Anabolic Therapy in Modern Medicine

Anabolic therapies have been found to be useful in the treatment of numerous diseases and conditions and their medical uses continue to expand. This work is a technical and comprehensive study of anabolic therapy, covering a wide range of diseases and conditions. Beginning with a description of anabolic agents and their historical medicinal use, the author provides a rationale for the use of anabolics in treating sarcopenia, CST–induced and postmenopausal osteoporosis, hormone replacement therapy in women, osteoporosis and andropause in men; the autoimmune diseases ALS, Chronic Fatigue Syndrome, MS, rheumatoid arthritis, Sjogren’s Syndrome, systemic lupus erythematosus, and systemic sclerosis; stroke treatment and rehabilitation, Type II diabetes in men, and AIDS. Also provided is rationale for the use of anabolic therapies in addition to cancer therapy in cardiopulmonary rehabilitation, spinal cord injuries and other conditions with secondary hypogonadism, dementia, Alzheimer’s, depression, and other CNS conditions, musculoskeletal conditions, major burns, wound healing, and the use of anabolic therapies in addition to TPN and nutrition in microgravity, prolonged immobilization, and space travel conditions, chronic anemias, and related conditions.

The late William N. Taylor, M.D., wrote widely on aspects of sports, health and medicine. He lived in Pensacola, Florida.

William N. Taylor, M.D.

Format: softcover (6 x 9)
Pages: 351
Bibliographic Info: references, index
Copyright Date: 2002
pISBN: 978-0-7864-1241-9
eISBN: 978-0-7864-8444-7
Imprint: McFarland

Preface 1

PART I: Androgens: Synthesis and Scope of Chemical Potentials

1: Introduction: Anabolic Therapy and the Body’s Catabolic Responses to Ill-Health Conditions 5

2: Historical Use of Anabolic Agents in Medicine 9
Introduction: Defining the Breadth of Anabolic Agents 9
Defining the Scope of Patients Who Require Anabolic Therapies 10
Summary: Anabolic Therapy Is the Future of Medicine 11

PART 2: Anabolic Therapy for Sarcopenia, Osteoporosis, and Hormone Replacement Therapy

3: Rationale for Anabolic Therapy in Sarcopenia and Frailty Conditions 15
Introduction: Sarcopenia: The Condition of the 21st Century 15
The Need to Reeducate Health Care Providers 16
Hypoandrogenemia and Hyposomatomedinemia in Sarcopenia 17
Androgen and Other Anabolic Therapies for Sarcopenia 18
Androgen Therapy for Sarcopenic States Associated with Chronic Illnesses 22
Additional Health Benefits of Androgen Therapy in Sarcopenic States 22
Summary 23

4: Rationale for Anabolic Therapy in Corticosteroid-Induced Osteoporosis 32
Introduction: Iatrogenic Bone Disease 32
Hypoandrogenemia and Hyposomatomedinemia in CST-Induced Osteoporosis 33
REDUCED BONE FORMATION 34
INCREASED BONE RESORPTION 38
ALTERED CALCIUM METABOLISM 38
ALTERED BONE ARCHITECTURE 39
Studies with Anabolic Therapy for CST-Induced Osteoporosis 39
Summary 42

5: Rationale for Anabolic Therapy for Postmenopausal Osteoporosis and Hormone Replacement Therapy in Women 51
Introduction: Postmenopausal Androgen Deficiency and Underutilization of Androgen Therapy 51
Androgen Deficiency Links Many Diseases in Postmenopausal Women 53
Barriers for Adequate Management of Postmenopausal Osteoporosis 55
Androgen Therapy Mimics Ovarian Function 56
Androgen Therapy Reverses BMD Deficits in Postmenopausal Osteoporosis 57
Historical Highlights Regarding the Clinical Use of Androgen Therapy in Women 58
Androgens Directly and Indirectly Stimulate Normal Bone Formation 62
Androgen Therapy Corrects Hypoandrogenemia and Hyposomatomedinemia 63
Androgen Therapy Improves Menopausal Vasomotor Symptoms, Elevates Mood, Increases Libido, Improves Quality of Life, and Modulates Anabolic Cytokines 64
Impact of Estrogen-Androgen HRT on Lipids and Thromboemobolic Event Risks 67
Summary 68

6: Rationale for Anabolic Therapy for Osteoporosis and Andropause in Men 88
Introduction: Andropause Contributes to Osteoporosis and Other Diseases in Men 88
Redefining Andropause in Men 90
Historical Highlights of Androgen Therapy for Andropause in Men 90
Androgens Directly and Indirectly Stimulate Normal Bone Formation 92
Androgen Therapy Corrects Hypoandrogenemia and Hyposomatomedinemia 93
Hypoandrogenemia, Androgen Therapy, and Risk for Prostate Cancer and Benign Prostatic Hypertrophy 94
Hypoandrogenemia, Androgen Therapy, and Cardiovascular Risk Factors 97
Androgen Therapy and Its Neurosteroid, Neuroprotective, and Neuroimmune Benefits 99
Summary 100

PART 3: Anabolic Therapy for Autoimmune Diseases

7: Rationale for Anabolic Therapy in Autoimmune Diseases 119
Introduction: Abnormal Sex Steroid Profiles? 119
Gender Dimorphism in Autoimmune Diseases 120
Androgens Are Immunomodulating Agents 122
Androgens Are Neuroprotective and Neuroregenerative Agents 125
Androgens Are Potent Neurosteroids 127
Androgens Are Anabolic Agents 129
Androgens Are Osteoblast Stimulators 130
Summary 130

8: Rationale for Anabolic Therapy in Amyotrophic Lateral Sclerosis 145
Introduction: Anabolic and Neurotrophin Factor Deficiency? 145
Anabolic Therapy for ALS 147
Summary and Remarks 147

9: Rationale for Anabolic Therapy in Chronic Fatigue Syndrome 150
Introduction: Chronic Fatigue Syndrome: A Neurosteroid Deficiency? 150
Hypoandrogenemia and CFS 150
Studies with Anabolic Therapy in CFS 151
Summary 151

10: Rationale for Anabolic Therapy in Multiple Sclerosis 155
Introduction: A Major Loss of Anabolic Potentials to Counteract Severe Catabolism 155
Hypoandrogenemia and Hyposomatomedinemia in MS 156
Anabolic Therapy for MS Patients in Rehabilitation 157
Summary 158

11: Rationale for Anabolic Therapy in Rheumatoid Arthritis 164
Introduction: Androgens, the Missing Hormones in RA 164
Mechanisms of Hypoandrogenemia in RA 165
Androgen Therapy in RA and for RA-Related Sequelae 167
Summary 168

12: Rationale for Anabolic Therapy in Sjogren’s Syndrome 175
Introduction: Hypoandrogenemia Associated with Sjogren’s Syndrome 175
Pathologic Mechanisms and Hypoandrogenemia in SS 176
Studies with Androgen Therapy in SS 177
Summary 177

13: Rationale for Anabolic Therapy in Systemic Lupus Erythematosus 183
Introduction: Sex Hormones and SLE 183
Androgen Deficiency and SLE 184
Studies with Androgen Therapy in SLE 185
Androgen Therapy and Cytokine Profiles in SLE 186
Summary 187

14: Rationale for Anabolic Therapy in Systemic Sclerosis 193
Introduction: Scleroderma and Androgen Deficiency 193
Studies with Androgen Therapy for SSc 194
Summary 194

PART 4: Anabolic Therapy for Other Catabolic Diseases and Conditions

15: Rationale for Anabolic Therapy in AIDS and HIV Infection 201
Introduction: Hypoandrogenemia and AIDS Wasting 201
Studies of Anabolic Therapy for HIV-Infected Patients 202
Summary 203

16: Rationale for Anabolic Therapy in Burns and Major Thermal Injuries 208
Introduction: A Prolonged Major Catabolic Condition 208
Hypoandrogenemia and Hyposomatomedinemia in Major Burns 208
Complications and Sequelae of Thermal Injury-Induced Hypoandrogenemia and Hyposomatomedinemia 209
Studies of Anabolic Therapy for Major Thermal Injuries 209
Summary 210

17: Rationale for Anabolic Therapy in Cancer Patients 217
Introduction: The Anorexia/Cachexia Syndrome: Description and Pharmacologic Management 217
Hypoandrogenemia and Hyposomatomedinemia in Cancer Patients 218
Studies with Androgen Therapy for Cancer Patients 219
Summary 219

18: Rationale for Anabolic Therapy in Cardiovascular Diseases and Cardiac Rehabilitation 224
Introduction: Hypoandrogenemia Is a Multifacted Risk Factor for Heart Disease 224
Hypoandrogenemia Promotes Cardiovascular Disease 225
Incidence of Hypoandrogenemia and CHD in Men 226
Hypoandrogenemia Contributes to Hyposomatomedinemia and Heart Disease 227
Androgens Are Beneficial Cardiovascular Agents 228
Summary 229

19: Rationale for Anabolic Therapy in Chronic Obstructive Pulmonary Disease 235
Introduction: A Major Catabolic Condition 235
Hypoandrogenemia in COPD Patients 235
Studies with Anabolic Therapy in COPD 236
Summary 237

20: Rationale for Anabolic Therapy in Stroke Treatment and Rehabilitation 241
Introduction: A Lack of Clinical Use of Anabolic Agents for Stroke Patients 241
Androgen Deficiency and Low Anabolic Stimuli in Stroke Patients 243
Androgen Deficiency, Atherogenesis, Fibrinolysis, and Thromboembolic Events 244
Androgens Are Neuroprotective Neurosteroids and Neuroendocrine Modulators of the Cytokine System 245
Conclusion: Androgens Play a Key Role in the Entire Constellation of Stroke Pathogenesis, Recovery, and Rehabilitation 246
Recommendations for Anabolic Therapy 250

21: Rationale for Anabolic Therapy in Type II Diabetes in Men: Medical Management and Rehabilitation 261
Introduction: Gender Dimorphism in Type II Diabetes 261
Hypoandrogenemia in Men with Type II Diabetes 263
Hypoandrogenemia Induces Hyposomatomedinemia in Men with Type II Diabetes 265
Consequences of Hypoandrogenemia and Hyposomatomedinemia in Men with Type II Diabetes 266
Available Studies of Androgen Therapy for Type II Diabetes in Men 267
Recommendations for Anabolic Therapy in Men with Type II Diabetes 267

22: Rationale for Anabolic Therapy in Chronic Renal Failure 274
Introduction: Uremic Hypoandrogenemia and Its Dramatic Clinical and Financial Impacts 274
Hypoandrogenemia in Patients with CRF 275
Hypoandrogenemia-Related Diseases and Conditions in Patients with CRF 276
Studies with Anabolic Therapy in CRF 277
Summary 278

23: Rationale for Anabolic Therapy in Muscular Dystrophy and Other Primary Myopathies 283
Introduction: Many Myopathies Are Associated with Hypoandrogenemia 283
Anabolic Therapy for Myopathies 284
Summary 285

24: Rationale for Anabolic Therapy in Spinal Cord Injury 289
Introduction: Spinal Cord Injury Creates Catabolic Endocrine Abnormalities 289
Studies with Anabolic Therapy in SCI 290
Summary 291

25: Rationale for Anabolic Therapy in Alzheimer’s Disease and Cognition Deficits 294
Introduction: Reduced Anabolic Potentials A›ect Cognition 294
Studies with Anabolic Agents in Cognitive Dysfunction and AD 295
Summary 296

26: Rationale for Anabolic Therapy in Osteoarthritis 300
Introduction: Reduced Anabolic Processes Result in Joint Destruction 300
Systemic and Local Anabolic Losses in Osteoarthritis 300
Studies with Anabolic Therapy in Osteoarthritis 301
Summary 302

27: Rationale for Anabolic Therapy in Prolonged Immobilization, Microgravity, and Extended Space Travel 305
Introduction: Dramatic Losses of Anabolic Potentials 305
Studies with Anabolic Therapy for Immobilization and Microgravity Conditions 306
Summary 307

28: Rationale for Anabolic Therapy with Nutritional Replacement Treatments 309
Introduction: Critical Illness Is Associated with Profound Catabolism and Reduced Recuperative Abilities 309
Studies with Anabolic Agents and Nutritional Support 310
Anabolic Therapy with GHRH-GH-IGF-IGFBP Axis Components 311
Summary 312

29: Rationale for Anabolic Therapy in Dermatological Maladies and Wound Healing 316
Introduction: Loss of Anabolic Potentials Delays Wound Healing 316
Anabolic Therapy and Mechanisms of Action for Wound Healing 317
Summary 317

30: Rationale for Anabolic Therapy in Miscellaneous Ill-Health Conditions 320
Introduction: Loss of Anabolic Potential Can Result in a Variety of Ill-Health Conditions 320
Fibromyalgia 320
Skeletal Muscle Contusions and Injuries 321
Major Joint Replacement: Preoperational and Rehabilitation 321
Traumatic Brain Injury 322
Summary 322

Afterword: Hypoandrogenemia Is the Most Commonly Missed Disorder in Modern Medicine 327
Index 329
About the Author 337