New Study on Testosterone Prescriptions

[RoyHobbs]

http://well.blogs.nytimes.com/2014/01/29/study-adds-to-concern-about-cardiac-risks-for-older-men-taking-testosterone/?hp

[james1947]

RoyHobbs

Thanks for the link. It is important to have much as possible knowledge before taking any medication.

James

[MattFoley]

Here's an article to consider:


Testosterone Fears from VA Study are Baseless
   
Recently, The Wall Street Journal, and other periodicals, published the results of a study from JAMA that claimed to link testosterone therapy to heart risks.  You can read the WSJ coverage here:

http://online.wsj.com/news/articles/SB10001424052702303661404579180294201174958

This article was either misleading tabloid fodder that slipped through the editing filters, or was published because scare tactic headlines like this are known to attract attention and mouse clicks. Either way, it's neither accurate, nor responsible reporting.

There are three key problems with this article: their math is sensationally deceptive regarding the risks, the test group is not a representative sample of a normal population, and most critically, they fail to report that the testosterone prescribed under this study is substantially different than what most people today would be prescribed for a common body chemistry imbalance.

Firstly, regarding the math: the article lead claims "testosterone raised the risk of death, heart attack, and stroke by about 30%", but then later in the article clarifies that the number is actually 26%, and then fails to point out that the relative risk is only 6%, as the risk in the control group was 20%.

Secondly, it's important to note that this data was taken from a group of older veterans with pre-existing coronary vascular disease – hardly a representative sample of the total population, and definitely a high-risk group, with or without testosterone. So the conclusion of even a 6% risk increase is at least suspect, and probably wrong.

Third, and most critically, the study only included patients on high-dose monthly testosterone injections, and not the FDA-approved daily low-dose testosterone creams or gels that are commonly prescribed today (Androgel, Axiron, and Tesum). High-dose injections are known to be the only form of testosterone known to carry increased coronary vascular risk, and they create massive hormone swings due to the wide fluctuations patients experience between their monthly injections. The problem is not with the hormone itself; the problem is caused by the quantity, the frequency, and the delivery method.

I know this because when I did my residency rotation at the VA Hospital in theAndrology Clinic in 1990, we only gave testosterone in the form of monthly injections at fairly large doses. These injections are routinely associated with spikes in cholesterol as well as hemoglobin. This spike in cholesterol and hemoglobin that these patients experienced puts these patients at risk, because a rapid rise in hemoglobin is associated with stroke and blood clots. For similar reasons, we've also repaired damage done by 'sports clinics' and 'hormone replacement therapy clinics' that utilize these high-dose injections.

There are situations where testosterone can help someone correct a body chemistry imbalance. It's important to clarify that the vast majority of testosterone therapies prescribed by doctors today are FDA-approved transdermal gels or creams, and there is no documented association between transdermal testosterone therapy and heart risks.

Dr Richard D. Lee, MD
Lead Doctor, GeneSolve

http://gene-solve.com/testosterone-fears-from-va-study-are-baseless/

[james1947]

Thanks Matt for the article.
Reading it, things seems very different.

James

[RoyHobbs]

I don't have a dog in this fight, and it's always good to hear both sides. But what's the background of the group and the doctor publishing the counterpoint? I mean the WSJ and the NY Times aren't exactly random internet blogs.

[inkhorn]

Really! Do T if you need it. These blind studies are worthless. Read, as redundant, as I may sound "Testosterone For Life " by Morgantaler- Renown Harvard Prof and researcher who dispels the negative effect of T as the old school regards it. Most of us here are fighting for a normal male life. If T can help, so be it. If your worried about a heart problem, then throw in the towel and stop fighting Peyronies, prostate cancer, Ed, etc. There are so many of us here in desperation will do just about anything to beat this problem, let us not look to biased research to keep us in check. Fear will lead us into tacit assent. Regards Inkhorn

[MattFoley]

Thanks James.

RoyHobbs,

The doctor's background is as follows:

Adjunct Clinical Professor of Medicine. Stanford University School of Medicine
Adjunct Clinical Professor of Medicine. Keck School of Medicine, USC
Attending Physician: Stanford Medical Center
Diplomat: American Board of Family Practice.
B.A. U.C. Berkeley: Physiology and Public Health. 1980
Graduate Studies: Stanford University Health Services Research 1981-1983
M.D.: Michigan State University 1984-1988
Residency: Stanford University Family Practice at San Jose Medical Center 1988-1991

I don't know this doctor but I know that he's an advocate for re-balancing a persons' hormonal levels to help maintain good health and longevity.

My understanding is that article came from faulty data provided by VA doctors who work for the government. The U.S. govt. has no interest in seeing people live longer since that just costs more tax dollars. Increasing testosterone levels in a man gives him potentially a longer life and makes him less interested in being a slave-worker.

Inkhorn is absolutely right. We are fighting for a normal life and we refuse to be condemned to a life of misery, suffering and pain. Without testosterone and other hormonal actions, we might as well surrender and get it over with now.