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Diabetic men with low testosterone levels had a death rate twice as high as diabetics with normal testosterone levels, followed over 6 years (20% versus 9%).  When men with low testosterone were treated to restore normal levels, the risk of death was the same as men with normal testosterone levels.  The study was published in Endocrine Abstracts (2011; 25:P163)

Most of the deaths were due to cardiovascular disease.  Average age was 61 years.  Testosterone therapy was regulated to restore the men to normal levels, and not higher.

Another study revealed transdermal testosterone replacement provided improvements in insulin resistance, total and LDL cholesterol, and sexual health.

Congestive heart failure is the major cause of hospitalization in people over the age of 65, causing one fifth of hospitalizations, or 875,000 admissions.  Half of these patients die within five years.

Testing for testosterone deficiency should be performed in all men with heart failure.  Low levels, below 320 ng/ml, should be treated with hormonal support, in the absence of active prostate cancer.

Allan Sosin MD

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