Low testosterone levels in men shorten life expectancy

A study published today in the Annals of Internal Medicine reports that low testosterone levels in men may mean shorter life expectancy.

Researchers from the University of Western Australia, together with scientists from Australia, North America and Europe, conducted a systematic review and meta-analysis of 11 studies involving more than 24,000 participants.

The purpose of the study was to examine the relationship of sex hormones with mortality rates and the risk of cardiovascular disease in older men.

They concluded that low basal (endogenous) testosterone levels in men are associated with an increased risk of all-cause mortality, and very low testosterone levels are associated with an increased risk of cardiovascular death.

In their statement, the researchers said their study clarifies previous conflicting data on the relationship between sex hormones and key health indicators in older men.

Details of the study on low testosterone and mortality risk

They examined prospective cohort studies, previously defined in a published systematic review, involving "community-dwelling men with measured total testosterone concentrations by mass spectrometry and a minimum of five years of follow-up."

The team analyzed individual patient data to understand the relationship between baseline hormone levels (total testosterone, sex hormone binding globulin, luteinizing hormone, dihydrotestosterone, and estradiol) and the relative risk of cardiovascular events, cardiovascular deaths, and all-cause deaths.

According to the data, the researchers noted that only men with low concentrations of total testosterone had increased risks of overall mortality.

They reported that the key finding was that men with testosterone concentrations below 7.4 nmol/L (<213 ng/dL) had an increased risk of all-cause mortality, regardless of luteinizing hormone (LH) concentration. p>

LH is a chemical messenger in the blood that controls the actions of certain cells or organs and plays an important role in sexual development in children and fertility in adults.

Data showed that men with testosterone concentrations below 5.3 nmol/L (<153 ng/dL) had an increased risk of cardiovascular death.

The author of an editorial accompanying the study noted that the meta-analysis is especially valuable because of its rigorous methodology.

The researchers said their study is the first of its kind to conduct an IPD meta-analysis of major prospective cohort studies using mass spectrometry, considered the most accurate method for measuring testosterone, which can also accurately measure DHT and estradiol. p>

To conduct the IPD meta-analysis, the researchers obtained raw data from the nine included studies and reanalyzed the pooled data. They stated that this allowed "more complex analyzes of pooled data from multiple studies and provided more robust association testing."

Reaction to research on low testosterone

Dr. Yu-Ming Ni, a cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in California, said the study was unclear why the subjects had low testosterone levels.

"There could be many reasons, including obesity, liver problems, drug interactions and other hormonal causes of low testosterone," said Ni, who was not involved in the study. "Unless this is clarified in future studies, it remains unclear whether low testosterone causes cardiovascular disease, and it would be unwise and potentially dangerous to assume that treating low testosterone with hormone replacement therapy will reduce the risk of heart disease."

Nee cited one study published in the New England Journal of Medicine that found treating hypogonadism with testosterone replacement therapy was not associated with increased rates of heart disease "and certainly not with lower rates of heart disease."

"In summary, this study provides interesting information about the relationship between testosterone levels and heart disease, and further research is needed," Ni said.

Dr. S. Adam Ramin, a urologist, urologic oncologist and medical director of Urology Cancer Specialists in Los Angeles, also commented on whether men should take testosterone supplements.

"This study confirms what I also discuss with my patients about the risks of low testosterone," Ramin, who was not involved in the study, told Medical News Today. "Although most people think of testosterone in the context of sexual function, this male hormone has many functions. It is true that low testosterone levels will lead to decreased sexual desire and possible erection problems."

How to deal with low testosterone?

Ramin said low testosterone is also associated with loss of bone density, loss of muscle mass, weight gain, mood swings, fatigue and depression. He said low testosterone can also lead to heart attacks, strokes and death.

“In my practice, the majority of my older male patients in their 80s and 90s who are alert, cognitively sharp, energetic, independent, muscular and have a strong posture have natural testosterone levels above 500, with some as high as 600-700.”, said Ramin.

He added that men can naturally increase testosterone levels by reducing belly fat, sleeping at least 6 hours every night and avoiding processed foods.

Ramin noted that men should do at least 30 to 45 minutes of cardio exercise at least three times a week, avoid alcohol as much as possible, drink more than 3 liters of water per day and consume two to four eggs with a yolk per week.

He also said that for men with low testosterone, “taking DHEA 25-75 mg per day may help. However, this should be done under the supervision of a doctor to ensure that there is no prostate cancer."

Ramin said men can also take 2,000-4,000 IU of vitamin D3. He said men with low testosterone levels should avoid supplements with estrogenic compounds and bioflavonoids.