In our final testosterone article (for now, at least), we’ll cover the top two worries men, and oftentimes their partners, have when it comes to hormone replacement therapy. First:
“Won’t my natural production shut down?”
That’s a valid concern. When you take additional hormones, your body tends to kick back… relax… and stop producing the stuff on its own. “If you don’t use it, you lose it” and all that. Good news, though: When the supply runs dry, your body revives its production.
A review of studies by the University of Tennessee Graduate School of Medicine shows testosterone levels tend to bounce back to their previous levels.
That’s good…
… but this “bounce back” is to the same previously low levels that spurred the therapy in the first place.
That’s bad.
This, if anything, can cause a psychological dependency. But that’s like saying coffee should be avoided at all costs because you start jonesing for the energy every morning and risked crashing later on. It comes down to what your body can handle and how well you can manage an external stimulant.
(And before anyone freaks out because sex hormones are obviously more serious than coffee, it’s the principle of which I speak.)
Balancing a little extra testosterone on the side and dealing with the occasional taper, however, is a far cry from “take testosterone and your testicles will go on strike forever.” Here’s one reader’s experience:
“I am 60 years old and have been on doctor’s prescription for 10 years. I think it’s overrated for sex drive. It does help with energy level and mood swings. My muscle mass has not disappeared like a lot of buddies of the same age. However, I do work out three times a week in old traditional karate, which includes an hour of stretching and hour of karate forms. I have my blood checked every six months and annual visits to urologist. Don’t feel 60, but if I don’t work out, I do. Have tapered off testosterone before and the only noticeable side effect is a big case of lazy ass.”
Now let’s move onto something a little more scary: prostate cancer. If you’ve ever researched increasing your testosterone levels through hormone replacement therapy, you’ve probably read that doing so grows prostate cancer.
There’s just one problem with this:
It’s BS.
This rumor began based on the research of Charles B. Huggins, who won the Nobel Prize for, in part, castrating men. Seriously.
This party pooper reported that testosterone injection “activates” prostate cancer and enhances its growth “in all cases.” I’m sure he concluded that based on extensive studies and experimentation… right?
Oh, not so much.
This was discovered by Dr. Abraham Morgentaler in the basement of the Countway Library at Harvard Medical School. There, he dug up an old volume Huggins had contributed to in 1941. To make things more interesting, I’m picturing it as something similar to the scene where Indiana Jones swipes that weird golden figure thingy from the booby-trapped cave in Raiders of the Lost Ark.
Anyway, Dr. Morgentaler found out the myth of testosterone and prostate cancer was the result of three men being studied! The results were reported for only two… and one was already castrated. Plus, their possible prostate cancer growth was determined with a method since abandoned for its crappy results.
After outrunning a giant boulder threatening to trap him in the Countway Library forever (still doing the Indiana Jones thing here), Dr. Morgentaler went on to publish studies showing testosterone therapy has zero risk for increasing prostate cancer growth.
Not that the fear-mongering of evil steroids has ceased:
In a 2013 study published in JAMA, the authors conclude there’s an increase of heart problems among men with low testosterone who get testosterone therapy.
Dr. Morgentaler was quick to fire back to JAMA’s Journal Oversight Committee. Here’s what he wrote, according to DrugWatch.com:
“This article is a mess, and JAMA has behaved badly. Something is terribly amiss when a premier medical journal publishes such an obviously weak study that contradicts well-established literature, and in so doing fosters fear among the public. The concern is heightened when the journal’s response to inescapable evidence that the study is meritless is to deceive, distort, stonewall, and dig in. JAMA’s behavior suggests it is more interested in sensationalism and media coverage than scientific accuracy and integrity.”
Feel that, JAMA? That’s Dr. Morgentaler… to borrow a phrase from The Rock… laying the smackdown on you.
In fairness, I’ll grudgingly admit the good doctor has received financial backing from AbbVie, which sells AndroGel, the most popular testosterone treatment.
But here’s something you should know about researchers and their corporate ties (yes, it’s time for one of my sidetracks): Any sort of financial conflict of interest must be disclosed in a study. Yes, they can lie, and there is “back seat of a Lincoln Town Car-sized” wiggle room for messing with data to get the outcome the study funders want.
But here’s the thing: This is the villain everyone knows about. What people rarely consider is the bias toward toeing the government’s line or the culture of the school where the study’s taking place. This influence is much stronger and more insidious.
Anyway…
For all the study’s controversy, the increase in absolute risk it published for cardiac outcomes was a paltry 5.8 percent. Call me cavalier, but I might be willing to roll the dice if the upshot included feeling, functioning and looking more like a hormone-dripping 20-something. But that’s just me.
Especially considering a study out of Germany found an association between low testosterone and all-cause mortality. In other words, men with low T tended to die more from… everything. (And yes, that probably includes terminal cases of lazy ass).
Here’s to staying motivated,
Nate Rifkin
Underground Health
