Androstenedione: A Comprehensive Review of Dosage Uses, Risks and Raising Testosterone Levels.

Keywords: Andro, Androstenedione, Testosterone Levels, Estradiol, Estrogen in Men, Strength, Performance, Resistance Training Enhancement, Gynecomastia, Testosterone Supplements, Mark McGwire, HomeRun and Testosterone Levels.

More men today are being diagnosed with low testosterone and many men look to natural alternatives to improve their testosterone levels. Dietary supplements that promote an increase in testosterone levels are gaining in popularity and have been for several years. However, many of the components of such supplements are either unproven or contain other vitamins and contents that improve energy to mimic the benefits of an increase testosterone level. Many of these over the counter supplements in fact do not affect a man’s testosterone at all. The focus of this article series will address dietary supplements and adjunct medications that can improve a man’s testosterone level alone or in combination with testosterone replacement therapy. Specifically addressed will be the following agents: Androstenedione, DHEA (dehydroepiandrosterone, Androstenediol and Tribulus Terrestris.

Androstenedione

Androstenedione, also called "Andro" is a naturally occurring hormone produced in the testicles and adrenal glands in both men and women. Androstenedione is a scheduled III controlled substance and can only be provided now with a doctor’s prescription (Smurawa & Congeni, 2007). This was not always the case, as Androstenedione was easily obtainable as an over the counter supplement. Androstenedione is derived from DHEA and is manufactured as a prohormone. A prohormone is an inactive precursor to an anabolic steroid. In order for a prohormone to be active, it must be ingested in the body and converted, through an enzymatic reaction into its active form. Androstenedione is converted in the body to testosterone by aromatase. Androstenedione was first made famous when Mark McGwire admitted to its use during his remarkable home run race in 1998. (Kovac JR et.al.) (ESPN.com). Before McGwire admitted to its use, Androstenedione was an over the counter supplement between 1996 and 2004 (Kovac JR et.al.) Because of Androstenedione’s newly found fame after Mark McGwire admitted to its use and the public perception it improved his baseball performance, sales of the supplement spiked 500%. This led to clinical research studies between Harvard, Major League Baseball and the Major League Baseball Players Association looking at the the risks of "Andro". The studies brought concern for potential side effects and the risks of "Andro". As thus the FDA rightfully passed the Anabolic Steroid Control Act and listed Androstenedione as a scheduled III controlled substance.

The first well known study on Androstenedione was initially performed before Androstenedione gained baseball fame. In 1999 King et.al. conducted the first controlled chronic use study to review the effects of 300mg per day of Androstenedione usage with resistance training. Androstenedione was administered to healthy male subject at weeks 1,2,4,5,7, & 8. Anabolic steroids are often dosed in this matter, allowing weeks 3 and 6 free of any supplements to allow the body to recover from the supplement and reduce down regulation of the hypothalamic pituitary gonadal axis (maintain natural testosterone production and pituitary function). Study results revealed moderate increases in testosterone levels. This was also confirmed by later research from Leder et al.in 2000. Significant improvements in muscle size and strength due to Androstenedione or other anabolic enhancements remains unknown (Leder et al. 2000). Moderate increases in testosterone levels were found after approximately 1 month of use. (Leder et al. 2000). More importantly, Androstenedione use causes marked increases in estrogen levels. Use of aromatase inhibitors could be used to reduce estrogen related side effects and levels. Similar to testosterone replacement therapy, use of Androstenedione suppressed LH secretion by the pituitary.

Another study by Brown et. al (2000) provided study subjects the following supplements over an 8 week period: 300mg of Androstenedione and 150mg of DHEA, 750mg of Tribulus Terrestris, 625mg Chrysin, 300mg Indole-3- Carbinol and 540mg of Saw Palmetto. The study found no improvement in testosterone levels.

“The Andro-Project” by Broder et. al (2000) provided subjects age 35-65, 200mg per day of Androstenedione and subjects participated in a 12-week intense resistance training programming. Study results revealed no statically significant improvement in strength or body composition with the addition of Androstenedione to a high level resistance training program. Yet, interesting enough there was an increase in both free and total testosterone concentration levels by one month of treatment.

Commonly Asked Questions About Androstenedione

Does Androstenedione really work to improve strength, muscle size and raise testosterone levels.?

Androstenedione was once marketed as a supplement to improve muscle size and strength. Much of the research to date on Androstenedione convey it can increase testosterone levels slightly but significant improvements in strength, muscle size or any other beneficial anabolic effects are not witnessed. Furthermore, the side effects of the supplement such as, significant increases in estrogen levels, an adverse effect on lipid profiles can increase the risk of a cardiovascular events. As thus the benefit of using Androstenedione may not out way the risks of taking this weak oral androgen prohormone.

What are the side effects of Androstenedione?

o Androstenedione is a weak androgen, and highly susceptible to aromatization by the enzyme aromatase leading to an increase in estrogen. In men, prolonged elevated estrogen levels (estradiol, E2) can promote development of gynecomastia, reduce libido, worsen lipid profiles lending to an increase in cardiovascular events.

o Elevate levels of DHT

o Suppresses pituitary function thereby decreasing natural testosterone production in the testicles and reduction of sperm count (oligospermia)

o Liver function impairment

o No improvement in sexual performance (Brown et. al 2000; Wallace et.al. 1999)

o Possible risks for development of Prostate cancer, Pancreatic Cancer, Breast Cancer, premature closure of epiphyses.

o Positive urine test results for nandrolone metabolites ( Catline et.al. 2000; Uralets and Gillette , 2000)

What is the recommended dosage of Androstenedione (Andro)?

Much of the research and clinical studies have used between 200mg and 300mg Androstenedione daily. Yet, any benefit of Androstenedione when ingesting this amount have not shown to be beneficial. Side effects of the Andro far exceed any unknown benefit in performance.

Is Androstenedione illegal?

Androstenedione is classified as a schedule III-controlled substance by the United States Anabolic Steroid Act of 2004. The use of Androstenedione is prohibited by the International Olympic Committee and NCAA. Furthermore, there are no guidelines or clinical studies that provide Androstenedione to have a beneficial effect on sports performance. The known risk of using Andro out weight any unknown benefit of use.

Citations

Kovac JR, Pan M, Arent S, Lipshultz LI. Dietary Adjuncts for Improving Testosterone Levels in Hypogonadal Males. Am J Mens Health. 2016;10(6):NP109-NP117. doi:10.1177/1557988315598554

Leder BZ, Longcope C, Catlin DH, Ahrens B, Schoenfeld DA, Finkelstein JS. Oral Androstenedione Administration and Serum Testosterone Concentrations in Young Men. JAMA. 2000;283(6):779–782. doi:10.1001/jama.283.6.779

Broeder CE, Quindry J, Brittingham K, Panton L, Thomson J, Appakondu S, Breuel K, Byrd R, Douglas J, Earnest C, Mitchell C, Olson M, Roy T, Yarlagadda C. The Andro Project: physiological and hormonal influences of androstenedione supplementation in men 35 to 65 years old participating in a high-intensity resistance training program. Arch Intern Med. 2000 Nov 13;160(20):3093-104. doi: 10.1001/archinte.160.20.3093. PMID: 11074738.

Broeder CE. Oral andro-related prohormone supplementation: do the potential risks outweigh the benefits? Canadian Journal of Applied Physiology 2003 Feb;28(1):102-116. DOI: 10.1139/h03-009

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