Testosterone replacement therapy may be recommended to treat men with very low testosterone levels but it is not typically recommended for older men who are otherwise healthy even if their hormone levels are slightly below what is considered normal, according to Dr. Todd Nippoldt, an endocrinologist with Mayo Clinic.
A reader posed the question to Medical Edge from Mayo Clinic about whether he should consider testosterone therapy after a blood test revealed his levels of the hormone were slightly below average. “Should I talk to my doctor about getting treatment even if I don’t have symptoms?”
Mildly low levels of testosterone without symptoms – which include low libido, weight gain and muscle loss – generally do not require treatment, Dr. Nippoldt replied. However, the patient should discuss the findings with his doctor. “In some cases, low testosterone may be a sign of an underlying medical condition, or it could be a side effect from medication.”
Testosterone levels typically change throughout a man’s life and often decrease as men age. Thus, testosterone replacement therapy is not usually necessary despite what marketing campaigns from drug companies pushing products may say. Testosterone supplement side effects include noncancerous growths in the prostate, enlarged breasts, limited sperm production and accelerated growth of existing prostate cancer. It can also worsen sleep apnea.
Most alarming is the potential for life threatening cardiovascular problems. Recent studies show that testosterone therapy can increase the risk of heart attacks, strokes and death. The studies have prompted the Food and Drug Administration (FDA) to launch an investigation into the potential heart risks associated with the drugs.
“If after further evaluation your doctor recommends you take testosterone, it’s important to set up a monitoring plan with regular blood tests to make sure the prescribed dose is correct,” Dr. Nippoldt wrote. “Too much testosterone can result in an increase in red blood cell production, a condition known as polycythemia. That can lead to other problems, including blood clotting and stroke.”
Source: Chicago Tribune