Testosterone Therapy May Have Benefits, but Risks Too

The research was not created to look at risks and does not apply to younger men or those with normal levels of testosterone, said study leader Dr. Peter Snyder, a University of Pennsylvania hormone specialist. It found a 20% increase in arterial plaque among men aged 65 and older who received testosterone replacement therapy for a year, according to the study published today in the Journal of the American Medical Association (JAMA).

The Testosterone Trials were supported by grants from the National Institute on Aging; the National Heart, Lung, and Blood Institute; the National Institute of Neurological Diseases and Stroke; and the National Institute of Child Health and Human Development.

"The paper reporting the results of the first three trials published previous year was the first to show there were advantages to giving testosterone treatment to older men with low testosterone levels, and the bone and anemia trial results further support a benefit".

On the positive side, testosterone therapy significantly increased bone density in 211 men and corrected anemia in 126 men by increasing hemoglobin levels.

The hazard ratios similarly favored testosterone therapy for stroke and TIA and for the cardiac events separately, T. Craig Cheetham, PharmD, of the Southern California Permanente Medical Group in Pasadena, reported in JAMA Internal Medicine. The goal was to see if rubbing testosterone gel on the skin daily for a year could treat problems linked with low levels of the male hormone, which declines with age. Four of them delved on the effects on anemia, bone density, cognitive function, as well as coronary plaque buildup.

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"Our study finds benefits of testosterone treatment in improving bone density and anaemia".

"Testosterone and synthetic androgens have valuable medical applications but a key lesson is that such novel indications should be established by efficacy and safety studies and not preceded by wide-scale, off-label adoption", he wrote.

The participants were then randomly divided into two groups: one group took a daily dose of testosterone in the form of a gel for a year, while the other group took placebo for the same period of time.

Senior author Dr. Peter Snyder said that TTrials were created to investigate testosterone therapy's effectiveness rather than risk, apart from the fact that they did not address long-term consequences.

Low testosterone has been linked with everything from erectile disorder to prostate cancer to general fatigue, but most experts recommend seeking a doctor's advice before you supplement - especially if you don't have low T to begin with.

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Study Rundown: Decrease in serum testosterone commonly occurs in elderly men.

A third study found no association between testosterone supplementation and memory improvement. But it may also make artery disease worse.

Overall plaque volume and coronary artery calcification scores by CT angiography were similar between groups in their study within the Testosterone Trials ("T Trials"), the first of which showed an increase in libido but not vitality.

"The results on diverse outcomes indicate the potential trade-offs between benefits and risks of testosterone treatment in older men", Evan Hadley, MD, director of National Institute on Aging's Division of Geriatrics and Clinical Gerontology, said in a press release from the NIH. The Bone Trial included 189 of the 790 men in the overall study. AbbVie (formerly Solvay and Abbott Laboratories) also provided funding, AndroGel, and placebo gel. So longer, bigger trials will be needed to sort out the risks.

SHALENDER BHASIN: The frail elderly or people who have preexisting heart disease or have had a recent heart attack or a stroke - I think one should be particularly careful in those individuals.

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On the contrary, it was identified that after one year of use, an estimate of 140 men who had used the real thing had shown more plaque buildup. They weigh the available evidence and individualize their treatment decisions and have that conversation with their patients about the uncertainty, about the risks and benefits.


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