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Exogenous Testosterone + Factor V Leiden = Increased Risk of Thrombosis?

Posted by Henry I. Bussey, Pharm.D.
February, 2012

Dr. Charles J. Glueck of the Jewish Hospital of Cincinnati, Ohio recently contacted ClotCare regarding a publication from his group in which testosterone supplementation in six men was followed by thromboembolism (2 developed bilateral osteonecrosis of the hip, 3 developed pulmonary embolism, and one developed amaurosis fugax).1 Five of the six were found to be heterozygous for Factor V Leiden and the other patient was a 70 year old male with elevated Factor VIII, Factor XI, and homocysteine. None of these patients had a prior history of – or risk factors for - thrombosis except that 3 had a family history of thrombosis. Dr. Glueck and colleagues suggest that the aromatization of testosterone to estradiol may have a synergistic prothrombotic effect in men with Factor V Leiden just as has been observed in women with Factor V Leiden who use hormonal contraceptives. Dr. Glueck has graciously volunteered to assist others who may wish to explore this potential interaction further. He can be reached at cjglueck@health-partners.org.

Reference

Glueck CJ, Goldenberg N, Budhani S, et al. Thrombotic events after starting exogenous testosterone in men with previously undiagnosed familial thrombophilia. Translational Research 2011; 158:225-234 (doi: 10.1016/j.trsl.2011.06.003)

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