July 30, 2015

expert reaction to Testosterone Replacement Therapy (TRT)

In a paper published in The Ageing Male journal, a team of researchers have worked to establish the effect of different testosterone treatments on a group of men. The paper reports that different testosterone preparations appeared equally safe over long time periods, with either no change or improvement of cardiovascular risk factors observed in the patients.

Prof. Jonathan Seckl, Moncrieff-Arnott Chair of Molecular Medicine and Executive Dean (Medicine), University of Edinburgh, said:

“This research seems to be below the normal standard of science. It is a survey of self-selected patients without randomised controls and, in my opinion, seems primarily to serve the interests of clinics in the commercial sector. It doesn’t appear to add much to a complex topic that cries out for a large blinded, randomised clinical trial.”

Prof. Frederick Wu, Professor of Medicine and Endocrinology, Institute of Human Development, University of Manchester, said:

“This report describes the experience of a single-issue private clinic which prescribes testosterone to men (with non-specific symptoms) who have normal testosterone levels (83% had testosterone >10 nmol/L) without a diagnosis of hypogonadism (testosterone deficient).

“I’m not sure whether the authors have paid attention to currently accepted practice guidelines from multiple professional bodies and recent highly-publicised warnings from the FDA not to prescribe testosterone without an established diagnosis of hypogonadism.

“The reported lack of association between testosterone levels and symptoms is hardly surprising since the symptoms are not due to testosterone deficiency.

“There is not a shred of evidence from placebo-control data to support the conclusion of efficacy.

“For the extraordinary claim of ‘prolonged safety’ for testosterone treatment with a median follow-up of 1 year we need to have extraordinary evidence.

“In my opinion this publication is not only misleading but potentially dangerous, particularly when the author calls for many more men to be treated (inappropriately) with testosterone.”

‘Evolution of testosterone treatment over 25 years: symptom responses, endocrine profiles and cardiovascular changes’ by Carruthers et al. published in The Aging Male on Thursday 30^th July  

Declared interests

None received