TRT, Low Test, early death.

[Freakenstien]

Low Testosterone, Early Death?

Higher Death Risk in Men With Lower Testosterone Levels
By Daniel J. DeNoon (http://www.webmd.com/daniel-j-denoon)
WebMD Health News
Reviewed by Louise Chang, MD (http://www.webmd.com/louise-chang)

WebMD News Archive
Nov. 27, 2007 -- The lower a man's testosterone (http://www.webmd.com/men/testosterone-15738) level, the higher his risk of death -- especially death from heart disease (http://www.webmd.com/heart-disease/ss/slideshow-visual-guide-to-heart-disease).
The finding comes from a study of British men aged 40 to 79 by University of Cambridge gerontologist Kay-Tee Khaw, MBBCh, and colleagues.
"The men with lower testosterone (http://www.webmd.com/sex-relationships/low-testosterone-8/rm-quiz-truth-testosterone-html) levels had an increased risk of dying from any cause, but most particularly of cardiovascular disease (http://www.webmd.com/heart-disease/default.htm)," Khaw tells WebMD. "We looked at cancer (http://www.webmd.com/cancer/default.htm), too, and found no evidence of a link to cancer (http://www.webmd.com/cancer/cancer-prevention-detection-16/rm-quiz-cancer-myths-facts) with higher testosterone levels."
Nearly 12,000 men enrolled in the long-term study from 1993 to 1997. More than 800 of the men died by 2003; Khaw compared these men's testosterone levels to those of some 1,500 living study participants.
After adjusting for factors that might affect risk of death -- including age, weight (http://www.webmd.com/diet/healthy-weight-what-is-a-healthy-weight), smoking (http://www.webmd.com/smoking-cessation/default.htm), alcohol use, high blood pressure (http://www.webmd.com/hypertension-high-blood-pressure/default.htm), diabetes (http://www.webmd.com/diabetes/default.htm), physical activity (http://www.webmd.com/fitness-exercise/default.htm), education, and social class -- the link between low testosterone (http://www.webmd.com/men/what-low-testosterone-can-mean-your-health) and earlier death remained.




Compared to men with the lowest quartile (25%) of testosterone levels:


Men in the second lowest quartile were 25% less likely to die.
Men in the second highest quartile were 38% less likely to die.
Men in the highest quartile were 41% less likely to die.

"We found that low testosterone (http://www.webmd.com/men/ss/slideshow-low-testosterone-overview) predicts early mortality in men over the next 10 years or so," Khaw says. "But we think this finding needs to be replicated. We would like others to look at this in other populations of men and see if they get the same results."
The findings make sense to Robert Davis, MD, professor of urology at the University of Rochester, N.Y. Davis says low testosterone (http://www.webmd.com/men/testosterone-assessment/default.htm) is common among men with metabolic syndrome (http://www.webmd.com/heart/metabolic-syndrome/default.htm) -- a constellation of risk factors including abdominal fat, high blood sugar (http://www.webmd.com/diabetes/guide/blood-glucose), high blood pressure (http://www.webmd.com/hypertension-high-blood-pressure/ss/slideshow-hypertension-overview), low HDL cholesterol (http://www.webmd.com/cholesterol-management/hdl-cholesterol-the-good-cholesterol), and high blood (http://www.webmd.com/heart/anatomy-picture-of-blood)-fat levels.
"Certainly I'm not surprised at this finding. It's been shown that low testosterone (http://www.webmd.com/men/video/testosterone-replacement-therapy) correlates with metabolic syndrome, which is related to diseases like diabetes (http://www.webmd.com/diabetes/diabetes-health-check/default.htm), heart disease (http://www.webmd.com/heart-disease/heart-disease-facts-quiz), and vascular disease," Davis tells WebMD. "The need to check testosterone levels in people with metabolic syndrome is being recognized more and more among physicians."

Low testosterone may be bad, but it is not clear that testosterone replacement (http://www.webmd.com/men/guide/testosterone-replacement-therapy-is-it-right-for-you) therapy corrects this problem. Only clinical trials (http://www.webmd.com/a-to-z-guides/clincial-trial-guide-patients) can prove whether testosterone supplementation can lower the risk of death linked to low testosterone levels. Ironically, researchers have been reluctant to test testosterone replacement (http://www.webmd.com/prostate-cancer/video/testosterone-replacement-prostate-cancer) in clinical trials because of worries that the treatment may increase men's risk of prostate cancer (http://www.webmd.com/prostate-cancer/default.htm).
"Our study may provide some reassurance of those planning trials of testosterone supplementation," Khaw says. "The irony is that while a lot of men believe testosterone supplements (http://www.webmd.com/vitamins-and-supplements/lifestyle-guide-11/default.htm) may be good for their health, those trials have not been done because of ethical concerns of testosterone causing prostate cancer (http://www.webmd.com/prostate-cancer/ss/slideshow-prostate-cancer-overview)."
Davis worries that doctors are too wary of prescribing testosterone supplements (http://www.webmd.com/vitamins-and-supplements/supplements-assessment/default.htm) for men with too-low testosterone levels.
"It is a very underdiagnosed and undertreated problem," he says. "One of the myths is that androgen supplementation will cause a cancer (http://www.webmd.com/cancer/health-check-cancer-risk/default.htm). We know that prostate cancer often regresses when androgen is removed, but there is very little evidence that supplementing to normal levels increases risk of cancer, and some evidence it may lower it."




Khaw and colleagues report their findings in the Dec. 4 issue of the journal Circulation.
View Article Sources http://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/modules/todaysNews_plusSign.gif
SOURCES: Khaw, K.-T. Circulation, Dec. 4, 2007; vol 116, manuscript received ahead of print. Kay-Tee Khaw, MBBCh, professor of clinical gerontology, University of Cambridge, England. Robert Davis, MD, professor of urology, University of Rochester, N.Y.


© 2007 WebMD, Inc.

[SearingHigh]

Nice article

[Freakenstien]

yes, but its who do we believe?
Testosterone Therapy Linked to Heart Attack, Stroke, Low T Lawsuits (https://monroelawgroup.com/testosterone-therapy/)

[Hunta]

Time to up the dosage then?

[Freakenstien]

haha, maybe.. Risks in life no matter what you do I suppose..

[Freakenstien]

https://www.sciencedaily.com/releases/2015/11/151109160558.htm

se of testosterone replacement therapy in healthy men does not increase risk of heart attack or stroke, new study findsDate:November 9, 2015Source:Intermountain Medical CenterSummary:A new study of generally healthy men who used testosterone replacement therapy to normalize testosterone levels has found that taking supplemental testosterone does not increase their risk of experiencing a heart attack or stroke.Share:AddThis Sharing Buttons










FULL STORY

A new study of generally healthy men who used testosterone replacement therapy to normalize testosterone levels has found that taking supplemental testosterone does not increase their risk of experiencing a heart attack or stroke.
Researchers at the Intermountain Medical Center Heart Institute in Salt Lake City studied 1,472 men between the ages of 52 and 63 who had low testosterone levels and no prior history of heart disease. The men were patients at Intermountain Healthcare hospitals. Researchers found that generally healthy men who received testosterone supplementation to achieve normal levels did not increase their risk of heart attack, stroke, or death.
Results of the study were reported at the 2015 American Heart Association Scientific Session in Orlando on November 9, 2015.
"Our research examined the potential cardiovascular risks associated with generally healthy men who use testosterone supplements to normalize their levels and found no increase in those risk factors," said Brent Muhlestein, MD, co-director of research at the Intermountain Medical Center Heart Institute. "In fact, testosterone therapy in this population was shown to reduce the risk of heart attack, stroke and death, when compared to those men who weren't taking testosterone supplementation."
Earlier this year, the U.S. Food and Drug Administration required manufacturers of all approved testosterone products to add information on the labels to clarify the approved uses of the medications and include information about possible increased risks of heart attacks and strokes in patients taking testosterone.
Testosterone replacement therapy is commonly used in older men to normalize the hormone level and help patients feel better, have more energy and increase muscle mass. But physicians and patients must weigh the benefits and risks of providing patients with testosterone supplementation based on the information provided by the FDA and other research.
According to the FDA, the use of testosterone therapy has increased significantly, from 1.3 million patients in 2009 to 2.3 million patients who had a prescription for testosterone products in 2013.
Previous studies have been conducted on testosterone replacement therapy and its cardiovascular effects in men, with different results. While it is known that low levels of testosterone pose an increased cardiovascular risk, the risks versus benefits of supplementation have not been clearly identified.
During clinical follow-up after one and three years, the men in the Intermountain Medical Center Heart Institute study were categorized by whether or not they received at least 90 days of testosterone supplementation (topical gel or injection) or not. A Cox hazard regression analysis, which adjusted for 17 baseline variables, was performed to determine any association between testosterone supplementation and three-year outcomes of death, non-fatal heart attack and stroke.
"This particular study provides assurances to physicians and patients that using testosterone replacement therapy in a generally healthy population of men over the age of 50 to normalize levels doesn't increase a patient's risk of a heart attack or stroke, and actually shows a reduction in those risks," said Dr. Muhlestein.

Story Source:
The above post is reprinted from materials (https://intermountainhealthcare.org/news/2015/11/use-of-testosterone-replacement-therapy-does-not-increase-risk-of-heart-attack-or-stroke/) provided by Intermountain Medical Center (https://intermountainhealthcare.org/locations/intermountain-medical-center/). Note: Materials may be edited for content and length.

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[Freakenstien]

I was on TRT for a few years, but unfortunately, the doctor that had me on TRT went about it all wrong. So I went to see an endocrinologist who told me to stop taking it as the risk of heart attack was too great as found in recent studies. So I stopped. I went back to struggling in every day life and have come to the conclusion. Fuck the endo. He's clueless. All very well just saying stop cold turkey but I still dont have any energy. Endo said it would take a few years for my test levels to normalise.

Well if that is true, why would he want me to feel like shit for years? Why not prescribe a proper protocol (PCT) for me to restore hypothalamus, pituitary, testicular, Axis (HPTA) back to producing its own endogenous testosterone production?

Because he was clueless. And why does he think i was taking trt in the first place? For fun. So why didnt he address the issues that were making me lethargic before I went on TRT. Because he was clueless.

So I have decided to go back on TRT. But now I need to work out the risk factors. I know in older people with existing hear disease the risk is higher of heart attacks. But there appears to be a much lesser risk in normal healthy males. Been researching trying to get to the bottom of it and have come up this link below which I think may explain it all. So after waying up the benefits and risks, I am going to go back on. At the very least if I do decide to come off I can use a proper protocol and see if I can get my T levels back to some where near normal. But I do have one other option to consider before going back on. Im too over weight. Losing weight WILL change testosterone levels for the better and should bring down estrogen levels... So thats my first option. Get my weight levels down to normal and see what happens. I'll need to go get bloods now, Test and estrogen levels, then again when Im down to a normal weight to do a comparison.

Then if not feeling a whole lot better, its going to be time to start TRT. Happy to listen to anyones thoughts on this.
Im definitely no expert in any of this area but my thoughts are everything I have read points to TRT being safe for anyone who doesnt have pre-existing arterial or heart conditions. In fact TRT should also help prevent heart disease, diabetes etc. But it looks like its a good idea to have a good health check up before starting TRT

Ok link below and I think this is the important part to understand.

"Study LimitationsThe first issue I have with this study is that E and DHT levels were not measured. We always measure these byproducts and if either one becomes elevated we give enzyme inhibitors to block the conversion of T to the byproduct. In the case of high E, we know it is associated with more heart disease. I suspect this might be the main reason for increased heart disease in the men taking TRT.
Second, the men in the study were older, and most of them already had existing heart disease. We know from studies on women that estrogen replacement therapy (ERT) will prevent heart disease if started early before artery plaque has started, yet will agitate existing artery plaque. Thus it matters a great deal when the ERT is started.
Before starting women on ERT, if they have not been on hormones for more than 5 years or so, we always scan the arteries to check for plaque. If there is no plaque we start ERT. If there is plaque, we examine the causes thoroughly, then treat and stabilize the plaque prior to starting ERT.
I can only speculate, but I wonder if there is a similar, as yet unstudied, pattern in men such that TRT may prevent plaque, yet agitate existing unstable plaque. There was a similar study a few years ago done in a nursing home setting that showed increased risk of heart disease in men taking TRT. Again, these were much older men, many with pre-existing heart disease.
This is an area that deserves more specific research – does it matter when TRT is started, before artery disease is present, and does controlling E byproduct levels lower the risk of worsening heart disease."

http://imcwc.com/html5-blank/the-heart-of-the-matter-with-testosterone/