Major Risks for older men taking testosterone

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Many men, young, middle age and old, are pumping up their low T (Testosterone) levels by using one of the popular Testosterone treatments. Simply by using a Testosterone gel, cream or patch, they can pump up their muscles, their strength, their mood and their sex drive.   But by pumping up their Testosterone levels, they may also be pumping up their risk for a heart attack, or even worse.

The FDA is currently investigating the risk of stroke, heart attack, and death in men taking FDA-approved testosterone products. The FDA has decided to reassess this safety issue based on the recent publication of two separate studies that each suggested an increased risk of cardiovascular events among groups of men prescribed testosterone therapy.

The first publication that prompted the FDA to reassess the cardiovascular safety of testosterone therapy was an observational study of older men in the U.S. Veteran Affairs health system published in the Journal of the American Medical Association (JAMA) in November 2013. The men included in this study had low serum testosterone and were undergoing imaging of the blood vessels of the heart, called coronary angiography, to assess for coronary artery disease. Some of the men received testosterone treatment while others did not. On average, the men who entered the study were about 60 years old, and many had underlying cardiovascular disease. This study suggested a 30 percent increased risk of stroke, heart attack, and death in the group that had been prescribed testosterone therapy.

A second study reported an increased risk of heart attack in older men, as well as in younger men with pre-existing heart disease, who filled a prescription for testosterone therapy.  The study reported a two-fold increase in the risk of heart attack among men aged 65 years and older in the first 90 days following the first prescription. Among younger men less than 65 years old with a pre-existing history of heart disease, the study reported a two- to three-fold increased risk of heart attack in the first 90 days following a first prescription. Younger men without a history of heart disease who filled a prescription for testosterone, however, did not have an increased risk of heart attack.

Testosterone is a hormone essential to the development of male growth and masculine characteristics. Testosterone products are FDA-approved only for use in men who lack or have low testosterone levels in conjunction with an associated medical condition. Examples of these conditions include failure of the body to produce testosterone because of reasons such as genetic problems or chemotherapy. Other examples include problems with brain structures, called the hypothalamus and pituitary, which control the production of testosterone by the body.
None of the FDA-approved testosterone products are approved for use in men with low testosterone levels who lack an associated medical condition. FDA-approved testosterone formulations include the topical gel, transdermal patch, buccal system (applied to upper gum or inner cheek), and injection.

What to do if you are contemplating taking Testosterone?  Discuss your options with your doctor. Make sure you talk about your risk factors for heart disease (such as hypertension, diabetes, elevated cholesterol, family history of heart disease) and history of cancer. Discuss whether you should have the blood test for Testosterone and have a blood count checked. Discuss other options that are available for decreased sexual function like the medications Viagra and Cialis or Levetra.

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