60 Questions
Which hormone treatment in older men is associated with an increase in lean body mass and a decrease in fat mass?
Human growth hormone (GH)
Which hormone treatment in older men is associated with potential risks such as increased cancer risk and soft tissue edema?
Human growth hormone (GH)
Which hormone is a food supplement, not a drug, and is readily available in the USA with claims that may be unsubstantiated?
DHEA
Which hormone shows a decline in levels with age, with observational studies suggesting associations with improved quality of life, bone mineral density, and decreased cognitive decline?
DHEA
Which hormone treatment has no evidence for beneficial effects on body composition, physical performance, insulin sensitivity, and quality of life in aging individuals?
DHEA
Which hormone treatment may do harm by increasing the risk of osteoporosis and atrial fibrillation, with no evidence for beneficial effect?
Thyroid hormone (T4)
Which hormone treatment is associated with an increase in muscle strength with supra-physiological doses, but no convincing functional benefits demonstrated?
Testosterone
Which hormone is associated with nutritional status and insulin/glucose regulation?
Leptin
What is the term used to describe the hormonal changes in menopause and andropause?
MENOPAUSE and ANDROPAUSE
Which perspective emphasizes the idea of '80 is the new 60' and the use of supplements or hormones to counteract aging?
Pharma perspective
Which endocrine disorder is specifically mentioned in the text in relation to diet?
Obesity
Which hormone is referred to as the 'elixir of youth' in the context of aging?
GH - IGF system
Which hormone is associated with the term 'SOMATOPAUSE' in the pharma perspective?
GH - IGF system
What is the term used to describe the nutritional status and insulin/glucose in the context of anorexia nervosa?
Insulin/Glucose axis
Which of the following is a common phenotype in aging according to the text?
Hypogonadism, growth hormone deficiency, and high prevalence of fat mass and visceral fat
What happens to insulin and glucose levels with age according to the text?
They increase, leading to higher insulin resistance and prevalence of metabolic syndrome
How does metabolic syndrome prevalence vary according to the text?
By age and gender, affecting men and women differently
What characterizes menopause according to the text?
Ovarian failure and decreased estrogen levels, leading to symptoms such as hot flushes and night sweats in women
What is the cautionary approach recommended for hormone replacement therapy (HRT) according to the text?
HRT should be used with caution and clear indication
What is the association between testosterone levels and libido/erectile dysfunction in older men according to the text?
Poor association between libido/erectile dysfunction and testosterone levels
What is the potential effect of testosterone treatment on bone mineral density according to the text?
Positive effect on bone mineral density if hypogonadal, but the effect on fracture risk is still under study
What is the effect of starvation/anorexia nervosa on insulin, glucose, and leptin?
Insulin, glucose, and leptin all decrease
Which hormone is a permissive factor for the initiation of puberty and shows a correlation with BMI and body fat?
Leptin
What is the consequence of starvation/anorexia nervosa on the gonadal axis?
LH and FSH decrease
Which hormone deficiency is seen in acute starvation and anorexia nervosa, and is reversible with re-feeding?
Growth hormone
What is the effect of starvation/anorexia nervosa on cortisol levels?
Cortisol levels decrease
What happens to TSH and T4 levels in the context of starvation/anorexia nervosa?
TSH and T4 both decrease
Which hormone is associated with 'GH resistance' and down-regulation of hepatic GH receptor in the context of starvation/anorexia nervosa?
Growth hormone
What is the effect of aging on FSH levels in women according to the text?
FSH levels increase
What is the potential effect of aging on T3 levels according to the text?
T3 levels decrease
Which hormone is associated with the term 'SOMATOPAUSE' in the pharma perspective?
Growth Hormone (GH)
What is the effect of starvation/anorexia nervosa on insulin, glucose, and leptin?
Decreased insulin, increased glucose, decreased leptin
Which hormone treatment in older men is associated with an increase in lean body mass and a decrease in fat mass?
Testosterone
Which hormone deficiency is seen in acute starvation and anorexia nervosa, and is reversible with re-feeding?
Leptin
What is the effect of aging on FSH levels in women according to the text?
Increased FSH levels
What is the term used to describe the hormonal changes in menopause and andropause?
Climacteric
What is the prevalence of metabolic syndrome in middle to older age individuals according to the text?
30-40%
What percentage of women experience severe menopausal symptoms lasting 2 to 5 years?
25%
What is the average age of menopause according to the text?
Around 50
What is the impact of hormone replacement therapy (HRT) on fracture risk and osteoporosis according to the text?
It may reduce fracture risk and osteoporosis only while it is taken
What is the impact of age on insulin resistance according to the text?
Insulin resistance increases with age
What is the impact of menopause on bone mineral density according to the text?
Bone mineral density declines after menopause
What is the trend in total energy and protein intake with increasing age?
Decreases steadily with age
What is the effect of aging on lean body mass?
Decreases with each decade from the mid-thirties onward
What is the potential impact of hormone replacement in older individuals?
Requires careful evaluation of benefit-to-harm ratio, cancer risks, and economic costs
What is the common expectation regarding hormonal supplements and aging?
They can counteract the effects of aging effectively
What is the cautionary approach recommended for hormone replacement therapy (HRT) in older individuals?
Carefully evaluate benefit-to-harm ratio, cancer risks, and economic costs
What is the impact of age on weight gain according to the lecture?
Weight gain plateaus in the 50 to 70-year-old age range
What is the association between HRT and bone density in women?
HRT maintains bone density as long as it is taken, but it declines upon discontinuation
What is the risk associated with the use of unopposed estrogen in women with a uterus?
Increased risk of endometrial cancer
What is the trend in testosterone prescriptions over the past decades?
Significantly increased
What is the British Menopause Society's stance on HRT?
Advocates for a balanced approach, emphasizing menopause as a life stage
What is the relationship between testosterone levels and sexual function in men?
Poor association, high testosterone levels do not guarantee better sexual function
What is the approach to menopause in terms of hormone replacement therapy?
Shifted from long-term replacement to short-term treatment, focusing on symptom relief and minimizing risks
What are the potential risks associated with testosterone treatment in older men?
Increased risk of benign prostatic hypertrophy and prostate cancer
Which hormone treatment in older people has evidence suggesting stimulation of testosterone and reduction in fat mass, but lacks convincing evidence for functional benefits?
Growth hormone treatment
What is a concern related to growth hormone treatment in older people?
Potential risks and adverse effects
What is a potential effect of testosterone treatment on bone mineral density according to the text?
Improvement in bone mineral density
Which treatment is effective for male osteoporosis regardless of androgen status?
Bisphosphonate treatment
What is the impact of testosterone treatment in normal older men on aspects such as physical function, energy, vitality, cognitive function, mood, and quality of life?
Little impact on other aspects
Study Notes
Hormonal Influence on Aging
- Aging and hormonal influence on life expectancy may not equate to increased health expectancy
- Similar phenotypes in aging include hypogonadism, growth hormone deficiency, and high prevalence of fat mass and visceral fat
- Nutritional status and weight change from mid-30s to 50-70 years, with a decrease in lean body mass
- Insulin and glucose levels increase with age, leading to higher insulin resistance and prevalence of metabolic syndrome
- Metabolic syndrome prevalence varies by age and gender, affecting men and women differently
- Menopause, characterized by ovarian failure and decreased estrogen levels, leads to symptoms such as hot flushes and night sweats in women
- Post-menopausal hormone replacement therapy (HRT) has shown mixed benefits and risks, with the risk-to-benefit ratio depending on various factors
- Menopause is a life stage, not a deficiency state, and HRT should be used with caution and clear indication
- Testosterone levels in men gradually decrease with age, with poor association between libido/erectile dysfunction and testosterone levels
- Testosterone treatment in older men may lead to small improvements in sexual function, but potential risks include prostate issues and cardiovascular risks
- Testosterone treatment may have little or no evidence of benefit in physical function, cognitive function, and mood/quality of life
- Testosterone treatment may have a positive effect on bone mineral density if hypogonadal, but the effect on fracture risk is still under study
Older Men, Hormones, and Aging
- Testosterone deficiency in older men can lead to reduced sexual function, osteoporosis, and reduced muscle strength.
- The idea of treating androgen deficiency in older men is not new, with historical examples like Brian Secord's self-experimentation.
- Evidence suggests that testosterone treatment in normal older men may lead to small improvements in sexual function, but it has little impact on other aspects such as physical function, energy, vitality, cognitive function, mood, and quality of life.
- Concerns about potential risks of testosterone treatment include increased risk of benign prostatic hypertrophy, prostate cancer, elevated red blood cell levels, and possible cardiovascular risks.
- Testosterone treatment may improve bone mineral density and body composition, but its impact on fracture risk and functional benefits is uncertain.
- Bisphosphonates are effective for male osteoporosis regardless of androgen status.
- Growth hormone levels decrease with age, leading to lower levels of IGF-1, which is stimulated by growth hormone from the liver.
- Studies sponsored by pharmaceutical companies suggest that growth hormone treatment in older people can stimulate testosterone, increase lean body mass, and reduce fat mass.
- However, the evidence for functional benefits of growth hormone treatment in older people is not convincing, and there are concerns about potential risks and adverse effects.
- The diagnosis and treatment of partial androgen deficiency in older men should be approached with caution, considering potential harm and risks.
- Symptoms of androgen deficiency in older men have a high prevalence, but the clinical picture is not specific, and caution should be exercised in suggesting or avoiding treatment based on symptoms alone.
- The use of growth hormone as a potential anti-aging treatment has been proposed, but evidence for its efficacy and safety in older people is still uncertain.
Explore the intricate relationship between hormones and aging with this quiz. Delve into topics such as hormonal changes, menopause, testosterone levels, and the impact of hormonal influence on health expectancy. Test your knowledge on the effects of aging on insulin and glucose levels, metabolic syndrome prevalence, and the risks and benefits of hormone replacement therapy.
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