Behind the Headlines
You've probably seen the headlines that say something along the lines of: "FDA Declares Testosterone Therapy Unsafe" or "Testosterone Therapy Causes Heart Disease."
"Crap," you thought, "I've been wanting to try testosterone replacement therapy, but I don't want to die!" Well, according to the real research, you won't. In fact, healthy testosterone levels are actually associated with improved health overall.
So if you're thinking you're suffering from low T and want to do something about it, read on, and then go see a good doc.
1 – High T Leads to Prostate Cancer
About sixty years ago, in a galaxy known as the baby boomer 1950s, men with metastatic prostate cancer were given drugs that lowered testosterone, and their cancer got better. Thus, it was thought that higher levels of testosterone meant higher risk of prostate issues.
"No one has found additional evidence to support (the above) theory," notes Dr. Abraham Morgentaler, an associate professor of surgery at Harvard Medical School and the director of Men's Health Boston.
As he explains, several small-scale studies on T therapy showed a small increase in prostate cancer rates, BUT that rate was at about 1 percent per year – the same rate as expected with men of the same age not using T therapy.
Logically, risk of prostate cancer increases with age. At the same time, T levels fall. Thus, the two are inversely correlated. So, as T levels go down, prostate cancer risk goes up. Not the other way around. However, if you already have prostate cancer, T therapy isn't recommended.
2 – Testosterone Therapy Increases Heart Disease Risk
Older studies on testosterone replacement therapy showed an increased risk in death and heart disease as well as higher heart attack risk, respectively, in men with heart disease (coronary artery disease) who took T therapy.
There were problems with the older studies. For example, the dudes in the older studies already had things like subclinical heart disease, diabetes, and high blood pressure.
More recent studies have contradicted the previous findings. Some even point to T therapy reducing the risk of heart disease. One academic review cited several different studies that showed that death from heart diseases is strongly linked to T levels, meaning LOWER T levels lead to higher risk of dying from heart diseases.
This is because low T is a risk factor for things like obesity, insulin resistance, and high blood sugar, all of which increase your risk for atherosclerosis (hardening of your arteries... which is bad).
Many studies have shown that T therapy improves things like total LDL ("bad" cholesterol) and overall lipid profiles. Others have shown that T therapy improves insulin sensitivity and lowers inflammation.
In one super long, super big study, researchers stalked over 1000 men for three years. There was no correlation between T therapy and heart disease.
3 – Testosterone Therapy Will Kill You
Thank media hype for this one. Because of the bad press linking T therapy to things like prostate cancer and heart disease, T therapy came to be known as a hit man.
Again, like the prostate argument:
- T levels go down with age
- Mortality, of course, goes up with age
- Thus, the older you get, the lower T you have, and the higher your risk of death.
So, it's back-asswards to say that higher T is related to higher risk of death.
Science agrees. There are significant ties between T levels and all-cause mortality. One study showed that every 6 mmol / L increase in T correlated with a 21 percent lower risk of all-cause mortality. Another study followed almost 800 men, followed up with them 12 years later, and found that higher T levels were related to less risk of death.
I Want to Try It
Always talk with your doc about testosterone replacement therapy before going for it. There are risks involved, but those are generally linked with high doses that wouldn't be prescribed by a good doctor. Don't be "that" guy.
Don't expect it to be some kind of magical cure-all. You still have to do the work. But testosterone therapy isn't the psycho killer some have made it out to be. What it WILL do is help put you back in balance.
Related: The Complete Guide to T Replacement
Related: The Effects of Mild Cycles
- Paul Morris Et. Al., "Testosterone and cardiovascular disease in men", Asian Journal of Andrology 14 (2012)
- " A Harvard Expert Shares His Thoughts On Testosterone Replacement Therapy: An Interview with Abraham Morgentaler", Harvard Medical School, March 2009
- Todd Nipoldt, "What are the heart risks associated with testosterone therapy?", Mayo Clinic
- Nazem Bassil et. al., "The benefits and risks of testosterone replacement therapy: a review", Therapeutics and Clinical Risk Management 5 (2009)
- Dr. Joel Heidelbaugh, "Male Hormones", Lecture Given at Metabolic Medicine Institute.
- Abdulmaged Traish et. al., "Testosterone Deficiency", The American Journal of Medicine 124 (2011