If there is one thing I have learned in my 20 years as a pharmacists it is that all drugs are both good and bad. That is proving true with Testosterone. It’s good because it keeps men vigorous and strong, but the downside it can possibly increase risk of prostate problems, sleep apnea problem and now…cardiovascular disease. Those seem to be problems predominant in men. Geez, we already know it’s hazardous being a man. They don’t even live as long as women.
This a new study linking testosterone use with an increased risk of dying of cardiovascular events. http://jama.jamanetwork.com/article.aspx?articleid=1764030 is consistent with and earlier study, http://www.ncbi.nlm.nih.gov/pubmed/20592293?dopt=Abstract&holding=caugamlib
In this new study, 8,709 men who visited a Veteran’s Administration facility for coronary angiography from 2005 to 2011 and subsequently had serum testosterone < 300 ng/dL (< 10.4 nmol/L), were followed for mean 27.5 months. At the time of angiography, 20% had a previous myocardial infarction (MI), 50% had diabetes. More than 80% had at least 20% stenosis in ≥ 1 epicardial vessel on angiography. Following angiography, 14% began testosterone therapy at some point during the follow-up period (63.3% had testosterone patch, 35.7% had injection, and 1.1% had gel). The median time from angiography to beginning of therapy was 531 days. The primary outcome was a composite of all-cause mortality, MI and ischemic stroke.
Before your eyes glaze over with technical terms, I’ll parapharase: men that were studied were already old and falling apart. They had bad arteries and had undergone a procedure to open the blood vessels in their heart. Of those men…some were put on testosterone and some weren’t. This study was looking back on data already collected for other reasons. It was not pre-thought out and the men were not divided up equally and fairly. I’m not sure what prompted the men to start on testosterone, but the study did say that those using testosterone were generally younger and healtheir. And that is what is so startling about this study, despite being in better shape they had more heart attacks, strokes and as a results deaths. It happened 25.7% of the time to the testosterone group, compared to 19.9% for the men not taking testosterone.
Sad, I know. I was hoping testosterone could breathe new life into older more frail men. I need to re-think that.
So what does that mean for young healthy men? Does it mean they need to avoid testosterone or start taking it early before they get old and develop clogged arteries? Your guess is as good as mine.
So what should we do differently? Number one, do everything in our power to reduce cardiovascular risks and do not minimize the importance of this just because we can’t see it developing. We can see skin rashes, skin sores, infections, and sunburns and we can halt the disease with immediate attention. But this is not the cases with the inner lining of the blood vessels.
Cardiovascular disease is silent and unseen, yet it is deadly. If we could only look in our bodies and see the inner lining of our blood vessels that carry vital life sustaining blood, oxygen, and nutrients becoming red, inflamed, hardening, scaring, tearing, thinning, scabbing over with plaque, and breaking we would be compelled to take sudden and aggressive action.
In light of this news we need to rethink whether or not to use testosterone in each individual situations. We need to answer the questions, Would you rather live 20 more years in your current state: testosterone free and for some that includes feeling lethargic, depressed, weak. Or would you rather live 15 years feeling more alive and vibrant and strong.
I’m not “for” or “against” anything. I just feel that people need the facts so they can make up their own minds on how to live their lives.
It’s your life. It was given to you, no one else.
Stay tuned for a future blog on how to assess your cardiovascular risk using an online calculator and how to reduce your risk to as low as possible. Because if you do choose to stay on testosterone, or start it new, I recommend you do everything in your power to take care of your arteries and veins and you can do that with drugs and supplements. I will tell you how in a future blog.
POWER TO THE PEOPLE!
1/31/2014 What the FDA says about the subject http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm384225.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery
And, another one of my favorite sources of info: http://www.rxwiki.com/news-article/heart-attack-risk-and-testosterone-therapy-linked-men?utm_source%3D4258017b-eb25-f144-213f-2cfa68889773%26utm_medium%3Drss%26utm_campaign%3Dshort=&utm_source=dlvr.it&utm_medium=twitter