The study is observational which means the research is not conducted directly by the Martins’ team.

We are just monitoring a trial where the hormone is already being administered by other doctors for an unrelated condition. We are observing the associated effects on memory and amyloid production,” Professor Martins said.

Prior to starting the trial, the men agreed to have both a blood test and a memory test that was administered by the Alzheimer’s research team.

Further blood samples were then taken one month later and will continue every three months for 13 months. In the study, the testosterone is given in a cream form that is applied to the scrotum but it can also be taken orally, as an injection or as a patch that is applied to the skin. 

According to Professor  Martins, timing is of paramount importance in the management of Alzheimer’s.

 “We think it is probably too late once the disease has clearly manifested so we wanted to investigate whether administering testosterone early on would help improve memory,” he said. The Well Men Centre study subjects have been followed for four months so far. What the excitement is about is that the level of both LH and beta amyloid in the bloodstream – which are both linked with the development of Alzheimer’s – decreased after the subjects took testosterone. The other highly significant finding is that there has been universal improvement in certain aspects of learning and memory, such as the ability to remember word lists, after taking testosterone.  

It is still early days and there are only 25 in the study so far but Professor Martins describes the humans,” he said. A larger and more sophisticated Indonesian trial will be run by a student of Professor Martins who is doing a PhD in neurosurgery. It is a double blind trial which means neither the subjects nor those running the trial knows whether testosterone or a placebo cream is being given.

There are 46 men in the study who all claim to have memory problems and who all have low testosterone. Of the men, 23 receive testosterone for six months and 23 receive the placebo. This is followed by a break of four weeks which is known as the ‘wash-out period’ then the two groups are swapped over.  

Monitoring in the study is carried out via monthly blood samples and a sophisticated scan known as a magnetic resonance spectroscopy (MRS) image. The MRS provides a baseline measure by looking at overall brain structure but

it can also show functional changes in the chemistry of the brain which provide a measure of the health of the nerve cells. Neurons (nerve cells) normally release particular chemicals or metabolites and these metabolites change when the neurons are ‘sick’.

“It is a clever idea because it means the subjects become their own controls in the study,” Professor Martins explained. 

According to Professor Martins, the metabolites released from supporting cells called astroctyes are of particular interest to the research team because these cells become inflamed in Alzheimer’s. As with any drug though, there are potential side effects. There is a risk that if you have the hormone-sensitive kind of prostate cancer, testosterone will flare it up so subjects with an enlarged prostate gland or a high Prostate Specific Antigen (PSA) score are excluded from the Indonesian study.

The incidence of prostate cancer in men taking testosterone is very similar to the incidence in the general public – and they usually fare better because they are so closely monitored. Other factors such as obesity, exercise and diet also contribute to low testosterone levels. These levels can be increased and amyloid levels reduced by lowering fat intake, increasing physical activity and losing weight. Professor Martins’ researchers have shown that high HDL (the ‘good’ cholesterol) is associated with low amyloid production and it is thought that HDL may act as a clearing agent. 

What is of concern though, is that testosterone levels are dropping world-wide and no one knows why.

 “It may be as simple as the obesity epidemic and high-fat diets but it may be more complex than that. It is a concern for many reasons - and the incidence of Alzheimer’s is one,” he said. The destruction of the brain that occurs in Alzheimer’s disease steals identities, ruins lives and burdens economies but the world class research carried out by Professor Martins’ team is unravelling many pieces of the complex dementia puzzle.

 He was part of the group that first identified beta amyloid as the key culprit in Alzheimer’s disease 20 years ago and, more recently, the team that pioneered the work demonstrating the link between testosterone and amyloid levels in men with prostate cancer. Now, they may be in the verge of another breakthrough with testosterone, but Professor Martins remains cautious. “Testosterone is more attractive than anything else I know of so far because of its fascinating multifunction capabilities and the fact that it is already available on the market,” he said. “However it is early stage and we still need to show its real efficacy in a clinical trial. It looks very promising but it must be administered under medical supervision and people need to undergo the appropriate safety tests first otherwise they are playing with fire.”