Vitamin D and testosterone in healthy men: A randomized controlled trial

Abstract

Context: Available evidence shows an association of vitamin D with androgen levels in men. However, results from preliminary randomized controlled trials (RCTs) are conflicting. Objective: To evaluate whether vitamin D supplementation increases total testosterone (TT) levels in healthy men. Design: The Graz Vitamin D&TT-RCT is a single-center, double-blind, randomized, placebo-controlled trial conducted between December 2012 and January 2017. Setting: Endocrine outpatient clinic at the Medical University of Graz, Austria. Participants: Ninety-eight healthy men with TT levels $10.4 nmol/L and 25-hydroxyvitamin D [25(OH)D] levels,75 nmol/L completed the study. Intervention: Subjects were randomly assigned to receive 20,000 IU/wk of vitamin D3 (n = 50) or placebo (n = 50) for 12 weeks. Main Outcome Measures: Primary outcome was TT measured using mass spectrometry. Secondary outcomes were free testosterone, sex hormone-binding globulin, estradiol, follicle-stimulating hormone, and luteinizing hormone levels; free androgen index; metabolic characteristics; and body composition. Results: In healthy men [mean values 6 standard deviation: age, 39 years (613 years); 25(OH)D level, 53.3 nmol/L (618.3 nmol/L); TT, 19.1 nmol/L (65.6 nmol/l)], no significant treatment effect on TT was found; however, there were significant effects on quantitative insulin sensitivity check index (QUICKI) and a trend toward decreased Matsuda index. In the treatment group, median (interquartile range) changes for TT, QUICKI, and Matsuda index were 0.5 nmol/L (20.63 to 0.63 nmol/L; P = 0.497), 20.02 (20.04 to 0.01; P = 0.034), and 20.9 (23.2 to 0.8; P = 0.051), respectively. Conclusion: Vitamin D treatment had no effect on TT levels in middle-aged healthy men with normal baseline TT, but it significantly decreased QUICKI. Additional studies investigating vitamin D effects on TT and insulin sensitivity in healthy men are required.