Testosterone treatment reserved for men with symptoms
DEAR DR. ROACH: I am a 70-year-old male. I receive testosterone injections (in the butt) from my provider every three weeks, and have been receiving these injections for roughly five years. My provider reviews my bloodwork every six months before he writes a prescription renewal for testosterone, which I then take to his office for safekeeping and the regular injections.
My latest bloodwork indicates that my testosterone serum is low at 310, and free testosterone is low at 4.9. After five years of injections, I continue to have low T; it does not seem to be improving. At my most recent visit, the doctor increased the injection dosage from 2 ml to 3 ml. I am concerned because of the heart, prostate and other risk factors I read about. Any advice or cause for concern? — M.M.
ANSWER: Testosterone treatment is indicated for men with symptoms of low testosterone levels and confirmed by blood testing. It is not a “tonic” to be used without due consideration.
There has long been concern about adverse effects of testosterone, especially to the prostate and to the heart. Most prostate cancer is testosterone-sensitive, and removing testosterone was one of the oldest treatments for prostate cancer. However, restoring normal levels of testosterone in a man with low levels is now considered to have low potential for increasing prostate cancer. It has not been definitively proven to be safe, but the many studies that have been done have been reassuring. Authorities recommend more-aggressive prostate cancer screening for men on testosterone treatment.