Jun 25, 2014 8:00 AM

Author: Libby Mitchell

Testosterone is big business.

Every year companies selling testosterone replacement products bring in big bucks, and it is expected that by the year 2017 worldwide sales could reach five billion a year. There are testosterone sprays, testosterone injections, testosterone gels, and even a testosterone nasal spray. And while the companies pushing these products promise they will boost energy, improve health, and help with sex drive, what they aren’t telling customers could be dangerous.

The Food and Drug Administration says testosterone replacements can cause a condition called polycythemia – an increase the red blood cells in the body, which can raise the risk of potentially deadly blood clots. Each year blood clot related conditions like deep vein thrombosis and pulmonary embolism kill more than 180,000 Americans.

“That this is why we need to make sure that men make an informed decision before starting testosterone. Almost anyone will feel better if put on testosterone, but not everyone needs it,” says James Hotaling, MD, urologist with the Utah Center for Reproductive Medicine at the University of Utah. His colleague William Brant, MD, a surgeon and urologist at University of Utah Health, echoes his concerns, “Patients need to make sure that they are being appropriately monitored by physicians who are knowledgeable.”

The problem with ordering testosterone supplements without seeing a doctor is that even if there is a warning label on the product, as is now required by the FDA, the full weight of the risks may not be understood. “The key is a balanced discussion about the benefits versus the risks,” says Brant. For instance, the age of the patient should be considered. Men over the age of 60 with heart problems are at higher risk than other groups. Also testosterone therapy should not be considered by men who still want to have children.

Brant also warns against starting on testosterone replacement as a first line of defense. “Going to a clinic that will treat everyone with testosterone replacement or getting testosterone when the levels are normal just puts the patient at risk without any benefit,” he says. It should be clear that low testosterone levels are present, and responsible for the medical problem being treated. 

There are times that testosterone therapy will help. Doctors say the important thing is to cut through the hype, and get the facts, before using the hormone replacements.

Libby Mitchell

Libby Mitchell is the Social Media Coordinator for University of Utah Health Care. Follow her on Twitter @UUHCLibby

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