Low testosterone Rx, testosterone heart risk, testosterone-induced acne

Treatment with the male hormone testosterone has been highly controversial for years. The FDA makes it clear that testosterone side effects are worrisome and physicians should NOT prescribe the hormone the way this doctor did.

Q. At my recent physical, my doctor gave me the results of my blood work. My testosterone was low and he recommended T shots.

I had been experiencing some ED and lethargy but attributed that to my age. The shots have helped me but I wonder about adverse effects. Are there any?

A. Testosterone, either as an injection or topical gel, is contentious. The FDA cautions doctors not to prescribe this male hormone to healthy men with “low T” linked to aging. The agency states that testosterone is only for men with hypogonadism and warns about an increased risk of heart attacks and strokes.

The FDA Warns of Testosterone Side Effects:

Here, in its own words, is the latest FDA Safety Announcement (March 3, 2015):

“The U.S. Food and Drug Administration (FDA) cautions that prescription testosterone products are approved only for men who have low testosterone levels caused by certain medical conditions. The benefit and safety of these medications have not been established for the treatment of low testosterone levels due to aging, even if a man’s symptoms seem related to low testosterone. We are requiring that the manufacturers of all approved prescription testosterone products change their labeling to clarify the approved uses of these medications. We are also requiring these manufacturers to add information to the labeling about a possible increased risk of heart attacks and strokes in patients taking testosterone. Health care professionals should prescribe testosterone therapy only for men with low testosterone levels caused by certain medical conditions and confirmed by laboratory tests…

  • “Patients using testosterone should seek medical attention immediately if symptoms of a heart attack or stroke are present, such as:
  • Chest pain
  • Shortness of breath or trouble breathing
  • Weakness in one part or one side of the body
  • Slurred speech”

What Does the Science Say About Testosterone Side Effects?

A study in the New England Journal of Medicine (Feb. 18, 2016) contradicts the FDA’s stance.  It demonstrated that men with low testosterone experienced improved sexual function and mood after using a testosterone gel with no increased risk of cardiovascular complications. Another analysis of available data also found no link to heart attacks and strokes (Expert Opinion on Drug Safety, Oct. 2014).

The FDA moves slowly. It can take the agency decades to discover serious side effects from prescription or over-the-counter medications. Equally, it can take the FDA many years to reverse direction on a warning like the one about testosterone side effects re: heart attacks and strokes.

That is not to say that testosterone side effects are imaginary. Here is what clinical trials revealed with one testosterone topical gel (AndroGel):

Testosterone Side Effects:

  • Increased PSA readings
  • Mood swings, anxiety, irritability, impatience, anger, aggression, insomnia
  • Increased blood pressure
  • Sinusitis
  • Increased hemoglobin
  • Skin irritation in the area of the gel
  • Acne
  • Urinary difficulties, hesitancy, nighttime bathroom runs

The Bottom Line on Testosterone:

There is still tremendous confusion about testosterone treatment. We did a deep dive on the pros and cons of testosterone therapy at this link.

What Are the Pros and Cons of Testosterone Therapy?

You can also learn more about the controversy regarding testosterone and prostate cancer here.

How to Take Testosterone Without Fear of Prostate Cancer

Should you wish to learn how to avoid pricey T shots or gels that violate FDA’s recommendations, you may wish to listen to our one-hour radio interview with John La Puma, MD on how to boost testosterone naturally.

Show 975: Boosting Testosterone Naturally

Share your own story about low T and testosterone in the comment section below.

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  1. Daniel J. Walls

    Great article i was actually searching for this. Describe very briefly i appreciate the effort to write this post. I also explained some good techniques on my blog about low testosterone. Definitely come back in future for more info.

  2. susan

    My brother’s urologist gives him Clomid to raise testosterone levels. Do you know how that would help? Is it dangerous?

  3. Mark

    Chronic low testosterone, not due to any illness or other medical problem or condition, puts older men at risk for heart attacks, depression, diabetes, prostate cancer(due to higher estradiol, one form of estrogen) and general debility. What’s crazy is that the FDA has approved topical testosterone gels and even testosterone pellet implantation! It’s like they’re playing ‘good cop/bad cop’, standing over the shoulder of doctors who understand testosterone replacement and do it in a responsible manner.

  4. MR

    I once read that the best way for a man to naturally raise his testosterone level is to exercise regularly, but of course not to overdo it.

  5. Adrienne
    North Carolina

    What about women with low testosterone? A doctor suggested to me that this could be a problem in women as well, and that one patient of his had benefited from T supplements. Thoughts?

  6. JEFF

    Here are the side effects of T shots that could happen to you…Acne,mostly around chest area, extreme Anger, Man boobs,have fun! Oh and shrinking of testicles.This all happened to me at 46 with one shot and last one o might add.

  7. John
    South Carolina

    After a “mini stroke” in 2011, I returned to my previous doctor whom I had stopped seeing because he stopped taking insurance. He had some extensive lab tests done that the hospital neglected to do, and found that I had very “low T”. He immediately prescribed Testosterone Cypionate which I personally inject every 10 days. After 4 years I have experienced no side effects so far. Five other doctors with various specialties in stroke victims all gave conflicting reasons why I had a stroke in the first place (high cholesterol? No! a hole in the back of my heart? No! High Blood pressure? Maybe, but it was not much elevated. A neurological disorder? No!, etc.). My previous doctor said he believed they were all wrong. His theory was that I had a “constricted vessel” in my brain that burst, and very low testosterone was a major contributor in my case. So I continue to give myself these injections. It is quite simple and virtually painless, just an injection with a very small needle (25G one inch long) into either left or right shoulder muscle. Still alive and well at 72!

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