Description
Inclusion Criteria:
- * obese men with body mass index (BMI) of ≥35 kg/m2
- * age between 40 to 65 years old
- * average fasting testosterone level from 2 measurements taken between 8 to 10 AM on 2 separate days of \<300 ng/dl
- * Luteinizing Hormone (LH) of \<9.0 mIU/L
- * Estradiol of ≥17 pg/ml
- * Symptoms consistent with androgen deficiency as assessed by Androgen Deficiency in Aging Male (ADAM) questionnaire
Exclusion Criteria:
- * pituitary or hypothalamic disease,
- * drugs affecting gonadal hormone levels, production and action or bone metabolism (bisphosphonates, teriparatide, denosumab, glucocorticoids, phenytoin)
- * diseases affecting bone metabolism (e.g. hyperparathyroidism, untreated hyperthyroidism, osteomalacia, chronic liver disease, significant renal failure, hypercortisolism, malabsorption, immobilization, Paget's disease),
- * prostate carcinoma or elevated serum prostate specific antigen (PSA)\> 4 ng/ml,
- * Hematocrit \> 50%,
- * untreated severe obstructive sleep apnea,
- * Cardiopulmonary disease (e.g. recent myocardial infarction, unstable angina, stroke) or unstable disease (e.g., New York Heart Association Class III or IV congestive heart failure
- * severe pulmonary disease requiring steroid pills or the use of supplemental oxygen (that would contraindicate exercise or dietary restriction)
- * History of deep vein thrombosis or pulmonary embolism
- * severe lower urinary tract or prostate symptoms with International Prostate Symptom Score (IPSS) above 19
- * excessive alcohol or substance abuse
- * unstable weight (i.e. \>±2 kg) in the last 3 months
- * condition that could prevent from completing the study
- * screening bone mineral density (BMD) T-score of \<-2.0 at the spine, femoral neck or total femur
- * history of osteoporosis or fragility fracture
- * Diabetes mellitus with a fasting blood glucose of \>140 mg/dl, and/or Hemoglobin A1C (A1C) \>8.5%.
Ages Eligible for Study:
40 Years to 65 Years (ADULT, OLDER_ADULT)
Sexes Eligible for Study: MALE
Accepts Healthy Volunteers:
No