November 17, 2013
John DiTraglia MD
Several weeks ago we reported on a report in the New England Journal of Medicine that showed that for old men who have low testosterone, supplementation improved a lot of things. I was ready to ask my doctor, Dr. Arrick, to give me a prescription for testosterone to shrink my belly and make me run faster - or at least test me to see if I was low.
But this week’s Journal of the American Medical Association had a report titled “Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels,” that changed my mind. (1) These authors from a consortium of 76 VA hospitals studied a group of 8709 men in their 60s who had low testosterone levels. Most of them had heart disease and 50 percent had diabetes. They gave 1,223 (16 percent) of them replacement testosterone treatment and watched for three years. The group given testosterone treatment had a 30 percent increased occurrence of heart attacks or strokes or death, that was significant enough to stop the study. The increased risk was no different in the younger men and the ones without heart disease. Whoops. These authors conjecture that maybe testosterone somehow worsens arteriosclerosis.
Remember when we used to think estrogen would fix everything? Even I wanted to take it. Maybe I’ll try buying expensive new running shoes.
1. Vigen R et al. JAMA. 2013;310(17):1829-36.