New research has found that testosterone replacement therapy is safe for men with heart disease to help treat low testosterone levels. However, the study also found that it’s not an “anti-aging tonic” as some have claimed.
Since 2014 there has been an industry of marketing testosterone as stopping “manopause.” The claims were that it improved sexual function, energy and strength for all older men. But people questioned its safety as a small study found that testosterone use coincided with higher heart attack rates. The FDA required testosterone supplements to carry a warning label, and prescription use declined. This new, large study can set people’s minds at rest about the heart risks.
“The results of this study provide reassuring and substantial evidence that testosterone replacement therapy does not appreciably increase the risk of death from cardiovascular causes when appropriately prescribed,” said study author Dr. Michael Lincoff of the Cleveland Clinic.
“What we’ve shown here is that for a very specific group of men, testosterone can be given safely,” said senior author Dr. Steven Nissen, a cardiologist at the Cleveland Clinic. “But it is not to be given as an anti-aging tonic for widespread use in men who are aging.”
The study showed that major cardiac issues like heart attacks and strokes were no more common among men using testosterone gel than those using a placebo. The trial used more than 5,000 men at 316 sites across the U.S. They used either testosterone or a placebo gel for an average of 22 months. In the course of the study, 182 men in the testosterone group and 190 men in the placebo group experienced “major cardiac events.” The men taking testosterone were likelier to experience atrial fibrillation, acute kidney injury and blood clots.
The men in the study, who all had low levels of testosterone or “low T,” had heart risks to begin with. That means the study doesn’t show if testosterone treatments would increase heart risks for people who don’t need testosterone replacement therapy. That, coupled with the increased risk of atrial fibrillation, kidney health problems and blood clots, led the researcher to not advise people to take testosterone without being advised to by their doctor.
Clinical trials of the effectiveness of testosterone have been mixed. In the new study, around 60 percent of the participants dropped out as they saw no change in their symptoms. Some men swear by it, others are unimpressed. If a person has a medical history of kidney health problems, blood clots or atrial fibrillation, testosterone’s small benefits are not enough to overcome the dangers.
Many men have lower testosterone levels as they age and might benefit from taking testosterone replacement therapy. But, others take it in hopes of feeling like they are 18 for better sexual performance. However, there is no proof that it can aid people who don’t have low T.
Dr. Nissen called low T a “very common disorder.” But he added that testosterone “should not be used by bodybuilders. It should not be used by athletes. The concerns about the misuse of testosterone are quite high. And I think we have to be very cautious.”