikonzero.
Neine anemia, muviri haugamuchiri ropa rakakwana re-oksijeni, rinoendeswa nehemoglobin iri mumasero matsvuku eropa. Anemia inogona kuva yanyoro kana yakaoma. Vanhu vane chirwere chekushaya ropa vanogona kunzwa vaneta kana vaneta. Zvimwe zviratidzo zvinosanganisira uhuzha, kupera kwepfufu, kana kuti musoro.
Kurara kwenguva refu kunogona kukuvadza mwoyo, uropi, uye dzimwe nhengo. Dzimwe nguva, chirwere chakanyanya kwazvo chinogona kukonzera rufu.
Dambudziko reAnemia Rakaitwa kuti rione kana varume vakwegura vane maitiro asina kunzwisiswa anemia uye pasi e testosterone vangave nekuvandudzwa mune maitiro avo ehemoglobin.
Migumisiro kubva kuchirongwa chekuchipatara yakaratidza kuti paive nekuwedzera kukuru mu hemoglobin mune varume vose vane chirwere chisina kutsanangurwa chekushaya ropa uye pamwe nevarume vane chirwere chekushaya ropa chinokonzerwa neicho chikonzero chakashandisa testosterone gel. Izvi zvinogona kuva zvechiremba, uye testosterone mishonga inogona kushandiswa kukurudzira humoglobin muvarume vanopfuura 65 avo vasina tsanangudzo yezvinyorwa zvemaperembudzi uye zvakaderera testosterone. Zvisinei, kumwe kutsvakurudza kunoda kuitwa.
Tsipa Kuedza
MunaFebruary 2017, migumisiro yeBercal Trial yakabudiswa.
Sezvo varume vakwegura, havasi ivo vanongowedzera kuderera muzvikwata zve testosterone asiwo vanoderera mumapfupa emapfupa emagetsi, pfupa, uye masimba emapfupa uyewo kuwedzera mune mapfupa emapfupa.
Usati watsvakurudza nezvemigumisiro ye testosterone pamapfupa hauna kusakwanisa. NeT Bone Trial, vatsvakurudzi vakaedza kutsvaga kana hutachiona hwemafu hwakawedzerwa mushure mekurapwa kwe testosterone kuvarume vakwegura vane maitiro epasi e testosterone.
Utachiona hwemapfupa hwakaongororwa uchishandisa maviri simba x-ray absorptiometry (DEXA), uye simba refupa rakaongororwa uchishandiswa computed tomography (CT) kuongorora.
CT inzira yekufungidzira inoshandisa x-rays kutora mifananidzo yepamuviri yemuviri. DEXA inoshandisa shanduko shoma x-rays kuti iongorore mabheji emagetsi uye kuverenga zvikoro. Mune mamwe mazwi, DEXA inotarisa kuti yakawanda sei calcium nezvimwe zvicherwa zviri mufupa.
Kunze kwe-vitamini D uye-calcium supplement, varume vanotora mishonga inobata pfupa havana kubviswa kubva pachidzidzo. Uyezve, varume vane pasi DEXA zvikoro zvakabviswa kubva pachidzidzo.
Vatsvakurudzi vakawana kuti varume vakagamuchira kurapwa kwehommone vakawana kuwedzera mune simba repafu uye simba. Simba rinowedzera rakanga rakakura mumutsana kupfuura zvaiva mumuchiuno. Zvisinei, sekune dzimwe Medzo, tsvakurudzo dzakawanda dzinoda kuitwa. Kudzidza kukuru pamusoro pemakore akawanda kwaizoda kuitwa kuti uone kana testosterone inogona kuderedza ngozi yefupa rakaputsika.
Kuchenjerera Kushanda Kushanda
Muna February 2017, migumisiro kubva kuCognitive Function Trial yakabudiswa.
Maererano nekurambazve uye vamwe vanyori vekudzidza:
Kukwegura kunobatanidza nekuderera mune mamwe mabasa ekuziva, kusanganisira mazwi nemashoko ekurangarira, hutungamiri hwehutano, uye unyanzvi hwepakati. Kukwegura muvarume kunobatanidzwawo nekuderedza serum testosterone, zvichiita kuti kuwedzerwa kuderedzwa kwe testosterone kukanganisa kunogona kuita kuti kusangana kwepfungwa kuve nemakore kunokonzera.
Muchidzidzo ichi, varume vakwegura vane pasi-testosterone nemakore ekubatwa kwekuyeuka kwepfungwa vakapiwa testosterone. Chirwere chekuyeuka kwechizvarwa chakafananidzirwa chakatsanangurwa nekurangarira kunyunyuta uye kusakundikana kwedzidzo yekutaura nemashoko nekuona.
Ichi chidzidzo chakanga chisina kuratidza kuti kurapwa kwe testosterone kwakabatsirwa nehutano hwehutano hwekuyeuka.
Mwoyo Mucherechedzo
Dzidzo pamusoro pemigumisiro ye testosterone pamigumisiro yemwoyo inopesana. Iyo Mwoyo Yeutano yakagadzirirwa kutarisa kana testosterone supplementation kuvarume vakwegura vane maitiro epasi e testosterone zvingatadzisa kukura kweiyo isina kujekeswa yeronary artery plaque volume.
Nyaya isina kubvumirana neyeriyiti yakavhara mabhuku yakave yakabatanidzwa kurwisa kwemoyo uye zvinetso zvemoyo zvinotevera. Inoshandiswa uchishandisa coronary computed tomographic angiography, chirongwa chinokosha chokuongororwa.
Vatsvakurudzi vakawana kuti mune varume vanotora testosterone gel, pakanga paine kuwedzera kukuru kwekusava nekwakagadziriswa kweyeriyiti yeplate volume. Ichi chinowanikwa pamusoro pekuda kwekuti kuwedzerwa kwepachika yevhesi kunoderedza chironga cheropa chinopisa, izvo zvinogona kukuvadza. Coronary arteries inopa moyo neropa.
Zvakare, sekumwe kune dzimwe Medzo, kutsvakurudza kwakawanda kunofanirwa kuitwa kuti uwane zvinorehwa zvayo zvekudzidza.
Pasi Pasi
Migumisiro yezviongorori izvi inoratidza kuti utachiona hwe testosterone mumajeri evanhu vane chetetesterone inogona kutora mamwe mazano. Zvisinei, zvirwere zve testosterone zvinogonawo kuisa njodzi. Icho chaicho chekushandira-off hachizivikanwi. Zvidzidzo zvikurusa uye zvekare zvinoda kuitwa kuti zvijekese migumisiro ye testosterone pamweya wehutano, hutano hutano, urema, nezvimwewo.
Kana iwe uri murume akwegura ane chirwere chepasi che testosterone uye uchida kutora testosterone, sarudzo iyi inofanira kunyatsoongororwa nechiremba wako. Chiremba wako achakwanisa kuongorora zviri nani kutarisa kwemamiriro ako uye kana kushandiswa kwehomoni kunogona kukuisa iwe pangozi. Iko pfungwa yakaipa kuti chero munhu upi zvake afunge mune hormone supplementation pasina kutarisirwa kwechiremba. Kungofanana nemhomoni inowanzoitika mumuviri hairevi kuti inogona kutorwa pasina zvakaipa.
Pakupedzisira uye kuti uwane chiyero chakanaka, chimbofunga hutungamiri uhwu hwekuparadzanisa pamusoro pekuedza T kubva kuNIH:
Nemhaka yekuti miedzo yeT inotungamirirwa nevarume vakuru vasina chikonzero chaicho chokuderedza testosterone kunze kwekukwegura, izvi zvinoguma hazvishandisi kune varume vane hutachiona hushoma nekuda kwezvikonzero zvimwe kushembera. Chero ani zvake anotarisa kurapwa kwehomoni anofanira kukurukura zvinogona kuitika zvinoshungurudza uye zvinobatsira nehutano hwehutano.
> Sources:
> Budoff, MJ, et al. Testosterone Treatment uye Coronary Artery Plaque Volume muVarume Vakura NeTesttosterone. JAMA. 2017; 317 (7): 708-716.
> Kurega, SM, et al. Testosterone Treatment uye Kugadzirisa Kushanda Kwevarume Vakura NeTesttosterone uye Matambudziko Akakanganwa Nezera. JAMA. 2017; 317 (7): 717-727.
> Roy, CN, et al. Sangano reTesttosterone Levels NeAnemia muVarume Vakwegura A Controled Clinical Trial. JAMA Internal Medicine. February 21, 2017 (e-pub).
> Snyder, PJ, et al. Migumisiro yeTesttosterone Treatment paAvumumric Bone Density and Strength in Men Older With Low Testosterone A Controlled Clinical Trial. JAMA Internal Medicine. February 21, 2017 (e-pub).
> Snyder, PJ, et al. Migumisiro yeTesttosterone Treatment in Vakwegura. New England Journal of Medicine. 374 (7): 611-624.