Editorial Commentary: Testosterone, Growth Hormone, and Vitamin D Supplementation Is Not Routinely Indicated for Orthopaedic Surgery Patients.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
testosterone replacement therapy (TRT) | increase | mood | aging males | - | Benefits include improvements | #1 |
testosterone replacement therapy (TRT) | increase | cognition | aging males | - | Benefits include improvements | #2 |
testosterone replacement therapy (TRT) | increase | libido | aging males | - | Benefits include improvements | #3 |
testosterone replacement therapy (TRT) | increase | energy | aging males | - | Benefits include improvements | #4 |
testosterone replacement therapy (TRT) | increase | quality of life | aging males | - | Benefits include improvements | #5 |
testosterone replacement therapy (TRT) | increase | functional outcomes | orthopaedic surgery patients of both sexes | - | benefits could also include improvements | #6 |
testosterone replacement therapy (TRT) | increase | bone mineral density | orthopaedic surgery patients of both sexes | - | benefits could also include improvements | #7 |
testosterone replacement therapy (TRT) | increase | lean body mass | orthopaedic surgery patients of both sexes | - | benefits could also include improvements | #8 |
testosterone replacement therapy (TRT) | increase | early mobilization | orthopaedic surgery patients of both sexes | - | benefits could also include improvements | #9 |
vitamin D | increase | fracture healing | - | - | may benefit | #10 |
vitamin D | increase | bone metabolism | - | - | may benefit | #11 |
vitamin D | increase | muscle recovery | - | - | may benefit | #12 |
vitamin D | increase | healing of tendons and wounds | - | - | may benefit | #13 |
growth hormones (specifically BPC 157) | increase | endurance training | - | - | may optimize | #14 |
growth hormones (specifically BPC 157) | increase | metabolism | - | - | may optimize | #15 |
growth hormones (specifically BPC 157) | increase | tissue repair | - | - | may optimize | #16 |
growth hormones (specifically BPC 157) | increase | surgical recovery | - | - | may optimize | #17 |
Endocrinologists and family medicine physicians prescribe testosterone replacement therapy (TRT) for decreased levels of androgens in aging males. Benefits include improvements in mood, cognition, libido, energy, and quality of life. In orthopaedic surgery patients of both sexes, benefits could also include improvements in functional outcomes, bone mineral density, lean body mass, and early mobilization. A challenge is that patients may request supplementation with TRT and other supplements, including vitamin D (which may benefit fracture healing, bone metabolism, muscle recovery, and healing of tendons and wounds) and growth hormones (specifically BPC 157, which may optimize endurance training, metabolism, tissue repair, and surgical recovery). However, TRT and other supplements have risks and may not be indicated. TRT is not recommended for routine use in the perioperative management of orthopaedic surgery patients.