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To the Editor: Dr Emmelot-Vonk and colleagues¹ reported the findings of a randomized, placebo-controlled trial of 237 older men treated with oral testosterone supplementation for 6 months. This is an area of clinical importance for physicians prescribing testosterone to older men in whom the efficacy and safety of androgen administration remains unclear. However, there are methodological issues that make some of the null results of this trial difficult to interpret and place into clinical context.

Participants in this trial were healthy, community-dwelling older men who did not report clinical manifestations of androgen deficiency. Moreover, the primary inclusion criterion was a single total testosterone level lower than 13.7 nmol/L (400 ng/dL). Although normal ranges for testosterone were not provided, mean baseline total and free testosterone levels in the study cohort were within the low-normal range for young, healthy men using most assays. Thus, most enrollees were neither clinically nor biochemically androgen . . . [Full Text of this Article]

Stephanie Page, MD, PhD
page@u.washington.edu
Division of Metabolism and Endocrinology

Alvin M. Matsumoto, MD
Division of Gerontology and Geriatric Medicine
Department of Medicine
University of Washington School of Medicine
Seattle

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RELATED ARTICLE

Effect of Testosterone Supplementation on Functional Mobility, Cognition, and Other Parameters in Older Men: A Randomized Controlled Trial
Marielle H. Emmelot-Vonk, Harald J. J. Verhaar, Hamid R. Nakhai Pour, André Aleman, Tycho M. T. W. Lock, J. L. H. Ruud Bosch, Diederick E. Grobbee, and Yvonne T. van der Schouw
JAMA. 2008;299(1):39-52.
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RELATED LETTER

Effects of Testosterone Therapy in Older Men—Reply
Marielle H. Emmelot-Vonk, Harald J. J. Verhaar, and Yvonne T. van der Schouw
JAMA. 2008;299(16):1900-1901.
EXTRACT | FULL TEXT