{"doi":"10.1210/clinem/dgaa521","title":"Markers of Iron Flux during Testosterone-Mediated Erythropoiesis in Older Men with Unexplained or Iron-Deficiency Anemia","abstract":"CONTEXT: Testosterone treatment of hypogonadal men improves their hemoglobin, but the mechanism is not understood. OBJECTIVE: To investigate possible mechanisms by which testosterone stimulates erythropoiesis in hypogonadal older men with unexplained or iron-deficiency anemia. DESIGN: The Anemia Trial of The Testosterone Trials, a placebo-controlled study in older, hypogonadal men. SETTING: Twelve academic medical centers. PARTICIPANTS: A total of 95 hypogonadal men (testosterone < 275 ng/mL) ≥65 years with anemia (hemoglobin < 12.7 g/dL). They were classified as having unexplained (n = 58) or iron deficiency anemia (n = 37). INTERVENTION: Testosterone or placebo gel for 1 year. MAIN OUTCOME MEASURES: Markers of iron metabolism during the first 3 months of treatment. RESULTS: Testosterone replacement significantly (P < 0.001) increased hemoglobin in the 58 men who had unexplained anemia (adjusted mean difference 0.58 g/dL; 95% confidence interval, 0.31-0.85). Testosterone replacement tended to increase hemoglobin in the 37 men who had iron deficiency (0.38 g/dL; -0.19, 0.95), but the response was more variable and not statistically significant (P = 0.19). In men with unexplained anemia, testosterone replacement suppressed hepcidin (-8.2 ng/mL; -13.7, -2.7; P = 0.004) and ferritin (-19.6 µg/L; -32.8, -6.3; P = 0.004), but in men with iron deficiency, testosterone replacement did not. The decrease in hepcidin was moderately correlated with the increase in hemoglobin in the men with unexplained anemia (correlation coefficient -0.35, P = 0.01) but not in those with iron deficiency anemia (correlation coefficient -0.07, P = 0.73). CONCLUSIONS: Testosterone replacement of older hypogonadal men with unexplained anemia stimulates erythropoiesis associated with increased iron mobilization. This effect appears to be attenuated by iron deficiency.","journal":"The Journal of Clinical Endocrinology & Metabolism","year":2020,"id":82155,"datarank":0.662386203831284,"base_score":2.639057329615259,"endowment":2.639057329615259,"self_citation_contribution":0.3958585994422889,"citation_network_contribution":0.26652760438899503,"self_endowment_contribution":0.3958585994422889,"citer_contribution":0.26652760438899503,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":12,"citers_with_citation_signal":11,"citers_with_endowment":11,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9604,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT00799617"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":424193,"name":"Alisa J. Stephens‐Shields","orcid":"0000-0003-1926-0796","position":1,"is_corresponding":false},{"id":109414,"name":"Shalender Bhasin","orcid":"0000-0002-3982-6200","position":2,"is_corresponding":false},{"id":250024,"name":"Susan S. Ellenberg","orcid":"0000-0002-2364-5253","position":3,"is_corresponding":false},{"id":362880,"name":"Harvey Jay Cohen","orcid":null,"position":4,"is_corresponding":false},{"id":424194,"name":"Peter J. Snyder","orcid":"0000-0002-9838-3139","position":5,"is_corresponding":false},{"id":316813,"name":"Andrew Artz","orcid":"0000-0003-0803-9607","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-18T21:53:19.932222Z","pmid":"32785689","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}