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Study on Testosterone Undecanoate for Muscle Strength and Mass in Men with Obesity and Low Testosterone Undergoing Bariatric Surgery

Registered drugNo placebo
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What is this trial about?

A plain-language summary of the goals, design and what participants do

This clinical trial is focused on studying the effects of testosterone replacement therapy in men who have undergone bariatric surgery, which is a type of surgery to help with weight loss. The study is particularly interested in men with two conditions: obesity and male hypogonadism. Male hypogonadism is a condition where the body does not produce enough testosterone, a hormone important for male development and health. The treatment being tested is called testosterone undecanoate, which is given as a solution for injection known as Nebido. Some participants will receive this treatment, while others will receive a placebo, which looks like the treatment but does not contain the active substance.

The purpose of the study is to explore how testosterone therapy, combined with exercise and diet counseling, affects muscle strength and mass in men who have had bariatric surgery. Participants will be randomly assigned to receive either the testosterone treatment or a placebo. The study is designed to be double-blinded, meaning neither the participants nor the researchers will know who is receiving the actual treatment or the placebo. This helps ensure that the results are not influenced by expectations or bias.

Throughout the study, participants will be monitored for changes in muscle strength, body composition, and physical function. This includes tests like measuring muscle strength in different parts of the body and assessing physical performance through activities such as stair climbing. The study will also look at other health indicators, such as glucose metabolism, which is how the body processes sugar, and blood clotting factors. The trial is expected to continue until early 2026, providing valuable insights into the potential benefits of testosterone therapy for men with obesity and low testosterone levels following weight loss surgery.

The research process

The trial runs in 6 steps – from screening to follow-up. Each step says what happens and what the team monitors.

  1. Step 1

    Joining the study

    Upon joining the study, participants are randomly assigned to receive either the active medication or a placebo. This process is double-blinded, meaning neither the participant nor the researchers know which treatment is being administered.

  2. Step 2

    Medication administration

    Participants receive an intramuscular injection of either testosterone undecanoate or a placebo. The active medication is administered as a 1000 mg solution for injection, known as Nebido. The placebo is an oily solution similar in appearance to the testosterone solution.

  3. Step 3

    Treatment schedule

    The injections are given at regular intervals throughout the study period. The exact frequency and duration of the treatment are determined by the study protocol and communicated to participants during the trial.

  4. Step 4

    Monitoring and assessments

    Participants undergo regular assessments to monitor muscle strength and body composition. These assessments include tests for maximal isometric muscle strength in the shoulder and lower extremities, as well as performance-based measures like a stair climb test and maximal oxygen uptake (VO2max).

    Additional evaluations include glucose metabolism tests and coagulation status assessments.

  5. Step 5

    Diet and exercise counseling

    Throughout the trial, participants receive counseling on diet and exercise to support their overall health and the study's objectives.

  6. Step 6

    Completion of the study

    The study is estimated to conclude by January 1, 2026. Upon completion, participants may receive information about the treatment they received and the overall findings of the study.

Who can join the trial?

4 criteria

  • Must be eligible for **bariatric surgery** according to Danish national criteria. This means being between 18 and 60 years old, having a **BMI** (Body Mass Index) over 35 with a specific secondary disease, or a BMI over 40 with significant health issues as assessed by a specialized team.
  • Must be a Caucasian man.
  • Must have a **total testosterone** level below 12.0 nmol/l. Testosterone is a hormone important for male health.
  • Must have no **contraindications** for testosterone treatment. This means there should be no medical reasons that would make testosterone treatment unsafe for you.

Who cannot join the trial?

5 criteria

  • Individuals who are not men cannot participate in the study.
  • Participants must be adults, as the study does not include children or teenagers.
  • Individuals who are not undergoing **bariatric surgery** cannot participate. Bariatric surgery is a type of surgery that helps with weight loss by making changes to the digestive system.
  • Participants must have **hypogonadism**, a condition where the body doesn't produce enough testosterone, a male hormone.
  • Individuals who are not willing to follow the exercise and diet counseling provided in the study cannot participate.
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Investigated drugs

  • Testosterone Replacement Therapy

    is being studied to see if it can help improve muscle strength and mass in men who have low testosterone levels and are undergoing bariatric surgery. This therapy involves giving testosterone to help bring hormone levels back to normal, which might support better muscle health and overall well-being.

  • Exercise and Diet Counselling

    is also part of the study. Participants receive guidance on physical activities and healthy eating habits. The goal is to see if combining these lifestyle changes with testosterone therapy can further enhance muscle strength and mass after surgery.

What is already known about the treatment

Testosterone – Testosterone is administered as an injection, patch, gel, or tablet, depending on the specific formulation. It is currently well-established in medical literature as a treatment for male hypogonadism, a condition characterized by low testosterone levels. The main therapeutic indication for testosterone is to restore normal testosterone levels in men with hypogonadism, which can help improve muscle mass, strength, and overall well-being. At the molecular level, testosterone works by binding to androgen receptors, influencing the expression of genes involved in male sexual development and maintenance. It is classified as an androgen and anabolic steroid.

Investigated diseases

  • Obesity

    Obesity is a condition characterized by excessive body fat accumulation that may impair health. It is typically measured using the Body Mass Index (BMI), where a BMI of 30 or higher is considered obese. The progression of obesity can lead to increased risk of various health issues, including heart disease, diabetes, and joint problems. It often results from a combination of genetic, behavioral, and environmental factors. Over time, obesity can lead to complications such as metabolic syndrome and increased inflammation in the body. Lifestyle changes, including diet and exercise, are commonly recommended to manage this condition.

  • Male Hypogonadism

    Male hypogonadism is a condition where the body does not produce enough testosterone, the hormone responsible for male physical characteristics and reproductive function. It can be caused by problems in the testicles or the pituitary gland that controls them. Symptoms may include reduced libido, fatigue, decreased muscle mass, and mood changes. The condition can develop at any age, but its effects vary depending on when it occurs. In adolescents, it may delay puberty, while in adults, it can lead to infertility and decreased bone density. The progression of hypogonadism can affect overall health and quality of life.

Trial detailsLast updated 2 Oct 2026
Age18+ yearsPhasePhase IIITrial ID2024-517015-73-00Estimated enrolment64 patientsSponsorEsbjerg Og Grindsted Sygehus

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