Two recent studies have indicated that testosterone replacement therapy causes a significant increase in the incidence of heart attacks, death, and strokes. As a result, our friends at the FDA are planning to investigate whether there should be a concern about the use of testosterone.
Let me start by providing some facts:
1) Nearly 100% of men who have heart attacks have been found to have low testosterone levels.
2) The heart has more testosterone receptor sites than any other part of the body.
3) Studies done at the NIH have indicated that men with massive heart attacks always go into severe congestive heart failure (CHF). However, they were able to demonstrate that those men given testosterone at the time of admission to the hospital never went into CHF.
4) There have been studies that have shown that atrial fibrillation his been eliminated by using testosterone.
There are many urban legends in medicine. One of the more prominent of these mistruths is that testosterone causes prostate cancer. I now suspect that we have a new urban legend about testosterone in the making. When looked at logically, one might ask the following: if testosterone causes prostate cancer as well as an increase in the incidence of cardiovascular disease, then why is it that men in their late teens do not have these problems at a time when testosterone levels are highest?
The fact is that testosterone can easily convert into estradiol, the strongest of all the estrogens. It is well known that estrogen cannot only cause vascular problems, but is also the underlying cause of prostate cancer in men. Even though there are easy ways to prevent this conversion of testosterone into estradiol, I suspect that the majority of doctors prescribing testosterone fail to consider those potential problems related to estrogen. Another point to consider is that those men with the highest testosterone levels have been found to have the lowest incidence of prostate cancer.
I would also like to point out that the majority of doctors who prescribe testosterone are actually treating lab test. When it comes to hormone replacement, you can never go wrong treating a patient, but you go wrong treating a lab test. Consider the following: testosterone is released early in the AM, usually around 2-3 AM. Many men experience morning erections around this time or a few hours later. The absence of morning erections is actually the most reliable indication of a low testosterone level. Instead, doctors rely on a test that is taken hours after the hormone has been released, by which time it has attached to many receptor sites so that reliable levels can no longer be assessed by testing blood levels. As a result, a low level is noted and testosterone is often needlessly prescribed.
This scenario is more problematic when it comes to older men because they are more likely to convert testosterone into estradiol. I suspect, that the majority of men involved in these two studies might have fallen into this category.
Another concern is that the recommended application sites for testosterone are often wrong. In fact, one pharmaceutical company recommends that it be placed in the axilla (armpit). The problem here is that there is an enzyme, alpha-reductase, located around hair follicles that is able to convert testosterone into dihydrotestosterone (DHT). Is it possible that this factor is contributing to problems of a cardiovascular nature?
For the most part, traditional medicine has ignored the need that women have for testosterone. I should mention that I have blogged on this subject previously. As a reminder, heart attacks are the number one cause of death in women. In fact, it occurs as a cause of death six times more commonly than any other cause. I suspect that it is actually a low testosterone level in post menopausal women that is contributing to this.For those interested in learning more about hormones, including testosterone, I would recommend my book “The Miracle of Bio-identical Hormones” which is available on Amazon or on my website
A more in-depth discussion of hormones can be found in my manual for healthcare practitioners which is a companion to the book. It is called “The Platt Protocol for Hormone Balancing“, and is available only on my website. It describes a safe and effective way of using testosterone cream that not only is more effective for erectile problems, but is also healthier from the standpoint of the heart.