2265 North Clybourn Avenue    Chicago, IL 60614    P: 773.296.6700     F: 773.296.1131

Disappointments With Testosterone

For 80 (!) years physicians have prescribed testosterone to men without being certain if it actually had any effect other than raising testosterone levels. The only FDA-approved indication for testosterone is pathological hypogonadism, in which there’s an actual disorder of the male reproductive system that results in the body not producing enough testosterone. Examples are testicular damage from mumps, a genetic condition called Klinefelter syndrome, or problems with the pituitary gland, your body’s master gland.

Just as a woman’s sex hormones, estrogen and progesterone, decline with age, so goes a man’s testosterone. A woman might experience hot flashes, night sweats, disturbed sleep, and brain fog as result of diminishing sex hormones. Whether the mental fogginess is caused by low estrogen or by chronically interrupted sleep is uncertain. But menopause can be very uncomfortable.

For a man it’s different. Symptoms of declining testosterone are vague and may be unrelated to testosterone, indistinguishable from just getting older. The word “andropause” (intended to imply male menopause) has the ring of a Big Pharma neologism created to induce anxiety in aging male Baby Boomers who are feeling less than booming, but who are reluctant to confront the inevitable passage of time.

Driven by Adam Smith’s laws of supply and demand, doctors around the world (myself included) measured testosterone levels and, crackerjack scientists that we are, concluded that by merely raising testosterone from a pathetic low to a punchy high we could beat time at its game and reverse aging.

“Low T”
A lot of women, especially those on hormones themselves, liked this construct. The guy in your life exhausted and grumpy when he comes home from work? Looking a bit flabby? No longer the sexual stallion you married? Maybe you, too, egged on by Big Pharma’s commercials, thought, “I wonder if he has low T”?

“Low T.” As damning as Hester Prynne’s Scarlet A. “Honey, when you go in for your check-up, ask the doctor about your testosterone.”

Everyone, doctors and patients alike, took a major leap of faith by equating “High T” with a better life. Smelling the proverbial meat a-cookin,’ Big Pharma poured tens of millions into TV ads and visiting drug reps. Ever see those Charles Atlas ads on the back of comic books? Here’s what they looked like. Yes, Big Pharma was selling the promise of Mr. Atlas without all the hard work.

What muddied up everything was that every one of Big Pharma’s testosterone treatments raised a guy’s testosterone number. The before-and-after results were impressive. A guy could leave his doctor with a spring in his step because his once little-nothing-of-a-T now merited bragging rights at his bar, health club, board room, or hunting lodge.

But questions loomed large. Did men feel better with their new testosterone gains? And, was this a safe thing to do?

To a T
I’ll share with you a piece published in JAMA (Journal of the AMA) in 2017, reporting on two testosterone trials. Here’s a CNN overview as well.

In the first trial, researchers from several medical centers around the country recruited approximately 800 men over 65, all of whom had the dreaded Low-T for no apparent reason other than age. Half were given a testosterone-containing gel, the other half a placebo (the same gel, but without testosterone). They were retested periodically over the next 12 months.

First, to nobody’s surprise, everyone using the actual testosterone gel did show a measurable increase in T levels.

Sexual energy and function: men in the testosterone group seemed better during the first weeks of the study, but by the end of the study there was no difference between them and the placebo group. There was no explanation for this. I think the “You can’t fool Mother Nature” rule applies.

Cognitive function: there was no difference between the two groups in several tests of mental functioning.

Heart disease: the researchers began by taking baseline CT (computerized tomography) images of the coronary arteries in all men. One year later, there were no heart attacks in either group, but compared to the placebo group the T-taking men had narrower arteries and more plaque buildup (though not calcified plaque) than the placebo gel group. In the long run, non-calcified plaque leads to calcified plaque and this finding alone may be enough to warrant a death knell for testosterone.

Bone strength: there was improved bone density in the testosterone group, but not enough to warrant use of testosterone for male osteopenia (low bone mineral density), which is rare in itself.

Blood count: there was a mild increase in hemoglobin (red blood cell) levels of the testosterone group. This is a known effect of testosterone, but again not clinically useful.

The conclusion is simply this: as a man ages, his testosterone slowly falls, but without the overt misery many women experience with their drop in estrogen. The alleged benefits of using testosterone to increase your numbers from low to high are little more than smoke and mirrors, and with the changes in coronary arteries quite possibly dangerous.

Interestingly, there’s an herbal blend that stimulates the body to make more of its own testosterone. Testosterone Formula contains vitamins, minerals, and herbs that support and maintain healthy T levels. While there have been no clinical trials on this product, there’s an important difference in action between pharmacologic T and this supplement. The herbs it contains are three adaptogens (ginseng the best known), which work by helping the body adapt to stress and function optimally. When you take Testosterone Formula, everything involved in the body’s manufacture of testosterone functions more efficiently and, as a result, in many people there’s a slight rise in T levels.

Using adaptogens to improve natural function is, by the way, the exact opposite of what prescription testosterone gel will do. The high level of testosterone created by the gel will literally turn off a man’s ability to make his own T.

The most significant steps a man can take to slow down aging are related to lifestyle. He needs to exercise regularly, maintain a healthy weight, eat a nutritious whole-foods diet, remain mentally active, avoid tobacco, and get regular check-ups to make sure he’s not developing silent killers like diabetes or high blood pressure.

And remember, even Charles Atlas finally died.

Be well,
David Edelberg, MD

Leave a Comment


  1. Gracen Smith says:

    Thank you! Dr.Edelberg! I haven’t heard a doctor speak the truth in so long that I have given up listening to them.
    -GSmith

  2. John Doe says:

    As someone who has taken hormone therapy (injectable testosterone) in the past, I can tell you that there is absolutely no substitute. An herbal supplement may bring you up ~100pts in combination with strict diet and heavy weightlifting, but if you’re seriously low (200s or below) the only way to go up to the 800-1000s range is through IT… and the differences are dramatic. The increases in libido, muscular endurance, and overall increase in well-being cannot be understated.

    That said, there are costs to every benefit. I have no doubt that it did put stress on my vascular system (my BP went way up) and immune system (many of us visit WHC for chronic conditions – steroids are basically poison when you have these). I have no doubt however that for many people, the quality of life experienced at higher-end T levels for the next 30 years is preferable to a 40 year span at low T levels. To each their own there.

    My problem with this post is the way it is presented. Is Testosterone over-prescribed to middle aged guys who just want to be on low-dose steroids? Absolutely – go to Tavern On Rush on a Saturday night or hang out at the East Bank Club pool and that becomes abundantly clear. But for you to write essentially a shill article for some herbal supplement sold in-house is more reminiscent of Dr. Oz than the man at the helm of the practice many of us look at to pioneer our own health journeys.

  3. Shawn says:

    Your remarks about testosterone therapy show lack of knowledge about the current state of the practice. A good reference would be the late Dr John Crisler’s brief book,Testosterone Replacement Therapy – A Recipe for Success. Note in particular his chapter on using Human Chorionic Gonadotropin (HCG) as a co-carrier compound to prevent shutdown of men’s HPT axis for testosterone production (in the case of secondary hypogonadism, which is what most aging men suffer from). Another good reference to help TRT naysayers “get up to speed” is the Mayo Clinic Symposium summary, “Fundamental Concepts Regarding Testosterone Deficiency and Treatment; International Expert Consensus Resolutions”; Mayo Clinic Proc. July 2016;91(7);881-896. I especially appreciate their Resolution 3 starting that testosterone deficiency (TD) is a global health concern. I’m certain there are a good percentage of men misdiagnosed with depression who are actually experiencing one of the myriad of symptoms of TD.

Join our Newsletter

Get health recommendations, delicious and time-saving recipes, medical news, supplement reviews, birthday discounts, and more!

BIRTHDAY

Health Tips

Dr. Edelberg’s Health Tips contain concise bits of advice, medical news, nutritional supplement and pharmaceutical updates, and stress relief ideas. With every Health Tip, you’ll also receive an easy, delicious, and healthful recipe.

When you sign up to receive Health Tips, you can look forward to Dr. Edelberg’s smart and very current observations arriving in your in-box weekly. They’re packed with helpful information and are often slightly irreverent. One of the most common responses to the tips is “I wish my doctor talked to me like this!”

Quick Connect

Get One Click Access to our

patient-portal

The Knowledge Base

Patient education is an integral part of our practice. Here you will find a comprehensive collection of staff articles, descriptions of therapies and nutritional supplements, information addressing your health concerns, and the latest research on nutritional supplements and alternative therapies.

Join our Newsletter

Get health recommendations, recipes, medical news, supplement reviews, birthday discounts, and more!

Upcoming Workshops

**Adrenal Boost!
Wednesday, December 4, 6-8pm
With Caley Scott, ND, and Renee Zambo, C-IAYT Yoga Therapist

Course Fee: $75.00

Feeling Tired? Need help improving fatigue? Learn to boost energy with WholeHealth Chicago’s Naturopath Caley Scott and Yoga Therapist Renee Zambo. More →

**Facial Guasha Class
Thursday, December 5, 6-7:30pm
Hosted by Mari Stecker, LAc

Course Fee: $75.00
(includes take-home facial guasha tool and custom anti-aging facial oil!)

Join us and learn a traditional Chinese facial rejuvenation technique that you can do yourself! Guasha treatment is a 2,000 year old Chinese massage technique that uses a flat tool to apply pressure to the skin to increase circulation as it moves along acupuncture channels. More →

Recent Health Tips

  • The Chemical Swill In Your Body (And What To Do About It)

    Two Harvard social scientists writing in JAMA estimate that 80,000 people will die unnecessarily every decade because of the Trump administration’s repeal of clean air regulations, with another 80,000 deaths caused by the more recent repeal to clean water rules. If you ask a Trump supporter about this, you’ll likely get an answer like “More jobs.” Well, yes, perhaps, but waiting for someone to die Read More

  • NAD+: Finally Getting Serious About Anti-Aging Therapy

    We’re living in a time of major, worldwide breakthroughs when it comes to understanding how we age and also the steps we can take to not only slow down aging, but to all appearances reverse the process. Over history, the fountain of youth seekers came, literally and figuratively, to dead ends, but back then Ponce de Leon had no internet in Florida. I do and Read More

  • The Cleveland Clinic and WholeHealth Chicago

    I know, I know. It’s presumptuous of me to mention Cleveland Clinic in  the same line, much less on the same page, as WholeHealth Chicago, though we do have significant attributes in common, as you’ll see today. This research article, which appeared last week on the JAMA website, links the two of us in ways we never expected, though it didn’t surprise us. Naturally, we Read More

Support your brain, heart and immune system health this month with 20% off BodyBio Balance Oil

Omega 6s and Omega 3s are the most powerful nutrients we can give our bodies. BodyBio Balance Oil is formulated with a ratio of four (4) parts omega 6 to one (1) part omega 3. Taken in this ratio, these nutrients positively impact brain function, digestive health, immune support, liver function and cardiovascular activity.

Click here to take advantage of this month’s promotion!