T Nation

Testosterone Tied to Worse Cardiac Outcomes


#1

Comments on TRT Article

Take a look and place your comments, please:

http://www.medpagetoday.com/Cardiology/PCI/42747


#2

Yep , that is why men don’t live as long as women . Ask yourself do you want to live a long time like a " girly man " or would you rather live shorter and stronger as the Alpha Male


#3

[quote]Sir toddington wrote:
Yep , that is why men don’t live as long as women . Ask yourself do you want to live a long time like a " girly man " or would you rather live shorter and stronger as the Alpha Male[/quote]

+1
Quality over quantity, especially for those that suffer from low T levels (actually need it).


#4

I don’t think we need to resign ourselves to shorter lives simply because we’re on TRT. We just have to accept that the treatment does come with its own increases in risk and adjust accordingly; eat smarter, keep exercising, and adjust your lifestyle to counteract the predisposition.

Fortunately, not perpetually feeling like crap gives us a much better shot at making those sorts of productive changes in our lives. We just need to make sure we make them!


#5

"Finally, Nissen urged caution and common sense, pointing out that a “fall in hormone levels in both men and women is a normal part of aging; it is not necessarily a disease. Making it into a disease may end up causing more harm than good.”

This may be so, but at 42 when my T level should be around 500-600 Ng/dl, and the reality is that it’s at 198 Ng/dl; this is not normal.

I did not see any mention of “normalized” T levels for their age after therapy. Their TRT could have been ineffective or their levels could have been higher than the normal range, thus putting them at higher risk of coronary artery disease, myocardial infarction, and cerebrovascular accident.

Other studies have shown low T levels put men at greater risk for heart disease / heart attack.

http://www.health.harvard.edu/fhg/updates/testosterone-and-the-heart.shtml

http://men.webmd.com/news/20030527/low-testosterone-linked-to-heart-disease

http://www.nytimes.com/1994/05/10/science/testosterone-may-avert-heart-attack.html

In my opinion, genetics and obesity play a greater role in predicting cardiac disease.
I’ve seen young, fairly fit men (40-50) who have terrible heart problems due to bad family history of heart disease. I’ve also known of 40-50 year old distance runners who are extremely cardiovascularly fit drop dead of myocardial infarction. If TRT gives me more energy to do cardio and lift weights, and I can keep losing weight, I think I’m at lower risk of cardiac disease, diabetes, or stroke.

The one problem that does seem related to TRT is prostate cancer, which even then, is statistically low incidence.


#6

That’s funny! I seem to recall reading a article somewhere that tracked older men for a certain point. At the end of the study most all of the men that passed away were very low on T, and the ones still alive were in the higher ranges. I wish I could find it.


#7

[quote]cobra003 wrote:
That’s funny! I seem to recall reading a article somewhere that tracked older men for a certain point. At the end of the study most all of the men that passed away were very low on T, and the ones still alive were in the higher ranges. I wish I could find it.[/quote]

Here’s one: http://jcem.endojournals.org/content/97/6/2050.full

“In an observational cohort of men with low testosterone levels, testosterone treatment was associated with decreased mortality compared with no testosterone treatment. These results should be interpreted cautiously because residual confounding may still be a source of bias. Large, randomized clinical trials are needed to better characterize the health effects of testosterone treatment in older men with low testosterone levels.”

I suppose that these don’t necessarily contradict each other; TRT could reduce all-cause mortality rates while still increasing cardiac mortality rates. Given how comparatively easy it is to give attention to cardiac issues, though (not saying that enough people do!), I’d definitely even take an increase in morality for the benefits of TRT.


#8

It’s a flawed study.

From a Life Extension press release:

"In studies designed to assess the impact of testosterone replacement therapy, one of the most important considerations is to measure subjects’ blood levels of testosterone regularly throughout the study period. This allows the physicians and researchers conducting the study to make sure subjects are taking their testosterone as directed and that their blood levels are rising as expected.

"In the retrospective study published in JAMA, only 60% of study subjects receiving testosterone had a follow-up blood test to assess their testosterone levels. Among them, average testosterone levels rose from a very low level of 175.5 ng/dL at baseline to a still far-from-optimal level of 332.2 ng/dL during testosterone therapy.

“Raising testosterone levels from a very low 175.5 ng/dL to a still low 332.2 ng/dL is unlikely to deliver robust health benefits. In fact, research has shown that restoring testosterone levels to at least 500 ng/dL is associated with pronounced health benefits, whereas benefits may be less evident at lower levels. (References: Ohlsson C, Barrett-Connor E, Bhasin S, et al. High serum testosterone is associated with reduced risk of cardiovascular events in elderly men. The MrOS (Osteoporotic Fractures in Men) study in Sweden. Journal of the American College of Cardiology. Oct 11 2011;58(16):1674-1681.; Aversa A, Bruzziches R, Francomano D, et al. Effects of testosterone undecanoate on cardiovascular risk factors and atherosclerosis in middle-aged men with late-onset hypogonadism and metabolic syndrome: results from a 24-month, randomized, double-blind, placebo-controlled study. The journal of sexual medicine. Oct 2010;7(10):3495-3503.)”


#9

The men in that study had profound health problems, perhaps too late for intervention. Some degeneration is not reversible. The “study” did not optimize T and E levels, so perhaps the increased mortality was from elevated E2 and estrogen dominance. If the men felt more energized and actually got off there butts and did something, perhaps the stress was more than their conditions could tolerate. My father is 97 and shovels show in the winter, maybe he will survive another winter, he does not care what takes him down.