The hypoandrogenic-anabolic deficiency state: endocrine and metabolic shifts in men.

In recent years there has been increased interest in and awareness of the consequences of the male hypogonadal state which frequently occurs as one component of the androgen deficiency complex. This is important as it allows for abnormal energy partitioning which adversely alters anabolism and the maintenance of cellular and tissue biological integrity. Accumulating evidence strongly suggests that over time all forms of diminished androgen availability, in males, leads to adverse metabolic shifts that direct energy control mechanisms towards a progressive dysfunctional anabolic state. It is now apparent that whenever hypotestosteronemia is detected other components of the androgen-anabolic deficiency complex should be evaluated. This relationship can best be viewed as the hypoandrogenic-anabolic deficiency triad: decreased gonadal, adrenal and somatotropic biosynthetic activity which requires separate evaluation of each axis. These combined deficits may provide part of the explanation for the inconsistent reports regarding the benefits of androgen and other replacement treatments. Furthermore, it suggests that these deficiencies may require simultaneous repair in order to achieve better metabolic response profiles.