Supplemental Testosterone and Its Risks

I wrote an article on Human Growth Hormone (HGH) and the popularity of peptides that stimulate its secretion in the body to treat some of the maladies of aging, including brain fog, loss of muscle mass, decreased libido, and low energy. Supplemental testosterone is purported to have many of the same benefits. Millions of men are using testosterone by prescription as an injection or topical gel to restore “normal” levels of this hormone, as its concentration in the bloodstream decreases with age. This is spurred by aggressive direct-to-consumer marketing by pharmaceutical companies that manufacture the hormone. Like HGH-promoters, there are many common misconceptions and risks associated with testosterone supplementation.

Signs of low testosterone (see above) are very common in most of us as we age, unrelated to hormonal changes. It is common for men to request a test to measure testosterone from their doctors, and usually the levels are normal. Despite this, many men obtain testosterone via online sources, where it is readily available, and feel better when they begin therapy. 

Several problems may arise once the hormone supplementation begins. First, exogenous testosterone inhibits the body’s production, making it difficult to stop using it. Some men experience immediate side-effects such as oily skin and acne and swelling of the breast area and ankles. Over time, the risk of heart disease and death from heart attack and stroke increases. Testosterone therapy may cause enlargement of the prostate with difficulty urinating, and an increased likelihood of prostate cancer. Mood swings, irritability, and depression are common. Muscle mass often increases, but actual strength may decrease. Hair loss, headaches, obstructed breathing during sleep, and fatigue may occur. 

While the benefits of therapy in men with low (free) testosterone may outweigh the risks, use of this hormone for those with normal levels for age is fought with adverse and dangerous side effects and to be discouraged for those seeking to optimize their health.

Note: Although I am a physician, the content in this article is not meant to diagnose, treat, cure or prevent illness or disease in the reader – it is for educational purposes only.

References

• Lee OD, Tillman K. An overview of testosterone therapy. Am J Mens Health. 2016 Jan;10(1):68-72.
• Khera M. Controversies with testosterone therapy. Can J Urol. 2020 08;27(S3):20-23.
• Groti Antonič K, Zitzmann M. Novel perspectives of testosterone therapy in men with functional hypogonadism: traversing the gaps of knowledge. Aging Male. 2024;27(1):2296460.