By Dennis Thompson
The increased risk occurred whether or not a man had the low-testosterone condition known as hypogonadism, but appeared to be more pronounced in middle-aged men than in seniors, the findings showed.
These findings should cause men to think twice about asking for testosterone treatments to battle normal symptoms of aging, said lead author Rob Walker, a graduate research assistant at the University of Minnesota School of Public Health, in Minneapolis.
“If a potential patient reads this and maybe is seeking out testosterone therapy for some kind of common symptoms, like weight gain or sexual function, maybe they should seek out behavioral changes or lifestyle changes that will improve their health without a prescription,” Walker said.
Still, more than 1 million U.S. men over 30 received testosterone therapy in 2016, the researchers noted. Evidence suggests it’s still being prescribed to some who don’t suffer hypogonadism, a condition in which the body isn’t producing enough of the male hormone.
To further investigate the risk of testosterone treatment, Walker and his team analyzed insurance claims for nearly 40,000 men filed between 2011 and 2017.
The investigators focused on men who experienced either deep vein thrombosis or pulmonary embolism. Pulmonary embolism occurs when a deep vein clot breaks free and travels into the lungs, blocking some or all of their blood supply.
Men without a low-testosterone condition who took the hormone had 2.3 times the risk of developing a deep vein clot within six months, the results showed. Men diagnosed with hypogonadism had 2 times the risk.
“In men without hypogonadism, men under 65 almost had a tripling of risk versus men 65 years and older, whose risk was only about 1.5 times greater,” he said.
Testosterone poses this risk because it “revs up the consistency of the clotting factors in the blood,” said Dr. Umesh Gidwani, an associate professor of cardiology, critical care and pulmonology at the Icahn School of Medicine at Mount Sinai in New York City.
The hormone increases red blood cell count, which thickens blood and makes it flow more sluggishly, Gidwani said. Testosterone also amps up the action of platelets, the blood cells responsible for forming clots.
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SOURCES: Rob Walker, Ph.D., M.P.H., graduate research assistant, University of Minnesota School of Public Health, Minneapolis; Umesh Gidwani, M.D., associate professor of cardiology, critical care and pulmonology, Icahn School of Medicine at Mount Sinai, New York City; Nov. 11, 2019, JAMA Internal Medicine, online