Testosterone therapy (TTh) has long been a subject of both fascination and controversy. Dr. Karla Alberts, ND has been prescribing testosterone therapy for 12 years at her clinic, Summit Naturopathic – a multidisciplinary clinic that specializes in cardiometabolic health and bioidentical hormone therapies (bHRT) for both men and women – with offices located in Truckee and El Dorado Hills. We met with Dr. Karla Alberts to discuss the benefits of TTh for men and the misconceptions that may surround its reputation. Below, you will find a few common questions Dr. Alberts has encountered in her practice.
Does testosterone therapy cause prostate cancer?
No, testosterone does not cause prostate cancer or any other type of cancer. This is one of the biggest misconceptions that I see with patients and practitioners alike. This fallacy came about as the result of a poorly designed study over 80 years ago, and we’ve been working to overturn this false perspective for many decades. Numerous, impressive studies have shown that men with higher testosterone levels have no increased risk of prostate cancer, and there are even studies to suggest that higher testosterone can actually lower the risk of this disease.
Is there a risk of heart attacks or strokes associated with testosterone therapy?
A recent landmark study called the TRAVERSE trial, was an FDA-mandated trial to investigate the cardiovascular safety of testosterone. The study was vast and well-designed and looked at testosterone use in men who either already had pre-existing cardiovascular disease or possessed a high risk for it. The results provided reassurance that there was no increased risk of heart attack or stroke with testosterone use in these men.
Another important moment for TTh was in 2015, when, in an attempt to resolve these controversies, an international expert consensus conference was held to determine the benefits and risks of TTh. A panel of medical experts sifted through decades of research, and unanimously concluded the following: The evidence does not support increased risks for cardiovascular events or prostate cancer with TTh. And we continue to see evidence in support of this.
Is there any evidence supporting the occurrence of "Roid Rage" in individuals undergoing testosterone therapy?
Aggressiveness and moodiness aren’t caused by high testosterone, but rather by what testosterone turns into, which is estrogen. It’s important to manage estrogen not just to mitigate side effects, but also to protect the prostate. In my practice, we have several ways to manage estrogen and keep it well-balanced. Testosterone, in all actuality, is quite calming and tends to balance out aggression, anxiety, and mood swings.
What are the benefits of TTh?
Simply put - to make life better and to enhance the longevity of life. Testosterone improves mental-emotional well-being, sleep, stamina, motivation, and energy, and also improves thyroid function. It improves sexual health and most certainly has a significant impact on intimacy and the quality of our relationships. It also enhances the ability to gain and maintain muscle mass, which is of utmost importance as we age. Testosterone has been shown to lower our risk of diabetes, Alzheimer’s, depression, cardiovascular disease, and prostate cancer. The risk of not doing TTh - in my opinion, is greater than the risk of doing it.
What is the method for administering testosterone?
Testosterone can be administered in many ways - oral, sublingual, topical, injections, and pellets. I can prescribe all routes of administration, and find injections to be the most efficacious for male patients.
How do you optimize testosterone protocols in your patients?
In addition to keeping an eye on testosterone and estrogen levels, my patients get a comprehensive workup twice per year, which also includes an assessment of thyroid and adrenal function, markers of inflammation and nutrient status, cardiovascular health, and metabolic markers. If any of these are imbalanced, we address them. All patients get custom recommendations for optimal dosing of testosterone and supportive supplements. Recommendations to protect cardiovascular health are discussed and can include lifestyle suggestions such as regular blood donations, setting exercise plans, or the use of pharmacotherapy.