Testosterone Use & Heart Disease! The Truth!
My Competitive Life had a chance to sit down and speak with top Cardiologist in the North East, Dr. Sal Trazzera. Dr. Trazzera, board certified in numerous areas of cardiology, including Nuclear diagnostics, a former collegiate hockey player, still a competitive athlete, and owner of the Texas Brahmas (semi-pro Hockey team) gave us an education on Testosterone use and Heart disease. Dr. Trazzera owns the Farmingdale Heart Center, interested in receiving a consult with Dr. Trazzera, to make an appointment and call 516 249-1020.
- Discussing testosterone and effects on the heart, overall what are your feelings towards testosterone use, in respect to athletes and anti-aging?
Testosterone is an androgenic steroid sex hormone produced primarily in the testicles in males but in small amounts in adrenals and ovaries in females. It exerts its anabolic effects on muscle and bone and its androgenic effect by providing male sexual characteristics such as growth of facial hair, penile and testicular growth. Clearly both men and women need testosterone to maintain healthy muscle, bone and connective tissue as well as maintaining normal male (and female) sexual function. Testosterones effect on heart muscle is similar to its effect on skeletal muscle and smooth muscle in the gut or intestines. It partakes in normal growth and repair in all muscle, including the heart. That being said, the use of synthetic exogenous Testosterone in supraphysiologic doses has been observed and been reported in the medical literature to have adverse effects. This can, and does, take place if doses being administered drive the free and total testosterone levels above normal range, which can be seen in both males and females. Physiologic effects of exogenous supraphysiologic doses of Testosterone can adversely affect blood lipids such as Total Cholesterol (increases), HDL, Cholesterol or “good” Cholesterol (decreases) and Triglycerides (increases). This may (and does in my experience), predispose to premature cardiovascular disease including coronary artery disease, left ventricular hypertrophy (enlarged, thickened heart muscle), heart attack, carotid artery disease, hypertension and stroke. As females’ age and estrogen levels decline, menopause is naturally reached. Males experience a similar decline in production in endogenous Testosterone at times as early as their 30’s and certainly by age 40 and hence forth. Why do you think they call us “little old men”? We lose muscle and bone growth more and more as we age losing both height and muscle mass. I check serum Testosterone levels on all of my male patients c/o of fatigue, weight loss, poor libido, erectile dysfunction and strength loss as well as most males over the age of 35. Although this may not be common practice, I have found low testosterone levels to be highly prevalent in my experience. My stance on the use of Exogenous Testosterone replacement therapy in athletes is simple. If I can demonstrate a reasonable indication; i.e., those signs and symptoms previously mentioned, along with a low or declining Testosterone level, I feel it is reasonable to replace their testosterone to within a normal physiologic range. My vast experience is that patients improve clinically and rarely demonstrate adverse effects.
2. With your knowledge, what are some side effects seen with use of testosterone?
Gynecomastia, testicular atrophy, acne, hirsutism, clitoral enlargement (females), sweating, flushing, aggressiveness to name a few.
Is that dose specific? Yes
Long-term use? As previously mentioned, cardiovascular side effects.
Have blood profiles changed after stopping use” Generally blood profiles return to levels seen prior to replacement.
3. The media portrays steroids as a link to heart attack, any truth to that with research?
The media, in general, feeds off sensationalism and fear, thus I put little value in what is published in most periodicals and broadcast on television. As well, the medical community would consider it unethical to do a randomized double blind placebo controlled trial on the effects of testosterone on causing heart attacks. I can attest to the fact that in my twenty plus year in medicine and 17 years in cardiology… the inappropriate abuse of testosterone (an anabolic steroid) over long periods of time does cause premature atherosclerosis, coronary, cerebrovascular and peripheral vascular disease, heart attacks, strokes, hypertension and Cardiomyopathy. I have seen it time and again! It has been reported in many peer review medical journals over the last 30-40 years. On the contrary… aspirin can cause you to bleed to death if misused! Thus, testosterone replacement therapy has been proven to be safe and effective if administered and monitored under the care of a competent licensed medical professional. AND I reiterate… a competent licensed medical professional
4. Could this be the cause of unhealthy diet?
Some athletes take testosterone and then eat like hell, plus combine many other supplements like insulin and GH. Unless you are a physician trained in the use of these hormones such as an endocrinologist, internist or cardiovascular specialist, I would discourage these types of cocktails. I think the way to approach this type of athlete would be to look at what they are taking, check the effect of these exogenous hormones and supplements on their normal serum levels and make recommendation to adjust their diets, supplement and hormone intake accordingly with the goal of achieving appropriate physiological levels.
5. Would you say genetics, lifestyle, and physical fitness are more key determinants in heart disease and health?
Absolutely. Unequivocally, YES.
6. Can Testosterone benefit heart health? My experience has been that it not only can, but it does, as I have explained previously.
7. What advice would you give for people deciding to take Testosterone? Testosterone replacement therapy is much more common than you might think. Seek a consultation with an appropriately trained physician with experience in caring for patients and athletes who utilize Testosterone, usually an endocrinologist, primary care sports medicine physician or internist. Ask any male over age 50 who their physician is, there is a high probability they may, in fact, be on testosterone.
