What are the risks of low testosterone?

Introduction

Low testosterone levels in men have been linked to various health risks, including increased mortality, cardiovascular disease, and other adverse clinical outcomes. This synthesis aims to consolidate findings from multiple research studies to provide a comprehensive understanding of the risks associated with low testosterone.

Key Insights

Increased Mortality Risk:
- Low testosterone levels are associated with higher all-cause mortality in men, independent of various risk factors such as age, lifestyle, and preexisting health conditions .
- Specifically, low testosterone levels predict increased mortality from cardiovascular disease (CVD) and cancer .
Cardiovascular Disease:
- Low testosterone is linked to a higher risk of cardiovascular events and mortality. This association is independent of other risk factors like age, diabetes, and hypertension .
- Testosterone deficiency is associated with components of the metabolic syndrome, such as visceral obesity, insulin resistance, hyperglycemia, hypertension, and dyslipidemia, which are risk factors for CVD.
Chronic Kidney Disease (CKD):
- Among male patients with CKD, low testosterone levels are associated with increased risks of all-cause mortality, cardiovascular mortality, cardiovascular events, and infectious events .
Inflammation and Metabolic Health:
- Low testosterone levels are inversely correlated with inflammatory markers like IL-6 and CRP, suggesting a link between testosterone deficiency and systemic inflammation .
- Testosterone replacement therapy has been shown to reduce waist circumference, cholesterol levels, and circulating pro-inflammatory cytokines, and improve insulin sensitivity and glycemic control in diabetics.
Prostate Cancer:
- There is no significant association between testosterone treatment and an increased risk of aggressive or any prostate cancer in men with low testosterone levels.
Symptomatic Androgen Deficiency:
- Factors such as age, low income, and increased waist circumference are associated with low testosterone and symptomatic androgen deficiency, which includes symptoms like low libido, erectile dysfunction, and osteoporosis.

Conclusion

Low testosterone levels in men are associated with increased risks of all-cause mortality, cardiovascular disease, and adverse clinical outcomes, particularly in those with chronic kidney disease. The relationship between low testosterone and systemic inflammation further underscores the potential health risks. While testosterone replacement therapy shows some benefits in metabolic health, its long-term safety, particularly concerning prostate cancer, remains inconclusive. Addressing modifiable risk factors like waist circumference may help mitigate some of the adverse effects associated with low testosterone.

What are the risks of low testosterone?

Summary

Introduction

Key Insights

Conclusion

Sources and full results

Low serum testosterone increases mortality risk among male dialysis patients.

Low testosterone levels in men on hemodialysis are associated with increased mortality risk, suggesting hypogonadism as a treatable risk factor for chronic kidney disease.

Low serum testosterone levels are associated with increased risk of mortality in a population-based cohort of men aged 20-79.

Low serum testosterone levels are associated with an increased risk of all-cause mortality in men aged 20-79, and may serve as a predictive marker for cardiovascular disease and cancer mortality.

Testosterone deficiency: a risk factor for cardiovascular disease?

Low testosterone levels in men are linked to metabolic syndrome and type 2 diabetes, increasing their risk of cardiovascular disease and premature death.

Low serum testosterone and mortality in older men.

Low testosterone levels in older men are associated with an increased risk of death over the next 20 years, regardless of multiple risk factors and preexisting health conditions.

Clinical review 1: Adverse effects of testosterone therapy in adult men: a systematic review and meta-analysis.

Testosterone therapy may cause increased hemoglobin and hematocrit levels and a small decrease in high-density lipoprotein cholesterol, but its safety and impact on patient-important outcomes remain unclear.

Low Testosterone Level and Risk of Adverse Clinical Events among Male Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Cohort Studies

Low testosterone levels are an independent predictor of increased risk of adverse clinical events in male patients with chronic kidney disease.

Low testosterone at time of transplantation is independently associated with poor patient and graft survival in male renal transplant recipients.

Low testosterone levels at the time of kidney transplantation are associated with poor patient and graft survival in male renal transplant recipients.

Testosterone treatment and the risk of aggressive prostate cancer in men with low testosterone levels

Testosterone treatment is not associated with an increased risk of aggressive or any prostate cancer in men with low testosterone levels and normal PSA levels.

Low testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors.

Low plasma testosterone levels are associated with increased cardiovascular events in middle-aged Japanese men with coronary risk factors, independent of risk factors and endothelial function.

Correlates of low testosterone and symptomatic androgen deficiency in a population-based sample.

Waist circumference is a potentially modifiable risk factor for low testosterone and symptomatic androgen deficiency, with symptoms potentially being a consequence of poor health status.

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