5 Myths and Facts About Low Testosterone
Low testosterone is a condition surrounded by misinformation. What’s true, though, is that your own habits may affect your levels.
Advertisements seemingly everywhere these days make claims about what low testosterone therapy can do for you.
But all the hype has led to many misconceptions about “low T” and its treatment, says Robert Brannigan, MD, a urologist at Northwestern Medicine in Chicago. “There’s been a real uptick in the use of testosterone replacement therapy, so there is a lot of confusion out there.”
Want the lowdown on low T? Here are five important myths and facts about low testosterone.
Fact: You should be cautious about starting low testosterone therapy.
Not everyone needs testosterone therapy. The condition, also known as hypogonadism, affects approximately 39 percent of men over age 45, with men in their 60s and 70s more at risk than men in their 40s and 50s, according to the American Urological Association. Even a doctor’s recommendation doesn’t mean supplementation is appropriate. A study published in JAMA Internal Medicine in August 2013 found that about 25 percent of men taking testosterone supplements had never had their testosterone levels measured.
“Many ‘low T centers’ have sprouted up,” Dr. Brannigan says. “Many do a good job of defining if low testosterone is an issue, but some do not.”
Always insist on a blood test to assess your testosterone levels before you begin any supplements.
Fact: Your own habits can lower your testosterone levels.
Some lifestyle choices can have a negative effect on the amount of testosterone in your body. For instance, Brannigan says, smoking reduces testosterone levels. Tobacco is thought to interfere with the body’s production of luteinizing hormone, which helps make testosterone.
Being overweight or obese can produce a similar effect, Brannigan adds. Too much fat tissue in the body can cause testosterone to be converted into estradiol, a female hormone. “That feeds back to the pituitary gland and tells the body to stop making luteinizing hormone, thus lowering the body’s drive to make testosterone,” Brannigan explains. In fact, overweight and obese men who began a program of exercising and dieting increased their testosterone levels significantly as they lost weight over 12 weeks, according to the findings of a study published online in the Endocrine Journal in March 2015.
Myth: Testosterone supplements can increase your sperm count.
The idea seems logical – more male hormones mean more sperm, right? In truth, supplementing with testosterone can actually lower the amount of sperm that your body produces, Brannigan says. When the pituitary gland senses high levels of testosterone in the body, it suppresses the release of luteinizing hormone, which can decrease sperm production. The effect is so marked that testosterone-based medications have been studied as possible male contraceptives, according to Brannigan.
Myth: Testosterone supplements can cause prostate cancer.
Men who develop prostate cancer are often given medications to reduce the amount of testosterone in their bodies, reports the American Cancer Society. But that doesn’t mean testosterone is a cancer-causing hormone. “If prostate cancer is present, testosterone can support its growth,” Brannigan says. “But there’s not any evidence that testosterone, by itself, can cause prostate cancer.”
Fact or Myth: Testosterone supplements may cause cardiovascular disease.
There is still much debate about this particular bit of information. In March 2015, the Food and Drug Administration put out a memo cautioning doctors that testosterone supplements could possibly increase patients’ chances of heart attack, stroke, and even death. The agency also began requiring prescription testosterone products to carry a new warning label explaining the risk.
But some doctors, including Brannigan, believe the FDA issued the warning out of an abundance of caution. Though some studies have shown an elevated risk for cardiovascular effects, he says, most of them lack the rigor that’s needed to definitively prove a risk. For example, a study published in JAMA, the American Medical Association journal, in November 2013 found that testosterone caused an elevated risk for cardiovascular effects, but the study involved only men who had undergone coronary angiography. “From the get-go, that’s a special group of people, so it’s hard to generalize the findings,” Brannigan says. Other sources have similarly noted the flaws in these studies, including a review published in 2015 in the Asian Journal of Andrology.
In its memo, the FDA also encouraged more studies on the possible link between testosterone and heart problems, and several are likely needed before doctors fully understand the risk, Brannigan says. In the meantime, he advises, be sure to discuss the risk of cardiovascular effects with your doctor before starting any testosterone therapy, especially if you have a history of heart disease.
