January 2014 | Washington, DC Beacon

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Say you saw it in the Beacon | Fitness & Health

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Testosterone raises risks for older men By Lindsey Tanner Testosterone treatments may increase risks for heart attacks, strokes and death in older men with low hormone levels and other health problems, according to a large Veterans Affairs study recently published in the Journal of the American Medical Association. The results raise concerns about the widely used testosterone gels, patches and injections that are heavily marketed for low sex drive, fatigue and purported antiaging benefits, the authors and other doctors said. Men who used testosterone were 30 percent more likely to have a heart attack or stroke, or to die, during a three-year period than men with low hormone levels who didn’t take the supplements. Hormone users and nonusers studied were in their early 60s on average, and most had other health problems, including high blood pressure, unhealthy cholesterol and diabetes.

with the VA’s Eastern Colorado Health System in Denver. The nationwide study involved an analysis of health data on 8,700 veterans with low levels of testosterone, the main male sex hormone. All had undergone a heart imaging test, and many had risk factors for heart problems, including blocked heart arteries. Risks linked with testosterone were similar in men with and without existing heart problems. Nearly 26 percent of men using testosterone had one of the bad outcomes within three years of the heart test, compared with 20 percent of nonusers. It’s unclear how the hormone might increase heart risks, but possibilities include evidence that testosterone might make blood platelets stick together, which could lead to blood clots, the study authors said. Previous studies on the supplements’ health effects have had mixed results — with some research suggesting potential heart benefits — but none of the studies has been conclusive.

testosterone is safe for these men,” said editorial author Dr. Anne Cappola, a hormone expert at University of Pennsylvania and an associate journal editor. “In light of the high volume of prescriptions and aggressive marketing by testosterone manufacturers, prescribers and patients should be wary” and more research is needed, she wrote. Annual prescriptions for testosterone supplements have increased more than five-fold in recent years, climbing to more than 5 million and $1.6 billion in U.S. sales in 2011, the study noted. Dr. Nathaniel Polnaszek, a urologist with Scott & White Healthcare in Round Rock, Texas, said he prescribes testosterone for many men, mostly in their 40s

and 50s, who have low levels and erectile dysfunction or other symptoms. He called the study “concerning.” “This is something I’m going to be discussing with my patients,” he said. Testosterone levels gradually decline as men age, and guidelines from doctors who specialize in hormone-related problems say hormone supplements should be considered only in men with symptoms of low levels, including sexual dysfunction. They’re not advised for men with prostate cancer because of concerns they could make the disease spread, said Dr. Robert Carey, a former Endocrine Society president and a professor of medicine at the University of Virginia Health System. — AP

Not a definite link The research doesn’t prove that testosterone caused the heart attacks, strokes or death, but echoes a previous study in older men and should prompt doctors and patients to discuss potential risks and benefits of using the products, said the study’s lead author, Dr. Michael Ho, a cardiologist

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An editorial in the journal said it is uncertain if the study results apply to other groups of men, including younger men using the hormone for supposed antiaging benefits. “There is only anecdotal evidence that

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