risks of testosterone replacement

Reported Risks of Testosterone Replacement Therapy

Scott Brandt, M.D. BHRT, Hormone Therapy for Men, Testosterone Replacement

Hormone replacement therapy continues to be a somewhat controversial topic. Despite the proven direct benefits of testosterone therapy, newly published studies have reported negative results and risks of testosterone replacement. In this post, we will take you through some of the recent articles and the press that it has generated. We will also discuss the flaws in these studies and share not only our opinion but those of several well respected experts in our field. We will conclude the blog with ThriveMD’s stance on the debate and reassure our patients that testosterone replacement therapy not only improves their mood, energy and libido but also provides long-term excellent cardiovascular health benefits.

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The Studies

risks of testosterone supplementation - Vail COTestosterone replacement studies that recently made news and received ample attention were published in PLOS One in January 2014, JAMA in November 2013, and the NEJM in July 2010. The studies reported an increase in cardiac risks and higher rate of heart attacks in patients undergoing testosterone replacement therapy. The PLOS One study is the most recent of the studies mentioned above and gained national coverage in the New York Times.

After reading these recent studies, one might reconsider undergoing testosterone replacement therapy. Then why is testosterone replacement therapy continuing to be a popular treatment option, and why do experts in restorative medicine proclaim it to be safe and effective?

Published Expert Responses

To answer, let us first look at what our colleagues in the field have to say. Dr Neal Rouzier, a top expert in the field of hormone replacement therapy, shares his thoughts regarding the JAMA study. Rouzier states, “that the study was observational and retrospective in nature, which raises several issues. As the authors themselves state, this type of a study is prone to biases and cannot prove causation. More studies are needed to make up for the flaw and conclusions should be based on a trend of studies, not just one study alone. That is crucial since a vast majority of studies in the last decade have shown opposite outcomes and benefits of testosterone replacement – either no effect or protection against heart attacks.” Dr Rouzier further notes on the tendency of all people – “we tend to prioritize new studies and reject older ones – regardless of methodology used.”

Next, Josh Trutt MD, an active member of the Age Management Medicine Group and the American Academy of Anti-Aging Medicine, responded promptly to the New York Times article quoting the PLOS study. Dr Trutt states that NYT focuses on “a weak observational study” instead of looking into more grounded studies like the one published in JAHA on December 2013. In the JAHA article, researchers state that “normal testosterone levels play an important role in maintaining cardiovascular health, and testosterone replacement therapy in men with hypogonadism improves obesity, Type 2 Diabetes, myocardial ischemia [angina], exercise capacity, and [improves abnormal QT intervals on EKG].” Moreover, NYT did not grant much attention to some of the most important take-aways of the PLOS One study – namely that testosterone replacement helps reduce body fat and improve metabolism. The two factors are highly effective in preventing heart disease. Every patient prior to undergoing testosterone treatment should have a careful evaluation and be monitored closely during the course of therapy. Testosterone therapy is not for everyone, but leaving out this tool and waiting until testosterone levels become far too low can have irreversible effects.

Where ThriveMD Stands

The studies were not only poorly designed, but more importantly they were poorly interpreted. There have been numerous well designed, evidenced based studies that firmly support the use of testosterone replacement therapy and the optimization of hormonal levels. We shouldn’t ignore all the positive testosterone health benefits that have been well proven in prior studies. We will continue to manage our patients with careful attention to their medical history and laboratory serum hormone levels. ThriveMD strongly believes in testosterone optimization to reduce cardiovascular risk, improve energy, mood, and libido as well as decrease the risk of dementia and osteoporosis.

Is Testosterone Replacement Therapy Right For Me?

At ThriveMD, the treatment is carried out in the following steps:

  1. Evaluation
  2. Blood draw for laboratory level
  3. Discussion with patient
  4. Treatment decision
  5. Followup labs to optimize levels
  6. Ongoing consultations

To hear an expert opinion on the specific treatment that will best benefit you, or to learn more about testosterone replacement therapy, be sure to contact us.

*Individual patient results may vary. Contact us today to find out if testosterone replacement therapy may be able to help you.

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John Beeman
John Beeman
23:05 08 Jan 17
I just wanted to give an update regarding the stem cell procedure performed by Dr. Brandt at Thrive about 3 years ago. My range of motion continues to improve--remarkable at 64.I skied 150k in 5 days last week and never iced my knee once. I can't remember skiing that many feet w/out having to ice in the last 20 years. The knee treated has been without an acl since I was 18 and is pretty severely arthritic,but I am getting better performance now than I have in recent memory. Thank you, Dr. Brandt!!
Laurel Wilkerson
Laurel Wilkerson
21:22 08 Aug 16
Great job by the Thrive MD team in Edwards. With a torn achilles tendon, I was really opposed to surgery. When I discovered Dr. Brandt and team, I was thrilled. They are most professional and explained every step of the process and procedure for treatment options. I am on the road to recovery, and I am so thankful to have discovered Thrive. Before you let an orthopedic doc operate, take the time to explore and discuss stem cell therapy. Thrive MD made the process easy and convenient. Thanks! One year later update - ankle is doing great. Skied 52 days in 2015-16. Hiking, biking and all are no problem. Great team of caring people who know their business.
Lisa Harris
Lisa Harris
15:59 02 Jan 17
After struggling with an Achilles injury for 1 1/2 years and trying everything to heal it - steroid, physical therapy, wearing a boot, no activity, stretching, etc - I decided to have stem cell therapy at Thrive.md. It was a short procedure and an afternoon of post op recovery, which after 6-8 weeks, resulted in a full recovery from my injury. This seemed to finally stimulate blood flow and healing to an injury I had resigned myself to having forever. I highly recommend this procedure for tendon injuries like this one.
John Reilly
John Reilly
13:44 04 Nov 16
I saw Dr Brandt on 8/8/16 for a lower back stem cell injection. From the injection, I got a serious infection in my lower spine. As a result, I spent 2 days in the Vail hospital and have been on daily IV antibiotics for the past 8 weeks. A few weeks after the injection, I started feeling increased pain which was a different pain than before my injection. It was much sharper and a shooting pain. I communicated this information to Dr Brandt and his staff. There only response and treatment was stronger pain meds. oral and injected steroids (the worst thing to do when an infection is present). The pain became so intense and debilitating, I finally made an appointment with an orthopedic surgeon. Their team quickly discovered from listening to my symptoms and reviewing a new MRI that I had an infection. I also discovered from a search on DORA that over the past 13 years Dr Brandt's has a history of incidents with the DORA which regulates medical professionals. Over this time, his license was suspended for a period of time and is he currently practicing on probation through 2019. At one point, the AG said he was unfit to practice medicine.
Zvezdomir Zamfirov
Zvezdomir Zamfirov
03:55 14 Nov 16
I am a pain management physician myself. I am 52, and physically very active. I still play soccer competitively. Six months ago I suffered a hip injury with a labrum tear. Due to the pre-existing wear and tear, the only conventional treatment, which was offered to me was total hip replacement. I wanted to remain physically active and continue to play sports, so I decided that this is not the best option for me. I choose instead to try stem-cell therapy. Ten days ago I had my procedure done by Dr. Brandt, and since then I have nothing but positive things to say about him and his practice. Everyone in his office was extremely welcoming and put me at ease and comfort about my procedure. The procedure went very smooth. And I did not have ANY post procedure pain or discomfort. I had no need for any pain medication. I was back to work seeing patients on the 2nd day after the procedure. My hip already feels noticeably better. I have the second procedure scheduled in four weeks, and I am confident that in another 3-4 weeks I'll be back playing soccer again. Thank you, Dr. Brandt and team for taking such excellent care of me.
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