If you have been concerned about whether testosterone therapy increases your risk of heart disease or stroke, then worry no more. A recent large study compared rates of myocardial infarction (MI), or a heart attack, and rates of stroke in the general population versus with testosterone therapy. The results were overwhelmingly in support of appropriate testosterone therapy.
Testosterone therapy patients had a 7 fold lower risk of heart attack and a 9 fold lower risk of stroke. This study was reported at the American Association of Clinical Endocrinologists meeting in Houston, TX.
It thus suggests a protective effect of testosterone against MI and strokes, and that there is no evidence to suggest a worsening of MI or stroke even in those patients at high risk of developing these problems.
There are many men on testosterone therapy who have become somewhat apprehensive of taking testosterone after a recent study in JAMA that had suggested an increase in MI events. However, this study has been criticized for many reasons, including inadequate testosterone treatment. The increase in testosterone levels in the blood in that study was only from around 250 to around 350 ng/dL. We know from many prior studies that one must achieve testosterone levels over 500 ng/dL to see a benefit in MI occurrence, as was achieved in the most recent study.
Over 40,000 patients were evaluated over five years, and the goal was to increase their blood levels to over 500 ng/dL. Here’s the results:
|Studied population||Rate of MI/100,000||Rate of stroke/100,000|
|General population group||208||93|
|Testosterone therapy group||30||10|
Put in perspective, this study suggests that without testosterone therapy, a man has a seven fold increased risk of developing a heart attack (MI0, and a nine times risk of developing a stroke. Thus, it is obvious that there is a health protective benefit of testosterone and, in fact, many other studies have confirmed similar results.
There are many benefits from taking testosterone therapy as one gets older and has low testosterone levels in his blood. Raising the levels appropriately can offer improved libido, sexual function, energy level, cognitive function, muscle mass, and motivation. Most men just feel better on it and note an improved quality of life. Now we have confirmation that we can use it and also benefit from decreased risks of MI or stroke.
There are several ways to get testosterone therapy. You can use creams, gels, injections or pellets. At our office, we have found that most men prefer the testosterone pellet therapy because it is very effective, long lasting, and they don’t have to inject themselves or put creams or gels on themselves daily. Most pellets last around 4 months.
So if you are on testosterone therapy, or if you think you would like to be on it, go for it!
Tan RS, Cook K, Reilly WR. Testosterone therapy is not associated with MI or strokes. Abstract 1353. Presented at American Association Clinical Endocrinology 23rd Annual Scientific Meeting May 16th, 2014