In the past, I've written quite a bit about testosterone replacement therapy (TRT). In June, I wrote about the position the American Association of Clinical Endocrinologists was taking on TRT: "The benefits to treat low testosterone in both men and women substantially outweigh any risks." I agree with their position, so much so that I take testosterone myself, and I regularly prescribe it to my patients, who have seen great results. So I was happy — but not surprised — to hear about a large new study confirming the benefits of TRT for men with low levels.
This study was the largest of its kind so far and included the longest follow-up period. Published online in August in European Heart Journal, this study followed more than 83,000 male veterans with low testosterone levels. It assessed their risk of myocardial infarction (MI), stroke, and death over a 14-year period.
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None of the men in the study had a previous history of stroke or MI, which helped reduce bias in the results. Other smaller studies have not used previous history of cardiovascular disease as an exclusion criteria, which makes interpreting the results more difficult.
All of the men received TRT for their low levels, but some were able to achieve testosterone normalization, and others were not. The findings reveal just how important achieving normalization is: a 47% mortality benefit, an 18% MI benefit, and a 30% stroke benefit compared to those who did not achieve normalization.
The researchers concluded that TRT was a safe and beneficial treatment option for patients with low testosterone, assuming they received appropriate follow-up care. I agree. While TRT does have some risks (as does nearly anything we do), its benefits far outweigh them. If you suspect you may have low levels of testosterone, find an experienced medical professional to test you and, if necessary, help you normalize them.
Yours for better health,
Frank Shallenberger, MD