Testosterone Replacement Therapy (TRT) is a well established science and there are hundreds of studies documenting the safety and effectiveness of TRT. Some of the largest studies simply observe that men who are low in testosterone have about a 50% increased death rate over the subsequent decade when compared to men with normal testosterone levels.
Heart disease is the number one killer in men. Testosterone helps prevent heart disease by improving the cholesterol profile, discouraging blood clots, and by keeping blood vessels open and elastic. Testosterone can be given to men with advanced heart disease and is shown to improve their functional ability to stress the heart.
Sarcopenia is the age-related loss of muscle mass, strength and function. Muscle is replaced by fat and fibrous tissue. Hormone decline, particularly androgens like testosterone, is one of the biggest reasons for sarcopenia in men and women. Maintaining muscle mass means less frailty, more energy and more stamina.
Testosterone indirectly prevents diabetes by preventing sarcopenia. But, TRT also has a direct effect on helping insulin work better. Several studies show men who replace testosterone need about 50% as much insulin. Adding TRT to an exercise program results in much better blood sugar control than exercise alone. TRT should be considered in all patients with type 2 diabetes or metabolic syndrome X.
Osteoporosis or “brittle bones” is not as common in men as women, since men build stronger bones in the first place because of testosterone. However, the mortality and disability caused by osteoporosis in men is worse than in women! Again, TRT has a direct stimulating effect on bone — testosterone will build bone!
Dementia and depression are much higher in men with low testosterone levels. Testosterone has both protective and growth-stimulating effects on nerve tissue in the brain, and is shown to have a regulating effect on the plaque that accumulates in the brain with Alzheimer’s Dementia. TRT improves cognition and mood, especially abstract and spatial skills such as reading a map, coordination and balance, and motor control.
The myth of testosterone causing prostate cancer has been thoroughly debunked. In fact, at the time of diagnosis, men with prostate cancer tend to have a lower testosterone level than average. Men with low testosterone also tend to have more aggressive forms of prostate cancer. TRT does not increase the risk of cancer, and recent studies show it is even safe to use TRT after treatment of prostate cancer.