Androgens increase erythropoiesis (EPO) by acting directly on stem cell proliferation and through its action on the kidneys to stimulate EPO production (69). Androgen therapy in hypogonadal and eugonadal men results in elevation of hematocrit and hemoglobin (17,40,55). The increases in hemoglobin and hematocrit occur within 3 mo, but progressive increases are uncommon, unless the dose of testosterone is adjusted upward or another cause for polycythemia is also present. Direct dose-response relationships have been shown between testosterone and hematocrit and hemoglobin concentrations (21). Thus, androgen therapy must be used with caution in subjects with baseline hematocrit of 50% or higher. When the hematocrit rises above 53%, the subject must be carefully monitored and the dose of testosterone replacement adjusted downward to ensure that hyperviscosity with increased risk of thrombosis does not occur.
Abnormal liver function tests have been reported with orally administered 17 alkylated androgens (70,71). Because of the possibility of liver toxicity and the increase in LDL and decrease in HDL-C associated with 17 alkylated androgens, they are not recommended for use as androgen replacement. It should be noted that native testosterone and testosterone esters administered as replacement therapy do not result in abnormalities of liver function, nor do they affect glucose or insulin concentrations (16,17,40,55).
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Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...