American culture today is saturated with advertisements for testosterone therapy. Industry analysts expect that the Low T industry may bloom into a $5 billion a year business by 2017.
Low T historians point to at least one pivotal moment: the publication of a highly influential article on the power of testosterone replacement, “The He Hormone,” published in 2004 in The New York Times Magazine. Conservative blogger and author, Andrew Sullivan, penned the piece. Sullivan was (and remains) a powerful thought leader, someone with a hard-won reputation for “speaking truth to power” and for defending controversial positions. He has earned enmity from both the left and the right of the political spectrum.
At the age of 35, Sullivan complained of constant feelings of lethargy and depression. He had been taking anti-HIV drugs for years, and his doctor checked his blood work. Per Sullivan, his T levels had dropped “below those of most 8-year-olds,” a fact that “shocked” his doctor.
Based on his physician’s recommendations, Sullivan started taking testosterone and witnessed huge improvements in his energy and mood. At the age of 50, he recently boasted: “I have energy, I am leaner and have more muscle mass, and I am motivated to work out and can sustain [my] focus.” Sullivan attributes this stamina and good feeling to his testosterone implants, which he still gets — four implants, every month.
Sullivan’s experience is compelling, and “The He Hormone” is definitely worth a read, if for no other reason than because it explains testosterone science using simple, powerful metaphors. However, just because one person (or many) feels better on a particular drug or therapy does not mean that the therapy will offer universal benefits.
Science is not just about coming up with cool ideas about how the world works: it is also about trying really hard to falsify those hypotheses. It is not about saying: “I took this pill; it made me Superman; therefore, everyone needs to take this pill.” Science is about making educated guesses about how the world works, and then ruthlessly testing those ideas in highly controlled settings to try to refute them. No hypothesis has ever been “proven” according to this philosophy. What happens is that scientists “fail to disprove” their guesses, leaving them as winners by default.
Unfortunately, this means that real science is a back-breaking, slow, expensive, often painful process. Years of careful research can be fatally undermined by a single “uncomfortable” study or observation.
That is how science is supposed to work.
In any event, Sullivan, who is HIV positive, immediately noted a stunning physical and emotional transformation when he first started taking his “manhood supplement.” He noted that before he started the therapy: “I weighed around 165 pounds. I now weigh 185 pounds. My collar size went from a 15 to 17.5 in a few months; my chest went from 40 to 44. My appetite in every sense of that word expanded beyond measure. Going from napping two hours a day, I now rarely sleep in the daytime and have enough energy for daily workouts and [my] work schedule. I can squat more than 400 pounds. Depression, once a regular feature of my life, is now a distant memory. I feel better able to recover from life’s curveballs, more persistent, more alive. These are the long term effects. They are almost as striking as the short term ones.”
Sullivan’s essay is a fascinating study of the sheer power that testosterone has on human development, psychology and physicality. It is hard to overstate the profound influence this hormone has with respect to differentiating the two sexes. Indeed, as Sullivan notes, it has played a huge, underappreciated role in the development of human culture and civilization itself.
Sullivan reflects: “Without testosterone, humans would always revert to the default sex, which is female. The Book of Genesis is therefore exactly wrong. It isn’t women who are made out of men. It is men who are made out of women. Testosterone, to stretch the metaphor, is Eve’s rib.”
Testosterone helps defines a man as a male: it is, in some sense, the quintessence of “maleness.” Testosterone replacement therapy can also clearly lead to short term benefits – potentially significant ones – in certain men who obtain the treatment. So it is easy to understand why the market for the supplementation has expanded.
But do our assumptions about this therapy’s usefulness rest on solid scientific ground? The next post will assess.
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