We have been discussing testosterone, its synthetic cousins, and the growing desire of pharmaceutical companies to get some under your skin.
Recent growth in testosterone replacement therapy is, in part, attributable to an aging population, simplified methods of delivery, such as gels and creams, and longer acting treatment. An effective marketing push by pharmaceutical companies has also driven consumer interest.
As testosterone replacement therapy becomes more popular, it is reasonable to ask: How safe is this form of treatment? If you live in North America, you could seek out this information through the US Food and Drug Administration (FDA), or the Therapeutic Products Directorate (TPD) at Health Canada, or look at one of the millions of peer-reviewed scientific articles on PubMed. But that is boring. Let’s look instead at a completely unbiased and obviously neutral website. Namely, http://www.testosterones.com. So, tell us testosterones.com, is testosterone replacement therapy safe?
- This is the primary question, this is the primary concern of most men; is Testosterone Replacement Therapy safe? With absolute assurance we can emphatically state “Yes” yes it is. No one has ever died due to therapeutic testosterone use; for that matter there have been no recorded death in history due to testosterone use, not even when doses are of a supraphysiological nature as is common in performance enhancement. Numerous studies have shown that the testosterone hormone when administered to healthy adult men does not cause any serious health concerns or problems when responsible use is implored.
There you go. According to testosterones.com, because no one has died from testosterone use, it is, therefore, safe. Even when taken in mega-doses, no one has died. Hence, safe. And, even better, when men are implored to be responsible, no serious health concerns or problems occur.
Now I don’t wish to disparage testosterones.com’s reporting of the current mortality and morbidity risks associated with testosterone use. But, they may have missed a few studies in their literature review.
Testosterone is an anabolic-androgenic steroid that has both growth (anabolic) and masculinizing (androgenic) properties. Studies reviewing the consequences of prolonged high doses of synthetic testosterone and other anabolic-androgenic steroids reveal that these substances may considerably increase your risk for stroke, liver damage, and cardiac disease.
Most studies, however, have had to rely on circumstantial evidence and the link between life threatening health events and testosterone use is not immediate or direct. For example, a retrospective review of Finnish weight lifters found that these athletes tended to die prematurely when compared to age-matched peers. Although it was strongly implicated that steroid use was the most likely cause of early death, other factors can not be ruled out.
Unfortunately, there is an absence of longitudinal studies tracking the long-term impact of supraphysiological dosing of testosterone. As well, no randomized clinical trials have been done in which human participants are given increasing levels of testosterone until they die. Because that would be illegal and unlikely to get past an ethics review board.
However, when hamsters are allowed to self-administer testosterone without restriction, one out of four of these poor little guys will eventually die. Deaths are directly related to peak daily self-administration of testosterone: the greater the amount, the greater the rate of mortality. Results of animal studies have also suggested that anabolic-androgenic steroids tend to mimic physiological and behavioral patterns similar to what one finds among strongly addictive substances.
So, at least for hamsters and Finnish weight lifters, high levels of testosterone may not be safe after all.
For the rest of us, time will tell.
- Wood, R. I. (2008). Anabolic-androgenic steroid dependence? Insights from animals and humans. Frontiers in Neuroendocrinology, 29, 490-506.
- Kanayama, G., Hudson, J. I, & Pope, Jr., H. G. (2008). Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse. A Looming Public Health Concern? Drug and Alcohol Dependence, 98, 1-12.