Many smart people want to see testosterone therapy much more closely regulated. They fear the potential for harm. On the other side, many smart people argue the benefits outweigh the potential risks.
For instance, Dr. Abraham Morgentaler, a Men’s Health contributer, authored a book called “Testosterone for Life: Recharge your Vitality, Sex Drive, Muscle Mass, and Overall Health.” He wants more men to participate in Testosterone Replacement Therapy (TRT). In an interview with WebMD, he said: “despite all the recent advertising campaigns, awareness of Low T and its importance for men’s health remains very poorly recognized by both the public and by physicians.” Dr. Morgentaler also says that “based on dozens of studies [testosterone has important relevance] to health issues, such as diabetes, obesity, metabolic syndrome and osteoporosis.” He also observes that: “men with Low T die sooner than men with normal levels of testosterone.”
Dr. Morgentaler is right that having Low T can be a sign of a lack of health. But his observations don’t necessarily suggest that using testosterone therapy will lead to health benefits or longevity. They merely suggest that having Low T is, in and of itself, a risk factor.
This begs two questions:
1) What actually causes Low T?
2) What can be done to prevent Low T and/or fix any underlying associated health problems?
Doing the opposite of what harms a man, physiologically, may not make him well.
For instance, perhaps a bad diet causes both Low T and health problems in a man. Any attempt to fix the Low T without addressing his underlying diet issues would prove woeful. It would be like prescribing an ice bath for a patient who has a fever and congestion. The bath might get the temperature down (temporarily), but it would not address the underlying infection causing both the fever and the congestion.
The link between Low T and health problems might be robust, but is the solution to those health problems “just raise T”?
Per Dr. Michael Eisenberg, a urologist at Stanford Hospital and clinics in Palo Alto, “lower testosterone levels have been linked to higher risk of cardiovascular problems, [but] again, it’s not clear if low testosterone levels actually cause heart problems.”
The following graph shows the general gist of this problem:
Many patients, doctors, and even science journalists (who should know better) make the mistake of confusing correlation for causation. For instance, the rates of autism and organic food consumption in the United States over the past decade or so correlate almost astonishingly well. However, no scientist would ever suggest that eating organic food causes autism – or that having an autistic kid causes people to want to eat more organic food. The relationship is just there, but it is an artifact. It does not tell us any information about what causes what.
Likewise, just because Low T is associated with negative health problems does not mean that the reduction in testosterone, in and of itself, caused the harm. Not does it imply that simply boosting testosterone levels to normal will fix the issues. Those ideas are certainly plausible, but they are not given.
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