OSA - Low testosterone/Osteoporosis

[fredouil]

Hi guys,

I am 39, I have been diagnosed with very low Testosterone last year and last month I broke my elbow with small fall, look like i have an advanced osteoporosis
The chir says my bones are like 80yo'ones ;-(

My new endocrinologist is now more seriously trying to find out the causes and asked me to undertake a sleep study : severe OSA, AHI :77

he is saying OSA can cause low Test and therefore osteoporosis.

Are you aware of that, I haven't found much article that clearly link OSA with low T and even less with osteoporosis.

Do you have any links/articles/

anyone with the same problem ???

i am getting a resmed S9 next week, hope it helps

Thank you

[Goofproof]

I suppose your wife is in bed with many broken bones and a very bad case of Sleep apnea. P.S. Women have lower Testosterone than men (4 times lower)

All of lifes problems aren't caused by Sleep Apnea, they can make life worse if untreated, but they aren't the cause. Sounds like your Dr. went to school like BUSH took flying lessons in the Air Force. JIm

[fredouil]

thank you for this helpful reply, you obviously do not know much endocrino.

[Goofproof]

thank you for this helpful reply, you obviously do not know much endocrino.

I have LOW "T", Type II diabetes, taking med's for 20 years, two types of insulin, 3 times daily, and I had untreated Sleep Apnea for 5 years before any LOW "T", Type II diabetes came into the picture. I've probably forgot more than your Encrony (SP intentional) has learned about Sleep Apnea. Jim

[Julie]

Hi -

"OSA can cause low Test and therefore osteoporosis."

This is plainly ridiculous medically... you have either misunderstood your doctor, or he needs to be replaced immediately.

Sleep apnea does not cause osteoporosis, whatever other obscure connection there might be in a given patient.

[Mimmie]

According to the Endocrine Society’s clinical guidelines, certain men shouldn’t take testosterone supplements. Men with metastatic prostate cancer or breast cancer absolutely shouldn’t, because testosterone can stimulate these cancers to grow. Other conditions can potentially be made worse by testosterone therapy, including sleep apnea, severe benign prostatic hypertrophy, severe congestive heart failure, or high red blood cell counts (erythrocytosis).

There was also an article on it back in 2002. Decreased Testosterone Levels Linked To Sleep Disorder
July 25, 2002


Sleep apnea is a respiratory disorder that affects 4%-9% of adult males. Its most common manifestation is loud snoring and it may occur several hundred times throughout the night, resulting in sleep fragmentation and excessive daytime sleepiness. The current study, reported in the July issue of The Journal of Clinical Endocrinology & Metabolism, found that nearly half the subjects who suffered from severe sleep apnea also secreted abnormally low levels of testosterone throughout the night.

[cre8vmynd]

Here are a couple studies I've found in the past regarding OSA and low t.

http://men.webmd.com/news/20110603/slee ... stosterone
http://jcem.endojournals.org/content/87/7/3394.full

Here's information regarding osteoporosis in men.
http://www.webmd.com/osteoporosis/livin ... 7/male-men

Here's a paragraph from the article:
The most common cause of male osteoporosis is testosterone deficiency, says Mystkowski. "There's a clear consensus that when you're evaluating men with osteoporosis, you always evaluate for testosterone deficiency," he says.

The analogy of a woman with OSA having "many broken bones" because she has t levels far lower then men is not appropriate. Optimal levels of testosterone are completely relative to the individual and especially wether the person is male or female. Is this not common sense?

And to say that the claim of a connection with OSA, low T and male osteoporosis is "plainly ridiculous medically" isn't right either as the above article shows.

I would encourage all those who like to shoot from the hip with their comments to take a minute and think about what you're saying before you hit that submit button.

Casey...

[Julie]

Hi -

What I said was that "sleep apnea does not cause osteoporosis", and clearly separated that from other 'connections' regarding testosterone or anything else.

And even if low testosterone is implicated in osteoporosis to an extent, it does not automatically follow that OP is therefore caused by OSA.

Do not misquote me please... Julie

[Jay Aitchsee]

I don't think it's unreasonable at all. If, as commonly agreed, most of the body's repair takes place while we sleep, and much of that repair involves the endocrine system, then sleep disturbances due to OSA could very likely cause the body's repair system to malfunction and cause an endocrine imbalance, including low T, insulin resistance, heart disease, etc.
I think it's also possible that an endocrine imbalance could lead to OSA through a pathway like metabolic syndrome.
Kind of a "chicken and egg" thing.
Jay

[2flamingos]

I don't remember which dx came first - OSA or Low T, but have been on treatment for each for about the same length of time. So far, I do not seem to have any signs of osteoporosis; nor has my OSA gotten worse with T replacement. I am now on my 3rd T replacement med. Have tried Androgel, Androderm, and now Fortesta. My preference was for the Androderm - the patches were great, but the skin reaction (looked and felt like a burn) was not.

[jamiswolf]

Julie wrote: Sleep apnea does not cause osteoporosis, whatever other obscure connection there might be in a given patient.

You weren't mis-quoted...you were proven wrong.
Jamis

[cmanbrazil]

I started off breaking bones. First one ankle skating boarding with my kids. Okay,42, overweight, shouldn't be skating boarding so understandable. Then I cracked a rib swinging a golf club, then broke my other ankle and I said something is wrong. previously I'd never broke a bone in my life. Well it took about six month's and three doctors to understand I had low testosterone and low vitamin D. My endocrinologists -never had one before- suggested that sleep apnea was related. If you are like me an skeptical about doctors and their cavalier, 20 minute approach to healthcare, then you tend to rule out some of their suggestions. So I started on the testosterone replacement therapy -consists of gel on the arms- and large amounts of vitamin d. I felt better for maybe a month, but It didn't last long, and I seemed more tired every day.

So three months later I do the sleep tests and what to you know. I am having apnea events more than 80 times an hour. For the month i have used the machine, I have on average felt better, although I had to have the machine adjusted from 8 to 11. Now I am wondering if the machine works can I get of of hrt meds? The doctor is clueless.

[fredouil]

thank you cman i wanted to see if others have the same issue.

I quite like the hormone replacement, it was only one injection every 3 months (reandron 1000), the gel is far less effective and could end up on my kid skin but my new endocrino ask me to stop the replacement to see for the time being to find out the causes.

for what i read OSA can really reduce dramatically the T level , I hope CPAP helps but i expect getting back on HRT if my level are still low (which I dont mind).HRT increases the bone density by 8% after only 18 months.

be very careful with the Vit D, quite unhealthy in high dosage.I take vit D + calcium, I will probably take some bisphosphonate later on.

Cheers

[cmanbrazil]

thank you cman i wanted to see if others have the same issue.

I quite like the hormone replacement, it was only one injection every 3 months (reandron 1000), the gel is far less effective and could end up on my kid skin but my new endocrino ask me to stop the replacement to see for the time being to find out the causes.

for what i read OSA can really reduce dramatically the T level , I hope CPAP helps but i expect getting back on HRT if my level are still low (which I dont mind).HRT increases the bone density by 8% after only 18 months.

be very careful with the Vit D, quite unhealthy in high dosage.I take vit D + calcium, I will probably take some bisphosphonate later on.

Cheers

We need to support one another. There are few in my circles who understand or respect low t or sleep apnea. Its hard explaining to people how not getting enough sleep or having low t make it hard to remember, feel good, have energy, not be so damn irritable, etc.

I would love to be off of androgel for cost alone. What if I lose my insurance? I hope to start weaning myself off of it soon.

I would be interested in the vitamin D info you have. To my understanding you would have to take an extreme amount to take it at a high dose.

[fredouil]

We need to support one another. There are few in my circles who understand or respect low t or sleep apnea. Its hard explaining to people how not getting enough sleep or having low t make it hard to remember, feel good, have energy, not be so damn irritable, etc.

I would love to be off of androgel for cost alone. What if I lose my insurance? I hope to start weaning myself off of it soon.

I would be interested in the vitamin D info you have. To my understanding you would have to take an extreme amount to take it at a high dose.

Yeah people dont imagine the impact of low testosterone.you re right about the memory, when i was on hormone replacement my memory was pretty much photographic and my thinking was bloody sharp , i would have loved to have that during my uni times. my bad concerning the vit D toxicity it looks like the hypercalcemie risk has been reassessed lately (my uni lectures date a bit).
I am lucky in Australia we dont need insurance for serious stuff, i get it free for life.