Do the risks of testosterone therapy outweigh the benefits?

June 08, 2015
Volume 12    |   Issue 68

There has been a lot of bad press out there recently about giving testosterone to the men and women who need it. About two years ago, a study came out that showed that testosterone replacement in men who had heart disease increased the death rates. This study was a gross misrepresentation of the facts, and has been refuted by me, as well as others. But that didn't stop the lawyers who were quick to seize an opportunity. Now a day doesn't go by that you can't see a litigation ad on TV for testosterone therapy. Naturally, a lot of men who need it are now afraid of the supposed risks. So what do the experts have to say about it?

Just recently, the American Association of Clinical Endocrinologists commissioned a panel of endocrinologists to evaluate the benefits verses the risks of testosterone replacement therapy. Remember that virtually everything you do for your health has both risks and benefits. For example, take exercise. The benefits are obvious, but it would be ridiculous to say that exercise carries no risk at all of an injury. So the question for any therapy — natural or not — is do the benefits outweigh the risks? And according to the findings of this panel, "The benefits to treat low testosterone in both men and women substantially outweigh any risks."

The panel goes to explain a soon-to-be-published position statement on the theoretical risks of testosterone and cardiovascular disease. That's the supposed risk the lawyers jumped on. The panel explicitly states that there is no compelling evidence that testosterone replacement increases cardiovascular risks. They further conclude that testosterone therapy, in fact, improves many of the risk factors for cardiovascular disease. These include decreasing fat mass, increasing muscle mass, and decreasing insulin resistance. But that's not the end of the story.

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I take testosterone. And I regularly prescribe it to my male and female patients. But that doesn't mean that there are absolutely no risks. I agree that there are many well documented benefits to replacing sagging testosterone levels. And I also agree that when properly prescribed, testosterone therapy does not increase the risk of cardiovascular disease. But it does increase the risk of blood clots. And it does raise the viscosity or thickness of the blood. And in cases of prostate and estrogen-positive breast cancer, testosterone therapy will cause the cancers to grow faster. All of these problems can be serious, but they can be avoided when the treatment is properly administered and the proper precautions are dealt with.

First of all, no one who has had prostate or estrogen-positive breast cancer within the previous five years should receive testosterone therapy. Additionally, all men and women who get testosterone therapy should be on other therapies to decrease their chances of blood clots. This would include gingko biloba extract, which you can find in a scoop of my Super Immune QuickStart. Additionally, for the first year of therapy the following lab tests should be done every three months: PSA (men only), testosterone, estradiol (estrogen), and CBC. After that, the same tests should be done at least once a year. This does not completely eliminate all risk. But here's the point. If your testosterone levels are too low for what your body needs, the risks of not taking testosterone are far greater than the risks of taking it.

Yours for better health,


American Association of Clinical Endocrinologists' 24th Annual Scientific and Clinical Congress Panel Discusses Testosterone Replacement Therapy. May 20, 2014. Life Last accessed May 25, 2015.

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