We in the medical profession profess to be open-minded. Yet, when it comes to helping patients maintain hormone health, many doctors are cemented to beliefs drawn from outdated studies rather than the latest data.
It’s not uncommon for patients I meet to say, “I feel terrible, but my family doctor says my blood tests are all normal.”
As an endocrinologist, I specialize in hormone-related conditions and follow research more closely than most physicians. Testosterone therapy is one area particularly prone to misinformation, so allow me to separate myth from facts based on good science.
Ashok Kadambi, MD
Fellow of the American College of Endocrinology
Testosterone Myths and Facts
MYTH : Testosterone causes aggression.
FACT: Many aggressive and irritable men have low testosterone levels. Testosterone helps improve focus and concentration, reducing aggression.
MYTH: The symptoms of testosterone deficiency (Low-T) are a normal part of aging and don’t require treatment.
FACT: Hypertension, heart disease, elevated cholesterol, diabetes, cataracts and many cancers are age-related and yet commonly treated. There is no justification in singling out Low-T as a condition that does not merit treatment just because it becomes more prevalent with age.
MYTH: A testosterone level in the “normal reference range” should not be treated.
FACT: Some men have symptoms of Low-T even when lab tests show their total testosterone levels in the “normal” reference range. This is because there is great variation in the human body’s sensitivity to the androgen receptor. There is also great variation from lab-to-lab.
MYTH: Most patients with Low-T are impotent.
FACT: The most common symptoms of low testosterone are fatigue, depression, weight gain and lack of motivation or drive. Most men still retain potency even at low levels of testosterone. One ought not to wait until becoming impotent to begin a therapeutic trial with testosterone replacement. In my clinic, I listen carefully and am guided by the patient and his symptoms. The lab report is a tool to monitor safe blood levels. We will adjust dosage until the patient sees symptom improvement. Our in-house laboratory is highly consistent and accurate so I trust it’s findings and ensure safe blood levels.
MYTH: Testosterone causes increase in the risk of blood clots known as Venous Thromboembolism (VTE).
FACT: The weight of published clinical studies points towards tremendous cardiovascular benefits of testosterone. This myth is built on studies later proven to be flawed which caused the FDA to order a caution statement in all testosterone products. Those studies were later retracted, but the warnings remain. This caused a feeding frenzy by attorneys who rely on negative, yet flawed, studies to convince a jury.
MYTH: Testosterone deficiency is uncommon and treatment must be restricted only to men with severely low blood levels and extreme symptoms.
FACT: Low-T is a major global public health concern affecting up to 30% of men. A major US study estimated that treating Low-T could save as much as half a trillion dollars in healthcare expenditures over 20-years.
MYTH: The benefits of optimizing testosterone levels are marginal
FACT: Testosterone deficiency is strongly linked to increased prevalence of diabetes, cardiovascular disease, as well as osteoporosis and cognitive decline