Is Low T a Real Problem or Ad-Driven Fad?

http://www.aarp.org/health/conditions-treatments/info-2014/low-testosterone-therapy-controversy.html

by Peter Jaret, AARP Bulletin, July/August 2014

Not so long ago, when a middle-aged man lost muscle or his sex drive, he was simply "getting older." Not anymore. These problems are now symptoms of a condition dubbed "low T," or low testosterone.

At least, that's what a torrent of television and print ads from the makers of testosterone replacements would have you believe. "Millions of men 45 or older may have low T," warns one such ad. "So talk to your doctor about low T."

Considering how most men feel about muscle and sex drive, the result has been predictable. A 2013 study in JAMA Internal Medicine found testosterone prescriptions grew more than threefold between 2001 and 2011. Data from IMS Health shows T sales rose from $324 million in 2002 to nearly $2.3 billion in 2012. Sales could hit $5 billion by 2018.

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T therapy was originally developed for men whose bodies can't produce enough testosterone, often because of injury to the testicles, cancer or genetic defects. But now, critics say, aggressive marketing has convinced many men to take the hormone in hopes of feeling and looking younger. That exposes otherwise healthy bodies to serious side effects.

"When you take testosterone, your body shuts down its own production," says John La Puma, M.D., director of a clinic in Santa Barbara, Calif., that focuses on men's health. As a result, the testicles may shrink and you could require supplementation indefinitely. That means long-term considerations like expense, inconvenience and, worst of all, possible catastrophic health issues.

A study published last year in the Journal of the American Medical Association reported a 30 percent jump in the risk of stroke, heart attack and death among men undergoing testosterone therapy. The FDA is investigating whether warnings should be issued.

There is one piece of useful information that no advertiser will offer: "A lot of men don't need testosterone replacement to feel and look better," says La Puma. "All they need to do is eat a healthier diet and be a little more active." When obese men shed an average of 17 pounds, a recent study found, their testosterone levels climbed 15 percent. Indeed, a healthy diet, quality sleep and regular exercise can help any man build muscle, improve libido and raise energy levels. No prescription required.