Testosterone Replacement Therapy (TRT) can Improve Chronic Obstructive Pulmonary Disease (COPD) in Men

Spirometer to Check for COPD (NIA)

Researchers from the University of Texas Medical Branch at Galveston discovered that testosterone replacement therapy (TRT) might slow the progression of chronic obstructive pulmonary disease (COPD) in men. Results of their research were published in September 2018 in the journal Chronic Respiratory Disease.

Men with COPD have Low Levels of Testosterone

Men with COPD often have low levels of testosterone and this may make their condition worse. Also, if they take steroid-based medicines to relieve their shortness of breath, the steroids may also increase their risk for low testosterone levels.

Testosterone Replacement Therapy (TRT) Might Improve Lung Performance in Men with COPD

Previous studies had suggested that testosterone replacement therapy (TRT) might improve lung performance in men with COPD. However, the researchers from the University of Texas Medical Branch were the first to carry out a large scale study to confirm this association. The aim of the study led by Jacques Baillargeon, professor in preventive medicine and community health at UTMB was to learn whether testosterone replacement therapy could lower the risk for respiratory hospitalizations in men with COPD who were middle-aged or older.

The Clinformatics Data Mart and the National Medicare Database

The researchers examined medical data from the Clinformatics Data Mart on 450 men aged 40-63 with COPD, who had begun testosterone replacement therapy between 2005 and 2014. They also used data from the national Medicare database on 253 men with COPD who had begun testosterone replacement therapy between 2008 and 2013.

Results

Results showed that men with COPD on testosterone replacement therapy had fewer respiratory hospitalizations compared with the COPD men who were not on testosterone replacement therapy.

Middle-aged men with COPD on TRT had a 4.2% greater decrease in respiratory hospitalizations compared with COPD men who were not on TRT.

Older COPD men on TRT had a 9.1% greater reduction in respiratory hospitalizations compared with COPD men not on TRT.

These results suggest that TRT may slow the progression of COPD in men.

Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is a progressive deteriorating lung disease that includes emphysema and chronic bronchitis. It is caused mainly by smoking cigarettes, although some cases are from exposure to industrial inhaled pollutants such as asbestos, fiberglass, sheetrock, radon gas and second-hand smoke. Respiratory infections and asthma also can lead to COPD. A few cases have a rare genetic risk for COPD called Alpha-1-antitrypsin deficiency. While COPD is incurable, it can be treated. According to the Centers for Disease Control and Prevention (CDC), Lower respiratory diseases that include COPD are the third leading cause of death in the United States. About 15.7 million Americans have COPD, although the rate may be higher, as many people do not know that they have COPD.

Symptoms of COPD

• Coughing
• Wheezing
• Bringing up phlegm that may be clear, white green or yellow
• Feeling short of breath and struggling to breathe
• Tight feeling in chest

COPD Can Have a Very Bad Effect on the Quality of Life

COPD can have a very bad effect on the quality of life and is a major cause of disability, as people with COPD may:

• Be homebound and dependent on oxygen therapy
• Be limited in their activities and have difficulty walking upstairs or uphill
• Find it difficult to bathe, take a shower or dress themselves
• Not be able to work
• Be dependent on special breathing equipment like portable oxygen tanks
• Not be able to participate in social activities like going out to eat with friends or family, going to picnics or barbeques, going to events and places of entertainment, going to places of worship and celebrating religious holidays or just getting together with family, friends or neighbors.
• Suffer from confusion or memory loss.
• Have many visits to the emergency room or overnight hospital stays.
• Also suffer from other chronic diseases like arthritis, congestive heart failure, diabetes, coronary heart disease or stroke
• Suffer from depression or other mental conditions and have emotional problems
• Report a fair or poor health status

Exacerbation or Flare-ups

Exacerbations or flare-ups are times when people get a sudden worsening of symptoms and this can lead to hospitalizations, which can be followed by an increased risk for a heart attack or stroke. Each exacerbation causes further damage to the longs. In extreme cases lung function can shrink to as little as 15%.

Treating COPD

The main step in treatment is to quit smoking. Most treatments are aimed at improving breathing function, as people with COPD are often struggling to breathe. This may be by:

Oxygen therapy

Bronchodilators

Inhalation devices

See our blog post from September 21, 2018 about a new kind of treatment for COPD with a Zephyr Endobronchial Valve. See also our blog post from May 17, 2019, that shows how group singing can be beneficial to people suffering from COPD.

The Need for Long-term Care

Many patients with severe COPD end up needing to go to a skilled long-term rehabilitation and nursing facility such as the Van Duyn Center for Rehabilitation and Nursing in Syracuse, New York. Van Duyn has a Respiratory Wellness unit that is staffed by professional respiratory therapists. Van Duyn also has wonderful recreational therapy programs and the air in Syracuse has been rated by the American Lung Association for being among the cleanest cities in America for fine particle air pollution:

Ranked 122 for high ozone days out of 227 metropolitan areas

Tied for 1st for cleanest metropolitan areas in the country for 24-hour particle pollution

Ranked 174 for annual particle pollution out of 187 metropolitan areas

Conclusion

Since COPD is a chronic incurable disease, anything that might be able to slow down its destructive progression should be welcomed.