Medically Reviewed by Alan M. Blaker, MD

Testosterone is a powerful hormone. It makes voices deep, grows beards and helps develop muscle mass. It might also help protect men against heart problems.  MIGHT is the key word.

CORRELATION or CAUSE?

In much the same way that women experience lower estrogen levels as they age, men see a drop in their testosterone. By age 60, approximately 20% of men have “Low T” (as they say on TV).  And about 30% have “Low T” by age 70.

“The research on testosterone’s impact on a man’s heart health offers much evidence of a link or correlation,” says McLeod Cardiologist Alan Blaker, MD. “However, there’s a difference between a ‘link’ and whether testosterone ‘causes’ heart issues.”

EVOLVING RESEARCH RESULTS

Testosterone and its impact have stirred much interest and lots of formal research in recent year. These research results might help clarify this subject for you.

The most recent research involved 2,500 men between the ages of 69 and 81. It found that the men, who had the highest natural levels of testosterone, were the LEAST VULNERABLE to heart problems.  Does that mean men should run out and get testosterone?  No.

Just a few years ago, a study found that heart failure patients given additional testosterone showed “significant improvement”.  But the improvements seemed to be primarily in improving their muscles and ability to exercise – not a direct impact (cause) on heart improvement.

Another study published in 2010 showed much the same results.  In six months on “Low T” therapy, men over 65 gained muscle strength and endurance, compared to a group of men not receiving extra testosterone.  The bad news: nearly six times as many men in the “T” therapy group had a heart attack, blocked artery or died of another heart problem than the group of men NOT given extra testosterone.

A recent study looked at men after starting testosterone therapy – using gels, patches or injections for “Low T”.  It found an INCREASED RISK of heart attack in these men, especially among older men and middle-aged men with a history of heart disease.

In the wake of this report, the Food and Drug Administration is studying whether  “Low T” supplements should carry safety warnings.

Most of the research has been limited in scope and sample size. The researchers generally agree that more research is needed to clarify the cause and effect of testosterone, supplements and men’s hearts.

CONCLUSIONS

It’s difficult to reach absolute conclusions from the range of research.  But keep in mind these few thoughts:

• Elderly men with naturally higher levels of testosterone seem to have less risk of heart attack.
• Men with low testosterone may have a slightly higher risk of developing heart disease or suffering a heart attack.
• Taking testosterone supplements may improve muscle mass but does not seem to improve a man’s cardiovascular health and is possibly related to higher risk of heart attacks or blocked arteries.
• Monitoring of testosterone levels on therapy may be of help pending results of the FDA review for patients on testosterone replacement therapy where the benefit is thought, by your healthcare provider, to exceed the possible risk.

FINAL THOUGHT.  Whether or not a man is taking testosterone therapy, if he is experiencing symptoms related to heart problems, he should see his personal physician or a cardiologist.

Find a Cardiologist near you.

Sources include:  McLeod Health, National Institutes of Health, Journal of the American Medical Association, Journal of the American College of Cardiology, Journal of Clinical Endocrinology & Metabolism, Harvard Health Publications, Canadian Institutes of Health Research, New England Journal of Medicine