The ads are all over TV men suffering from low T or low testosterone can boost their levels and improve a variety of macho attributes by using one of several types of testosterone supplements. But according to the FDA, this may not be such a great idea.
Testosterone (T) is the hormone produced by the testes after puberty that is responsible for male sexual characteristics such as increased muscle mass, body hair, and of course, libido. There are some genetic anomalies and medical conditions that result in subnormal levels of testosterone or hypogonadism. These individuals are prescribed supplementation to bring their hormone to normal levels.
In the normal course of events, testosterone levels peak in early adulthood, and then tend to decline as a man ages. As of late, supplementation has been promoted as a way to maintain youthful levels, which supposedly will give the user the vigor and sexual performance of a young men.
The FDA warns, however, that the use of these supplements likely will not have the desired results, and may actually be harmful. Not only are the results not always found, but some studies have suggested negative cardiac impacts from T supplementation. The agency emphasizes that using T supplements for the medical conditions that cause low T is the only use for which they have been approved.
In a perspective essay in the New England Journal of Medicine, Dr. Christine P. Nguyen of the FDA and colleagues expressed their concerns about the recent increases in the numbers of men using T supplementation for so-called age-related hypogonadism. In 2010 that number was about 1.2 million by 2013 it had risen to 2.2 million, with the greatest increases seen in men between the ages of 40 to 64 years. These authors noted that in 2002 a committee of the Institute of Medicine was convened to assess the evidence related to the efficacy and safety of T supplementation for these men. The committee reported that the data was limited and inconclusive. The FDA authors concluded that the need to replace testosterone in older men who lack a distinct, well-recognized cause of hypogonadism remains debatable.
Further, these authors noted that some large observational studies had suggested that T supplementation was associated with increased cardiovascular risk, while other studies did not. They suggested that well-controlled clinical trials of T supplementation be initiated perhaps by a consortium of the companies that produce the supplements in order to clarify the potential benefits and risks of these products.
ACSH s senior nutrition fellow Dr. Ruth Kava commented This is obviously a situation in which the advertising has outpaced the science. We need to know if, first the decline in T levels with aging really causes the decreased energy, etc. seen by older men, and second will supplementation to levels found in young men really ameliorate those problems without excessive risks to their health.