Testosterone Therapy Debate: A Closer Look at Shocking Heart Risk Claims

As we all strive to lead healthy and active lives, testosterone therapy has become a hot topic over the past few decades. Some studies claim it to be a miracle treatment for increased muscle mass and improved sexual performance, while others argue it may in fact be dangerous. Let’s delve deeper into this controversial issue to paint a better understanding of testosterone therapy.

The Testosterone Therapy Controversy

In the past 50 years, there has been a wealth of medical literature showing the benefits of testosterone replacement for millions of men and women. However, a 2014 study published in PLOS ONE titled “Increased Risk of Non-Fatal Myocardial Infarction Following Testosterone Therapy Prescription in Men” claimed that testosterone therapy doubled the heart attack risk in older men. This caused a widespread reconsideration of its safety and benefits.

However, this study has since been heavily criticized for its methodology and conclusions, leading to newfound support for testosterone therapy as a safe and effective treatment for hypogonadism (low blood testosterone levels) and aging-related declines in male hormones.

Analyzing the Controversial Study

Finkle et al.’s study compared the health care records of 55,593 men prescribed testosterone therapy to those prescribed Viagra® or Cialis®. They concluded that men with pre-existing heart disease doubled their expected heart attack rate within the first 90 days after getting a prescription for testosterone.

There are several problems with the study’s methodology and conclusions that must be explored, such as:

  1. Retrospective database analyses vs. randomized controlled clinical trials: The study’s retrospective analysis allowed researchers to manipulate data, as opposed to conducting a randomized controlled clinical trial. This makes the claim that testosterone therapy is the cause of increased heart attacks more challenging to prove.

  2. Timing of heart attacks: Researchers compared heart attacks in the treated group after just 90 days of initiating testosterone. It is unlikely that testosterone could cause heart attacks in such a short period, suggesting other factors such as underlying heart disease could be responsible.

  3. Controlling factors: The study didn’t adequately control important factors that could influence heart attack risk, including lifestyle, environment, cardiovascular disease risk variables, blood tests, EKG, exercise tolerance, and muscle-to-fat ratios.

  4. Testosterone types, doses, and methods of administration: Testosterone taken by mouth significantly increases cardiovascular disease risk, but injected and transdermal routes do not 1. The study does not differentiate between these factors.

  5. Invalid comparison: Comparing testosterone therapy to Viagra® or Cialis® is not an accurate measurement, as these drugs induce vasodilation 2 (which lowers cardiovascular disease risk).

  6. Bio-identical vs. synthetic testosterone: The study does not distinguish between patients receiving bio-identical testosterone and those receiving synthetic methyl testosterone. There may be important differences in effects between these hormone preparations 3.

The Benefits of Testosterone Therapy

Numerous studies published prior to the controversial 2014 study have shown the safety and efficacy of testosterone therapy in men and women who need it. Among these benefits are:

  • Increased muscle mass and strength
  • Rebuilds bone
  • Strengthens the heart and blood vessels
  • Lowers total cholesterol and blood sugar levels
  • Raises HDL (good) cholesterol levels
  • Lowers blood pressure
  • Reduces blood clot risk
  • Improves tissue oxygenation
  • Supports non-cancerous prostate gland health
  • Improves libido and sexual performance

The Bottom Line

While the testosterone therapy debate is still ongoing, it is essential to have a thorough understanding of the available research and make informed decisions. Consulting with a knowledgeable medical professional who can properly assess your needs, and considering natural options to boost testosterone levels, are important steps to ensure safe and effective treatment.

It is vital for patients and medical professionals to review the studies carefully before making a decision on testosterone therapy. With sound science and thorough research, we can form a better consensus of this controversial issue.

  1. Borst SE, Shuster JJ, Zou B, Ye F, Jia H, Wokhlu A, Yarrow JF. Cardiovascular risks and elevation of serum DHT vary by route of testosterone administration: a systematic review and meta-analysis. BMC Med. 2014 Nov 7;12:211. 
  2. http://circ.ahajournals.org/content/110/19/3149.full 
  3. http://www.tahomaclinicblog.com/bioidentical-testosterone/