Testosterone Replacement Therapy (TRT)- Improve Your Health, Reduce MI’s, Stroke and Heart Disease (studies)

guysjumpingThis one’s mostly for dads and grandpa’s, although I have found several teens and early 20’s young men suffering from anxiety, depression, or fatigue who have ended up having the testosterone levels of an 80 year old man.

A previous JAMA article (which you can read here… ) shows the huge benefit of TRT (Testosterone Replacement Therapy), despite the title and wrong conclusions made in this article.

What an unfortunate blunder that JAMA – the Journal of the American Medical Association – would publish an article with the wrong conclusion in the title and the conclusion.

This article, picked up by the media and likely to be misquoted for years to come, suggests that there is increased risk of heart attacks and stroke for those on testosterone therapy. A simple reworking of the numbers they present in the study shows that they have miscalculated their results and came to the absolute wrong conclusion, opposite to what their results show. I present below a summary of their results and the links to the abstract in full for your review:

This was a retrospective study looking at a VA population of 8709 men with testosterone levels below 300 ng/dL. They present in the results that there were 1710 events (748 deaths, 443 MI’s and 519 strokes). Of the 1223 men who had been started on testosterone therapy, 67 died (5.4%), 23 had heart attacks or MI’s (1.8%), and 33 had strokes (2.6%).

Using these numbers, that means there were 8,709-1223 = 7,486 men not taking testosterone. Of this group 681 (748-67) died (9%), 420 (443-23) had MI’s (5.6%), and 486 (519–33) had strokes (6.5%).

This study shows that testosterone replacement therapy reduced the risk of death from 9% to 5.4 % cutting that risk almost in half. The chance of MI went from 5.6% to 1.8%, a 300% reduction and the chance of stroke went from 6.5% to 2.6%, a 2.5 times (250%) reduction in risk.

This study, in fact, shows what numerous other studies over the past couple decades have consistently shown: testosterone replacement therapy for those with low testosterone reduces deaths, MI’s, and strokes, not to mention the myriad of other benefits to mental health, energy, weight, sex drive, and overall fitness and well being.

I list for you below links to many of the articles showing the health benefits of testosterone replacement therapy for those with low testosterone:



Testosterone Treatment and Mortality in Men with Low Testosterone Levels

Conclusions: In an observational cohort of men with low testosterone levels, testosterone treatment was associated with decreased mortality compared with no testosterone treatment.



Testosterone deficiency is associated with increased risk of mortality and testosterone replacement improves survival in men with type 2 diabetes.

Conclusions: Low testosterone levels predict an increase in all-cause mortality during long-term follow-up. Testosterone replacement may improve survival in hypogonadal men with Type 2 Diabetes.



Endogenous Testosterone and Mortality Due to All Causes, Cardiovascular Disease, and Cancer in Men

European Prospective Investigation Into Cancer in Norfolk (EPIC-Norfolk) Prospective Population Study

Conclusions: In men, endogenous testosterone concentrations are inversely related to mortality due to cardiovascular disease and all causes. Low testosterone may be a predictive marker for those at high risk of cardiovascular disease.



Low free testosterone predicts mortality from cardiovascular disease but not other causes: the Health in Men Study.

Conclusions: Low testosterone predicts mortality from CVD but is not associated with death from other causes. Prevention of androgen deficiency might improve cardiovascular outcomes



Hypogonadism as a risk factor for cardiovascular mortality in men: a meta-analytic study.

Conclusions: Lower testosterone and higher E(2) levels correlate with increased risk of CVD and CV mortality. TRT in hypogonadism moderates metabolic components associated with CV risk.



Clinical review: Endogenous testosterone and mortality in men: a systematic review and meta-analysis.

Conclusions: Low endogenous testosterone levels are associated with increased risk of all-cause and CVD death in community-based studies of men



Low serum testosterone, arterial stiffness, and mortality in male haemodialysis patients.

Conclusions: We showed that testosterone deficiency in male HD patients is associated with increased CVD and all-cause mortality and that increased arterial stiffness may be a possible mechanism explaining this association.



Testosterone deficiency syndrome (TDS) and the heart



Low serum testosterone and mortality in older men.

Conclusions: Testosterone insufficiency in older men is associated with increased risk of death over the following 20 yr, independent of multiple risk factors and several pre-existing health conditions.



Plasma total testosterone and incident cardiovascular events in hypertensive patients.

Conclusions: Our results show that low plasma testosterone is associated with increased risk for a MACE (Major Adverse Cardiovascular Events) in hypertensive patients



Low free testosterone is associated with heart failure mortality in older men referred for coronary angiography.

Conclusions: Low levels of FT are independently associated with increased CHF mortality.



Relationship Between Low Levels of Anabolic Hormones and 6-Year Mortality in Older Men

Conclusions: Age-associated decline in anabolic hormone levels is a strong independent predictor of mortality in older men. Having multiple hormonal deficiencies rather than a deficiency in a single anabolic hormone is a robust biomarker of health status in older persons.



Testosterone: a metabolic hormone in health and disease.

Clinical trials demonstrate that testosterone replacement therapy improves the insulin resistance found in these conditions as well as glycemic control and also reduces body fat mass, in particular truncal adiposity, cholesterol and triglycerides


Dr. Paul




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