Dr. Ron’s Research Review – June 5, 2019

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This week’s research review focuses on reversible insensitivity to androgens in men with untreated gluten enteropathy

Plasma androgen and gonadotrophin concentrations have been measured before and during treatment of 23 men with gluten enteropathy. Before treatment, there was marked rise in total plasma-testosterone, free testosterone concentration (as assessed by the free testosterone index), and plasma-luteinising-hormone concentration. In contrast, 5 alpha-dihydrotestosterone concentrations were lower than normal. All these abnormalities reverted towards normal with successful treatment of the jejunal mucosal lesion. These data are consistent with a reversible tissue resistance to circulating plasma-testosterone in men with gluten enteropathy and subtotal villous atrophy. (Green et al., 1977)
Despite high circulating free testosterone concentrations, patients with subtotal villous atrophy have high plasma-L.H. concentrations. The failure of high plasma- testosterone concentrations to suppress pituitary L.H. secretion in these patients suggests that the hypothalamic-pituitary system is insensitive to the inhibitory action of raised plasma-testosterone. One possible explanation for this could be failure of conversion of testosterone to D.H.T. 

 

Dr. Ron

 


Articles

 

Reversible insensitivity to androgens in men with untreated gluten enteropathy
(Green et al., 1977)  Download
Plasma androgen and gonadotrophin concentrations have been measured before and during treatment of 23 men with gluten enteropathy. Before treatment, there was marked rise in total plasma-testosterone, free testosterone concentration (as assessed by the free testosterone index), and plasma-luteinising-hormone concentration. In contrast, 5 alpha-dihydrotestosterone concentrations were lower than normal. All these abnormalities reverted towards normal with successful treatment of the jejunal mucosal lesion. These data are consistent with a reversible tissue resistance to circulating plasma-testosterone in men with gluten enteropathy and subtotal villous atrophy.

 

References

Green, J. R., et al. (1977), ‘Reversible insensitivity to androgens in men with untreated gluten enteropathy’, Lancet, 1 (8006), 280-82. PubMed: 64806