Testosterone on Wall Street

My cousin recently sent me a link to "Keep taking the testosterone" published last Friday in the Financial Times in which the author interviewed a solo physician who's been prescribing testosterone to Wall Street traders who aren't able to compete and think as clearly as they had a decade earlier.  The author also mentioned my former employer who apparently will be opening up an office there shortly.  The commentary made for more interesting reading as writers came out from both sides of the camp.  There were those who decried testosterone supplementation since it would be expected from working 12 hour days 7 days a week without time for proper nutrition & exercise.  Good point!  Others chimed in from personal experience about how much better they felt.  Still others suggested that there's really no need to be an alpha male as one ages & becomes more mature (my paraphrase).

I would just like to point out that, contrary to what was written about testosterone fueling prostate cancer, there is actually a small but growing body of medical literature suggest that this is, in fact, not the case.  Sure, if your testosterone is totally in the weeds, adding a bit more might support growth.  But the newest theory suggests that at some low level, anything more won't make a difference.  How can that be?  Think about watering a plant in a container.  If the soil is absolutely parched, that first bit of water will be nothing short of amazing.  Probably that second bit, too.  But at some point, the soil will become saturated with water and hold no more.  If you continue to water this plant, the excess won't cause the plant to grow any more, any faster.  It will only spill out of the container and make a mess.

Likewise, if you take a look at the range of testosterone levels of men who've been diagnosed w/prostate cancer, it's a wide spread, essentially mirroring the normal reference range.  In other words, low normal testosterone is not protective against prostate cancer, nor does high normal testosterone cause it.  So how did we come to our erroneous way of thinking?  Because in men in whom their prostate cancer has spread, one proven treatment is to remove testosterone.  But that doesn't mean the testosterone caused it in the first place.  That's the problem with making assumptions.

So if you need testosterone, take it under supervision.  But don't take it just to make your numbers look nice. And remember that what's normal for your friend, might be high for you, so don't compare yourself to your buddy.  Because excess testosterone might increase your risk for change in mood for the worse, development of oily skin or acne, loss of hair, enlargement of your prostate, development of male breasts (gynecomastia), even loss of libido (from excess conversion into estradiol).  And if you aren't watching, excess testosterone might also increase your blood pressure, lower your HDL (good) cholesterol, and increase your blood count, all of which might increase your risk for heart attack, stroke & untimely death.  Remember, too much of a good thing isn't.

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