Effect of reversible androgen deprivation on hemoglobin and serum immunoreactive erythropoietin in men

To examine the role of testosterone in the maintenance of hemoglobin levels, we studied the effect of reversible androgen deprivation on hemoglobin, serum immunoreactive erythropoietin, and serum testosterone in seven men treated with a luteinizing hormone‐releasing factor (LHRH) agonist for 6 months and then followed for an additional 6 months. The mean serum testosterone level was 4.35 ± 1.05 ng/ml initially and it decreased to castrate levels in all patients by 6 months. After stopping therapy, there was a rapid increase in serum testosterone such that by 12 months the mean concentration was normal. The pretreatment hemoglobin was 15.2 ± 0.9 g/dl (mean ± SD); after 6 months of androgen deprivation it had fallen to 14.1 ± 0.4 g/dl (P < 0.05). Six months after stopping therapy, the hemoglobin rose to pre‐treatment levels. Before treatment, serum immunoreactive erythropoietin was 9.5 ± 4.6 mu/ml (mean ± SD) and did not change significantly during or after the 6 month period of androgen deprivation. No significant inhibition of burst‐forming unit‐erythroid (BFU‐E) or colony‐forming unit‐granulocyte macrophage (CFU‐GM) was observed at the serum levels of nafarelin acetate obtainable in vivo. These data suggest that, within the normal range of hemoglobin in men, androgens are a determinant of the red cell mass.