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