8 Myths About Testosterone

Biodentical Hormone Replacement Therapy in Denver

8 Myths About Testosterone

Healthy male BioTE Denver patient

8 Myths About Testosterone

Even though Testosterone replacement therapy (TRT) has been used since the 1930’s, there are many myths about it’s safety.  Here are 8 myths about testosterone and the reality behind it’s benefits.

1) Testosterone Causes Prostate Cancer

The research behind this myth goes back to 1941 when a doctor noted that one of his patients with metastatic prostate cancer lived longer after being castrated. After decades of research, this outcome has never been repeated.  In fact, analysis of more that 250,000 medical records of Swedish men, indicated the exact opposite. Men who’d undergone TRT for more than a year did not see an increased risk of prostate cancer.  Actually, their risk of aggressive prostate cancer was reduced by 50 percent.

In another study, researchers in the United Kingdom looked at 1,400 men who had received TRT for up to 20 years.  They found only 14 cases of prostate cancer over the course of the study.

2) High Levels of Testosterone Leads to Hair Loss

Of the myths about testosterone therapy, this may be the most commonly known.  For decades, people have been lead to believe that men with male pattern baldness have higher levels of testosterone. In fact, baldness is genetically determined. It is true that some testosterone in the body is converted to dihydrotestosterone (DHT).  This substance can bind to hair follicles and weaken them, eventually causing the hairs to fall out. However, this type of hair loss is linked to genetics and not elevated testosterone levels.

Over the counter Minoxidil and prescription Propecia help prevent the formation of DHT and are effective treatments.

3) Testosterone Supplementation Increases the Risk of Cardiovascular Disease

In 2016, a small sample of studies caused the FDA to worry about testosterone.  The authors of one study examined a large group of men who’d been on TRT for 90 days. Younger men with a history of heart disease showed a 2 to 3x increase in risk of heart attack. Men over 65 who started TRT had a two-fold increase in the risk of heart attack, regardless of their cardiovascular history.

However, there were several problems with the study:

  • The study didn’t consider levels of testosterone before or after treatment. Therefore, there’s no way to know if the subjects started with low testosterone or just received too much testosterone.
  • However, the study didn’t monitor estrogen levels or red blood cell levels. Elevated levels of both of these can cause heart problems.
  • The control group in the study was on a drug to prevent heart attacks so comparing the two groups is like comparing “apples and oranges”.

The Journal of the American Heart Association published a meta-study compiling the results of testosterone and heart health. They found that higher levels of testosterone were essential to heart health. In fact, they found that low levels of Testosterone were associated with a higher rate of mortality in general, as well as higher rates of cardiovascular mortality, obesity, and diabetes.

The list of possible conditions associated with low testosterone included:

  • Increased risk of cardiovascular disease
  • Narrowing of carotid arteries
  • Abnormal EKG
  • More frequent congestive heart failure
  • Increased incidence of angina
  • Increased body mass index
  • Type II diabetes
  • Metabolic syndrome
  • Insulin resistance
  • Increased belly fat
  • Higher death rate from all causes, including cardiac mortality

In addition to the above findings, researchers at the Intermountain Medical Center Heart Institute recruited 755 heart patients between the ages of 58 and 78 who also tested low in testosterone.  These men were divided into three groups, two of which received TRT in the form of gel or an injectable, and one group that served as the placebo group.

After one year:

  • 64 patients who weren’t on Testosterone replacement therapy suffered a major cardiovascular event (stroke, heart attack, or death).
  • Only 12 of  the patients on medium doses of Testosterone experienced a major cardiovascular event.
  • Only 9 patients on high doses of Testosterone experienced a major cardiovascular event.

In other words, the patients NOT taking Testosterone were 80% more likely to suffer an adverse event.

4) Testosterone Increases Aggressive Behavior

Myths about testosterone abound.  These include the belief that men with high testosterone levels are more often moody, depressed, and even angry.  Meanwhile, men with normal or low testosterone levels are typically more friendly and sociable.

Dr. Christina Wang of UCLA found the opposite.  In fact, men with low levels of Testosterone were likely to be aggressive than men with high Testosterone.  Once men with lower levels of Testosterone received Testosterone replacement, their attitude and anger disappeared.

However, very high doses of testosterone can create aggressive tendencies.  Of course, “roid rage” can occur in men predisposed to such behavior.

5) Men Should Only Receive Testosterone Supplementation if Their Levels are “Low”

Unfortunately, most doctors don’t typically measure Testosterone levels. If they do, they typically only measure “total Testosterone”  This is the total amount of Testosterone in the blood stream.

These numbers may range anywhere from 300 to 1100 ng/dL (nanograms per deciliter of blood). However, even if the results indicate that you have “normal” testosterone levels, it might not be normal for you.  Maybe your Testosterone levels were 1,000 in your twenties, but now are only 400. While this can be considered “normal”, it may not be optimal for you.

There is also a substance in the body called “steroid hormone binding globulin”, or SHBG.  This substance binds to sex hormones making them inactive.  This can affect up to 60% of your Testosterone and can increase as you grow older.  The higher these levels, the less Testosterone that is available to do “the good stuff”. So, while your Testosterone level may be “high”, much of it could be unusable.  When looking at your testosterone levels, your doctor should look at “total’ testosterone levels as well as “free” testosterone levels.

Determining normal Testosterone levels‘ can be complicated.  Regardless of lab values, symptoms of decreased testosterone levels are very important in determining the need for supplementation.

6) The Main Symptom of Low Testosterone is Erectile Dysfunction (ED).

Many men first seek out Biote Therapy because they’re having trouble with erections or experiencing a diminished sex drive.  However, this tends to be a symptom that shows up after many others.  Typically, symptoms of low Testosterone begin with decreased energy, increased body fat or belly fat, depression, and difficulty falling asleep or staying asleep.

7) Women Don’t Need Testosterone Replacement.

Estrogen is the hormone most often associated with women.  However, testosterone levels in healthy women are about ten times greater than her estrogen levels. Testosterone  plays a huge role in women’s health, psyche, and libido, just like in men.

Like in men, low Testosterone levels in women cause many symptoms.  These include decreased bone density and muscle mass, gains in body fat, and decreases in sexual desire and energy.  However, it’s very important for women to work with a provider skilled in testosterone replacement (like our BioTE providers).

8) Testosterone Replacement Will Cause Your Testicles to Shrink and Reduce Your Sperm Count

Of the 8 myths about testosterone, there’s a little bit of truth to this one. Introducing additional testosterone into your body will suppress it’s normal production. As a result, the testicles may reduce in overall volume and sperm production can slow or stop. The World Health Organization actually discussed using steroids as a male contraceptive.

To help with these changes, the BioTE supplement program maximizes the benefits of BioTE, counteracting these effects. We encourage patients to wait until their family is complete before starting BioTE therapy.  However, these effects are temporary and any symptoms typically rebound within a few weeks of cessation.

Are your Testosterone Levels low?

Take the BioTE QuizThis article paraphrases an excellent article by TC Luoma at T-Nation.com.