October 19, 2010
Low Testosterone Increases Heart Death Risk?

Too little T is a risk as we age?

Low testosterone levels seem to be linked to a heightened risk of premature death from heart disease and all causes, suggests research published online in Heart.

The finding refutes received wisdom that the hormone is a risk factor for cardiovascular disease.

I'm not so sure about the refutation of received wisdom. Toxins depend on dose. Likely there's an ideal range of testosterone and outside of that range either above or below one is at increased risk of death. The trick is to know what is the ideal range. That's hard to figure out without double blind prospective studies. Also, likely: the ideal range varies by person. But customizing testosterone replacement based on genes and metabolic tests still lies many years into the future.

Since one in four men had low T I would be very curious how a control group of similar age men without heart disease would compare.

The researchers base their findings on 930 men, all of whom had coronary artery heart disease, and had been referred to a specialist heart centre between 2000 and 2002. Their heart health was then tracked for around 7 years.

On referral, low testosterone was relatively common. One in four of the men was classified as having low testosterone, using measurements of either bioavailable testosterone (bio-T) - available for tissues to use - of under 2.6 mmol/l or total testosterone (TT) of under 8.1 mmol/l.

They are defining low as clinical testosterone deficiency. Well, how common is that in older men?

These measures indicate clinically defined testosterone deficiency, referred to as hypogonadism, as opposed to a tailing off in levels of the hormone as a result of ageing.

During the monitoring period almost twice as many men with low testosterone died as did those with normal levels. One in five (41) of those with low testosterone died, compared with one in eight (12%) of those with normal levels.

The argument against hormone replacement is that some of the decline in testosterone with age might lower risk of diseases by basically turning down the RPM on an old engine. The male body pays a price from being ramped up by testosterone. Look at risks discovered with hormone replacement therapies for women as a cautionary tale. It is hard to second guess nature to produce a long term gain in our health.

Update: Hormone replacement therapy for women might increase the risk of several cancers by boosting blood vessel formation (angiogenesis). If that is the correct mechanism for boosted cancer risk it illustrates the problem with turning up metabolism in old age. Just like in cars old parts can not be pushed to higher levels of performance without risk of damage. The body slows down with age probably in part to prevent cells and organs from malfunctioning in deadly ways. Cures for cancer would enable us to turn up our metabolisms in old age.

Share |      Randall Parker, 2010 October 19 11:19 PM  Aging Cardiovascular Studies

Jake said at October 20, 2010 1:36 AM:

Low testosterone levels are highly inflammatory.

Dr William Davis, the famous preventative cardiologist, believes that men need to optimize testosterone levels in order to reverse heart plaque formation.

All prostate cancer victims have low testosterone levels.

jeffrey dach md said at October 20, 2010 4:21 AM:

An October 2010 JAMA article revelation that Progestins cause breast cancer is "old news". The astounding thing is that none of the news articles mentions that Progestins are chemically altered forms of progesterone. Progesterone is a naturally occuring human hormone, FDA approved for use as a drug. and is readily available at pharmacies, and is known to prevent breast cancer. Why not use Progesterone instead of the chemically altered "monster" progestins?? Millions of women have switched to natural progesterone.

You are probably wondering why do we use the word, "bioidentical"? That's an excellent question. I can remember back when I was in first year medical school learning biochemistry at the University of Illinois in Chicago. Our class used Lehninger's classic textbook of biochemistry. Lehninger never used the word, bio-identical hormones, because all hormones are by definition, bioidentical hormones. They simply used the word, "hormone". Using a word like "bioidentical" was simply redundant and unnecessary for a biochemistry textbook, as it should be today.

Why are the smart women switching to bioidentical hormones?
Bioidentical hormones are safer and more effective than chemically altered synthetic hormones.

To read more:


jeffrey dach md

Brian said at October 20, 2010 6:54 AM:

Lot's of stuff going on in this post, what with men and women, natural vs synthetic hormones...so I'll just concentrate on the men. First, the decline in testosterone as you age increases risk, particularly if you are overweight. Men start becoming estrogen dominant and when you add testosterone, the risk can increase if caution is not used. Why? Some of the testosterone will be converted to estrogen (estradiol), significantly increasing the risk of a fatal event. So due diligence in natural hormone replacement therapy should also include monitoring estrogen levels so that estrogen blockers can be administered if needed.

PacRim Jim said at October 20, 2010 9:34 AM:

The human body is a system of systems, so until we understand the manifold effects of tampering with them, it might be wise to go on aging and dying as usual. No need to accelerate the hateful process.

Jimmy J. said at October 20, 2010 12:28 PM:

I guess I'm a test case for testosterone replacement therapy. I have been using bioidentical testosterone cream six days per week for the last five years. When I started the protocol at age 72, my testosterone was minimally normal for my age. My doc tests my levels every three months and makes any adjustments to the amount/strength of the cream. I take an estrogen blocking pill 4 days per week and that keeps my estradiol levels where they should be.

The therapy does not make me feel like a young stud again (That has been a bit of a disappointment), however, I am maintaining my muscle mass and strength. I am stronger and feel more well than I did five years ago. I took six months off the therapy to see what the effects might be, and I noticed a decline in strength and general feeling of well being. Thus, I will be on the therapy for the duration. If you want and can afford the protocol, it is a long term commitment. Maybe, God willing, I will last another 20 years and be able to stay active most of that time.

I also tried HGH supplementation. It is far more expensive and, at the dosage level I got, I did not notice many benefits - possibly better sleep. My doc has been under pressure from the Feds because of the HGH therapy and has decided to discontinue it to keep from running afoul of the law. For those who believed they benefitted from it that has been a real tragedy.

Tuck said at October 20, 2010 2:43 PM:

Getting your testosterone levels up is the easiest thing in the world.

Stop eating carbs.

"Testosterone Decreases after Ingestion of Sugar"

kenh said at October 23, 2010 4:22 PM:

Are the blood level units perhaps mis-typed (in the original article as well). mmol/l, millimol/L, maybe should be nmol/l. I'm trying to convert my test levels, given in conventional units, to the units in this article.

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