Is Testosterone Therapy Safe? Part 1 : Cardiovascular Health

Testosterone replacement therapy (TRT) has become increasingly popular for men experiencing symptoms of low testosterone levels. If you're considering exploring TRT, safety is likely your top concern. This series of posts addresses the primary safety concerns associated with TRT and how we at FreshRx keep our patients safe, happy, comfortable, and feeling GREAT. Let's begin with cardiovascular issues:

Cardiovascular Events:

Studies in the past have suggested that TRT may increase the risk of cardiovascular problems, such as heart attacks and strokes, especially in men over the age of 65. Luckily, the majority of research since the 2010s have not only supported the safety of testosterone use, but many recent studies have demonstrated a PROTECTIVE cardiovascular effect of TRT for men.

Last year (2023), the New England Journal of Medicine published a compelling study hoping to clarify information about cardiovascular safety in Testosterone therapy. The investigators made sure to use men in the age range of 45-80, ALL of which had pre-existing increased risk for cardiovascular disease (CVD). This is important because the study aimed to assess cardiovascular health on TRT specifically, so both the placebo group AND the TRT group needed to have equal risk for CVD at the start of the study. At the conclusion of the study, the placebo group (so the group NOT on TRT) actually experienced more cardiovascular events than the group on TRT. This study further increases confidence in the medical community that TRT is safe and effective for men, EVEN those with increased risk for cardiovascular events like heart attacks and strokes.

While current evidence is extremely reassuring, at FreshRx we monitor patients closely for ALL risks that have been associated with TRT, past and present. We take a thorough medical history and draw a full set of labs before approving patients for treatment. We also draw labs periodically to make sure there are no increasing markers of disease. For example, periodically checking a "CBC" (complete blood count) helps us to monitor patients' Hematocrit (Hct) levels, which may increase while on TRT. If we see that a patient's Hct levels are higher than normal, we require patients to donate blood to reduce that level. Simple as that. But without drawing labs regularly, providers cannot identify changes like this one.

Testosterone therapy has the potential to drastically improve patients' lives. TRT is extremely affective at alleviating symptoms such as fatigue, reduced libido, depression/impaired mood, and decreased muscle mass. TRT can be a wonderful experience, but it is not a risk-free one. Always undergo treatment with a qualified medical provider to stay safe and stress-free!

If you're interested in learning more about Testosterone Replacement Therapy, reach out to us at FreshRx for a free consultation!