Non-Medical Solutions to Raising Your T Level

I am often asked what can a man do to raise his testosterone level without taking testosterone replacement therapy.  Here are a few suggestions that may be helpful.

1. Exercise and lift weights

If you want to increase your testosterone levels, you will need to increase your exercise frequency. Regular exercise will not only help you by preventing different lifestyle related health problems, but it will also help you by boosting your testosterone levels. Men who regularly exercise have a higher testosterone levels. Even elderly men will also have higher testosterone levels if they regularly exercise.

2. Reduce stress and cortisol levels

If you are suffering from long-term stress, it can increase the levels of cortisol hormone. If your cortisol levels are high, testosterone levels will decrease.

That’s why, you need to reduce stress as much as possible and which will also decrease the cortisol levels in your body. Regular exercise, whole foods, good sleep, balanced lifestyle and laughter can help you to reduce stress and also improve your overall health.

3. Get more Vitamin D

Vitamin D offers several health benefits and it boosts testosterone naturally. If you consume just 3,000 IU of vitamin D3 per day, it can increase testosterone levels in the body by 25%.

You can get more vitamin D by increasing your exposure to sunlight regularly. You can also take a daily supplement of 3,000 IU of a vitamin D3 supplement.

4. Get Enough Sleep.

A lack of sleep affects a variety of hormones and chemicals in your body. This, in turn, can have a harmful impact on your testosterone.

The time honored goal is try for 7 to 8 hours per night.

5. Keep a Healthy Weight.

Obesity can have a deleterious effect on your testosterone levels.  Exercise and diet can improve your testosterone and also is good for your heart to avoid obesity. 

6. Review Your Medications.

Some medicines can cause a drop in your testosterone level. These include: pain medications, steroids (prednisone), anabolic steroids such as those used by athletes and body builders, and anti-depressants. 

7. Deep 6 the Supplements.

You may be bombarded with unsolicited snail mail and E –mail offering testosterone boosting supplements such as DHEA.  Let the truth be told, you are wasting your money as these supplements will not boost your testosterone.   

Bottom Line: Although these suggestions may be helpful, they are just a step in the right direction.  For more information about testosterone replacement therapy, speak to your physician.

 

 

Adding Spice To Your Sex Life- Cinnamon and Testosterone

 

It is normal for a man’s sex drive or libido to decline as he ages. The reason? The male hormone, testosterone, which is responsible for the libido starts to decline about 2-3% a year after age 30. This article will discuss a non-medical solution, cinnamon, that may have an impact on a man’s sex drive or libido.

Animal studies have demonstrated that cinnamon can reduce high blood sugar levels and improve insulin sensitivity and also the testosterone boosting and testicular health. Therefore, it’s very much possible that cinnamon can be used to increase testosterone levels in humans.

 Cinnamon is a spice that you may only associate with baking and desserts, but there are plenty of cinnamon benefits that make it a great spice to use everyday and as a dietary supplement.

When using cinnamon as a supplement be sure to use organic cinnamon and not the conventional variety you typically find in the spice aisle at the grocery store. Just like with vegetables, conventional spices can contain the same herbicides and pesticides when they are conventionally manufactured.

Benefits of cinnamon:

Improves Metabolism

Cinnamon often makes it onto the list of foods that you should be eating if you are trying to lose weight. Cinnamon has the ability to rev up the metabolism, which can help you lose weight more effectively.

By the way, daily exercise is also a natural way to get your metabolism going.

Reduces Cholesterol

Cinnamon has been shown to help lower the levels of LDL cholesterol in the body, often referred to as the bad cholesterol. This makes it a fantastic all-natural remedy for high cholesterol levels.

High cholesterol over long periods of time can lead to more serious heart problems such as stroke and heart attack.

Reduces Blood Sugar Levels

Cinnamon has been shown to help keep blood sugar levels where they should be, and is often recommended to diabetics to help naturally regulate blood glucose levels. You can use cinnamon even if you are not diabetic as a way to keep your blood sugar within healthy guidelines.

Antibacterial Properties

Cinnamon acts as an antibacterial agent in the body, and with that because of that it is very helpful in treating a myriad of problems. This is why it is often recommended for an upset stomach, because it can help clear harmful bacteria from the digestive system.

Cancer Fighter

Cinnamon has been shown to be effective cancer fighting foods, and there are many reasons for this, but the chief among them is cinnamon’s antibacterial property.

More studies are needed before cinnamon can fully be given the green light and regarded as a cancer-fighting agent.

Heart Disease Prevention

Because of cinnamon’s ability to lower cholesterol levels and improve blood circulation throughout the body, it can be used to help prevent heart disease.

Anti-Inflammatory

The anti-inflammatory nature of cinnamon means that you can use it to help with a number of conditions caused by inflammation.

Helps Balance Hormones

Cinnamon can help balance hormones in women, making it a great all-natural remedy to try before turning to medication like estrogen replacement therapy. Cinnamon acts to lower the amount of testosterone produced by women, while increasing the amount of progesterone.

Helps Brain Function

The aroma of cinnamon has long been thought of as being a brain booster, and modern science is backing that up. Reason enough to start opt for cinnamon scented candles, or cinnamon essential oils for aromatherapy.  Cinnamon can help your brain work better and keep you more alert, just by smelling it.  Rather than use energy drinks or other artificial ways to make yourself zeroed in, you can use the scent of cinnamon to give you that extra mental edge needed during a typical workday.

Clears the Digestive Tract

Cinnamon can help clear out your digestive tract, which will help your body absorb the nutrients from the foods you eat more easily. This also means you’ll have fewer stomach problems including indigestion, diarrhea, and constipation.

Increases Circulation

Cinnamon has a warming effect on the body, and can help improve blood flow throughout. There are plenty of diseases and conditions, like sexual functioning, that are caused by poor circulation, so taking steps to improve that circulation can be very beneficial indeed. Improved blood flow in the body can help improve the sex drives of both men and women, as it helps blood flow to the reproductive organs. For men this means stronger erections and for women it means increased sensitivity of the clitoris and labia.

Improves Your Mood

You can use cinnamon as a sort of aromatherapy to help improve your mood. That’s because for this benefit of cinnamon you simply need to smell it. The aroma of cinnamon acts to shift you to a better mood.

Many things can occur throughout the day to put us in an off mood, so it’s important to have a collection of steps you can take to try and shake you out of a funk and get you back to feeling good.

Alzheimer’s Prevention

One of the more surprising cinnamon benefits is its ability to help prevent Alzheimer’s. Research is promising in regards to cinnamon’s effect on the brain, enough so that it would be smart to start taking it as a supplement if you feel you are at risk for Alzheimer’s.

Bottom Line: Most men and women today want to maintain and restore their ability to be sexually intimate with their partner. Yes, there are pills and medications that can be effective. However, there are natural options, like cinnamon, that are available to nearly everyone and at low or minimal cost that may improve their ability to be sexually active. Also there are numerous other benefits of cinnamon that make it a worthwhile option. It’s hard to think of a spice like cinnamon as being anything more than a flavoring agent, but which is currently being studied for its beneficial effects including sexual intimacy and performance.

Testosterone and the Prostate Gland-Hormone Replacement Is Safe For Your Prostate Gland

I am also asked if using testosterone, injections, topical gels, or pellets, will worsen urinary symptoms in men suffering from testosterone deficiency.

Millions of Americans suffer from testosterone deficiency.  They have symptoms of loss of energy, erectile dysfunction, loss of libido, loss of muscle mass, and emotional mood swings.  The diagnosis is easily made with a testosterone blood test.

A recent review finds no evidence that testosterone replacement therapy causes or worsens urinary tract symptoms or increase the size of the prostate gland.

Although the Endocrine Society and other associations have suggested severe urinary symptoms as a contraindication to TRT treatment, investigators found little evidence to support it worsening urinary symptoms in men using testosterone replacement therapy.

The investigators discovered that men with mild urinary sympmtoms experienced either no change or an improvement in their symptoms following TRT.

Remarkably, the study explained that the therapy may actually improve voiding symptoms.

Bottom Line:  Testosterone replacement therapy is safe in men with urinary symptoms and will not worsen those symptoms but may actually improve their symptoms.

Source

Kathrins M, Doersch K, Nimeh T, Canto A, Niederberger C, and Seftel A. The Relationship Between Testosterone Replacement Therapy and Lower Urinary Tract Symptoms: A Systematic Review. Urology S0090-4295(15)01053-3. doi:10.1016/j.urology.2015.11.006.

Ladies, Is Testosterone The Answer To The Low Libido Question?

Almost everyone knows that testosterone is the man’s hormone and is responsible for his sex drive or libido. But few know that testosterone is also the hormone for women’s sex drive and libido. This blog will discuss the role of testosterone in women and what you can do if your sex drive is in the tank.

If you are a menopausal woman, chances are pretty good that your sex drive has slowed down since your “roaring twenties and thirties”.

Some of you will go so far as to say that you have no interest in sex whatsoever. There is a really good physiological reason for this decrease in interest, by the way. When women hit their forties and beyond, the ovaries start their journey toward menopause. That means that we are getting closer to the end of our ovarian production of both estrogen and testosterone. These hormones play a critical role in women’s sexual health and wellness. The decline in testosterone is a normal part of aging, but it can have a profound physical and emotional impact on some women.

Women make plenty of testosterone from their ovaries, starting at puberty and lasting a few until menopause or until the ovaries stop producing estrogen and testosterone. Testosterone has several duties, including improving our sense of well-being and energy, maintaining bone health and, of course, assisting estrogen in the pursuit of sexual health and normal functioning.

Testosterone therapy is approved by the FDA in menopausal women who have the diagnosis of hypoactive sexual desire disorder (HSDD).

Bottom Line: Women with low sex drive might want to speak to their doctors and have their testosterone level checked. If the testosterone is low and the women complains of a decrease in her sex drive, then testosterone replacement in women is an option.

Low T Or Don’t Let Your Balls Get Deflated!

I don’t have an opinion on “Deflate Gate” but I do have an opinion on treatment men who have symptoms of low testosterone with testosterone replacement therapy. This blog will discuss the symptoms of testosterone deficiency, how the diagnosis is confirmed, and the treatment options for low T.

The symptoms of low testosterone include more than just the loss of libido or sex drive. They include lethargy, loss of muscle mass, softening of bones that can result in fractures of the spine and hips, and moodiness and even depression. If you’re concerned that you may have low testosterone, your doctor can check your testosterone level with a simple blood test. If you and your doctor decide that you need treatment, there are several options for testosterone replacement.

The overall goal of testosterone replacement therapy is to increase your testosterone level until it is in the middle of the normal range, which for an adult male should be between 300 and 1,000 nanograms per deciliter (ng/dL). What’s normal for you will depend on your age and your symptoms. Testosterone replacement therapy improves signs of masculinity — deepening the voice, increasing muscle mass, and prompting the growth of pubic and facial hair. It also relieves symptoms of low testosterone such as decreased sex drive, poor erections, low energy, and depression.
You should have testosterone replacement treatment only if you’ve been diagnosed with low testosterone by a doctor and you’re taking it under a doctor’s supervision.
Testosterone replacement therapy can take the form of gels, injections, transdermal patches, and tablets that dissolve under your lip. Each type of testosterone replacement is effective, and each also has advantages, disadvantages, and side effects.
• Testosterone replacement injections. Depo-Testosterone (testosterone cypionate) and Delatestryl (testosterone enanthate) are forms of testosterone replacement therapy given by injection. The advantages of injectable testosterone are that you take it only once every one to two weeks and it’s relatively inexpensive. The disadvantage is that testosterone levels may be difficult to control — too high just after your injection and too low just before the next injection.
• Testosterone replacement gels. Testosterone gel preparations — AndroGel, Axiron, and Testim — are the easiest testosterone therapy to administer and have been shown to be very effective in several studies. Testosterone gels must be applied to the skin on your arms or shoulders about the same time every day. Disadvantages are the higher cost, possible irritation to sensitive skin areas or your eyes, and the possibility that the medication can rub off on someone else.
• Testosterone replacement patch. A testosterone transdermal patch called Androderm is applied to the skin each night and left in place for 24 hours. You’ll need to pick a not-too-hairy spot on an arm, your stomach, or your back, and choose a different spot every night. The main disadvantage to using the patch is skin irritation.
• Testosterone replacement using a tablet under the upper lip. Striant is a testosterone tablet that you place under your upper lip against your gum (a so-called buccal system) and replace every 12 hours. You don’t chew or swallow these tablets, which mold to your upper gum so you can eat and drink normally. Disadvantages of the buccal system include irritation of the gums, toothache, and bitter taste.
• Testosterone pellets. There are pellets that can be inserted under the skin in the doctor’s office. The pellets will last from 4-6 months and then is repeat again.

In addition to the short-term side effects of the different testosterone replacement options, there are longer term side effects common to all testosterone replacement treatments:
• Acne
• Enlargement of the prostate gland
• Breast swelling and tenderness
• Increased urination and fluid retention
• Worsening of breathing problems during sleep, such as sleep apnea
• Weight gain
• Increase in red blood cells

In most cases, testosterone replacement for low testosterone is safe and effective. However, you should not use testosteroone replacement if you have certain medical conditions.
Although there is no evidence that testosterone replacement therapy causes prostate cancer, it can cause an existing cancer to grow more quickly. You shouldn’t take testosterone replacement if you have prostate cancer, male breast cancer, or if your prostate has been diagnosed as being abnormal through a rectal exam or by a blood test. So be sure your doctor rules out these illnesses before starting any treatment.
If you have a medical condition that causes you to produce an excess of red blood cells or if you have untreated obstructed sleep apnea (OSA), you may not be able to take testosterone replacement.

Bottom Line: Low testosterone is a diagnosis that is easily made with a simple blood test. This blood test can be made by your doctor and treated under medical supervision. If you’re being treated for low testosterone, make sure to keep regular doctor appointments and let your doctor know if you have any side effects.

DHEA For Low T: Facts and Warnings

I have treated many men with low testosterone and many ask for a solution that does not involve testosterone replacement therapy. This blog will discuss the use of DHEA in men and how effective it may be for solving the symptoms of low T.

DHEA is a hormone that is naturally made by the human body. It can be made in the laboratory from chemicals found in wild yam and soy. However, the human body cannot make DHEA from these chemicals, so simply eating wild yam or soy will not increase DHEA levels.

Athletes and other men use DHEA to increase muscle mass, strength, and energy. But DHEA use is banned by the National Collegiate Athletic Association (NCAA).

DHEA is also used by men for erectile dysfunction (ED) and in men who have low levels of testosterone in order to improve well-being and sexuality.

Like many dietary supplements, DHEA has some quality control problems. Some products labeled to contain DHEA have been found to contain no DHEA at all, while others contained more than the labeled amount.

How does DHEA work?
DHEA is a “parent hormone” produced by the adrenal glands near the kidneys and in the liver. In men, DHEA is also secreted by the testes. It is changed in the body to a hormone called androstenedione. Androstenedione is then changed into the major male hormones including testosterone.

DHEA levels seem to go down as people get older. Some researchers think that replacing DHEA with supplements might prevent some diseases and conditions.

DHEA is Possibly Effective for:
• Aging skin. Some research shows that taking DHEA by mouth increases the thickness and hydration of the top layer of the skin in elderly people. Early research shows that applying DHEA to the skin for 4 months improves the appearance of skin.

DHEA has Insufficient Evidence for:
• Aging. Taking DHEA does not seem to improve body shape, bone strength, muscle strength, insulin sensitivity, or quality of life in people older than 60 who have low DHEA levels.
• Hormone deficiency in men (partial androgen deficiency). Early research suggests that taking 25 mg of DHEA daily for one year might improve mood, fatigue and join pain in older men with hormone deficiency.
• Physical performance. Some research shows that older adults who take DHEA have improved measures of muscle strength. However, other research has found no effect of taking DHEA on muscle strength.
• Sexual dysfunction. Evidence on the effectiveness of DHEA for sexual dysfunction is inconsistent. Taking DHEA by mouth for 24 weeks seems to improve symptoms including erectile dysfunction and overall satisfaction in men. However, it does not seem to be helpful if erectile dysfunction is caused by diabetes or nerve disorders.
• Weight loss. Early evidence suggests that DHEA seems to help overweight older people who are likely to get metabolic syndrome to lose weight. It is not known if DHEA helps younger people to lose weight.

Bottom Line: DHEA is probably not a panacea for low T or a treatment for ED or erectile dysfunction.

Read This To See About Low T (Testosterone)

Low testosterone affects millions of American men. Men who suffer from low testosterone have decreased libido, decrease in erections, and lethargy or loss of energy. In this blog I will discuss the importance of testosterone and the treatment options for the diagnosis of low T.

What Is Testosterone and Why Does It Decline?
Testosterone is a hormone produced in the testicles. It’s what puts hair on a man’s chest and responsible for his beard. It’s the force behind his sex drive.
During puberty, testosterone helps build a man’s muscles, deepens his voice, and boosts the size of his penis and testes. In adulthood, it keeps a man’s muscles and bones strong and maintains his interest in sex. In short, it’s what makes a man a man (at least physically).
After age 30, most men begin to experience a gradual decline in testosterone about 1% a year. A decrease in sex drive sometimes accompanies the drop in testosterone, leading many men to mistakenly believe that their loss of interest in sex is simply due to getting older.
The diagnosis of low T is made by a history of the symptoms of low T and a simple blood test that checks the testosterone level. The test is best done in the morning before 10:00 A.M. when the hormone level is the highest.

The bottom of a man’s normal total testosterone range is about 300 nanograms per deciliter (ng/dL). The upper limits are 1,000 to 1,200 ng/dL. A lower-than-normal score on a blood test can be caused by a number of conditions, including:

Injury to the testicles
Testicular cancer or treatment for testicular cancer
Hormonal disorders
Infection
HIV/AIDS
Chronic liver or kidney disease
Type 2 diabetes
Obesity
Some medicines and genetic conditions can also lower a man’s testosterone score. One of the most common drugs associated with low T are the SSRIs which are used to treat depression. Aging does contribute to low scores. In some cases, the cause is unknown.

Risks and Benefits of Testosterone Treatment?

There are also risks. Testosterone treatment can raise a man’s red blood cell count as well as enlarge his breasts. It can also accelerate prostate growth. Men with breast cancer should not receive testosterone treatment. These are uncommon side effects of testosterone treatment.

Men with prostate cancer who have symptoms of low T and have a low and stable PSA can receive testosterone treatment, however, they need to have a PSA and digital rectal exam every 1-2 months while receiving testosterone replacement.

The treatment with testosterone is safe as long as men receive careful monitoring.

Treatment options for low T include injections of testosterone given every two to three weeks, the daily application of gels under the arm or on the abdomen or lower thighs, and pellets inserted under the skin in the doctor’s office which last for 4-6 months.

Bottom Line: Low T is common. Help is available. See your doctor and get a blood testosterone level and if it is low consider hormone replacement therapy.

Do Women Have Low T? The Role Of Testosterone in Women

Testosterone is the male hormone produced in the testicles that is responsible for sex drive or libido. Women also make testosterone in their ovaries. After menopause the amount of testosterone is decreased and will affect a woman’s sex drive and libido.
Testosterone, widely and misleadingly understood to be the “male” hormone. Men produce 10 times more testosterone than women, but in their early reproductive years women have 10 times more testosterone than estrogen coursing through their bodies. And many experts now believe that it’s the loss of testosterone, and not estrogen, that causes women in midlife to tend to gain weight, feel fatigue and lose mental focus, bone density and muscle tone — as well as their libido. Testosterone is a woman’s most abundant biologically active hormone. Adequate levels of testosterone are necessary for physical and mental health in both sexes.



Benefits for Women
 
Women, before, during and past menopause, and sometimes as early as in their mid-30s, invariably have low testosterone levels. Not all women will experience its wide variety of symptoms, like low libido, hot flashes, fatigue, mental fogginess and weight gain. For those who do, and who seek to avoid taking synthetic oral hormones (shown by National Institutes of Health findings to pose an increased risk for breast cancer, heart attack, stroke, blood clots and dementia), bioidentical testosterone (whose molecular structure is the same as natural testosterone) has been shown to be safe and effective.

Some testosterone is converted by the body into estrogen — which partly explains why it is useful in treating menopausal symptoms. For those at high risk for breast cancer, or who have had it, that conversion can be prevented by combining testosterone with anastrozole — an aromatase inhibitor that prevents conversion to estrogen. Nonetheless, testosterone has been shown to beneficial for patients with breast cancer. Preliminary data presented at the American Society of Clinical Oncology have shown that, in combination with anastrozole, testosterone was effective in treating symptoms of hormone deficiency in breast cancer survivors, without an increased risk of blood clots, strokes or other side effects of the more widely used oral estrogen-receptor modulators tamoxifen and raloxifene.

Other benefits cited for testosterone therapy include:

Relieving symptoms of menopause, like hot flashes, vaginal dryness, incontinence and urinary urgency.

Enhancing mental clarity and focus. Researchers at Utrecht University in Holland recently found that testosterone appears to encourage “rational decision-making, social scrutiny and cleverness.”

Reducing anxiety, balancing mood and relieving depression combined with fatigue. Dr. Stephen Center, a family practitioner in San Diego who has treated women with testosterone for 20 years, says the regimen consistently delivers “improvement in self-confidence, initiative and drive.”

Increasing bone density, decreasing body fat and cellulite, and increasing lean muscle mass. Testosterone is the best remedy available for eliminating midlife upper-arm batwings.

Offering protection against cardiovascular events, by increasing blood flow and dilating blood vessels, and against Type 2 diabetes, by decreasing insulin resistance.

Countering the Myths

Some women believe, also incorrectly, that testosterone therapy will produce “masculinizing” traits, like hoarseness and aggression. While the hormone may cause inappropriate hair growth and acne in some women, those side effects can be remedied by lowering the dose.

Testosterone therapy has been approved for a variety of conditions in women as well as men in Britain and Australia. But while the U.S. Food and Drug Administration has approved of testosterone for use in men whose natural levels are low, the agency has not sanctioned it for women, for any reason.

How Treatment Works

Women can take testosterone as a cream, through a patch or in the form of pellet implants, which have the highest consistency of delivery. Synthesized from yams or soybeans, and compounded of pure, bioidentical testosterone, the pellets, each slightly larger than a grain of rice, are inserted just beneath the skin in the hip in a one-minute outpatient procedure. They dissolve slowly over three to four months, releasing small amounts of testosterone into the blood stream, but speeding up when needed by the body — during strenuous activities, for example — and slowing down during quiet times, a feature no other form of hormone therapy can provide.

To determine a patient’s dosage, some doctors measure testosterone levels in the blood.

Side effects of the insertion procedure, which are rare, include infection, minor bleeding and the pellet working its way out or being extruded. Some patients notice improvements within a day or two; others do not perceive benefits for a couple of weeks.

Bottom Line: Since implantation is a surgical procedure, and the pellets are manufactured by a variety of pharmaceutical compounders, who may have varying safety standards, it’s important for women to consult with an experienced, board-certified physician about treatment. Ask your doctor if you feel you are having symptoms related to low testosterone and see if testosterone replacement would be right for you

Low T, To Treat Or Not To Treat?

There’s controversy on the use of testosterone in men who suffer from low T. In this blog I would like to share the benefits of treating low T
from several thousand men who had symptoms of decreased testosterone.

About 40% of men older than 40 have low T. If you have low T, with symptoms that are decreasing your enjoyment of life, you need to weigh the risks and benefits of treatment. There could be a big upside to treatment.

Once you start low T treatment, you need to continue it or your testosterone level will drop back down.

The U.S. Food and Drug Administration has approved testosterone treatment for men with low testosterone and symptoms of low T, such as:
• Lack of sex drive
• Fatigue
• Weak bones
• Depressed mood
• Loss of muscle
• Erectile dysfunction (ED)

The Benefits of Treating Low T
If you meet the guidelines for treatment and you and your health care provider decide the benefits outweigh the risks for you, there are good reasons to treat low T.
Possible benefits you may experience include:
• Reduced weakness
• Less chance of falls and fractures
• Improved mental ability
• Improved sexual desire
• More energy
• Better quality of life
According to the American Urological Association, you may also experience:
• Better sleep
• Better erections
• Decreased body fat
• Increased muscle mass
• Stronger bones

Current Guidelines
The most up-to-date guidelines for when to treat low T are from the Endocrine Society. The guidelines say that low T should be treated if you have an early morning blood test that shows low testosterone and you have symptoms of low T.
The guidelines also list other medical conditions where the risks of low T therapy outweigh the benefits. The conditions include prostate cancer, sleep apnea, and heart disease.

Bottom Line: Millions of American men suffer from low T. Low testosterone on a blood test is not enough reason to treat low T. If you meet have symptoms of low T and have a blood test that confirms low T, the benefits can make treatment worthwhile.
If you have any questions about the management of low T, speak to your doctor.

What You Need To Know About Low T (Testosterone) and Heart Disease

I have received dozens of calls from men who are concerned about the recent study that reports that testosterone replacement therapy increases the risk of heart attacks and strokes. This blog is intended to clarify some of the misinformation that is attracting so much media attention. The Androgen Study Group, a large group of physicians and researchers of which I am a member, is calling for the retraction of the paper that appeared in the Journal of American Medical Association linking testosterone and cardiovascular risks — data that its authors of the paper in the journal are standing firmly behind.

In a letter to Howard Bauchner, MD, editor-in-chief of the Journal of the American Medical Association, members of the group — formed in response to the paper and comprised of more than 125 doctors — said the study’s credibility was compromised by at least two corrections and should be pulled from the journal.
A close friend and colleague, Dr. Abraham Morgentalker pointed out the there’s no misconduct, no one faked any data, it’s just sloppy. The group called it “gross data mismanagement.”

The paper, published in JAMA in November by Michael Ho, MD, PhD, of the Eastern Colorado VA, and colleagues, found that testosterone therapy was associated with a greater risk of death, heart attack, and stroke in male veterans who’d had coronary angiography. (If the men were having coronary angiography, it stands to reason that they already had some heart disease or they wouldn’t have been subjected to this invasive procedure)

But two corrections have since been published. The first, in the Jan. 15 issue, was a clarification that the results were based on “estimates” and not raw data.

The second, which Morgentaler and colleagues focus on in their letter to the editor of the journal, involved reclassivication of patient who were excluded from the study. More than 1,000 excluded patients were assigned to different categories of exclusion, including 100 who were women!

The authors included almost 10% women in an all-male study, so why should we believe any of the other data? The Androgen Study Group points out that the data were so off that it’s hard to believe the data for the entire study are accurate.

However, Ho and colleagues said they “stand firmly by the results of our study,” noting that the overall number of excluded patients remains the same, as does the total number of included patients, and the main results of the study were not changed.

The study group said that these claims run contrary to 40 years’ worth of research on testosterone, which suggests that the hormone has some beneficial effects in certain heart patients.

But the testosterone therapy field has garnered much media attention for its financial relationships with industry. Several articles in the New York Times, including one on the marketing of “Low T”, another on the selling of testosterone gels, and an editorial, have questioned the potential overselling of the therapy.

It is true that several members of the Androgen Study Group, myself included, have relationships with testosterone drug makers, such as AbbVie, Watson, and Endo Pharmaceuticals.

It is my opinion that men who are symptomatic for low testosterone and have complaints such as lethargy, decreased libido, loss of muscle mass, and decrease in erections or potency AND who have a documented decrease in the blood level of testosterone, are good candidates for hormone replacement therapy. These men who are going to receive testosterone should have a normal digital rectal exam and a normal PSA test if they are less than 75 years of age.

Bottom Line: Low testosterone has effects that impact a man’s quality of life. If a man has symptoms of low T and a documented decrease in the blood testosterone level, he should speak to his physician about testosterone replacement therapy.