Is Testosterone Dangerous?
We have all seen them by now – the commercials on TV by law firms warning us of the harms of testosterone therapy. You might even some of their ads on this site. (We thought of trying to block these ads, but we rather like taking money from lawyers, LOL). Is testosterone dangerous as these commercials and ads claim? And, should you be concerned if you or someone you know is receiving testosterone therapy?
In the short the answer is “no”. Keep in mind that testosterone therapy has been used for more than 70 years. It is not a new treatment – it just seems that way as it is becoming more popular. Over a 20 year period, testosterone deficiency is estimated to contribute to 1.3 million new cases of heart disease, 1.1 million new cases of diabetes, and 600,000 new cases of osteoporosis, and is associated with increased number of outpatient visits, higher outpatient costs, and higher death rates.
A vast vast majority of the medical literature suggests that testosterone therapy is safe and effective.
Two recent studies have linked testosterone therapy to increase risks of heart disease and stroke in men. The Vigen study was published in JAMA in November, 2013 and the Finkle study in PLoS One in 2014.
These two studies linking testosterone therapy to increase risks of heart disease in men were poorly designed and were retrospective. The Vigen study had conclusions contrary to what the actual raw data showed. The raw data actually showed that men receiving testosterone therapy had one-half the rate of heart disease as the men not receiving treatment. Plus, this all male study included nearly 10% women. OOPS! Obviously the patients were not actually examined or questioned by the researchers. This study has already gone through two post-publications revisions and 29 medical societies with expertise in testosterone therapy across the world have petitioned JAMA to retract the article.
The Finkle study simply culled health insurance data bases for rates of non-fatal heart attacks up to 90 days following a testosterone prescription. It’s not known if these prescriptions were actually filled, and the study did not have data on other traditional risk factors for heart disease. There were no data on testosterone levels post-treatment, either. Perhaps most importantly the study did not have a control group.
Problems with these recent studies have been highlighted and well articulated by the Androgen Study Group. This group is headed by Dr. Abraham Morgentaler, an urologist generally considered the foremost authority on testosterone therapy and men’s health.
For more detailed information on the flaws and weaknesses of these studies follow the below links.
- Androgen Study Group letter to JAMA asking for retraction of Vigen study.
- Androgen Study Group’s comments on petition by Public Citizen petition of FDA to issue black box warning for testosterone.
- Death by Testosterone? We Think Not!
Commentary: Is Testosterone Dangerous?
Prior to the Anabolic Steroid Act of 1990 which classified testosterone (a substance every man, woman, and child make) as a controlled substance, the use of testosterone was rather common being used to treat male depression, anemia, hereditary angioedema, and even as an adjunctive treatment for breast cancer. Following the passing of the Anabolic Steroid Act the medical use of testosterone significantly declined only to become more popular this past decade when the perceived and imagined risks were put to rest. Dr. Morgentaler in his ground-breaking research has debunked many of the myths surrounding testosterone (google his name to find the many studies he has published).
We’ve discussed the events surrounding the Anabolic Steroiod Act in Why is Testosterone a Controlled Substance? Read that article for a more detailed discussion surrounding the classification of a hormone naturally made by the body as a controlled substance. In short – Congress classified anabolic steroids as controlled substances against the opinions and recommendations of the AMA, FDA, and DEA. A small part of history few people know including today’s physicians.
Is testosterone dangerous? No! But, testosterone therapy needs to be monitored closely by a knowledgable physician familiar with the subtleties of such treatment. Unfortunately, most physicians simply give men prescriptions for testosterone and not monitor them as closely as they need to be. Some testosterone gets converted into estradiol and dihydrotestosterone (DHT) and those levels need to be measured periodically. In addition, it’s important to periodically measure PSA levels and hemoglobin and hematocrits. This close monitoring minimizes the risk adverse effects from treatment.
What’s really dangerous are flawed studies that get published, sensationalized by the media, and seized upon by attorneys to gin up frivolous lawsuits. Those actions deter men from receiving a treatment that improves quality of life, and decreases the risk of chronic disease – evidenced by nearly 70 years of well-conducted studies.
Let’s use some common sense!
Is testosterone dangerous? Would the human body naturally make s0mething that is dangerous to itself? Seems doubtful, doesn’t it?