Probably the best study on Testosterone I have seen

[redback]

This really covers so much ground. Covers many negative studies and puts things in perspective. EG: One major study which linked heart disease with testosterone use was done on men over 74 years of age and half were diabetic and had existing heart conditions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886770/

[Bouncer]

it's not a study. it's a review of a bunch of studies. still helpful though.

the important part..

First, it should be noted that the population under study by Basaria et al had a mean age of 74 years (all patients <65 were excluded from this study). A very high percentage of the patient population in this study also suffered from various serious chronic illnesses including long‐standing diabetes, dyslipidemia, obesity, hypertension, and most importantly preexisting heart disease. Moreover, given that the primary purpose of this study was to measure improvements in physical strength, the patient population that was selected by Basaria et al had significant limitations in mobility at baseline. Second, the sample size included in Basaria et al's trial was relatively small. The number of adverse cardiovascular events in the testosterone group was relatively small as well, and the trial was stopped early. Third, Basaria et al's trial was not originally designed to analyze either primary or secondary cardiovascular outcomes. Basaria et al had intended to analyze the effects of testosterone replacement therapy on lower extremity strength and functional status in older men with limitations in mobility. Therefore, the authors were unable to perform a structured analysis of adverse cardiovascular events. In addition, a number of the adverse cardiovascular events that were reported by Basaria et al may be minor phenomena and not significant adverse cardiac events. For instance, the 2 cases of syncope may not have been secondary to cardiovascular disease and could have just been a vasovagal phenomenon. Premature ventricular contractions are very common in the general population and alone are generally not considered a major adverse cardiovascular event. Left ventricular strain pattern on exercise stress testing may have been caused by a variety of causes including underlying ventricular hypertrophy or hypertension. Thus, some of these adverse events are consistent with the baseline characteristics of Basaria et al's patient population, which was suffering from prevalent underlying chronic diseases. Finally, the cases of peripheral edema that were witnessed by Basaria et al could have been a result of the vasodilating effects of testosterone and not of CHF exacerbation. The authors did not made this distinction in their analysis.

Existing evidence seems to suggest that the most commonly encountered adverse event associated with testosterone replacement therapy is an increase in hematocrit, which is considered a known physiologic function of testosterone.^146–147 The clinical implications of increased hematocrit secondary to testosterone replacement therapy remain to be fully investigated. If a transdermal preparation of testosterone is used, a skin reaction at the site of testosterone application is common.¹⁴⁶ The clinical implications of this finding remain unknown at this time. Data from 3 meta‐analyses seem to contradict the commonly held belief that testosterone administration may increase the risk of developing prostate cancer. One meta‐analysis reported an increase in all prostate‐related adverse events with testosterone administration.¹⁴⁶ However, when each prostate‐related event, including prostate cancer and a rise in PSA, was analyzed separately, no differences were observed between the testosterone group and the placebo group.¹⁴⁶ Finally, the existing data from the 3 meta‐analyses seem to indicate that testosterone replacement therapy does not increase the risk of adverse cardiovascular events.^31,146–147 Evidence to the contrary has been reported by Basaria et al, however.¹⁵⁰ The 3 major factors that should be noted when interpreting the results of Basaria et al were thoroughly discussed above. Most recently, Vigen et al reported a higher rate of adverse cardiovascular events with testosterone replacement therapy in a retrospective cohort study of male veterans with hypogonadism who underwent coronary angiography.¹⁵¹ Vigen et al showed a 5.8% absolute risk increase for the composite of all‐cause mortality, MI and ischemic stroke in male veterans who were treated with exogenous testosterone. Although these results are statistically significant, the authors correctly point out the weaknesses of their study which include retrospective study design and lack of randomization, small sample size at extremes of follow‐up, lack of outcome validation by chart review and poor generalizability of the results given that only male veterans with CAD were included in this study. The controversy over the safety of testosterone replacement therapy will require large, prospective, randomized, placebo‐controlled trials in which cardiovascular events are the primary outcomes. Results from the Effects of Testosterone Replacement on Atherosclerosis Progressions in Older Men with Low Testosterone Levels (TEAAM) study are eagerly awaited to clarify any possible long‐term adverse consequences from testosterone replacement therapy. The Effects of Testosterone Replacement on Atherosclerosis Progressions in Older Men with Low Testosterone Levels study will be a new trial assessing the effects of exogenous testosterone on adverse events related to atherosclerosis in elderly men. Until the results of such large‐scale studies become available, we recommend caution when administering testosterone to elderly men.

Go to: Concluding Remarks


Given the very large population of patients in the United States who suffer from hypogonadism coupled with a projection of ≈481 000 new cases of hypogonadism annually,¹ an extensive amount of attention has been dedicated to the interplay between testosterone and various aspects of cardiovascular health and well‐being. Low endogenous bioavailable testosterone levels have been shown to be associated with higher rates of all‐cause and cardiovascular‐related mortality.^{39,41,46–47} Patients suffering from CAD,^13–18 CHF,¹³⁷ T2DM,^25–26 and obesity^27–28 have all been shown to have lower levels of endogenous testosterone compared with those in healthy controls. In addition, the severity of CAD^{15,17,29–30} and CHF¹³⁷ correlates with the degree of testosterone deficiency. Testosterone replacement therapy in men who suffer from hypogonadism and CAD has proven effective in increasing time to 1‐mm ST‐segment depression with exercise stress testing^50–52 and causing coronary artery vasodilation.⁵³ In patients with CHF, testosterone replacement therapy has been shown to significantly improve exercise tolerance while having no effect on LVEF.^140–144 It is highly likely that testosterone therapy causes a shift in the skeletal muscle of CHF patients toward a higher concentration of type I muscle fibers.¹⁴⁵ Testosterone replacement therapy has also been shown to improve the homeostatic model of insulin resistance and hemoglobin A1c in diabetics^26,68–69 and to lower the BMI in obese patients.⁷¹ There is growing evidence that suggests that testosterone may be able to control ventricular repolarization by modulating the length of the QTc interval. Lower levels of endogenous testosterone have been associated with longer duration of the QTc interval.^115–119 Interestingly, testosterone replacement has been shown to shorten the QTc interval.^115,117 Finally, a negative correlation has been demonstrated between endogenous testosterone levels and IMT of the carotid arteries, abdominal aorta, and thoracic aorta.^{126–128,32,129–130} These findings suggest that men with lower levels of endogenous testosterone may be at a higher risk of developing atherosclerosis. This review article has demonstrated that normal testosterone levels play an important role in maintaining cardiovascular health, and testosterone replacement therapy in men with hypogonadism improves obesity, T2DM, myocardial ischemia, exercise capacity, and QTc length. Current guidelines from the Endocrine Society make no recommendations on whether patients with heart disease should be screened for hypogonadism and do not recommend supplementing patients with heart disease to improve survival.¹⁵² Longitudinal, placebo‐controlled, randomized trials of testosterone replacement therapy in men with low testosterone levels are required to completely clarify the role of testosterone in survival of patients with heart disease.

[redback]

it's not a study. it's a review of a bunch of studies.

Yes that's a study you unacademic fuck! :D

There is also way more to read than what you have posted.

[Bouncer]

Yes that's a study you unacademic fuck! :D

There is also way more to read than what you have posted.

yea but i just posted the part that matters. lol

[Sustalog]

Haha.... nonetheless, it's a good read. Test is by far, by far, my favorite compound so I will just say thank you for the post.