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Michael Irwig Part 5, Dangers of Too Much Testosterone

In part 5, the conclusion of this Exclusive Interview, Michael Irwig talks with Diabetes in Control Publisher Steve Freed about the side effects of too much testosterone.

Michael Irwig, MD, FACE, is a general endocrinologist at George Washington University in Washington, D.C.


Transcript of this video segment:

Freed: Testosterone is a prescription item and there’s a lot of reasons for that because it can be dangerous. What are some of the side effects from testosterone or too much testosterone?

Irwig: Testosterone in the short term can cause an increase in the red blood cell count, and so, erythrocytosis, and so that has to be carefully monitored just to make sure that a man’s blood cell count doesn’t get too high. The thought is that if the blood cell gets too high that could be associated with increase in viscosity and maybe lead to things like blood clots and strokes. Testosterone can sometimes cause hypertension, acne, oily skin. We don’t have a large long-term randomized control trial to look at safety of testosterone over many years. So, we don’t really know what to tell patients who are going to be on this for 10, 15, 20 years in terms of is this going to impact any major outcomes such as heart attack, cancers, prostate cancer, bone health, fractures. So, we’re lacking that data from randomized trials but we do have data from other studies that can help to inform us. There is no evidence that testosterone causes prostate cancer but men who get put on the testosterone treatment get more PSA testing, they get more digital rectal exams, so there’s more detection of sub-clinical prostate cancer. And it is known from studies back in the 1940s that if you have a man with advanced prostate cancer that’s metastatic, testosterone can fuel that fire. So, you don’t want to give testosterone to a man who has metastatic prostate cancer.

Freed: So, it has been chosen for men that have prostate cancer that you would want lower testosterone because it’s the fuel for the cancer. Is that the understanding?

Irwig: Right. So, one treatment for advanced prostate cancer is actually androgen deprivation therapy. It’s to get that testosterone level really low either through physical castration or through medical castration, but then that brings into the side effects of kind of low energy and increase in body fat and those side effects.

Freed: Well, I want to thank you for your time. Really appreciated it. I’ve learned something and I hope our audiences learned something also. Enjoy the rest of your stay here in Boston.

Irwig: Thank you so much!

Freed: Thank you!

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