Testosterone's Ups and Downs

Testosterone's Ups and Downs

A wonderful misconception is hidden in our national obsession with "scientific consensus." Diets, climates, exercise, drugs all appear upon the stage preening and fretting against a background of "scientific consensus" when it is actually as real as CGI. The Testosterone therapy debate is a case in point.

For years evidence has been collected that testosterone therapy in testosterone deficient males improved cardiovascular health. A total of 46 studies imply, at least, that the replacement of testosterone to raise the hormone to normal levels results in a population with less cardiovascular problems, heart attacks and strokes. Then, in 2013, a retrospective study of a collection of patients treated with testosterone showed the opposite: Testosterone treated patients did not do as well as those not treated. There was nothing known about this population, only that they were prescribed the drug. It was not even known if they took the drug. Nor was their baseline health known--for example testosterone is give in some terminal and wasting disease-- and, on review, 10% were women.

A subsequent study--where the patients were collected from insurance form claims!--showed a similar risk.

So was the scientific consensus of the 46 studies wrong? Did everyone insist on better studies? Did anyone ask how the discrepancy between the previous studies and the new ones could be explained? Did anyone ask if 10% of the study population being  women might imply some inaccuracy? No. Instead, the NYT wrote an editorial about the scourge of overprescribing of medicine in the U.S., the FDA immediately put qualifiers on the medication inserts and 4000 people sued the pharmaceutical companies. 

Settled science.