A U of T study analyzed records of 8,700 veterans using a procedure known as coronary angiography to examine coronary arteries. The study found that, among the 1,200 men taking testosterone, their risk of suffering a heart attack, stroke or sudden death over a certain period of time was about one-in-four. The other men studied had a one-in-five risk.
But what can those numbers actually tell scientists about testosterone risks?
In an editorial that accompanied the publishing of the study in the Journal of the American Medical Association (JAMA), University of Pennsylvania’s Dr. Anne Cappola noted that “The important question is the generalizability of the results of the study to the broader population of men taking testosterone.”
The study was also just a single study — and an observational one, at that. As any good critic of epidemiology will note, observational studies are only useful for generating hypotheses, not for proving or disproving them.
Many doctors, in fact, did not seem all that concerned about the findings: cardiologist Dr. Michael Ho, who helped direct the study, noted that: “these [men] were sick, older veterans.” He implied that the Low T therapy might harm this cohort of men, yet potentially be benign or beneficial to other cohorts of men. In other words, the study had subtle ramifications that the always-ready-to-oversimplify media was all too happy to ignore.
Dr. Bradley Anawalt, a University of Washington endocrinologist who also examined the data, also expressed only vague concern: “this is a modestly cautionary study about giving testosterone to men over 60 [who have other risk factors].”
Did these doctors downplay the implications too much, or were they just being cautious?
On the one hand, it is very important to avoid extrapolating too much from the results of any study, even a carefully controlled one.
On the other hand, again, imagine the reaction if an identical study had found that testosterone therapy caused a 30% decrease in the risk of cardiovascular events for the cohort in question. What would the press think of that study? What would doctors and researchers say? More importantly, how would pharmaceutical companies react?
Based on the modern history of the pharmaceutical industry — Davis & Crump has catalogued the sordid tales of other drugs, like Granuflo, Lipitor and Risperdal in other blog series — odds are high that the industry would jump on the news of such a “huge breakthrough” and start selling testosterone therapy as a wonder drug capable of curing all ills.
The muted reaction of medical professionals to this study was both dramatic and suggestive.
The sad point is that the medical and pharmaceutical establishment appears happy to ignore results that are financially and logistically inconvenient. Conversely, when a study appears to vindicate a conventional position, the powers-that-be overstate its relevance.
What gets lost here is scientific integrity.
This is a real shame. Quite possibly, this selective analysis is a deep (albeit, indirect) root cause of suffering for hundred of thousands of American men.
This discussion of the science of testosterone therapy begs deeper questions:
- How did the “testosterone therapy craze” get started?
- Was there ever good scientific justification for it?
- How much research supports testosterone therapy? How much seems to refute it — or at least suggests that it could be dangerous to certain groups of men?
The next post will address those critical questions.
For insight into your Testosterone case, call the Davis & Crump team now at 800-277-0300 or email us at firstname.lastname@example.org.