Dear Dr. Garner,
I am writing because I am a 54-year-old male who just doesn’t quite feel the same as I used to feel. I don’t have the same zest for living and am generally sluggish. When I went to my doctor, he told me that I could benefit from testosterone therapy.
I have been on the therapy for about two months now, and I have to admit that I do feel better. I just want to make sure that I am not doing harm to myself. My wife tells me I could end up having a heart attack.
Could you please tell me if there is any risk to testosterone therapy and if you think I should be taking it?
Worried in Williamsburg
Dear Worried,
I am glad to hear that you are feeling better. Testosterone can, in fact, increase muscle mass, sharpen memory and concentration, boost your libido and improve your overall energy level.
Unfortunately, these benefits may come with a price.
A new Veterans Administration study published last week showed that testosterone treatment may increase the risk for heart attacks, strokes and death.
Men who use testosterone were 30 percent more likely to have a heart attack, a stroke or die as compared to those who did not take it.
The research does not prove that testosterone caused the heart attacks, stroke or fatalities, but it should alert doctors to re-examine their prescribing habits for testosterone.
No one should prescribe testosterone unless there is a documented low level in the blood, which should be 350 or less.
Testosterone is a hormone that is produced by the testicles. Natural testosterone, which is made by the body, helps men to maintain their sex drive, muscle mass, body density and fat distribution. Testosterone levels peak around adolescence and early adulthood. As men get older, it gradually declines, about one percent a year. While the level drops in all men, not all men go on to develop symptoms.
Simple Step to Diagnosis
In some patients, there may be emotional changes, changes in sleep habits and physical changes. A blood test is the only way to diagnose a low testosterone level. It has not been documented that testosterone therapy benefits all men.
Some men believe taking testosterone medication may help them feel young and more vigorous. Few studies have documented this.
In summary, before taking testosterone therapy, it is essential that a blood test be drawn to determine your actual level. This should be done under the care of a doctor who is experienced with testosterone therapy replacement so that the chance of harm is lessened.
I urge those considering it to first try lifestyle changes, including exercise and proper diet, to see if your mood and muscle mass can be elevated.
If this is not effective, I urge you to discuss the matter with your family doctor. A physician experienced in testosterone therapy may provide beneficial treatment.
Please keep me updated on your situation.[hr] Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.