New Findings for Doctors
Muscle Strength and Testosterone
New England Journal of Medicine A recent study reported in the journal found that older, frail men given testosterone to improve muscle strength and mobility experienced a higher rate of cardiac events and death than a control group not given the hormone. Dr. Burnett interprets the results of the study.
Dr. Burnett: “The take home message here is that there are adverse events associated with testosterone and I think that’s eye opening. We’re hearing so much news being brought to just take testosterone–because of all of these expected health benefits. But there may be some potential downsides. This article helps bring attention to that. Yes, while we’re thinking it may have some potential benefits in strength, in mood and health status, it could (at the same time) have some impact on cardiovascular health and metabolic risk. So I think we do have to recognize that there could be some adverse associations here ( in ordering the hormone for some men).
Who are the Right Men to Benefit from Testosterone Supplements?
New England Journal of Medicine Another recent report in the journal states that testosterone supplements should only be given to men who have both low blood levels of the hormone and sexual symptoms–such as low libido or erectile dysfunction. Dr. Burnett comments on the study.
Dr. Burnett: Question: How do we determine who is the right person to be treated rather than be indiscriminate about treatment? We must try to judge which patients really are symptomatically impacted, especially with regard to sexual function, and in particular to sexual interest or libido. Those patients may be worthy of trials almost irrespective of what is their testosterone level is because there is such a wide range of testosterone measurements. What is the normal cut off for one man versus another may be hard to know. Absolute numbers with respect to testosterone do not correlate with symptoms, with some men having what might be called low levels having no symptoms at all.
Could Harm Come from Some Testosterone Supplements But Not From Others?
Some studies related to testosterone supplements advocate the practice. Others say no and sound alarms. What’s a doctor to think?
Dr. Burnett: Different forms of the hormone have different side effects. Oral supplements of testosterone–at least in the forms we know of–could have some liver toxicities and other risks, so certainly those are not approved. There are other therapies that range from topical therapies to injections–and more recently now pellets that have been described. I think that therapies that can provide a more continuous physiologic response as opposed to high swings supertherapeutic levels then valleys may be potentially more beneficial. (I’m thinking may be topicals versus the steady state long term therapies.) The risk benefit profile needs to be carefully considered on an individual basis for any man considering testosterone.