The latest T guidelines are a “roadmap” to nowhere

They truly guideline us to death in the medical profession. And I guess they have to, given the number of dangerously uneducated doctors out there. Or maybe they do it in the hopes of turning us all into an army of automatons. (And if so, they’re doing a bang-up job, considering most docs can’t think or make a decision for themselves to save their lives. And all the computer and electronic medical record requirements for physicians certainly don’t help the problem.)

But, I digress. Let’s get to the real topic at hand… and you’ll see pretty quickly what inspired this little rant.

Today I want to talk about testosterone—yes, the “big T.” You see, the Endocrine Society recently issued updated guidelines on using testosterone therapy to treat men with hypogonadism (a condition where the testes produce little to no testosterone).

The Endocrine Society is calling these new recommendations “a broad roadmap” for handling diagnosis and treatment of the diagnosis and treatment of low T. It’s not, however, a precise set of instructions.

My question to them is, “Then why even bother?!”

I guess it’s a good sign that, as a whole, the medical field is finally paying more attention to this aspect of men’s health. And trust me, testosterone levels are something my male patients are always interested in, even if they’re interested in nothing else I have to say.

But I’ve said it before, and I’ll say it again… Conventional medicine has it out for treatments that aren’t making them money. And with the number of low T cases among men in this country, you can bet that this is one case where they’re absolutely green with envy at missing out on the pay day.

So this little axe they’re grinding shouldn’t surprise anyone at all.

Take this statement, for starters: “Recent surveys indicate many men are prescribed testosterone treatment without an appropriate diagnostic workup or monitoring plan. Some men receiving testosterone therapy do not have adequately documented hypogonadism.”

I hate to break it to them, but there’s a reason for this. And the Endocrine Society’s own broad brush is to blame…

Get this: The panel set a reference range of 264–916 ng/DL. That’s quite a range, don’t you think? Anyone with even a passing knowledge of normal testosterone levels will recognize that for the joke that it is.

They’re saying that a 20-year-old man with a T level of 264 is normal? I don’t think so. It should be more like five times that number. How are you going to tell doctors to aim for a “mid-normal” range, when you can’t even offer an accurate picture of what exactly that range is?

As is typical for most endocrine issues, these guidelines also fail to address the needs of each individual patient by using biomarkers so unspecific, they’ll surely end up missing more signs of disease than they catch. (Much like women and their thyroids—another perfect case in point.)

In this case, they recommend testosterone therapy to treat symptoms in men with low T. But they also think that otherwise healthy men don’t need to be screened for hypogonadism.

And that’s another point I disagree with completely.

All men should be screened for low T, because the symptoms are vast and they’re not very specific. Some are pretty clear-cut, like low sex drive and a decrease in erections. But the other symptoms—fatigue, lethargy, depression, decreased stamina, etc.—could easily waved off as just “getting older.” And men could be suffering needlessly because of it.

And as for the risks of treatment? Mainstream medicine has long been afraid of T replacement, so it’s true that there isn’t as much high-quality, long-term data as there should be. But despite the rumors, there’s no clear and definitive evidence that testosterone therapy raises the risk of heart problems or prostate cancer.

The fact is, higher T levels actually lower all-cause mortality. You’re less likely to die when you have more testosterone—a biological advantage from our caveman days that still holds true today.

So what’s the bottom line for you? Find a practitioner who really knows what he or she is doing—one that will walk you through your options and keep an eye on your PSA, your prostate, and your free testosterone numbers during treatment.

These are the values that really count. But for a more complete discussion of smart T replacement, head straight to my archives.

I’ve written about this topic extensively in the past. And subscribers to my monthly newsletter, Logical Health Alternatives, have access to all of it. So if you haven’t already, consider signing up today.

 

Source:

medscape.com/viewarticle/894075