Testosterone therapy has become increasingly popular for older men over the past two decades or so, but scientific evidence has lagged behind popular practice.
This story describes results of a group of coordinated trials with men over 64 years old. The story gives a detailed description of some recent findings, and provides quotes from both people who believe the results are useful, and others who say the study proves there is no real benefit to testosterone treatment. It also did a nice job navigating and clarifying the murky area between what the drug has been approved for and the wider/questionable broader uses promoted by its manufacturers and other proponents.
Testosterone therapy is one among a number of popular treatments to minimize the effects of aging. With a whole range of anti-aging regimens available, it is important to weigh the pros and cons of health fads against the weight of scientific evidence. This story makes it clear that knowledge about many of the potential benefits of testosterone is still in flux, and other claims just don’t bear up under the weight of scientific scrutiny.
Although this article mentioned that rub-on testosterone products are readily available, it did not explicitly mention the cost of those products, or compare them to existing, approved treatment for anemia and low bone density in men.
While the ideal would be a story that reported numerical data about what was actually found–what the scope of potential benefits/harms were in the trial–we’ll nonetheless give this a satisfactory score. There’s little doubt about the take-home message from this paragraph in the story: “A year of testosterone treatment was no better than a placebo for memory and thinking, and it increased fatty plaque in coronary arteries, a risk factor for heart disease. The hormone helped anemia and low bone density in the minority of men with those conditions, which can be treated with other, proven therapies.”
The author of this story makes possible harms of the therapy clear: testosterone therapy increased fatty plaque in coronary arteries, a risk factor for heart disease. It also talked about the possible risk of stroke in a subset of men.
This story does a good job of informing readers about the quality of and limitations to evidence for this therapy. It also gets points for mentioning the size of the main trial.
If anything this article is the opposite of disease mongering. It reports results of a study that was commissioned out of concern that testosterone is overprescribed to older men and that many men who use it either have normal testosterone levels have never been tested.
One minor concern is that the context/fact-checking is delivered subtly and may be missed on a quick read.
For example:
AbbVie, which donated its leading brand, Androgel, to the trials, said in a statement that the company is “committed to our patients and is proud of our continuous support of research that advances science for the benefit of hypogonadism patients.”
As explained elsewhere, hypogonadism occurs when the body doesn’t produce enough of the hormone due to disease, injury, or chemotherapy. It’s the condition for which testosterone-replacement therapy is approved–not experimental use for mood, libido, low bone density, etc.
The story does an exemplary job of citing credible, outside sources about the study. We did not detect any conflicts of interest that were overlooked.
This story takes a broad view, and looks at the evidence for using testosterone for a number of conditions. Given that, it would be tedious to try and discuss all the alternatives.
It’s made clear that testosterone is available. It would have been helpful to clearly state that this requires a prescription, but this is a minor quibble.
Novelty in this story is not so much about the treatment itself, which the article states has been a research focus since about the year 2000. The novelty here resides in the scope and expense of these clinical trials. The story makes that clear.
The story does not 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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