Blog - Castellano Health Institute
CALL US NOW AT (714) 530-2183

Testosterone Replacement Therapy and Mortality

Clinical guidelines recommend Testosterone Replacement Therapy (TRT) for men suffering from clinical symptoms of low testosterone when low Testosterone levels are documented. The most common symptoms of low testosterone include low sex drive/libido, low energy/fatigue, erectile dysfunction, and loss of muscle mass.  Currently there are 2.4 million men, ages 40-69, who meet the criteria for Low Testosterone (Hypogonadism).  With such large numbers of men qualifying for treatment, the question of safety arises.  Since the leading cause of death in men is cardiovascular disease, does prescribing testosterone therapy contribute to heart disease?

Contrary to current thinking, we know from studies that Low Testosterone is associated with a higher risk of cardiac events.  Most studies looking at testosterone replacement and cardiovascular disease have been relatively small and have shown some conflicting results.   But a recent large European retrospective study looked at the effect of Testosterone normalization on overall mortality, MI (Heart attacks), and strokes. 83,010 male veterans, with documented low testosterone levels were broken down into three groups and followed over 15 years.  At the end of the study, when comparing the normalized testosterone group (Gp1) to the non-treatment group (Gp3), there was an overall 56% decrease in mortality, 24% decrease in MI’s, and a 36% decrease in strokes in the Gp1. This large study showed that if your testosterone levels are low, you are less likely to die if you raise your testosterone levels to normal.

Even now, some patients are denied testosterone therapy by their physicians because they still believe that testosterone causes prostate cancer, leads to ‘Roid Rage’ or cardiovascular disease. We know these old myths take time to die off, but in the meantime, we are here to service those patients that can’t wait for their physicians to catch up with the latest scientific information. Unlike most physicians, Dr. Castellano knows that low testosterone is a risk factor for early death and that keeping your testosterone levels optimized reduces all causes of death.  At Castellano Health Institute, we stay on top of the latest medical knowledge so we can offer our patients the cutting edge of medical therapies.

Dr. Castellano is aware that all hormones have an interplay and a balance that must be maintained for optimal health. At Castellano Health Institute, we continually monitor total testosterone levels, estradiol, cbc, etc.  We know that testosterone is not the end-product, it breaks down to 6 other molecules, all which can have side effects.  We also know that each person is similar but different in how they may metabolize medicines, so therapies are always individualized.  At Castellano Health Institute, we specialize in all things Testosterone related, from treating low testosterone, erectile dysfunction, to the treatment of hair loss.