I’ve written before about the dangers of “Low-T” treatments. Now, other publications are really starting to get the word out to the men who need to know.
The newest message? Testosterone therapy is not only unnecessary for many men, but it can actually cause heart attacks and strokes. It may even kill you.
In fact, as I was reading the June issue of American Legion Magazine (a frequent source of useful health information), I came across an article cautioning men considering testosterone therapy. The article notes that while the number of men using prescription testosterone gels or injections is increasing, so is evidence that these men are putting themselves at increased risk of cardiovascular disease.
The good news is that help is on the way, albeit from the last source you might expect: the government. That’s right—in June, the FDA announced that all FDA-approved testosterone products must carry a warning label about the risk of blood clots in the veins.1
This follows the January announcement that the FDA is investigating the risk of heart attacks, strokes, and death in men who take FDA-approved testosterone products.2
Amazingly, the FDA was quick to add that its warning about blood clots has nothing to do with its investigation into heart attacks and strokes.
That claim is mind-boggling. Blood clots are the final event causing heart attacks and strokes in people with cardiovascular disease. So if Low-T treatments increase the risk of blood clots, by definition, they also increase the risk of heart attacks and strokes.
This fact is Pathology 101 everywhere but among the medical “experts” at the FDA.
Fortunately, other influential groups are also raising concerns about Low-T. In February, the U.S. Endocrine Society released a statement calling for more clinical trials to investigate the risks of heart attacks and strokes in older men who take testosterone.3
This is the same group of experts that has questioned the use of statin drugs. Statins lower cholesterol, which is the building block of all hormones. Since testosterone is a hormone, one might well wonder whether the current epidemic of Low-T is at least partially a result of so many men taking statin drugs.
The Endocrine Society went so far as to say it would be prudent “not to administer testosterone therapy to men who have had a cardiovascular event in the preceding six months.”
What spurred this announcement? Two analyses and a recent six-year clinical trail of more than 1,200 men supported by the Veterans Affairs Administration found a higher rate of heart attacks and strokes in men with pre-existing heart problems who were given testosterone.4
In addition, a large study published in January reported that men 65 and older who took testosterone for just three months doubled their heart attack risk. 5
If that weren’t bad enough, other research shows that testosterone is a risk factor for prostate cancer. That’s why men with prostate cancer can end up having their testicles removed.6 Testosterone therapy has also been linked to enlarged prostate, shrunken testicles, and low sperm count or sterility. Even acne is a side effect—the same problem that occurs in adolescent males when they get their first surge of testosterone.7
As wave after wave of studies raise serious questions about testosterone therapy, a growing number of medical experts are concurring with my early warnings about the appropriateness and safety of Low-T treatments.
But guess who doesn’t agree? Big pharma.
Now that there are profitable drugs for treating Low-T, the obvious risks of testosterone are being questioned. Doctors who frequently prescribe testosterone are saying they feel insulted by the implication that they are in any way influenced by the relentless advertising that urges patients to talk to them about the “horrors” of Low-T.
But drug companies wouldn’t keep running those annoying advertisements, over and over again, if they weren’t working.
Don’t fall victim to the Low-T hype. Here’s what you need to know.
Less is more when it comes to Low-T treatments
The New Jersey state attorney general asked me to serve on a panel a couple of years ago to help revise the state regulations governing prescription testosterone treatments.
The AG’s goal was to save New Jersey taxpayers some money. It turns out that the state was paying over $2 million a year for testosterone treatments for public employees. This included thousands of healthy young men—police and firefighters—who in no way needed such treatments.
Still, doctors were prescribing them. Our panel investigated several physicians who were operating “testosterone mills,” prescribing treatments without appropriate clinical guidelines and without the appropriate clinical background and training to do so. Fortunately, with our help, state regulators were able to put a stop to these abuses.
Unfortunately, it can be more difficult to apply that approach in the private sector. True health care reform would consist of implementing the successful “less is more” philosophy by cutting out dangerous, inappropriate, and invasive therapies and replacing them with safer, effective, and more cost-effective natural approaches.
This is particularly true for testosterone therapy. But the anti-aging movement is a powerful combatant in the Low-T wars.
“Testosterone is currently enjoying a reputation for being the elixir of youth, and there is a whole group of men who have low testosterone because of aging,” said Bradley Anawalt, chair of the Endocrine Society’s Hormone Health Network, in Medscape Medical News. “And we just don’t know if they can benefit from testosterone.”
He pointed to the history of other hormone therapies, such as estrogen-replacement therapy. The serious risks of estrogen therapy became clear only after thousands of women took it for decades. Do we really want history to repeat itself?
The Endocrine Society published a study in January reporting that the number of men beginning testosterone therapy in the U.S. has almost quadrupled since 2000. Even though many of these men don’t have any actual medical reason for Low-T treatments.8
And shortly afterwards, the New York Times printed an editorial stating, “Too many doctors are now writing testosterone prescriptions without even measuring the patient’s hormone levels, much less re-testing for confirmation and adjusting the dose after prescription.” 9
Hmmm…seems like those big pharma ads are having some influence after all.
Modern-day Ponce de Leons risking their lives for that mythical Fountain of Youth
The question of who should even receive testosterone therapy remains controversial. I fear far too many men don’t actually have truly troubling symptoms, but instead are just having trouble accepting the fact that they are getting older. And treatments for Low-T are really becoming just another entry on the sad list of dangerous “anti-aging” remedies.
The fact is, there is not enough long-term data to accurately assess the risks of continuing on this treatment.10
Case in point: One recent study looked at men age 65 or older with low testosterone. The researchers found that the men who were given testosterone treatments had more heart and blood vessel problems than the men who didn’t get the treatments.11
The study actually had to be discontinued because researchers were worried about how dangerous the Low-T therapy proved to be.
The bottom line?
We should stop fixating on “hormone replacement” by artificial methods. Men don’t need to use dangerous patches and gels to replace waning testosterone.
In fact, by doing so, they are actually messing with Mother Nature.
You see, while higher testosterone at younger ages is important for procreation,
losing testosterone after the typical age of reproduction probably helps men survive longer by lowering their risk of cardiovascular diseases and prostate cancer—the most common “old age” diseases in men.
It’s interesting to note that while the average lifespan continues to increase, there have historically always been some men who have outlived their brethren. So perhaps Low-T in older men is a biological adaption resulting from natural selection.
Of course, that doesn’t mean you can’t and shouldn’t look at ways to support the body’s natural youthfulness. When you do that, natural testosterone production in men stays stronger, longer.
The effects on the body and normal metabolic balance caused by any drug treatment are always different than when the body is supported naturally with nutrients to produce what it needs in a balanced manner. This distinction is especially critical when it comes to hormonal balance.
Taking any hormone drug is playing with fire. Whether it’s corticosteroids for suppressing the normal immune system, or hormones for their effects on disrupting normal metabolic balance, or testosterone for “anti-aging.” All of these suppress normal, natural hormone production and disrupt metabolic balance.
For men, eating right with adequate protein…keeping up with regular, light-to-moderate exercise…maintaining lean muscle…and getting plenty of sleep can help support natural testosterone levels. This approach just makes sense. And you will help keep your testosterone at the right, natural level.
Plus, a study last year showed that a combination of South African red bush and simple dandelion supports testicular cells in lab animals to naturally make more of their own testosterone.12
And men who took this same red bush-dandelion supplement for only two to three months enjoyed notably increased physical strength and performance—including marked improvements in walking ability, which is strongly linked to increased longevity.
That’s not anti-aging; that’s just healthy aging.
Put your testosterone to the test
Low testosterone levels can cause fatigue and reduced sex drive. But so can depression, poor relationships, unbalanced diets, or lack of regular exercise or sleep.
To determine if Low-T is really the culprit behind your symptoms, you must have your testosterone levels measured by a qualified specialist in internal medicine or endocrinology and metabolism. And remember that measurements are most accurate between 7 and 10 am. Don’t let them schedule you for a later appointment.
Even if tests show that your testosterone levels are substandard, Low-T treatments may not be appropriate if you are at high risk for prostate cancer, have severe urinary symptoms or prostate enlargement, have had a heart attack or stroke, or have multiple risk factors for heart disease.
If you do opt for testosterone therapy, be sure to follow up with tests to see whether the treatments are having an effect. Your doctor will also need to pay particular attention to your heart, cardiovascular, and prostate health.
1 U.S. Food and Drug Administration. FDA adding general warning to testosterone products about potential for venous bloodclots. http://www.fda.gov/Drugs/DrugSafety/ucm401746.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery. Accessed June 23, 2014.
2U.S. Food and Drug Administration. FDA Drug Safety Communication: FDA evaluating risk of stroke, heart attack and death with FDA-approved testosterone products. http://www.fda.gov/Drugs/DrugSafety/ucm383904.htm. Accessed June 11, 2014.
3 Endocrine Society. Endocrine Society Calls for Large-Scale Studies to Evaluate Testosterone Therapy Risks. https://www.endocrine.org/news-room/current-press-releases/endocrine-society-calls-for-large-scale-studies-to-evaluate-testosterone-therapy-risks. Accessed June 11, 2014.
4 Vigen R, et al. Association of Testosterone Therapy With Mortality, Myocardial Infarction, and Stroke in Men With Low Testosterone Levels. JAMA. 2013;310(17):1829-1836. doi:10.1001/jama.2013.280386.
5 Finkle WD, et al. Increased Risk of Non-Fatal Myocardial Infarction Following Testosterone Therapy Prescription in Men. PLoS One. 2014 Jan 29;9(1):e85805. doi: 10.1371/journal.pone.0085805. eCollection 2014.
6 National Cancer Institute. Hormone Therapy for Prostate Cancer. http://www.cancer.gov/cancertopics/factsheet/Therapy/hormone-therapy-prostate. Accessed June 11, 2014.
7 Cleveland Clinic. Testosterone Replacement Therapy. http://my.clevelandclinic.org/services/testosterone_replacement_therapy/hic_testosterone_replacement_therapy.aspx. Accessed June 11, 2014.
8 Layton JB, et al. Testosterone lab testing and initiation in the United kingdom and the United States, 2000 to 2011.J Clin Endocrinol Metab. 2014 Mar;99(3):835-42. doi: 10.1210/jc.2013-3570. Epub 2014 Jan 1.
9 New York Times. “Don’t Ask Your Doctor About ‘Low T.’” http://www.nytimes.com/2014/02/04/opinion/dont-ask-your-doctor-about-low-t.html?_r=0. Accessed June 11, 2014.
10 Cappola A. Testosterone Therapy and Risk of Cardiovascular Disease in Men. JAMA. 2013;310(17):1805-1806. doi:10.1001/jama.2013.280387.
11 Sugerman DT. JAMA patient page. Low testosterone. JAMA. 2013 Nov 6;310(17):1872. doi: 10.1001/jama.2013.280724.
12 Noh YH, et al. Improvement of andropause symptoms by dandelion and rooibos extract complex CRS-10 in aging male. Nutr Res Pract 2012; 6(6): 505–512.