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Observational registry studies suggest that long-term testosterone therapy in hypogonadal men may be associated with favorable changes in weight and metabolic markers [22,23]

Red flag symptoms requiring urgent assessment include: Severe abdominal pain or distension that is progressive or unrelieved Nausea and vomiting, particularly if unable to tolerate oral intake Inability to pass gas or persistent vomiting (possible signs of obstruction) Rectal bleeding or black, tarry stools suggesting gastrointestinal bleeding Unintentional weight loss beyond expected therapeutic effects Fever accompanying constipation, which may indicate infection or inflammation Signs of dehydration (extreme thirst, dry mouth, dizziness, dark urine) Patients with pre-existing gastrointestinal conditionsincluding inflammatory bowel disease, previous bowel obstruction, or diverticular diseaseshould have lower thresholds for seeking medical advice

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It is worthy to note that cardiovascular disease and kidney disease are closely interrelated [80] and diminished renal function is strongly associated with morbidity and mortality in heart failure patients [81]