‘Low T’ and MS Risk in Men

Ed Tobias avatar

by Ed Tobias |

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Statistics show that men are three times less likely than women to develop multiple sclerosis. Research has shown that men also develop MS at a later age than women and that their disease is more progressive. Could this all be related to “low T,” or low testosterone?

Researchers at Boston’s Brigham and Women’s Hospital have been researching this possibility. It’s part of a larger group of studies named CLIMB (Comprehensive Longitudinal Investigation of Multiple Sclerosis). Some of the findings that relate to testosterone are described in a recent article in the e-letter of the Accelerated Cure Project for MS.

According to the e-letter, interim results have revealed that a lot of men with MS also have low testosterone levels. Other recent research has indicated that low “T” levels may be an MS risk factor.

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If that’s so, could testosterone therapy help with MS symptoms? According to the article, maybe so. A small pilot study of male MS patients by the UCLA medical school demonstrated that testosterone therapy provided significant improvements in cognitive function and slowed brain tissue loss. The article cautions, however, that this study still needs to be validated by a study that’s both larger and placebo-controlled.

Benefits versus risks

The UCLA researchers write that there is a “potential to reverse gray matter atrophy associated with MS.” They think that combined with current treatments in MS that aim primarily to prevent inflammation and brain lesions, “testosterone may provide a complementary treatment aimed at neuroprotection via the preservation/restoration of gray matter.”
Any beneficial results, however, would have to be weighed against the many possible side effects of testosterone therapy. These include an increased risk of hypertension, heart disease, cancer, stroke, high red blood cell counts that could increase the risk of clotting, reduced sperm count, and emotional problems.

A better way to use testosterone with MS patients?

The Accelerated Cure Project article also reports that researchers at Northwestern University recently discovered that the immune system of someone with MS produces a cell called Th17 that can attack myelin. But they also found that in mice, Th17 production can be halted by a molecule called IL-33. And IL-33, these researchers say, appears to be produced by testosterone.

The Accelerated Care Project article concludes with the opinion that “treatment with testosterone is not a viable option for MS patients as its neuroprotective effect has yet to be confirmed and its risks outweigh its benefits. However, the newly discovered (Th17/IL-33) pathway testosterone regulates holds great promise in the development of more targeted therapies.”

Wouldn’t it be nice if “T” could be regulated to treat, and maybe even prevent, MS?

You’re invited to follow my personal blog at: www.themswire.com.

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Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today, or its parent company, Bionews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.

Merlin Leine avatar

Merlin Leine

I am 67 years old and was diagnosed with MS 18 years ago and it has been odownhill eversince I am running out of time for mouse tests and placebo stuff I need something now Merlin Leine

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Chris avatar

Chris

Merlin,

I completely understand your feelings about testing. Unfortunately the animal testing, as well as the 'blinded' testing using placebo controls, is vital to finding what works and what is safe. The biggest problem is that MS is so complex, involving several different systems and parts of our physiology and how they interact down to the molecular level. The good news is that there are hundreds if not thousands of people working on therapies and possible cures. Stem cell therapies are still much too far from being useful or effective yet, but we are quite close on several fronts using genetic engineering to be able to stop the disease and probably fix some damage as well. This would be in the 5 - 10 year range, which I know is still not soon enough. But there is always the chance for a breakthrough sooner... no one knows for sure. There is always hope, as that's really all we have. Medical science keeps racing forward by leaps and bounds, and it just keeps getting better and faster. Just think, 25 years ago there really wasn't much of anything for MS except things like steroids which did nothing but help calm inflammation, but didn't alter the course of the disease. Now we have around 14 drugs that can help delay onset of further disability, and one that resets the immune system. And most of those in just the past 10 years, with more coming in the next 2 years. I was diagnosed 16 years ago, and I too have steadily progressed the whole time, while the last 5 or 6 years it sped up a lot and now I'm bed bound. So I do very much understand where you're coming from. I try to hold on to hope, because without much proof of a cure or something comparable soon, it's all I really have.

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Barbara R Moore avatar

Barbara R Moore

Hi...I have secondary progressive m.s., was approved for Ocrevus and just had my full infusion. I am from N.J. and my insurance covered alot of the bill then the drug manufacturer paid the balance. I owed $5.00. It's too soon to make a judgement about Ocrevus but I'm praying I won't advance to ppms.

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Chris avatar

Chris

Barbara,

You don't advance to PPMS... SPMS is the progressive phase. PPMS (Primary Progressive MS) is a different course than the other two. PPMS type of multiple sclerosis is where the disease progresses from the onset without any remission. About half of people with RRMS (Relapsing Remitting MS) eventually transition to SPMS (Secondary Progressive MS), and there is no stage beyond SPMS. The purpose of Ocrevus in progressive types of MS is to try to limit or halt further accumulation of disability. So far it seems to work fairly well for many people.

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Mike M avatar

Mike M

I'm 31 Male and was diagnosed with MS January of this year and started treatment(Tysabri) in February. It seem to make it worse I went from just having numbness to toe\face to pain in my legs. MY infusion was Friday and the bottom of both feet went numb Saturday and when I drop my head it feels like a tingling sensation shoot down my back into butt and legs. My Doctor said she does really believe in counting brain lesions. She saying I have RRMS but seem hesitate when I asked. Is really a scary feeling.

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Spruce Cox avatar

Spruce Cox

Hey Mike,
I'm male and happen to be exactly twice your numeric age. I was diagnosed in 1994 (age 39) with SPMS and my experience has been a slow but steady decrease in strength, coordination, and stamina. I've been semi-active in MS support activities for years and wanted to respond to your story.

It appears to me that you’re comfortable with neither the treatment you’re on, nor your diagnosis, nor your doctor. Tysabri is once a month so I assume you’ve met with your doctor several times. She probably told you that for the first few days after a treatment you might get different reactions but they should settle out for the rest of the month. Has this settling out of treatment reactions occurred for each of your treatments?

Numbness and tingling are typical MS symptoms so it’s not clear to me if it’s the MS or the treatment. What helped me when I first started on Betaseron (subcutaneous shot self-inflicted every other day) in 1994 was writing down how I felt each day and I would take those to my doctor appointments and talk about them. Your note says that your doctor “does really believe” in counting brain lesions. Is that correct, or should it be “doesn’t really believe”? If she does believe then you should have had a few MRIs already. Ask her to show them to you and have her explain what she looked for and what she counted and is the number higher or lower than when you were first diagnosed.

I’m sure you know by now that diagnosing MS is not easy. If she did hesitate about your RRMS diagnosis, there could be several reasons, the most probable is that she’s following a protocol of different treatments to find the best one that works for you. Personally, I would understand that if she’s going through the hoops of an official process and other patients have had troubles like you’re having at this point in the process, then she’s probably doing the right thing. You should ask.

I could go on, but my recommendation is that you get a different neurologist at least for now, and compare how the two doctors approached the problem. Make sure you make any test and MRI and even her notes from your appointments available to the new guy. Because in the end, you’re going to have to trust your neurologist on most things related to MS for the foreseeable future, so take the extra time now to find someone you think will be a good fit. And one of the best ways to do that is to ask them every conceivable question you can come up with and compare answers.

Good luck.

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Kent Koerner avatar

Kent Koerner

I found a great neurologist, through my PCP. I told him I generally do not like neurologists. Well, he hooked me up with a great neurologist. The most important thing he did for me was send me to a mental health professional. At first I did not think it was necessary, now I am convinced that it is important. If you have not seen a mental health professional ask your neurologist to recommend one. I am really seeing the difference it can make. Oh, I was diagnosed with MS on a Monday, April 22, 1996. It only took me 21 years to get this piece of the puzzle in place; I can only say it really does help. Did not realize the baggage I was toting around because of MS.

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Michael A Grigsby avatar

Michael A Grigsby

MS messes with your brain and the leading cause of death so far as I have been told for MS sufferers is suicide. Having the right kind of help with this disease seems like such a confusing topic, but then that might just be my MS brain being confused after having it for 15 years since diagnosis. Then again the low T might have a factor role as well.

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Ed Tobias avatar

Ed Tobias

Michael,

I think that what you've been told about the leading cause of death for people with MS is incorrect. The top causes are complications from urinary infections and aspiration pneumonia. MS patients do have a higher suicide RATE than the general population but I think you'd find the same thing with people who have other serious, chronic diseases.

Ed

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