To get around the stringent rules that apply to prescription drug advertising, the ads
on TV offering help for Low-T do not advertise a specific product. Because they
can be considered to be “disease awareness” campaigns, they are regulated by the
Federal Trade Commission (FTC) and not the FDA. They assert that there are
many problems associated with Low-T relating to strength, energy, and libido but
don’t tell the viewers that abnormally low testosterone, or hypogonadism, is not
common, that testosterone treatment has risks, and the benefits are questionable.
These TV campaigns have resulted in greatly increased prescribing of testosterone
supplement therapy, with sales estimated at $5 billion in 2017.
Fatigue, depression, muscle weakness, loss of erectile function, and interest in sex
can be caused by androgen (testosterone) deficiency, but these symptoms can have
many other causes. Since the aging process leads to a decline in sex hormone
levels, in addition to a cluster of symptoms, a blood test is needed to determine if
blood testosterone levels are normal or low for a person’s age. One estimate is
that perhaps 5% of men have both low testosterone deficiency symptoms and abnormally
low blood testosterone. However, a careful study found that only 1.5% of
those screened for testosterone treatment eligibility had both low testosterone and
In the hope of restoring youthful vigor, many men are treated with testosterone
for the Low T Syndrome without a blood test. There is substantial, but not fully
definitive evidence that testosterone products increase CVD risks. For example,
one study found that after three years, an adverse cardiovascular event (e.g., heart
attack, stroke, death) was 29% higher among the men on testosterone therapy.
Another study with a small number of subjects found a doubling in CVD risk. A
study evaluating the risk of a heart attack 90 days after getting a prescription for
testosterone therapy found little increase in risk among men younger than 55, no
increases in risk for men age under age 65 (unless there was a prior history of heart
disease), a doubling of risk among men age 65 to 75, and a tripling of risk for men
older than age.
A study of insurance records of men with venous thromboembolism
(VTE) found that having taken testosterone within six months doubled the
risk of a VTE, some of which will result in a pulmonary embolism. Other studies
of testosterone therapy have not found an increased risk of CVD, at least one study
found a decrease, and they found no convincing evidence that higher testosterone
levels increase the risk of prostate cancer.
A study among older men with an average age of 72, found that testosterone therapy
only modestly enhanced strength and sexual function and cannot be considered
indicative of the benefits, or lack of benefits, for a younger population of men with
higher testosterone levels. The data needed to evaluate long term risks and benefits
of testosterone therapy are still inadequate. For most men, rather than opting
for testosterone treatment, endocrinologists recommend first trying a healthy diet,
cutting back on alcohol, increasing exercise, and losing weight. These actions alone
can boost testosterone by up to 15%.
This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel.