About two years ago, I came across the web-site of a doctor who had just begun to use fat stem cells, mostly for cosmetic uses, but also dabbling in knee arthritis. He claimed that many research studies showed that testosterone and other age management remedies dramatically increased stem cell production and quality. I immediately went onto the US National Library of Medicine to check as the few articles he referenced didn’t really conclude what he claimed. I searched for a bit and couldn’t find anything that really showed that testosterone boosted stem cells in real patients (there were only a few lab experiments). The concept intrigued me, as wouldn’t it be great if we could put male patients with low testosterone on a short course of supplementation and then take their stem cells, hopefully having improved their stem cell numbers or quality. In 2013 we got IRB approval to look at male patients with low T (this was a privately funded study by our clinic) and their stem cells. Before the men began testosterone, we harvested their bone marrow stem cells and then after 3 months of optimization, we took another batch of cells. We cryopreserved both samples so that we could treat them the same and then later brought both samples out for testing. In the initial pilot study of 4 patients, things looked pretty good in that testosterone seemed to help the cells. However, we also knew that we needed more patients, as what if we happened to pick the few men for which this worked when it didn’t really work for most? So we looked at another 17 patients. What were the results? Well regrettably, in the larger group of men, it didn’t work. While 2/17 did see dramatic increases in cell number, the rest did not. In fact, averaging it all out translates to about a 49% decrease in stem cell number after the testosterone. So what don’t we know? Well, don’t go throw out your T patch just yet. First, this is a very short course of treatment that we also combined with the other most commonly used age management therapy-thyroid optimization. Most experts in this field will tell you that it can take a year or two for men to see optimal benefits. We didn’t test that duration of use because we wanted to focus on an intervention that would be practical for our male patients. In addition, we didn’t try to do what many age management physicians will do in addition to testosterone-improve diet and exercise. We also didn’t use Human Growth Hormone (however we have been less than impressed with its effects on stem cells in culture). We’ll be looking more closely at this data this next few weeks and I will formally present all of it at the Age Management Medicine Conference in Orlando in April. We will be using a different way to measure stem cells (flow cytometry vs. P0 counts out of culture) to see if we get any different results. We will also investigate if the two men that really benefited were any different than the rest of the group. We also know we have a few study group members that may not have been 100% compliant, so we’ll be looking for relationships between hormone levels and counts. The upshot? The age management doctor dabbling in stem cells seems to have been wrong. Right now, we don’t have any data on which to recommend a short course of testosterone therapy for our male patients as a mechanism to improve their stem cells. There are now lots of questions. Why do some men’s stem cells benefit from this therapy while others do not? We’ll have to see where that leads…
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About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…