The disease-mongering of Low T (low testosterone) could have been an important subtheme of this column, yet it was barely mentioned. As our medical editor on this review wrote, “Low T syndrome reflects a cure in search of a disease.”
The column was solid for what it did – teasing for what more it could have done.
What does “feeling manly” mean? What does “virility” mean? Does a 1% per year decline in testosterone levels for most men mean they have a condition that requires treatment? There are conditions attributable to low testosterone that warrant treatment. This story – although it rated well – could have done a better job addressing such questions.
As it usually does, the Healthy Skeptic column itemized costs of the products in question.
See “evidence” criterion above
The story explained:
“Over-the-counter testosterone products may carry hidden dangers. A 2008 study in Clinical Cancer Research found that two men taking a supplement called Teston-6 developed unusually aggressive, fast-growing prostate cancer. Lab tests showed that the product contained hormones (including testosterone) that weren’t on the label, a common issue with noNPRescription products. The manufacturer quickly pulled it from the market.
“The problem with these sorts of supplements is that they don’t have to meet the regulations of the Food and Drug Administration,” says Dolores Lamb, a coauthor of the Teston-6 study and professor of urology at Baylor College of Medicine in Houston.”
There are also harms associated with appropriate testosterone replacement, including potentially dangerous increases in the red blood cell count (stroke risk), worsening sleep apnea, and increasing the growth of the prostate gland (possible cancer risk).
Repeated questions about evidence are raised:
• Dr. John Morley, a testosterone expert and director of geriatrics at St. Louis University, says that there’s not a lot of scientific evidence for any supplement that claims to boost or “promote” testosterone. And for him, that’s a real problem. “These sorts of products have been around forever,” he says. “As far as I know, none of them have been proven to work in a carefully controlled trial.”
• “Some of the individual ingredients in these products have been tested, with less-than-impressive results. In a 2007 study in the Journal of Strength and Conditioning Research, Australian researchers found that giving rugby players daily doses of Tribulus terrestris for five weeks had no effect on their testosterone levels.
Chlorophytum, one of the ingredients in HGH Up, has long been used as a supposed aphrodisiac for men. A search of the medical literature uncovers a single study suggesting that it may have “testosterone-like” effects, including enhanced sex drive and stronger erections, but the study was conducted on rats, not humans.”
We wish the column had more directly addressed the disease-mongering of low testosterone that takes place. It mixed in the needs of “men diagnosed with unusually low levels of testosterone” with men wanting help with “virility” without ever nailing the disease-mongering discussion. It came close when it quoted one physician who “often prescribes testosterone for men who have a significant deficit of the hormone, a condition called hypogonadism. The prevalence of this condition is controversial — it depends on how one measures testosterone and defines normal levels — but (he) estimates that 30% to 40% of middle-aged men don’t have enough testosterone to feel their best, sexually and otherwise. Even among these men, about one-third don’t respond to testosterone treatment. In other words, testosterone is hardly a sure-fire remedy against the ravages of aging.”
Yet the story never commented on the widespread marketing of “Low T syndrome” and product marketing estimates that it could affect millions.
Two independent experts were quoted.
The story briefly set up the story by explaining: “Men diagnosed with unusually low levels of testosterone are sometimes treated with prescription testosterone injections, patches or creams. Men who want to regain the levels of their younger days without a prescription may be interested in a different route: over-the-counter products that promise to boost testosterone naturally.”
The easy and widespread availability of products making testosterone claims was clear in the story.
The story explains “”These sorts of products have been around forever.”
It’s clear the story didn’t rely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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