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The Trouble with Low T Treatments

Have you noticed the ever-increasing collection of commercials targeting men with low testosterone, or “Low T?” Much like the advertising for Viagra and other ED medications, these ubiquitous sales pitches prey on the insecurities of mature men with promises of increased vitality, improved muscle mass, alleviating depression, and improved sexual performance.

But for some men, these drugs come at steep price.

A recent study published in the Journal of the American Medical Association indicates testosterone treatments may increase risks of heart attack, stroke and death in men. A previous study had to be cancelled in 2009 due to “an increased risk of adverse cardiovascular events.”

What is Low T?

Testosterone is an androgen, or male hormone, produced in the testicles and regulated by glands in the brain. Low testosterone, also known as androgen deficiency or hypogonadism, can result from problems in the testicles or the brain. This is different from the normal decrease in testosterone levels in men over 30, which is a normal part of the aging process and does not necessarily require treatment.


Testosterone Replacement Therapy (TRT) has been proven effective, but for whom? Low T diagnosis can be difficult since the symptoms of hypogonadism are arguably vague and may develop over time. Adding to the problem are aggressive marketing campaigns by pharmaceutical companies, which have resulted in blockbuster sales for drug makers like AbbVie and Eli Lilly. Reports indicate that the percentage of men being treated for “Low T” has almost quadrupled since 2000, reaching $1.6 billion in U.S. sales in 2011.

The Endocrine Society recommends testosterone treatment for men who are diagnosed as having low testosterone based on both symptoms and blood tests showing indisputably low testosterone levels, but some doctors are prescribing testosterone replacement therapy to healthy men who want to boost their libido, energy and strength.

However, testosterone treatment “offers no proven benefits for healthy men,” says Dr. Adriane Fugh-Berman, of Georgetown University Medical Center. “Low T syndrome is invented by pharmaceutical companies to sell treatment products.”



Testosterone treatments linked to heart risksAP/USA Today, November 5, 2013.

Too many men take testosterone when they don’t need it” by Endocrine Society, The Washington Post, January 13, 2014.

Popular ‘low T’ therapy divides the medical field” by Laura Ungar, The (Louisville, Ky.) Courier-Journal, June 12, 2013.

Association of Testosterone Therapy With Mortality, Myocardial Infarction, and Stroke in Men With Low Testosterone Levels” JAMA. 2013;310(17):1829-1836. doi:10.1001/jama.2013.280386.

“Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes: An Endocrine Society Clinical Practice Guideline” The Endocrine Society®, The Journal of Clinical Endocrinology & Metabolism, June 2010, Vol. 95(6):2536–2559.