Hypogonadism Clinical Trial
— ARMOROfficial title:
Musculoskeletal Resiliency and Adaptation to Sex Steroid Suppression and Replacement During Multi-Stressor Training
Non-combat-related muscle, tendon and bone injuries are the most common injuries suffered by military personnel, particularly in new recruits. These injuries impact military readiness and are responsible for roughly 60% of limited duty days, 65% of soldiers who are unable to deploy, and nearly $500 million in medical cost to the government annually in the Army alone. Drug interventions must be studied and developed to prevent these negative outcomes and prepare military personnel for the demands of military service. At the current time, military leadership has identified critical gaps in understanding how to minimize these injuries and train soldiers with drug intervention serving among those gaps. The goal of this study is to determine how a hormonal intervention can change muscle, tendon, and bone function as well as physical and psychological performance in response to mental and physical stress. To do so, we will examine sex hormone (testosterone, estrogen) levels, muscle, tendon, and bone images, blood samples, and physical and mental performance. We will look at things like changes in hormone levels, chemicals released from active skeletal muscles, and your body composition. The results from this study will be used to improve physical readiness training in the military with the goal of reducing injuries.
Status | Not yet recruiting |
Enrollment | 120 |
Est. completion date | August 1, 2026 |
Est. primary completion date | August 1, 2026 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years to 40 Years |
Eligibility | Inclusion Criteria: 1. Age 18-40 years 2. body mass index (BMI) 18-30 kg/m2 3. weight stable (±10 lbs) in past 2 months 4. takes part in moderate physical activity for at least 150 minutes/week 5. currently free of upper or lower body /extremity injury or impairment 6. able to commit to study duration 7. agrees to adhere to study requirements 8. not taking prescription medications or be willing to refrain from medication prior to and throughout the study period, unless approved by study physician 9. in men, total testosterone concentration within normal physiological range (300-1000 ng/dL) 10. in women, eumenorrheic (cycles of 26-35 days) and not using hormonal contraceptives for previous 3 months Exclusion Criteria: 1. Current smoker 2. current clinical diagnosis of an eating disorder 3. use of medication incompatible with measurement of reproductive and metabolic hormones or which may interfere with any of the study outcomes 4. current oligo/amenorrhea in women 5. any metabolic or endocrine disease 6. has been diagnosed with a medical condition, physical or psychological, that currently prevents potential subjects from exercising 7. currently pregnant or becomes pregnant during the study 8. history of heart condition OR high blood pressure 9. treating physician requires subject participates in medically supervised physical activity only 10. history of drug addiction, or regular use of recreational drugs 11. currently undergoing treatment for or have a history of mental health conditions 12. irregular lab results (e.g., PSA >3 ng/mL) 13. Current diagnoses of disorders known to affect bone metabolism including hyperthyroidism, hyperparathyroidism, osteomalacia, Cushing's, diabetes mellitus or renal insufficiency 14. Current use of medications known to affect bone metabolism including estrogens, androgens, anti-estrogens, bisphosphonates (oral bisphosphonates within one year of the baseline visit or IV bisphosphonates within three years of the baseline visit), calcitonin, fluoride, oral or inhaled glucocorticoids, suppressive doses of thyroxine, lithium, pharmacological doses of vitamin D (greater than 2000 IU/day), anti-convulsants, depot medroxyprogesterone within 6 months. 15. History of deep vein thrombosis, pulmonary embolism, or clotting disorders. 16. History of stroke or myocardial infarction 17. Serum 25-hydroxyvitamin D < 20 ng/mL 18. Thyroid dysfunction 19. Serum creatinine > 2 mg/dL 20. Personal history or history of a first-degree relative with breast cancer 21. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) > 2x the upper limit of normal 22. Serum bilirubin > 2 mg/dL 23. Serum alkaline phosphatase > 150 U/L 24. Plasma hemoglobin < 10 gm/dL 25. Hematocrit > 50 26. Fracture within the last 6 months. 27. Serum testosterone level < 270 or > 1070 ng/dL 28. Systolic blood pressure > 160 or diastolic blood pressure > 95 29. Active substance abuse 30. Triglycerides > 150 fasting 31. History of hereditary angioedema 32. History of chest pain at rest, during daily activities of living, or when performing physical activity 33. Musculoskeletal injury removing subject from physical activity for more than a month within the past 2 years 34. Recreational drug use more than 2 times per month in each of the previous 6 months 35. Self-reported vision is worse than 20/20. 36. Personal history or history of a first-degree relative with breast cancer 37. Experienced a fracture within the last 6 months 38. participated and taken investigational drug in any other clinical trial (including bioequivalence study) within six months prior to study drug administration 39. Diagnosed with eating disorder 40. Have food allergies, intolerance, restriction, or special diet needs 41. History of endometriosis 42. Current diagnosis of reproductive health issues, such as ovarian cysts, PCOS, pelvic lesions, undiagnosed ovarian enlargement 43. Have undiagnosed abnormal vaginal bleeding 44. Currently breastfeeding or within 2 months after stopping breastfeeding 45. Have dietary restrictions |
Country | Name | City | State |
---|---|---|---|
United States | Neuromuscular Research Laboratory | Pittsburgh | Pennsylvania |
Lead Sponsor | Collaborator |
---|---|
Bradley Nindl | U.S. Army Medical Research and Development Command |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Biomechanical: Tendon Cross-Sectional Area, change from baseline and throughout training, mean | Through study completion, an average of 8 weeks | ||
Primary | Biomechanical: Tendon Shear Wave Elastography, change from baseline and throughout training, mean | Through study completion, an average of 8 weeks | ||
Primary | Biomechanical: Tendon Thickness, change from baseline and throughout training, mean | Through study completion, an average of 8 weeks | ||
Primary | Biomechanical: Quadriceps Muscle Cross-sectional Area, change from baseline and throughout training, mean | Through study completion, an average of 8 weeks | ||
Primary | Biomechanical: Quadricpes Muscle Echointensity, change from baseline and throughout training, mean | Through study completion, an average of 8 weeks | ||
Primary | Body composition: Lean mass, change from baseline, mean | Through study completion, an average of 8 weeks | ||
Primary | Body Composition: Fat mass, change from baseline, mean | Through study completion, an average of 8 weeks | ||
Primary | Body Composition: Body mass, change from baseline and throughout training, mean | Through study completion, an average of 8 weeks | ||
Primary | Body Composition: Body Fat Percentage, change from baseline, mean | Through study completion, an average of 8 weeks | ||
Primary | Biochemical: Bone turnover markers (CTx + P1NP), change from baseline, mean | Through study completion, an average of 8 weeks | ||
Primary | Biochemical: Sex steroid hormones (Testosterone, Sex Hormone Binding Globulin, Estradiol), change from baseline and throughout training, mean | Through study completion, an average of 8 weeks | ||
Secondary | Bone microarchitecture: High Resolution- peripheral Computed Tomography, change from baseline, mean | Through study completion, an average of 8 weeks | ||
Secondary | Biochemical: Cell culture, extracellular vesicles, micro- RNAs, change from baseline and throughout study, mean | Through study completion, an average of 8 weeks | ||
Secondary | Biochemical: Measures of inflammation (IL6, IL-1B, TNFa, CRP), change from baseline and throughout study, mean | Through study completion, an average of 8 weeks | ||
Secondary | Biochemical: Measures of anabolism (Growth Hormone, Insulin-like growth factor-1), change from baseline and throughout study, mean | Through study completion, an average of 8 weeks |
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