#604

https://www.google.com/search?client=opera&q=testosterone+is+derived+from+cholesterol&sourceid=opera&ie=UTF-8&oe=UTF-8

The male sex steroid, testosterone (T), is synthesized from cholesterol in the testicular Leydig cell under control of the pituitary gonadotropin LH .

  • google side effects of statins; hypo testosterone

side effect of dropping cholesterole

Cholesterol and LDL is good for you especially as we age. Way too much invented re bad LDL/cholesterol. Do you own research on benefits of cholesterol.

Good luck to all, curt

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#605

You haven’t proven that lowering LDL decreases testosterone levels by a clinically significant amount.

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#606

I’m actually not talking about that colder temp is a problem in my goal case. Rather that lower temp is an example of a good longevity phenotype (low inflammation, low metabolic rate, growth pathways are not too revved up, etc).

(And yes, I regularly measure my thyroid markers and they are good)

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#607

Not my area of expertise by I think most cells in the body make their own cholesterol and regulate that ti the extent that they need

That is mostly independent from the amount of circulating cholesterol that is in the blood.

The amount of cholesterol in the blood is only a small percentage of all the cholesterol in the body

When we talk above cardiovascular disease it’s only really the blood based cholesterol that is the target. That can be lowered without really impacting cholesterol available for testosterone and other hormones.

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#608

“Reducing LDL-C with a statin was associated with both decreased testosterone levels and erectile dysfunction.”

Baspınar O, Bayram F, Korkmaz S, et al. The effects of statin treatment on adrenal and sexual function and nitric oxide levels in hypercholesterolemic male patients treated with a statin. J Clin Lipidol. 2016;10(6):1452-1461. doi:10.1016/j.jacl.2016.09.004

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#609

You as well, hasn’t proven that reducing LDL-c with a statin decreases testosterone by a clinically significant amount or erectile function.

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#610

We found no significant difference between atorvastatin and placebo on the levels of total testosterone in males. In females with PCOS, atorvastatin lowered the total testosterone, FAI, androstenedione, and DHEAS. The certainty of evidence ranged from low to very low for both comparisons. More RCTs studying the effect of atorvastatin on testosterone are needed.

What is the effect of atorvastatin on testosterone and other hormone levels in men and women? | Cochrane

The evidence for LDL being somehow important for testosterone production in males is bro science. But people will go out of their way to find potential benefits for it because they either refuse to take a statin or are on a heart killer (read: carnivore) diet. Nothing against carnivores on a statin :smiley:

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#611

I don’t bother posting actual evidence that completely refutes someone’s claim because they have the burden of proof. People really have no clue about scientific thinking.

High LDL will lead to atherosclerosis and erectile dysfunction. At the same time offer no improved immunity. The complete opposite is true of some people’s claims!

Bad science or cherry picking can be used to justify anything or support any belief that’s why…

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#612

The Cochrane article is a literature review. They say they, “searched for all studies in the medical literature that compared the effect of different doses of atorvastatin to placebo or no treatment in males and females, and also reported on their levels of testosterone and other androgens.”

In total, they found six studies. Four of them were in women, and two of them in men. And for the male studies, they report that, “We found two studies in men, where atorvastatin had no significant effect on total testosterone.”

They say, “The evidence from our review is current to November 2020.”

I already found a small study that concluded the opposite and had been indexed in Pubmed since 2016, and seems to fit their simple inclusion criteria (See my prior post). According to the study, “patients used statins for approximately 9 months.”

According to the Cochrane review, “We included all randomized controlled trials (RCTs) with a minimum duration of three weeks, that compared atorvastatin to placebo or no treatment, and measured one or more of the androgenic outcomes.”

Here is another study indexed in Pubmed since 2014: (1)

“The participants were divided into two groups,
which were uniform in terms of age and body mass:
a group of 38 men who had been taking statins (Group S; age: 58.6 ± 7.6 years) and a group of 151 men who were not taking statins (Group NS; age: 57.9 ± 5.6 years). The men in Group S had been taking atorvastatin at the dose of 20 mg/day or simvastatin at the dose of 20 mg/day for at least three months. Most of these men received statins for hyperlipidaemia or as part of treatment for
type 2 diabetes mellitus.”

“Our study showed that treatment with statins significantly reduced total testosterone, free testosterone, calculated free testosterone and bioavailable testosterone levels, and that it did so in an age-independent manner.”

This study also contains a brief literature review as of the time of writing where they cite to prior studies finding reductions in testosterone associated with other statins, as well as a couple negative studies finding no association.

========

(1) Mędraś M, Kubicka E, Jóźkow P, Słowińska-Lisowska M, Trzmiel-Bira A, Filus A. Treatment with statins and testosterone levels in men. Endokrynol Pol . 2014;65(6):464-468. doi:10.5603/EP.2014.0064

#613

Cochrane reviews are considered the highest quality evidence in medicine.
If your methodology differs, it might be you who is wrong…

And in this case, you are not using randomized trials, which they are.

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#614

I’m not making an argument. I’m simply investigating and yesterday was the first time I even thought about it. I did not start with a thesis. Your discussion with someone else prompted me to do a quick search out of curiosity. And I found a couple studies that suggest an association. Someone posted a Cochrane review limited to randomized, controlled trials. And the two studies I posted don’t qualify.

I will say that that the Cochrane analysis ended up being limited to two papers with the rest set aside. And it’s also limited to atorvastatin. So it’s very limited in scope.

Today I found the following meta-analysis from 2022. The title of the review is, “Do statins cause testosterone deficiency in men? Systematic review and meta analysis.” (1) And they comment that, “A reduction in total testosterone was evaluated in all studies after statin use. However, with the exception of Kannat 2009, all studies showed testosterone levels above the normal level (normal up to 300).” Their conclusion was that, “Statins cause a decrease in total testosterone, not enough to cause a significant deficiency.” However, their definition of a significant deficiency is falling below 300 and qualifying as a medical abmormality. It says nothing about maintaining optimal or even average testosterone levels for an age bracket. I don’t have the full text to see if that information is available.

As a side note, there are arguments that the cutoff for an actual deficiency should be substantially higher for younger men. In a 2022 paper titled, “What Is a Normal Testosterone Level for Young Men? Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44 Years Old” (2), they argue the minimum value for a medical abmormality (deficiency) should be on a sliding scale from 409 to 350 as you age from 20 to 44.

You write above that, “Cochrane reviews are considered the highest quality evidence in medicine.” Cochrane’s reputation was destroyed several years ago and will never be the same. And “destroyed” is not an overstatement. It was so bad that it forced warnings in other prestigious medical journals like the BMJ and Nature, led to a third of its governing board resigning or being fired, and the US Cochrane Center even shutting down for 2018 because of the scandal. And most of the Cochrane review groups in the UK have now disbanded because of it.

Here’s a snippet:

“The contention that Cochrane has been publishing reviews that are mainly beneficial to the sponsors of these interventions is probably a fact,” says Jefferson. “If your review is made up of studies which are biased and in some cases are ghost written or the studies are cherry picked and you don’t take that into account in your review, then its garbage in and garbage out – its just that the ‘garbage out’ is systematically synthesised with a nice little Cochrane logo on it.”

The BMJ subsequently called for a ban on financial conflicts of interest at Cochrane because of the allleged corruption.

======

References:

(1) L. Seligra Lopes, F. Glina, R. Spinola e Silva, E.A.C. Barros, B. Biselli, S. Glina. Do statins cause testosterone deficiency in men? Systematic review and meta analysis. The Journal of Sexual Medicine,
Volume 19, Issue 5, Supplement 2, 2022, Page S150,
ISSN 1743-6095.
064 Do Statins Cause Testosterone Deficiency in Men? Systematic Review and Meta Analysis | The Journal of Sexual Medicine | Oxford Academic.
https://www.sciencedirect.com/science/article/pii/S1743609522012085

(2) Zhu A, Andino J, Daignault-Newton S, Chopra Z, Sarma A, Dupree JM. What Is a Normal Testosterone Level for Young Men? Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44 Years Old. J Urol . 2022;208(6):1295-1302. doi:10.1097/JU.0000000000002928

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#615

There is information in that study abstract how much the testosterone was lowered by and it is not clinically significant.

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#616

Yes - generally Cochrane reviews are considered the gold standard.

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#617

There is information in the study abstract about the “mean” and CI. There’s more to it than that. What follows is commentary on an earlier meta-analysis with similar findings and why that isn’t enough.

“In this first meta-analysis of the issue, Schooling et al. [2] report that statins lower serum testosterone in both men and women, a potentially important finding. Unfortunately, the clinical implications of this observation are less clear than they could be because the only data available to them were the average changes in testosterone induced by statins. While the average changes may be small, the range of changes in individuals, potentially, might be much more substantial.”

#618

They were. That organization took a substantial blow to its reputation five years ago and there was ongoing published commentary for a while as to whether they should continue on. The prevailing opinion seemed to be that they should if they could “remember their roots” and “get their house in order.” I posted more info on that above.

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#619

That doesn’t mean random observational studies supercede them in the hierarchy of evidence.

#620

This is bordering on gossip, if you have a clear argument with evidence, that would be interesting to see.
The average is our base rate which we start our decisions from.

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#621

Thank you for this, I did not realize Cochrane was a sinking ship funded by the Bill and Melinda Gates foundation. I’ve been reading things that said they were the best. Always good to hear both sides.

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#622

Cochrane doesn’t perform rpc studies themselves, they only summarize existing ones. How it being funded by Bill Gates has anything to do with this is beyond me (still waiting for the covid vaccine to kill us all :clown_face: ). Such summaries are still worth more than observational trials.

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#623