Men with 'Low T': Know Your Heart Risks

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March 19, 2014


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You’ve probably seen the TV ads aimed at middle-aged or older men with “low T”.  Ask your doctor about low testosterone, the narrator says, if you’re feeling excessively fatigued, depressed and have experienced a reduced sex drive.

The media campaign by drug companies is one factor that is helping drive increased diagnoses of low testosterone. Also fueling this trend is an aging population, less stigma about the topic, and more precise testing. Sales of testosterone medication have soared.

However, men should be aware of recent studies linking prescription of the male hormone testosterone with a higher risk of heart attacks in older men – and in middle-aged men with a history of heart disease.

The research indicates that cardiac problems are potential side effects of testosterone gels, patches, pellets and injections. It is especially important for men with heart disease risk factors, including hypertension, diabetes, unhealthy cholesterol levels and a family history of heart disease, to consult their physician.

“The results of these studies confirm how important it is for men to make sure they are not already at risk for heart disease, or if they have any underlying risk factors, such as a family history, hypertension and high cholesterol,” said cardiologist Theodore Feldman, M.D., medical director of South Miami Heart Center and of Baptist Health’s wellness and prevention program.  “They should already know if they are at risk. Having this knowledge, their doctors can proceed with a treatment plan and careful monitoring.”

Study: Heart Attack Rate Doubles for Some
A new study published in January tracked about 56,000 older and middle-aged men around the country who were prescribed testosterone between 2008 and 2010. The study examined their rate of heart attacks in the year before receiving their new prescriptions, and in the three months after.

The results: Men 65 and older had double the rate of heart attacks in the months after starting the drug, as did those younger than 65 with a previous diagnosis of heart disease. The study presented no evidence of greater risk in the younger men without a history of heart problems.

“Men who are more likely to suffer from low T are middle-age or older, and so they should already be concerned with overall heart health,” said Dr. Feldman. “That includes regular checkups, exercise and proper dieting.”

Causes of ‘Low T’
It’s natural for testosterone levels to decline as men age, starting after age 30 and continuing throughout life. Testosterone is important for maintaining muscle mass, adequate levels of red blood cells, bone growth, sexual function and an overall sense of well-being.

Other causes of low testosterone levels include:

  • Injury, infection, or loss of the testicles
  • Chemotherapy or radiation treatment for cancer
  • Genetic abnormalities such as Klinefelter’s Syndrome (extra X chromosome)
  • Hemochromatosis (too much iron in the body)
  • Pituitary disorders caused by drugs, kidney failure or small tumors
  • Inflammatory diseases, such as tuberculosis, sarcoidosis and histiocytosis, which can impact the pituitary gland and the hypothalamus
  • Medications, especially hormones used to treat prostate cancer and corticosteroid drugs
  • Chronic illness
  • Chronic kidney failure
  • Liver cirrhosis
  • Obesity: High body fat can affect hormone production and response
  • Stress
  • Low Testosterone Symptoms
    Men with low testosterone levels can experience a diminished sex drive, feel depressed and have difficulty concentrating.

    Physical symptoms of low testosterone include changes in cholesterol  and lipid levels, decrease in body hair and a decrease in muscle mass, combined with an increase in weight gain.

    The most accurate way to detect the condition is to have your doctor measure the amount of testosterone in your blood.

    Testosterone hormone replacement increases the production of red blood cells, which can clump together or coagulate, essentially making blood thicker. That may be especially hazardous in men who have narrowed arteries from heart disease or aging.

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