R.A.A. was responsible for designing and conceptualize the protocol, reviewing analyzed data, providing feedback concerning writing and help interpreting the results of the study. R.S.G. was responsible for designing and conceptualize the protocol, reviewing analyzed data, providing feedback concerning writing and help interpreting the results of the study. We would like to thank all the study participants for their time and effort. Low, mid–normal, and normal range serum T were 288.8 ± 84.9 ng/dL, 461.0 ± 52.5 ng/dL and 648.0 ± 53.5 ng/dL, respectively. Clinicians who care for men with SCI should consider routine annual screening for depressed measures of serum T because physical findings and psychological symptoms that are often observed in the SCI population may also be speculated to be the result of, or contributed to, low T concentrations. These investigators observed an effect of aging on both total T (−0.124 nmol/l/year) and the free T index (−0.0049 nmol T/nmol SHBG/year). Certain health conditions may make TRT unsafe or require extra caution. These tests help doctors find problems early, adjust doses, and make sure therapy is working safely. If sleep apnea becomes worse, the doctor may suggest adjusting the therapy or treating the sleep issue separately. An increase in noncalcified and total plaque volumes is of clinical concern because any impairment of the vascular lumen can be considered deleterious.113 However, Budoff et al.,112 recently demonstrated that transdermal TRT in men with hypogonadism, significantly increased coronary artery noncalcified plaque volume (measured by coronary computed tomographic angiography). Indeed, raising T levels into the normal physiological range with transdermal TRT improved QTVI104 and normalized ventricular repolarization dynamics,105 thereby reducing the risk of arrhythmias in men with SCI. A 2005 meta-analysis of pooled studies99 suggested significantly higher risks of prostate events, specifically elevated prostate-specific antigen (PSA) concentrations in men with TRT than the placebo group. The therapy involves administering testosterone through various methods, such as injections, patches, gels, or implants. Testosterone therapy aims to restore hormone levels to a more normal range. This decline can lead to weakness, reduced mobility, and an increased risk of injuries, all of which can contribute to back pain. Testosterone therapy for back pain is an emerging field of interest in the medical community. The study suggested that testosterone might help protect the intervertebral discs, which act as cushions between the vertebrae, from degeneration. This condition is particularly concerning for older adults, who are more likely to experience both lower testosterone levels and osteoporosis. The vertebrae in the spine can become weak and compress, leading to chronic back pain. (A–D) Percentage change in total hip, femoral neck, distal femur, and lumbar spine (L2–L4) areal bone mineral density (aBMD) at 6 months (6 M) and 12 months (12 M), derived via dual-energy X-ray absorptiometry (DXA), in men who received testosterone replacement therapy plus finasteride (TRT + finasteride, black bars) or vehicle with placebo (vehicle+placebo, white bars) after chronic motor-incomplete spinal cord injury (SCI). (A,B) Percentage change in whole-body and region-specific fat-free mass and fat mass at 6 months (6 M) and 12 months (12 M), derived via dual-energy X-ray absorptiometry (DXA), in men who received testosterone replacement therapy plus finasteride (TRT + finasteride, black bars) or vehicle with placebo (vehicle+placebo, white bars) after chronic motor-incomplete spinal cord injury (SCI). To establish the association between serum testosterone (T) levels, biomarkers of cardiometabolic health and regional body composition variables after spinal cord injury (SCI).
