Is testosterone supplementation safe?
In the last 100 years, life expectancy for men has increased nearly two fold, according to the Centers for Disease Control and Prevention (CDC). In the year 1900 men lived until about age 46. By 2014, that age jumped to 76. There’s no question that men are redefining what it means to be 50, 60, and even 70 years old or more.
Regular exercise, a healthy diet, and adequate rest all help maintain energy and vitality for this age group. But men are also turning to one of the most advanced aging solutions around. Over the last decade, testosterone use among middle-aged and senior men has exploded. Known as testosterone therapy, the hormone reportedly helps to:
- boost energy levels
- increase muscle mass
- restore sexual prowess
Despite its popularity, scientists caution patients and doctors about using testosterone therapy. There isn’t enough information yet to determine the safety of regular testosterone supplementation. Fortunately, there are other options.
Testosterone is the hormone responsible for the development of the male external genitalia and secondary sexual characteristics. It's produced by the testicles. Testosterone is important for maintaining:
- muscle bulk
- bone density
- red blood cells
Adequate testosterone supports sexual and reproductive function. It also contributes to a man's sense of vitality and well-being.
As men age, their bodies gradually produce less testosterone. This natural decline starts around age 30 and continues throughout the rest of a man's life. According to Harvard Medical School, doctors still aren't sure about the significance of this decline. They’re also undecided if testosterone therapy is the best way to counteract the natural waning of the hormone.
Some men have a true testosterone deficiency, called male hypogonadism. This is a condition in which the body doesn't produce enough testosterone. It may be caused by problems in the:
- pituitary gland
Men who are at risk include those who have had an injury to the testicles and have HIV/AIDS. If you’ve gone through chemotherapy or radiation therapy, or had undescended testicles as an infant you are also considered at risk for hypogonadism.
Symptoms of male hypogonadism in adulthood include:
- erectile dysfunction
- decrease in muscle mass
- loss of bone mass (osteoporosis)
- decrease in beard and body hair growth
- development of breast tissue
- difficulty concentrating
- decreased sex drive
for male hypogonadism
Doctors can determine if you have male hypogonadism through physical exams and blood tests. If low testosterone levels are detected, your doctors may perform additional tests to determine the cause.
Treatment typically includes testosterone replacement therapy (TRT) in the form of:
TRT for healthy men?
Many men experience changes as they age that are similar to the symptoms of hypogonadism. But their symptoms may not be related to any disease or injury. Some are considered a normal part of aging, such as:
- changes in sleep patterns and sexual function
- increased body fat
- reduced muscle
- decreased motivation or self-confidence
The Mayo Clinic reports that TRT can help men with hypogonadism. The results are not as clear with men who have normal levels of testosterone or older men with decreasing testosterone levels, which is a normal part of aging. More rigorous studies are needed, according to the Mayo Clinic.
One study published in the Annals of Internal Medicine showed that testosterone combined with Viagra in otherwise healthy men worked no better than a placebo in improving erectile dysfunction.
Risks of testosterone
Studies are mixed on whether TRT is beneficial for normal men as they age. Some research has brought up serious risks with the therapy, particularly when taken long-term. This has led doctors to be cautious about recommending it. A large meta-analysis of 51 studies published in the Journal of Clinical Endocrinology and Metabolism looked at the safety of TRT. The report concludes that safety analysis of TRT is of "low quality" and fails to inform the public about any potential long-term effects.
The Mayo Clinic cautions that TRT also may:
- contribute to sleep apnea
- cause acne or other skin reactions
- limit sperm production
- cause testicle shrinkage
- enlarge the breasts
- increase the risk of heart disease
While there may be some risks to TRT, there are risks to low testosterone levels as well. These include a higher risk of:
- heart attack
- hip fracture
If you have male hypogonadism or a low testosterone level, talk with your doctor about whether TRT may be a good option for you. Discuss the risks and benefits of TRT in your case. Make the decision you feel is best for you
Maybe you don’t have hypogonadism, but you’re interested in feeling more energetic and youthful. The following alternative methods may help increase your testosterone level without the use of hormone therapy.
- Maintain a healthy weight. Overweight men are more likely to have low testosterone levels. Losing weight can bring testosterone back up.
- Exercise regularly. Sedentary men tend to have reduced levels of testosterone, as the body doesn’t need testosterone as much. Weightlifting can stimulate testosterone production. The key is regularly moving your body and using your muscles.
- Sleep 7-8 hours a night. Lack of sleep affects the hormones in your body.
- Try vitamin D supplements. A 2011 study published in Hormone and Metabolic Research indicated that supplementing with vitamin D, about 3,300 IU a day, increased testosterone levels.
- Get more zinc. Zinc deficiency in men has been associated with hypogonadism.
- Eat more nuts and beans. They're rich in D-aspartic acid, which promotes the production of testosterone, according to research published in Reproductive Biology and Endocrinology. Try adding these foods to your diet:
- Enjoy your morning coffee. There is some evidence that caffeine may increase testosterone levels.
One way to increase your testosterone levels is through TRT. It’s especially effective if you have hypogonadism. Studies have not yet demonstrated the effectiveness of TRT in helping men with normal levels of testosterone or older men with decreasing testosterone levels due to aging.
Men who take TRT usually experience increased energy, a higher sex drive, and an overall well-being. But its safety over the long-term hasn’t been established. There are a variety of lifestyle treatments involving exercise, diet, and sleep that have been shown to increase testosterone levels. Talk to your doctor about which of these treatments may be best for you.