I can’t turn on the radio without hearing a commercial about testosterone for men. They tout resolution of low libido, low energy and lack of muscle mass. Yes, while testosterone can improve these areas for a man it can also cause some life threatening complications that you need to know about. I recently had a conversation with a well-known cardiovascular surgeon and he has had to amputate two men’s legs under the age of 40 from blood clots caused by testosterone. In addition, he had 6 other men that required intervention to address the blood clots also caused by testosterone. This is serious!! There is a reason the FDA has a warning label concerning testosterone.
READ ON to learn about the side-effects of too much testosterone in men and how to avoid them…..
I think our media has cheapened what testosterone is really about. Yes, it can improve libido and can improve muscle mass but low testosterone can really affect a man’s interest in life, their vitality. I am a big believer that testosterone can made a huge difference in a man however testosterone can’t be blamed for everything. Many adverse effects occur because testosterone levels are too high and or blood parameters are not followed. There are many factors to take into account before initiating testosterone therapies. Following are some of these conditions to consider:
- Sleep apnea – if a man has sleep apnea they almost always will have low T. Address the sleep apnea and it will improve
- Cycling – if a man spends a lot of time on a bicycle then they typically will have lower T (they are in tight compression shorts with a lot of pressure in that area)
- Tight underwear – same reason as above
- Medications – many medications decrease T. Cholesterol lowering medications as well as blood pressure medications are two key categories but other medications are implicated.
- Stress – high stress will lower T
- High iron levels – avoid testosterone if the iron level is high.
Once you have considered these conditions and the decision to proceed with testosterone therapy has been made then it is important to be aware of the potential risks:
What are the risks of testosterone?
- Low sperm counts (this is why if the plan is to have babies testosterone has to be administered completely different to avoid loss of fertility)
- Shrinkage of testicles
- Prostate enlargement
- Fluid retention
- Aggressive behavior
- Mood swings, irritability
- High blood pressure
- Increased risk of heart attack and heart muscle damage
- Increased risk of blood clots
- Increased risk of stroke
- Kidney failure
- Gynecomastia (enlargement of breasts in men)
- Prostate enlargement
I believe that testosterone in a man can be life changing but I am cautious with the dosing and follow certain parameters on a regular basis to avoid complications. I also tell all my male patients that if every skirt that walks by is looking good then they have gone too high.
Most adverse events while taking T can be avoided if the man is screened properly and followed properly. These are the tests that I consider important (in addition to the T level itself). When initiating testosterone therapy in a man the following parameters should be checked in 6 weeks and then every three months thereafter:
- Monitor the red blood cell counts (hemoglobin and hematocrit). If the number of red blood cells is high the blood becomes thicker making it harder to pump which can increase blood pressure, increase risk of heart attack and stroke as well as cause kidney damage. If these parameters are high then donating blood is indicated and the dose of testosterone needs to be decreased to avoid further problems.
- Monitor kidney and liver function tests.
- Monitor blood pressure – I have seen even average testosterone levels cause spikes in blood pressure (meaning you don’t have to have high levels for this to occur)
- Monitor the PSA (prostate antigen) – testosterone won’t cause prostate cancer but cancer can develop and testosterone can feed it
- Monitor the estrogen levels – men make estrogen, too and if testosterone starts getting converted into this pathway men are more likely to develop gynecomastia.
If you or your loved one is being treated by a physician that is not following the blood work then ask for it to be done or find someone who is well versed in proper therapy. And men, seriously, if every skirt is looking good then you really need to take it upon yourself to lower your dose!
To your health,