Friday, November 08, 2013

TESTOSTERONE THERAPY, FRIEND OR FOE?

I know of many friends and even colleagues who are taking testosterone. Some for better health and many as an anti ageing  regime. Of course, medically testosterone is indicated as replacement in patients who hypogonadism.
The worrying trend is that many, and more and more are taking it for ant ageing purposes. Or for youth and beauty, in short. Well, a word of caution.
The 6th Nov issue of the Journal of the American Medical Association, carries an article by Dr Vigen from the Veterans Affairs Colorado Health Care System, Denver, entitled, "Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels". JAMA 2013; 310:1829-1835. Dr Vigen and colleagues studied 8,709 males who were undergoing coronary angiogram for vaious indications. They were all suspected of having coronary artery disease and they all had various co-morbidities. They all also had low testosterone levels, < 300 ng/dl. 1,223 of these males were also on testosterone therapy. They were all followed up for at least 3 years. At the end of 3 years, the investigators fund that the patients who were taking testosterone therapy had a 29% increase in MACE ( heart attacks, strokes and death ). When they broke down the MACE numbers by year of follow-up, 1st year 10.1% Vs 11.3%, Yr 2 15.4% Vs 18.5%, and Yr 3 19.9% Vs 25.7%. Noting that there was an annual increase in MACE as long as the patients were on testosterone. It is also important to note that ll the MACE numbers were in double digits ( even the controls ), suggesting that this population with suspected CAD and hypo-testosteronism were people who were less well to start and giving them testosterone did them harm.
This s not the only study to show this. An earlier TOM study was also prematurely terminated because more patients on testosterone had MACE events.
I personally believe that testosterone therapy is harmful to the heart and blood vessels. Ageing is part of a natural process, trying to buy yourself a few more years, may shorten your by a few less years.

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