About the author
Rebekah Harding is a Health Writer at The Edge. She is an experienced health and lifestyle writer with both digital and print bylines in Men’s Health, Cosmopolitan, Yoga Journal, Giddy, and more.
For men with debilitating symptoms of low testosterone (like fatigue, muscle loss, and low mood), finding out that their history of cardiovascular disease or heightened risk may disqualify them from treatment adds insult to injury. In 2010, a clinical trial on whether testosterone replacement therapy (TRT) could prevent muscle deterioration was halted after researchers observed a link between the administered testosterone gel and dangerous cardiovascular events and elevated blood pressure (1)
Shortly after, the FDA began requiring testosterone manufacturers to include warning labels that outlined the cardiovascular risk.
But results from a new double-blind clinical trial (TRAVERSE trial) have shown no short-term differences in cardiovascular adverse events with TRT in aging men with pre-existing cardiovascular disease (2).
The study investigated the safety of TRT in men with both hypogonadism—a condition in which your body doesn’t produce adequate levels of testosterone—and a history or risk factors of cardiovascular events.
Over 5000 men between 45 and 80 years old were divided into two groups: those who were administered a 1.62 percent testosterone gel daily and those who received a placebo gel. Researchers found that both groups had similar rates (around 7 percent) of major cardiac events like heart attack or nonfatal stroke. This suggests that TRT does not significantly increase short-term cardiovascular risk in men with preexisting cardiovascular disease.
However, the testosterone group reported higher instances of other side effects like irregular heart rhythm, acute kidney injury, and venous blood clots.
“We resolved one important question: Can we give testosterone to men with androgen deficiency to try to help them without harming them?” Cleveland Clinic cardiologist Steven Nissen, M.D., the study’s senior author, told the New York Times. “And the answer is, ‘yes.’”
What’s more, TRT may help mitigate other risk factors for cardiovascular disease, like reducing body fat and normalizing blood glucose (3, 4).
In fact, a 2024 meta-analysis involving 24,000 men across 11 different studies found a concerning link between low testosterone levels and a heightened risk of cardiovascular events (6). Men with extremely low T levels—below 153 ng/dL of total testosterone—were at the highest risk of dying from heart disease.
While TRT—prescribed and monitored by a doctor—is safe for your heart, using anabolic steroids can have major cardiovascular health consequences.
Anabolic steroids— unmonitored, high doses of hormones like testosterone or trenbolone—are typically used in bodybuilding to promote muscle growth and to dramatically increase strength. Doses of these steroids can be 10 to 100 times greater than TRT prescribed by a doctor.
A new study published in the Journal of Physiology found that anabolic steroid abuse is linked to a heart condition called atrial fibrillation, or a rapid and irregular heart rhythm (5). Atrial fibrillation puts you at a higher risk for stroke and heart failure.
The new research is promising, but men who have “uncontrolled or poorly controlled” congestive heart failure or those who have had a heart attack in the last three to six months may not be a good candidate for TRT, says Jim Staheli, D.O., Medical Director of Broad Health, Hone Health’s affiliated medical practice. And you’ll have to be carefully monitored by your doctor if you decide to take TRT after a major cardiac event.
If you suspect that you have low T, Hone Health’s at-home testosterone assessment tests eight testosterone biomarkers, including free and total testosterone, SHBG, and prolactin. If you qualify for treatment, TRT can be sent to your door.
Hone’s at-home testosterone assessment is the simplest way to uncover whether your levels are low. If you qualify for treatment, TRT can be sent right to your door.
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