Low T and Anemia: Science Studies a Connection in Older Men

Anemia, a harmful condition in which your body lacks sufficient red blood cells to carry healthy levels of oxygen, drastically increases in men over the age of 50, the age range most affected by low testosterone.

Similar to low testosterone, anemia isn’t a simple complication related to the normal aging process.

A woman wearing a white lab coat and protective eyewear examines blood in a pipette, possibly studying the connection between anemia and low testosterone.

The Causes of Anemia

Anemia is considered a sign of physical deterioration and disease, with common causes including:

  • Chronic inflammation
  • Vitamin B12 deficiency
  • Iron deficiency

It is associated with poor overall health, but it can also occur with no clear cause at all.

Anemia also may develop as a result of other disease conditions, one possibility being low testosterone.

Elevated rates of anemia in men suffering from hypogonadism (the clinical term for low testosterone) have led scientists to wonder whether testosterone could play a part in diagnosing and treating anemia and improving patients’ quality of life.

The Harmful Symptoms of Anemia

Anemia often causes severe damage to patients’ quality of life, with common symptoms including:

  • Frequent fatigue and muscle weakness
  • Increased frailty and loss of bone mineral density, increasing the risk of fractures
  • Lower cognitive function, dementia, and depression
  • Increased hospitalization with longer lengths of stay and more frequent readmission

The greatest cause for concern is anemia’s association with increased chances of premature death, including:

  • Increased odds of developing cardiovascular disease
  • Higher risk of heart attack and heart failure
  • Worsening of other diseases, such as cancer and renal failure

Some studies show that mortality risks may double, even in cases of mild anemia.

This article from the Mayo Clinic offers further information.

A Beneficial Side Effect?

Testosterone has a suppressive effect on a peptide hormone called pepcidin, which is known to be a regulator of iron absorption.

It is primarily made in the liver, and when suppressed, it can lead to increased iron stores in the blood.

More iron in the blood signals your bone marrow to increase red blood cell production, which potentially leads to a higher concentration of red blood cells and thickening or increased viscosity of your blood—a condition called erythrocytosis or polycythemia.

In non-anemic patients, this condition possibly increases the risk of clotting events if no preventative measures are taken.

However, in anemic patients, whose difficulty is the lack of healthy red blood cells, the stimulation of red blood cell production may be a positive change instead of a troublesome side effect.

Anemia and Low T: A Recent Study

A recent study tested 788 participants, 126 of whom were anemic, with 62 of those cases having no known cause.

The participants received either testosterone gel or a placebo gel, which was applied to the skin daily, with the goal of testosterone treatment to increase testosterone levels to within the normal range and maintain it during the one year study.

Compared with placebo, testosterone treatment for 12 months significantly increased hemoglobin levels and reduced the prevalence of both unexplained anemia and anemia of known cause.

More information on the study is available here.

While further research is needed, the findings of this study support 2 important medical possibilities:

  1. Testosterone deficiency may contribute to the development of anemia, especially in the absence of other causes
  2. Improved hemoglobin levels through TRT in men who have anemia of known cause suggests that this anemia may be caused by coexisting poor general health and low testosterone levels

In other words, the diagnosis, evaluation, and treatment of anemia in older men should take into account their testosterone levels.

Including TRT to increase hemoglobin levels and overall health may be beneficial.

The Benefits of TRT: Learn More

Your hormones are a part of many of your body’s essential systems—the production of red blood cells is just one example.

If you’re caught in a cyclical trap of poor health, it’s possible that your hormones are playing a part in your overall condition, exacerbating your difficulties or causing additional symptoms.

It might be time to talk to your healthcare professional about testing your hormone levels to see if Testosterone Replacement Therapy (TRT) or other hormone therapy might be the springboard your body needs to get out of the trap and back to feeling more like “you.”

Read our guide on all things “TRT” to learn more.

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(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.

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