A new study on testosterone by epidemiologist, William Finkle and researchers at UCLA, has found a link between the popular male hormone supplement and heart attacks. Finkle and his colleagues reviewed insurance claims for more than 55,000 men with a specific focus on the rate of heart attacks within 90 days of starting testosterone. The data showed that men aged 65 and older with diagnosed heart disease were at least twice as likely to have non-fatal heart attacks in the 90 days after they were prescribed testosterone medication than were men of the same age and health status who did not take the hormone supplement. The study showed that men under the age of 65 with a history of heart disease had triple the risk of heart attack.
For men under age 65 with no diagnosis of cardiovascular disease, testosterone supplementation did not appear to raise the heart attack risk, according to data in of the study. But in men older than 65, many of whom may have undiagnosed risk factors, rates of non-fatal heart attack rose as much as threefold in the 90 days after they filled a prescription for testosterone.
The U.S. Food and Drug Administration (FDA) has approved testosterone treatment only for conditions linked with “low T,” which means documented low testosterone levels. However, today testosterone is being used by many men who do not have “low T” to treat a variety of symptoms, including lowered libido, as well as fatigue. According to CBSnews.com, a study published earlier this month found 43 percent of men receiving testosterone had a normal level.
“We don’t know very much about this therapy,” said Dr. Steven Nissen, a cardiologist at the Cleveland Clinic. “What’s going on is a giant experiment with American men’s health at stake because we don’t have long-term data on the safety of those products.”
Prescription sales of testosterone have now surpassed Viagra prescriptions: since 2009, annual prescriptions for testosterone have more than doubled to 430 million, partially due to advertisements, CBSnews.com reports.
“Once it appears on television, with seductive ads that make men think it’s a fountain of youth, you’re going to see a lot of off-label usage,” Nissen said. The FDA has said that it is reviewing the study, as currently, testosterone does not carry a warning for heart attack on the label.
The research marks the third time in just four years that a well-conducted study has detected signs that testosterone supplementation may carry substantial risks for many men. It appeared Wednesday in the journal PLoS One and was authored by a team from the National Cancer Institute; Los Angeles-based Consolidated Research Inc., which develops statistical methods and software; and UCLS’s Fielding School of Public Health.
In 2010 and in November 2013, studies appearing in the New England Journal of Medicine and in the Journal of the American Medical Association, found evidence that men taking testosterone, especially men who were frail, elderly or had cardiovascular disease, were more likely than those who did not take the hormone to suffer a range of cardiovascular “events”—from heart attack to emergency artery-clearing procedures—soon after they began taking the supplement.
However, growth in prescriptions for testosterone patches, topical gels and creams, are now used by about 2.9 percent of U.S. men over age 40. From 2000 to 2011, such prescriptions increased fivefold, driven by aggressive advertising campaigns tempting men with low energy, sagging muscle tone and low libido to seek treatment for their “low T.”
It is estimated that American men today spend approximately $1.6 billion annually on prescription testosterone supplements and growth in this market is fastest among younger men.
The authors of this study said that large clinical trials are recommended to clarify which men might incur risks from testosterone supplementation that outweighed its benefits. Until those studies are conducted and the results recorded, they wrote, physicians counseling men who seek testosterone supplements, “might be well advised to include serious cardiovascular events in their discussion with patients of potential risks, particularly for men with existing cardiovascular disease.”
It is important for men to undergo appropriate testing to ensure that they actually have low levels of testosterone before starting treatment. Instead of men basing their decision on enticing advertising for the supplement, they should discuss the risks and benefits with their doctors or health care providers first. Heart attack and/or death are a big price to pay for a muscular physique or increased energy and libido!
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