Testosterone therapy has been used widely as the number one approach to bringing people suffering from low hormones back to optimal health. But is this treatment option safe enough to be applied to those with heart problems? Read on to find out the relationship between testosterone and heart disease.
Testosterone Therapy for People With Heart Disease: Friend or Foe?
Testosterone Therapy: Concerns Regarding Heart Disease
How Important Is Testosterone?
If you are a man and are well aware of how a man’s body works, you will probably know what testosterone – the male sex hormone – is and how it contributes to the person you are. This hormone, among other products of the endocrine system, is responsible for increasing your muscle mass and bones, deepening your voice, and giving you the fuel for sexual performance. So for anything that shapes your masculinity – strength, assertiveness, authoritativeness – testosterone plays a role.
What Is Testosterone Therapy?
As crucial as endogenous testosterone is, our bodies slowly lose amounts of this hormone over time, resulting in the need for a therapy that brings this vital substance back to its normal levels. This is when testosterone therapy, or testosterone replacement therapy (TRT), comes into play. In simple terms, testosterone therapy is a treatment option that emphasizes normalizing the testosterone levels in the human body, especially in those aged individuals whose bodies cannot produce enough hormones.
However, testosterone and the heart have long had a complex interconnected relationship. For example, people with cardiovascular disease are usually deficient in testosterone. In contrast, those having low testosterone are more susceptible to morbidity related to the heart. This complexity is further compounded as testosterone has a wide range of average values. For example, a healthy man can have between 270 and 1,070 nanograms of testosterone per deciliter (ng/dL). Therefore, scientists have not been able to determine the exact link between testosterone and heart disease.
Testosterone and Heart Disease
Research has been conducted to untie the knot between testosterone and heart disease. According to “Testosterone and the Heart” by Goodale et al., testosterone affects many aspects of heart health. A deficiency in this active hormone results in poor cardiovascular outcomes. Specifically, low testosterone has been linked to coronary artery disease, congestive heart failure, and metabolic syndrome.
Nevertheless, having too much of this hormone will not make you healthier just because having too little of it results in bad cardiovascular health. In reality, many testosterone supplements carry a box label warning mandated by the FDA that they may increase the risk of heart attack and stroke. The FDA has also restricted testosterone prescription to those deficient in this hormone due to pituitary or testicular disease.
As a result, whether increasing the “male hormone” by taking testosterone therapy can cause heart disease, so far, remains an unsolved question. Many researchers have even called for a large-scale trial to discover the possible tie-up between testosterone and heart disease fully. That said, more evidence indicates that the therapy does not increase cardiovascular risk than the opposite.
Evidence for the Effects of Testosterone Therapy on Heart Disease
According to a recent study published by The Lancet Healthy Longevity, testosterone has a variety of effects, both good and bad, on cardiovascular physiology. Some beneficial effects of testosterone, such as coronary vasodilation and increased coronary blood flow, improved vascular reactivity, increased muscle mass, decreased whole-body and visceral fat mass, and normalization of glycemia, have the potential to lower cardiovascular risk.
Nonetheless, other harmful effects of testosterone, such as increased hematocrit (red blood cell volume) and decreased high-density lipoprotein (HDL) cholesterol (or “good” cholesterol) as well as sodium and water retention, could raise cardiovascular risk.
The FDA’s warning regarding the potential heart disease risk and the harmful effects of testosterone mentioned above has caused concern in testosterone prescriptions and a subsequent fall in testosterone sales in the United States. The European Medicines Agency, on the other hand, confirmed that there is currently no reliable evidence that testosterone therapy raises the risk of heart disease.
After considering all the available findings, the study concluded that short-term and medium-term use of testosterone therapy does not increase heart disease risks. Yet, whether long-term use of the treatment can harm the heart remains to be evaluated. This means taking testosterone therapy within an appropriate duration does not affect the heart. But how long should the treatment last for it to be risk-free?
Can People at Risk of Heart Disease Get Testosterone Therapy?
According to the same study, testosterone treatment for 12 months in older men was linked to a higher increase in non-calcified coronary artery plaque volume associated with cardiovascular events. However, there were no noticeable signs of such risks within the first 9.5 months following the start of testosterone therapy. Therefore, by inference, a shorter time than a year should be the safe duration of testosterone therapy to prevent heart disease.
So, men low in testosterone with a risk of heart disease can take short to medium-term use of testosterone therapy that lasts shorter than 12 months. Still, people with heart health problems should receive counseling before the treatment to ensure the treatment’s safety and tolerability. Consult your doctor to determine the optimal duration of testosterone therapy that is risk-free, efficient, and sustainable for you.
A Healthy Lifestyle and Testosterone Therapy Work Better Together
Testosterone therapy can be a superior treatment option that increases the overall sense of wellness among those who suffer from low testosterone while causing no risk for heart disease if taken correctly. Testosterone therapy can be even more beneficial if implemented along with a healthy lifestyle like exercise and diet.
A lifestyle modification will increase testosterone levels and reduce the risk of heart disease since cardiovascular problems are often associated with a lack of physical activity and a high-fat diet. So, start testosterone therapy and a balanced exercise regime to regain a good quality of life, live better, and be your younger self again.
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