DEFY Blog
search the defy medical knowledge base:Last week’s Journal of American Medical Association (JAMA) published a retrospective study that was performed at the Veteran’s Administration (VA) hospital system. While it has long been known that testosterone replacement therapy (TRT) improves sexual function, bone density lean body mass, and improves lipids, this study concluded that testosterone therapy may increase the risk of cardiovascular problems in men with a history of heart disease. It cautioned that men with pre-existing cardiovascular problems and testosterone deficiency should avoid TRT. Several problems with the VA study are obvious after reviewing its data. This press release reviews each of those deficiencies.
Last week’s Journal of American Medical Association (JAMA) published a retrospective study that was performed at the Veteran’s Administration (VA) hospital system. While it has long been known that testosterone replacement therapy (TRT) improves sexual function, bone density lean body mass, and improves lipids, this study concluded that testosterone therapy may increase the risk of cardiovascular problems in men with a history of heart disease. It cautioned that men with pre-existing cardiovascular problems and testosterone deficiency should avoid TRT. Several problems with the VA study are obvious after reviewing its data.
While it is commendable that the VA hospital system collected data on the use of testosterone in over 8,000 veterans with cardiovascular disease, the study highlights deficiencies in the hospital system’s testosterone management protocol.
The VA study showed that 40% of patients did not have their testosterone blood levels retested after they started testosterone. The Endocrine Society, the American Association of Clinical Endocrinologists, the American Society of Reproductive Medicine, and the European Association of Urology recommend monitoring 3 months after initiation of testosterone therapy.
A previously published study showed that men with total testosterone blood levels below 550 ng/dl had a significant increase in their risk of cardiovascular disease, while men with levels above 550 ng/dl reduced their risk by 30%. Monitored participants in the VA study were only able to increase their total testosterone blood levels to 332 ng/dl, a value considered sub-optimal by all testosterone treatment medical guidelines.
Another shortcoming of the VA hospital system’s TRT protocol highlighted by the study is the lack of monitoring and managing of hematocrit (red blood cell volume) and estradiol (a female hormone originated by testosterone’s conversion in the body). It has been previously documented that high levels of hematocrit and estradiol can increase cardiovascular risks.
The majority of participants in the VA study used testosterone patches. Once a popular method of testosterone delivery, testosterone patches are no longer used due to their poor absorption and inconvenience. This is reflected in the VA study where most of the participants continued to have testosterone deficiency and increased cardiovascular risk.
Publishing flawed studies only increases the current misconceptions surrounding this important therapy and unnecessarily alarms TRT patients and their physicians. ExcelMale.com encourages patients, physicians and the media to closely examine studies for misleading information that could increase barriers to life-saving therapies.
ExcelMale.com urges the VA hospital system to revise their TRT protocol and to follow current testosterone guidelines. We want only the best for the men who have served our country.
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