RECENT Testosterone Gel/Cream/Patch Warnings and Side Effects
Testosterone therapy is in the news again (see my previous posts under the ALL LABELS) tab. I was on Androgel 1.62% for a short time about two years ago and am thankful that I had several immediate side effects that caused me to go off that therapy. The recent news is disturbing and involves apparently several lawsuits by individuals experiencing serious side effects. Recent side effects now includes heart attack and stroke among others. Dan When you are young and healthy, it never occurs to you that in a single second your whole life could change.
Testosterone Therapy May Actually Increase Your Risk of Stroke, Heart Attack and Death
By Dr. Mercola
While primarily associated with the notion of “manhood” and the attributes this word conjures up, the androgenic sex hormone testosterone plays an important role in a man’s health and well being over and beyond those related to sexual prowess.
For example, testosterone helps your body maintain muscle mass, bone density, optimal lipid profiles and levels of red blood cells, and can impart a general sense of vigor and “youthfulness.”
Around the age of 30, testosterone levels begin to decline. Symptoms of declining testosterone levels in men include decreased sex drive, erectile dysfunction, depression, poor concentration and impaired memory. Men with low testosterone levels may also experience weight gain, breast enlargement, and problems urinating.
Conventional treatment for low testosterone revolves around synthetic testosterone hormone replacement therapy, using either a testosterone cream, gel or patch.
However, recent research1 has raised a red flag, warning men that testosterone therapy may increase your risk of dying from a sudden stroke or heart attack. The study in question does have limitations however, and more research is likely needed before any definitive conclusions can be drawn.
That said, I believe it’s worth noting that there’s almost always going to be a significant difference between taking a synthetic hormone versus encouraging your body to produce more of a hormone naturally. I personally do not believe the risks are in any way comparable between these two strategies—both of which I’ll address below.
Are Men Putting Themselves at Risk by Misusing Testosterone?
I know first-hand that low testosterone is not an automatic outcome of aging, provided you incorporate certain lifestyle strategies that can naturally boost your testosterone levels.
Moreover, I firmly believe that naturally boosting your body’s production of testosterone (and other hormones) through lifestyle strategies such as exercise and diet will not be as likely to have negative impacts on your heart or longevity. On the contrary, these strategies are part and parcel of an overall healthy lifestyle, so they also automatically reduce your risk of most chronic disease, including heart- and cardiovascular disease.
Unfortunately, many men who feel they’ve “lost the spring in their step” opt for the quick and easy route of hormone replacement therapy. Data from the US Food and Drug Administration (FDA) shows annual prescription rates for testosterone have increased more than five-fold between 2000 and 20112,3. An estimated 5.3 million testosterone prescriptions were written in 2011.
This dramatic increase is causing researchers to question whether men may be abusing the hormone,4,5,6 as professional guidelines only recommend testosterone replacement therapy for men who have symptomatic testosterone deficiency.
According to the Endocrine Society, which is responsible for setting the clinical guidelines for testosterone replacement therapy, testosterone should only be given to men with persistent symptoms and “unequivocally low testosterone levels,” a condition known as hypogonadism. To determine this, you have to actually test your testosterone level, which is done with a blood test—ideally more than once, as your testosterone level can rise and fall during each day. Recent findings7indicate that 25 percent of men given a prescription for testosterone did not have their levels tested prior to receiving a prescription, and of the remaining 75 percent, it was unclear as to how many actually had a testosterone deficiency.
Testosterone Therapy May Increase Mortality, Study Says
The featured study,8 published in JAMA, noted that “a recent randomized clinical trial of testosterone therapy in men with a high prevalence of cardiovascular diseases was stopped prematurely due to adverse cardiovascular events.” To further assess this potential link between testosterone therapy and heart attack, stroke and all-cause mortality, the researchers looked at more than 8700 men who underwent a coronary angiography9 (a test that checks for blocked arteries). They wanted to determine whether having underlying coronary artery disease might modify the outcome in men taking testosterone.
Perhaps it’s just more risky to take testosterone if you already have heart disease? That did not turn out to be the case, overall... All of the participants had a total testosterone level of less than 300 ng/dL. Of the 1,223 patients who started testosterone therapy after their coronary angiography, nearly 26 percent of them suffered an adverse event (stroke, heart attack and/or death) within three years. In the group that did not take testosterone, less than 20 percent had an adverse event.
After adjusting for other differences between the groups, testosterone use was associated with a 29 percent increased risk for an adverse event—regardless of whether they had underlying coronary heart disease or not. The authors concluded that:
“Among a cohort of men in the VA health care system who underwent coronary angiography and had a low serum testosterone level, the use of testosterone therapy was associated with increased risk of adverse outcomes. These findings may inform the discussion about the potential risks of testosterone therapy.”
Other research10 published earlier this year found that testosterone replacement therapy did not appear to have any positive effects on the cardiovascular health of men who took it, noting that the “cardiovascular risk-benefit profile of testosterone therapy remains largely evasive.” Interestingly, the analysis does suggest that low testosterone and heart disease might both be caused by “poor overall health,” as stated by lead researcher, Dr. Johannes Ruige.11 This, again, is why I recommend focusing your efforts on healthy lifestyle strategies such as exercise rather than taking synthetic hormone replacement, the risk/benefit ratio of which is still largely unknown...