Muscle wasting, or the loss of lean body mass, occurs for a variety of reasons. For certain patient populations, testosterone therapy offers an opportunity to regain muscle mass and strength. After medical research demonstrated correlations between changes in testosterone levels and muscle strength, physicians began using testosterone as treatment for patients with severe muscle loss.  As a result of this testosterone therapy, numerous patients experienced improvements in muscle mass and strength.

arm muscle wasting

Example of Muscle Wasting


Muscle Wasting & Testosterone Therapy

There are multiple mechanisms by which testosterone helps build muscle. Perhaps the most direct influence testosterone has on the muscular system is through its binding to skeletal muscle cell receptors and stimulating synthesis of the protein that forms muscle. Testosterone also plays an important role in muscle genesis by recruiting stem cells to develop into muscle cells, thereby increasing lean body mass.


Muscle Wasting from Aging

As we get older, our production of sex hormones, including testosterone, tends to decrease. Muscle begin to deteriorate and our overall physiology begins to change and many causes can be attributed to this. Additionally, our tissues often become less sensitive to these hormones. The combination of these changes can result in our failure to experience effects of sex hormones. Because one important effect of sex hormones is muscle production, loss of sex hormone efficacy often leads to muscle wasting. As muscle wasting can occur from a reduction in testosterone, it is perhaps not surprising that testosterone administration tends to increase muscle mass and strength in older individuals with reduced serum testosterone levels. By simply replacing a hormone they are running out of, these older individuals can prevent unwanted changes that may accompany aging.

Dr. Olivieri emphasizes that as an elderly person you receive treatment for muscle wasting only from an experience testosterone therapy clinician. There are many vast different in treating male muscle wasting and female muscle wasting.


Type 2 Diabetes Mellitus

Testosterone deficiency is often observed in patients with Type 2 Diabetes Mellitus (T2DM) and is particularly prevalent in male patients.  Reduced levels of testosterone are associated with insulin resistance, a hallmark of T2DM. The majority of the body’s insulin sensitivity is accounted for by skeletal muscle, and it is thus possible that low testosterone levels contribute to the insulin resistance observed in T2DM. Therefore, while testosterone replacement therapy can reduce muscle wasting (a symptom of diabetes), it has also been shown to improve insulin sensitivity (a cause of diabetes) and glucose control in these patients.

Many lifestyle changes can greatly impact the treating of diabetes such as diet and exercise. The addition of testosterone therapy can greatly aid the recovery process but must be monitor closely by adequate doctors.

Another mechanism by which testosterone therapy may improve muscle wasting in diabetic patients has recently been revealed; cellular activation of a protein called NFkB is sufficient for skeletal muscle atrophy. In T2DM, signaling pathways involving this protein are altered. As testosterone is associated with decreased NFkB activation, its administration may help prevent muscle wasting through inhibition of this specific pathway. Thus, in this population, the benefits of testosterone therapy are multifold.

testosterone-replacement-therapy for overweight diabetics

A diabetic patient can sometimes suffer from being overweight or possible obese. While a direct correlation of testosterone levels has not been tied to body weight there is a strong causation in the effects increased testosterone provides. Many patients adhere to diet and exercise routines because of increase energy and mood.

Contact Dr. Joseph Olivieri, MD, FAAFP for a free medical consultation to speak about your diabetes concerns or to schedule a testosterone test with Dr. Olivieri, please call us at 212-510-7020 or send an email to


Muscle Wasting and Human Immunodeficiency Virus (HIV)

Dr. Joseph Olivieri has over 4 decades experience and specializes in treating the HIV virus with testosterone replacement therapy.

In patients with HIV, muscle wasting often occurs as a result of excessive break down of the protein comprising muscle. Our bodies normally break down ingested molecules for energy. However, in a weakened state, the rate of our protein break down often increases because protein is easier to break down than fat. Patients with HIV sometimes experience organ damage and immune cell destruction. These patients may also excessively break down protein to aid in organ repair and immune cell replacement. In this set of patients, muscle mass loss and decreased exercise capacity are associated with lower testosterone levels. A recent assessment of several studies evaluating the effects of testosterone therapy on muscle wasting in HIV patients determined that testosterone administration significantly increases muscle mass and strength in these patients. Specifically, whereas oral testosterone administration increased muscle mass and strength in these studies, intra-muscular injections of testosterone increased these muscle properties at an even higher rate. Thus, testosterone therapy has a demonstrated efficacy in HIV patients.

Understand Your Testosterone Therapy Options

Dr. Joseph Olivieri, MD, FAAFP has over 4 decades of experience as a physician and commonly performs testosterone tests for Ageonics Medical. He has served as a Staff Virology Physician at NYU Medical Center and was the HIV Medical Director at the Greenwich House.

For a free medical consultation or to schedule a testosterone test with Dr. Olivieri, please call us at 212-510-7020 or send an email to