See Dr. Margaret E. Wierman, JAMA Internal Medicine, July 1, 2015.
Friday, February 26, 2016
Just Right Treatment for Male Andropause
As men get
older, they are often treated for hypogonadism (low testosterone). This can be beneficial and safe, if initial
blood levels are low (200-250 nanograms) and if relative low doses of
testosterone topical gels are prescribed.
Other measures such treating chronic pain, diabetes, B12 deficiency,
hyperlipidemia and hypertension, weight loss, and IV chelation can safely raise
this hormone and improve quality of life.
However, treatment with injectable testosterone to achieve higher doses
can be dangerous. A huge study in the
U.S. and England, showed a 26% increase in a composite end point of heart
attack, stroke, and unstable angina and a 34% increase in all-cause mortality
for patients treated with injectable testosterone.
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Ah, another study bashing testosterone--in JAMA, of course. I cannot comment on it, because I haven't read it yet. However, Dr. Chappell may recall an earlier one (2013), searchable as PMID: 24193080. In brief, VA patients with heart disease, given testosterone, had more strokes, heart attacks, and deaths than those untreated. An astute orthomolecular physician pointed out to me that the pristine data as published showed HALF as many deaths in the testosterone group, with ever lower incidence of heart attacks and strokes. I wrote on my FaceBook, "So what gives? In brief, the data got cooked. As the authors explain, '[W]e used stabilized inverse probability weighting to adjust for any unmeasured confounders that may have affected when and if patients were prescribed testosterone...' In other words, they applied a 'fudge factor,' as college students all over the world do when their course work doesn't come out right. This particular fudge factor is serious, however.... This paper (in JAMA of course) lays bare the chilling possibility that embarrassing facts can be made to disappear, or even converted to anti-facts, through the proper choice of mathematical transformations. Ah, brave new world of science! Moral: figures don't lie, but liars can figure.
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