Anabolic Therapy in Modern Medicine

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About the Book

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.

About the Author(s)

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

Bibliographic Details

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

Table of Contents

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