Medical

Testosterone And Older Men's Health Yield Controversial Results, Says University Study

Testosterone And Older Men's Health Yield Controversial Results, Says University Study”

The results showed that after an year of testosterone treatment, men over 65 years of age with low testosterone significantly increased bone density and estimated bone strength compared to those on placebo. The results add to evidence that challenges bold anti-aging claims of popular supplements. They also found a build-up of plaque in the arteries - and say that more research is needed to see if the treatment causes a higher risk of heart problems.

The use of testosterone-replacement therapy has almost doubled in recent years, from 1.3 million patients in 2009 to 2.3 million in 2013, according to the U.S. Food and Drug Administration.

A new study suggests testosterone treatments may increase the risk of heart disease in older men.

Over a roughly three-year follow-up period, these men actually had a lower risk of cardiovascular issues than men who hadn't been given a testosterone prescription, researchers report. Testosterone therapy was good for the bones, but didn't help memory. The trials mark the beginning, rather than the end, of research into testosterone therapy, he said.

But for cardiovascular health, there was an effect-a bad one.

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The T Trials were conducted at 12 sites across the country in 790 men age 65 and older with low levels of testosterone and symptoms to which low testosterone might contribute.

Further, testosterone treatment also increased haemoglobin concentrations, corrected the anaemia of men who had no other identifiable cause of anaemia and corrected the blood levels of men who had an identifiable cause, such as iron deficiency. However, it was not a clinical trial; researchers used the medical records of more than 8,800 men in California to draw their conclusions. In the study, 247 got testosterone and 246 got a placebo.

For men with low testosterone, twelve months of daily application of a testosterone gel was linked with an increase in hemoglobin levels and bone density. But the effectiveness of testosterone has been controversial.

Overall, the findings from these studies "do not materially change the unfavorable balance of safety and efficacy to initiate testosterone treatment for age-related" declines in the hormone, writes David Handelsman, a reproductive endocrinologist at the University of Sydney, in an editorial that accompanies the study.

Romashkan noted that the FDA is working with the pharmaceutical industry to conduct additional large-scale clinical trials looking at the heart health effects of testosterone.

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The new work does "little overall to clarify the role of testosterone replacement" for cardiovascular risk and cognitive function, says Dimitri Cassimatis, a cardiologist at Emory University School of Medicine in Atlanta. However, other studies have found mixed results on this.

The Testosterone Trials were supported by grants from the National Institute on Aging; the National Heart, Lung, and Blood Institute; the National Institute of Neurological Diseases and Stroke; and the National Institute of Child Health and Human Development. He said decisions about whether to use testosterone should take into account men's individual risks for conditions the hormone could affect.

FMI: You'll find all the studies mentioned - and the editorial - in the February 21, 2017, issues of JAMA and JAMA Internal Medicine.

SUSAN ELLENBERG: It tells them that this is not likely to be a magic bullet for them but that it may lead to some improvements in some areas and probably not in others. There was some benefit for men with anemia - more on that study in a moment. However, the Testosterone Trials were too short-term to assess this risk.

But, Dr. Bradley Anawalt said, taken together, all the Testosterone Trial findings show that testosterone could be a reasonable treatment for older men suffering more than one condition related to low T. Anawalt is a professor of endocrinology at the University of Washington in Seattle and a member of The Endocrine Society's leadership council.

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"I would say, ‚We have uncertainty about the health effects of testosterone and your risk of heart attacks".



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