Worried about ‘low T’? You may want to worry more about treating it.

Treating low testosterone may be all the rage these days among men of a certain age. But men bothered by a midlife dip in energy and sex drive may want to think twice about bumping up their “low T” with a testosterone supplement, a new study says. The research, published in JAMA, links testosterone therapy to higher heart risks.

The Los Angeles Times “Science Now” blog reports that patients “taking testosterone were 30% more likely to suffer an adverse event – a stroke, a heart attack or death.” “Our findings raise some uncertainty regarding the potential safety of testosterone use in men,” concluded the authors, a group of physicians and epidemiologists in Colorado and Texas. While patients taking testosterone should not abandon the medication willy-nilly, they added, “it is important to inform patients that long-term risks are unknown and there is a possibility that testosterone therapy might be harmful.”

The Wall Street Journal reports that for the study, investigators looked at data on more than 8,700 men with low testosterone who underwent coronary angiography at some time between 2005 and 2011 in the US Veterans Affairs health system.

Forbes contributor Larry Husten writes that “after adjusting for differences between the groups there was a significant 29% increase in risk associated with testosterone (CI 1.05-1.58, p = 0.02).” The researchers found that “the effect size was the same in the groups of people who had coronary artery disease and those who did not.” He goes on to say, “The findings are hardly definitive, but may raise significant questions about the enormous increase in the use of testosterone in recent years, especially  given the absence of any evidence demonstrating the safety of testosterone therapy.”

AFP reports that “the increased risk of catastrophic events was especially notable, said researcher Anne Cappola of the University of Pennsylvania, because ‘the men who were taking testosterone in this study were slightly healthier to begin with.’”

The therapy is recommended for those with below-normal levels of the hormone whose symptoms include diminished sex drive, low energy, and worsening memory. In addition to improving sex drive and bone density, the hormone has been shown to increase muscle mass and strength.

However, it is not clear from this research whether the increased risk of death, heart attack and stroke existed among patients prescribed testosterone therapy for “low T syndrome” or younger men taking it for physical enhancement, the researchers said.

An ongoing randomized trial of more than 800 men over the age of 65 receiving testosterone or a placebo could help provide guidance for older men considering testosterone therapy.
Until more is known, however, “prescribers and patients should be wary,” one of the reseachers said.

The CNN “The Chart” blog reports, however, that some physicians “who looked at the study questioned the methods, saying many of these men already had heart issues.”

“You need to be careful about the conclusion you draw from this study,” says Dr. Warren Levy, a cardiologist and director of Virginia Heart, based in Northern Virginia. “The study is of men who had undergone cardiac catheterization – so that already selects out a higher-risk population. The conclusion may be that for men with a higher risk of cardiovascular disease, testosterone therapy may increase risk slightly.”

Bloomberg News points out that previous research on “testosterone supplements … in elderly males, funded by the U.S. National Institute on Aging and run at Boston Medical Center, was” halted after “an audit found it caused more heart attacks and high blood pressure.”

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