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Testosterone and Heart Attacks: Q&A

Who needs testosterone therapy?

The FDA has approved testosterone in a patch, gel, and other forms. The approval is for men with low blood levels and an associated medical condition, such as a problem with the hypothalamus and pituitary gland, which control the making of testosterone.

According to guidelines from the Endocrine Society, testosterone can be considered for men with confirmed low blood levels (usually below 300 nanograms per deciliter) and consistent symptoms,  including low libido.

Until more research is in, what's the best advice for men?

Getting a blood-level test of testosterone is crucial, experts agree. But they suspect many doctors don't check that before prescribing the testosterone.

"I don't think men should be fearful of it," Anawalt says of testosterone replacement therapy. "If they go to their doctor and it is truly low, the benefit exceeds any potential risk."

A man's health history should also factor into the decision about the therapy, Greenland says. "If I had had a heart attack, no, I wouldn't touch this.”

If a man has low testosterone, with no family history of heart attacks and no risk factors, "I would say proceed with caution," Greenland says.  "Certainly you would want to be monitored by a doctor.”

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