Tempted by all the ads about "Low T" to try testosterone replacement therapy with a drug such as Androgel or Axiron? A study out today should make you think twice. It linked supplemental testosterone to an increased risk of heart attack, stroke, and death.
Researchers studied 8,709 vets in their 60s with low testosterone levels, some of whom had a prior history of heart attack, diabetes, or coronary artery disease. All underwent coronary angiography, a test of blockages in the heart, and 1,223 were then prescribed testosterone therapy as either gel, injections, or patches.
After 3 years, men taking testosterone were 30 percent more likely to have died or to have had a heart attack or stroke. Overall, 19.9 percent of men not on testosterone therapy had one of those bad outcomes, compared with 25.7 percent who were on testosterone, according to the study published in this week's issue of JAMA.
The men in the study had clearly low levels of testosterone. That condition, called hypogonadism, is linked to fatigue, depression, and the loss of libido, bone, muscle, and facial and pubic hair. The author of an accompanying JAMA editorial worried about the implications of the findings for men without those low levels, who may be taking the drug for "low T syndrome" or for anti-aging purposes and younger men taking it for physical enhancement, saying, "Are the benefits—real or perceived—for these groups of men worth any increase in risk?" Patients and prescribers should be wary, the editorial concluded.
Our medical experts say there are better ways for men to deal with diminishing energy as they age. "Maintenance of a daily exercise program, alternating an aerobic activity with lifting light weights and stretching, may help compensate for some of the symptoms attributed to having a low testosterone level," said Marvin M. Lipman, M.D., an endocrinologist with expertise in hormone problems in men and women, and Consumer Reports chief medical adviser.
Stress, lack of sleep or exercise, and feelings about your partner can also sap your vim and vigor. Plus, diabetes, obesity, and pituitary tumors can contribute to low testosterone, as can some drugs. So they should be ruled out or addressed first, Lipman says.