Androgens for anemia – pro

Hypogonadism and anemia are common comorbid conditions in cancer patients. Testosterone replacement may improve such clinical parameters as anemia, sarcopenia, and low libido. Additionally, by increasing hemoglobin levels, testosterone replacement may allow for a dose reduction in recombinant human erythropoietin (rHuEPO), thereby reducing cost. Testosterone is among the oldest drugs in medicine. It has a long efficacy and safety record for its prime role of androgen replacement therapy in men with androgen deficiency.

Testosterone and synthetic analogue androgens have also been used in pharmacological androgen therapy (PAT) to produce androgenic effects on marrow, muscle or bone. Much of this data is now quite old; there are alos many papers on the use of androgens to treat anemai of hemodulaysis or renal failure. Although PAT is increasingly being superseded by newer, more expensive drugs, androgens remain cost-effective in many older applications.With the availability of eruthropietin, testosterone as an anemia treatment has become much less popular but has sometimes been combined with erytrithropoietin as an adjunct.

Androgens for anemia of marrow failure states is an old but well supported treatment that should be considered well supported by the medical literature.


Navarro JF. In the erythropoietin era, can we forget alternative or adjunctive therapies for renal anaemia management? The androgen example. Nephrol Dial Transplant 2003; 18: 2222–2226

Gascon A, Belvis JJ, Berisa F, et al. Nandrolone decanoate is a good alternative for the treatment of anemia in elderly male patients on hemodialysis. Geriatr Nephrol Urol 1999; 9: 67-72

Ballal S, Domoto D, Polack D, et al: Androgens potentiate the effects of erythropoietin in the treatment of anemia of end-stage renal disease. Am J Kidney Dis 17:29–33, 1991

Harry W. Daniell Androgen Augmentation of Epoetin Journal of Clinical Oncology, Vol 21, Issue 11 (June), 2003: 2224

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