Bobby Wolfe FNP
Testosterone replacement therapy or, TRT, has helped countless men feel better, reach their goals, gain confidence, and improve their overall health. It's long term safety has also come into question in recent years. However, in the past few years, there have been analyses of studies, that when grouped together, put the number of people in the studies in the hundreds of thousands. The most recent of these, was done in 2021. These studies have either shown a neutral or beneficial effect when it comes to TRT and cardiovascular risk (Guo C. et al, 2016).
This same study concluded that, "testosterone replacement therapy improves quality of life, increases lean body mass, significantly decreases total cholesterol, and is well-tolerated and safe for men with hypogonadism who are exhibiting PSA levels of <4 ng/ml." I would add that it decreases inflammation, helps to treat low libido and erectile dysfunction, improves recovery after injury or workout, just to name a few more. Another, more recent study stated that "It appears that TRT does not increase the risk of MI as compared to the non-intervention group." (Lee JH et al. 2021). Although they did say that further study would be beneficial.
As with everything you need to take your own wellness goals, the risks, and benefits into consideration, when considering treatment options. As for myself, the increased energy, better recovery, resolution of aphthous ulcers (canker sores), and general well being have far exceeded potential risks. The fact is, guys already have testosterone. Aging, laziness, lifestyle, diet, and environment have contributed to our declining testosterone levels. Does having optimal levels of testosterone increase risk of heart attack in a teenager? I didn't think so.
Guo, C., Gu, W., Liu, M., Peng, B. O., Yao, X., Yang, B., & Zheng, J. (2016). Efficacy and safety of testosterone replacement therapy in men with hypogonadism: A meta-analysis study of placebo-controlled trials. Experimental and therapeutic medicine, 11(3), 853–863. https://doi.org/10.3892/etm.2015.2957
Lee JH, Shah PH, Uma D, Salvi DJ, Rabbani R, Hamid P. Testosterone Replacement Therapy in Hypogonadal Men and Myocardial Infarction Risk: Systematic Review & Meta-Analysis. Cureus. 2021 Aug 26;13(8):e17475. doi: 10.7759/cureus.17475. PMID: 34513525; PMCID: PMC8405174.
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