Long-term testosterone supplementation in older men attenuates age-related decline in aerobic capacity

Tinna Traustadóttir, S. Mitchell Harman, Panayiotis Tsitouras, Karol M. Pencina, Zhuoying Li, Thomas G. Travison, Richard Eder, Renee Miciek, Jennifer McKinnon, Erin Woodbury, Shehzad Basaria, Shalender Bhasin, Thomas W. Storer

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Context: Testosterone increases skeletal muscle mass and strength, but long-term effects of testosterone supplementation on aerobic capacity, or peak oxygen uptake (V.O2peak), in healthy older men with low testosterone have not been evaluated. Objective: To determine the effects of testosterone supplementation on V.O2peak during incremental cycle ergometry. Design: A double-blind, randomized, placebo-controlled, parallel-group trial (Testosterones Effects on Atherosclerosis Progression in Aging Men). Setting: Exercise physiology laboratory. Participants: Healthy men aged ≥ 60 years with total testosterone levels of 100 to 400 ng/dL (3.5 to 13.9 nmol/L) or free testosterone levels <50 pg/mL (174 pmol/L). Interventions: Randomization to 1% transdermal testosterone gel adjusted to achieve serum levels of 500 to 950 ng/dL or placebo applied daily for 3 years. Main Outcome Measures: Change in V.O 2 peak. Results: Mean (6SD) baseline V.O 2 peak was 24.2 ± 5.2 and 23.6 ± 5.6 mL/kg/min for testosterone and placebo, respectively. V.O 2 peak did not change in men treated with testosterone but fell significantly in men receiving placebo (average 3-year decrease, 0.88 mL/kg/min; 95% CI, 21.39 to 0.38 mL/kg/min; P = 0.035); the difference in change in V.O 2 peak between groups was significant (average 3-year difference, 0.91 mL/kg/min; 95% CI, 0.010 to 0.122 mL/kg/min; P = 0.008). The 1-g/dL mean increase in hemoglobin (P < 0.001) was significantly associated with changes in V.O 2 peak in testosterone-treated men. Conclusion: The mean 3-year change in V.O 2 peak was significantly smaller in men treated with testosterone than in men receiving placebo and was associated with increases in hemoglobin. The difference in V.O 2 peak change between groups may indicate attenuation of its expected agerelated decline; the clinical meaningfulness of the modest treatment effect remains to be determined.

Original languageEnglish (US)
Pages (from-to)2861-2869
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Issue number8
StatePublished - 2018

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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