Despite the complete lack of evidence about whether it has any benefit, a day does not go by that I don’t hear a commercial on the radio for male sexual dysfunction.
By the end of the commercial, you are led to believe that the only reason for male sexual dysfunction is low T. Even worse, this low testosterone level seems to come out of nowhere and there is nothing you can do about it. Except, of course, come in for an appointment for testosterone cream, pills or injections.
Regular readers of the Rantings of course know that low testosterone levels are merely a symptom of a poor quality lifestyle and not the problem itself.
To put it plainer, smoke (while not good for you to inhale) is not the problem—the house fire is. The local fire department doesn’t rush to the scene of a house fire only to suck out the smoke and leave the fire raging.
And yet this is what the “testosterone movement” has led you to believe. There really is no other way to describe it. The past few years have seen a massive increase in the prescriptions for testosterone replacement therapy given to men (and women) based purely on low testosterone levels found on bloodwork.
Personally, it is incredibly rare for me to check testosterone levels in the blood, despite knowing a substantial amount about what contributes to low testosterone levels and how to fix low T problems.
Just because I don’t check for low testosterone does not mean that I don’t feel that low T is a problem. This particular study drives this point home. In it, researchers looked at 115 male patients with type 2 diabetes and divided them up between normal (≥12.1 nmol/L) and low (≤12.1 nmol/L) testosterone levels. They then compared levels of several markers of heart disease, including hsCRP, carotid artery carotid intima-media thickness (IMT) and atherosclerotic plaque by high-resolution B-mode ultrasound as well as assessing the health of the blood vessels (endothelial function) by brachial artery flow-mediated dilation.
Here’s what they found:
- Lower testosterone was linked to poorer carotid IMT.
- Those with low T had a 641% higher likelihood of a carotid IMT of 0.1 cm or greater (80% vs 39%).
- Low T patients had a 260% higher risk of having plaques in the arteries (68.5% vs 44.8%).
- Those with low T were 577% more likely to have endothelial dysfunction (80.5% vs 42.3%).
- Low T patients had higher hsCRP levels (2.74 vs 0.89 mg/L).
While some of this may be a little technical, the bottom line is that low levels of testosterone is a marker of incredibly bad health, especially as it relates to heart disease.
But this does NOT mean that supplementing with testosterone is the answer. Rather, the entire spectrum of lifestyle changes that include exercise, diet and stress management is the answer. As a matter of fact, the most recent concerns over the use of testosterone replacement therapy had to do with actually increasing the risk of heart disease. And this is on top of the well-accepted increased risk of developing prostate cancer.
This alone should YET again prove that we cannot find a single marker in the bloodstream and treat just that marker using artificial means (drugs, hormone therapy, surgery, etc…).