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Selling Testosterone

Testosterone ads for men are all over TV. Now come the warnings of health dangers. We’ll investigate.

An ad for the testosterone-boosting Fortesta Gel. ( Endo Pharmaceuticals)

An ad for the testosterone-boosting Fortesta Gel. ( Endo Pharmaceuticals)

Turn on television for the evening news, and it can seem like all Viagra and Cialis ads all the time.  But right in there for a while now, almost as wall-to-wall, are the ads telling men to check their testosterone.  Feeling sluggish, they ask?  Maybe it’s “low T”.  Ask your doctor, and you may soon be rolling testosterone into your armpit, getting it off a patch, an injection.  And revving up again for life.  A miracle!  Last week, a new study came out finding substantial risks.  Heart attack risk.  This hour On Point:  men, aging, “low T” talk, risk, and the charge of overselling testosterone.

– Tom Ashbrook

Guests

Melinda BeckHealth Journal columnist for The Wall Street Journal. (@MelindaBeckWSJ)

Lisa M. Schwartz, professor of medicine and community and family medicine at the Dartmouth Institute at Dartmouth College.

Brad Anawaltprofessor and chief of medicine at the University of Washington Medical Center.

Michael Kimmel, distinguished professor of sociology at SUNY at Stony Brook. Author of “Guyland: The Perilous World Where Boys Become Men,” “The Politics of Manhood,” “The Gendered Society,” “Misframing Men,” “Manhood in America” and “The Guy’s Guide to Feminism.”

From Tom’s Reading List

New York Times: Weighing Testosterone’s Benefits and Risks – “Officials at the Food and Drug Administration said on Friday that they were reassessing the safety of testosterone products in light of the recent studies, and will investigate rates of stroke, heart attack and death in men using the drugs.”

Live Science: Low T: Real Illness or Pharma Windfall? — “Because low T can be treated with prescription medication, it has become the health problemdu jour for aggressive pharmaceutical marketing: The airwaves are now flooded with ads showing doughy, middle-age men turning into vigorous athletes and confident lovers.”

The Dartmouth Institute: ‘Low T’: How To Sell Disease — “By lowering the bar, pharmaceutical companies target people in the ‘big grey zone’ between being clearly well or clearly sick. ‘There are a lot of American men. Some are grumpy. Some are tired. Some may not be interested in sex at the moment. And all of them are aging,’ say Schwartz and Woloshin. ‘This is the intended target of the campaign.’”

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  • Unterthurn

    It’s being marketed to women as well.
    Why?

    • John Cedar

      To get them to stop voting “D”.
      and increase their SAT math scores?

      • TFRX

        Ah, another right-wing science scholar chimes in.

    • Mari McAvenia

      Good question. Many years ago women were forbidden from taking estrogen and somehow we managed to survive that disappointment. I guess men want to remain youthful at all costs as they age while women are told that they need to be more “competitive” and “tough”, really, more masculinized. Since males are still very much “in charge” they will get what they want even if it makes them sick and crazy. Just guessing on this one. Big pharma isn’t in the business of making people better. Big pharma only exists to make obscene heaps of money in order to keep itself in business. Caveat emptor.

  • Ray in VT

    “Now come the warnings of health dangers”? Just listen to some of the disclaimers for these products. They don’t sound like they should be used around anyone.

  • Acnestes

    Geez, all you had to do was listen to the side effects listed in the ads, or maybe read the package insert if you really cared. Makes plutonium seem like mother’s milk.

  • lobstahbisque

    There’s a song in The Producers that actually contains the word testosterone: A remarkable linguistic achievement.

  • tncanoeguy

    I’m guessing that in most people lack of energy etc… can be addressed with changes in lifestyle – exercise more and eat well. But of course that doesn’t do much for the bottom line of big pharma.

  • http://neilblanchard.blogspot.com/ Neil Blanchard

    This sort of ‘pop a pill’ culture makes a profit center out of the bread and circus, that is so much of the problem in our economy.

  • AliceOtter33

    Do not mess with hormones. Therapeutic hormonal supplement is one thing, hormonal boosting is another.

    Here’s a 2011 study connecting high testosterone to cortisol ratio to increased predisposition to psychopathic behavior.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166523/

    We’re living in a time where for all our technological advance, we still have trouble referring to rape without quotations marks.

  • Bigtruck

    Just buy a Porsche like the other old guys.

  • AlanThinks

    Hey Tom, just turned 60, performing great in all areas – sex, back in school for a PhD, racing bicycles, swim and yoga multiple times per week, . The key – right diet (mostly plants) and daily vigorous exercise.

  • creaker

    Funny how medicine works in this country – people are supposed to self-diagnose based on 30 second ads trying to sell this stuff and then go demand their doctors prescribe based on their self-diagnosis.

  • viacarrozza

    My comment does NOT apply to men who need to take these powerful drugs for real medical reasons. It’s seems a better idea to eat really well, exercise consistently and go with the flow. Guys and girls of a certain age need to accept the natural order of things. I like older men who have calmed down a bit and older women who aren’t trying to be something they’re not. Do we really need everybody to be fueled up by more testosterone ? Give me a guy who possesses a little self-reflection, wisdom and thoughtful action toward contributing to a marvelous society.

  • ian berry

    Just what the world needs, an even more amped up and easily provoked population. It would be better if people just chilled out the heck out.

  • James

    I’m sorry, if your stupid enough to fall for any of this low T stuff you hear on advertisements, you live with the consequences. Just don’t use this as an excuse for more government regulations.

    • http://neilblanchard.blogspot.com/ Neil Blanchard

      Let’s blame the consumer!

      • Ray in VT

        I don’t want the government getting in the way of my snake oil and magic bean start up.

    • hennorama

      James — should someone who writes “if your [sic] stupid enough…” be criticizing others about their intelligence or lack thereof?

  • hennorama

    Given all this “low-T” advertising, one wonder if the makers of T/Gel® Therapeutic Shampoo are considering adding a warning that their product is not a testosterone supplement.

  • Emily4HL

    To me, this is the perfect reason to ban pharmaceutical advertising. We are one of very few countries that allow it.

  • Michael

    I was treated for low T in Australia, using a similar approach to what is done in the USA. While my symptoms improved, I was shortly thereafter diagnosed with enlarged prostate or BPH, a condition that was common in men in my family over 55 yo old. I was not yet 40, and wondered how much contribution to my early diagnosis of BPH was a result of low T treatment.

  • Bob Simon

    I am 62 and have WAY less energy and sexual interest than I did as a young man. I’d LOVE to boost my testosterone (402ng/dl) but my doctor says it’s normal. But he has no idea what is normal for me. If 800 is normal for me then I’m way low, right?

    • homebuilding

      I take it that you miss those teen-aged days when erections were not uncommon during church/mass/various public meetings where some decorum used to be expected…..and you took great pains to hide your situation from your friends, lest you be the butt of their jokes concerning you obvious arousal concerning “what’s her name?”

      We hear stories of such things–are they really true?

      Is this a driver of the ‘way too loose pants’ movement?

      (I’d bet a lot of money that no medical discussions and no treatment was ever discussed regarding this….)

    • ToyYoda

      If you want to have more sexual interest, sleep less. The less sleep you have, the less control your cortex (grey matter) has over the limbic system, the hornier you will become.

      Of course, getting by on less sleep will make you less energetic. So take Monster Energy Rehab. Get the Lemonade Iced Tea flavor. (The other Monster lines are just awful.)

      If you think I am being facetious, well I am sort of. There’s alot to libido than just T. Lots of factors play into it. (like the ones I mentioned above).

      There’s fitness. Fat tends to make you lethargic it also produces estrogen. Fat is also an insulator so your body has less a need to “rev up” to maintain body heat. This level or “rev up”, can influence your pysche and affecting your level of desire.

      I don’t want to understate that. I workout everyday, and when I skip days (due to life), I find my body core temperature drops (I’m 42). I feel cold and have preference to want to “turtle” into my cozy house. This is another way of saying I want to be less engaged with my world and more inactive. But after an intense workout, even hours after working out, my core is quite heated. I can walk out of my house at 40 degrees with my shorts on no problem.

      So I would look to hire a fitness trainer.

      Also, have a long term goal which to reach. That kicks the libido into gear. “Long term goal” is such a bad word for what I really want to describe. It makes it sound mundane. What I really want you to do is have a quest. Is there not some skill you always wanted to master, but all this time you’ve been dithering from one random thing to the next? Is there a foreign language you want to learn? Is there a musical instrument you always wanted to master? Pliny the Elder kept learning new languages until he was dead. Eric Kandel wrote the ‘The Age of Insight’ at age 70. This is a 600+ page book on art, the unconscious and the mind.

      Another thing to look at is novelty. Doing something over and over again will eventually dull your mind. I have tendency to zone out, and often times may get drowsy. At 62, I’d imagine you would feel like you’ve “seen it all”. But have you? As you get older you need to actively seek novelty, but it doesn’t have to be in things, it could be just re-arranging the order you do things during the day.

      So I believe that the mind is where most men’s “T deficiency” lies. Working out gets you into the *mental habit* of *doing* something. This *doing* is your libido, another term for libido is passion or inspiration.

      In the West, people wait for inspiration, or find their “passion” out there, or inject T hoping their libido revives. In the East -buddhism- passion comes from within. It is cultivated and attended to. I think the last two sentences are heretical for western minds.

      This brings me to my next aspect. That is sprituality. No, don’t be turned off. I’m not asking you to accept Jesus into your heart. I am asking you to be more like a buddhist (stripped of all the spiritual baggage). And what is that you ask? If you have gotten this far in my lengthy (sorry about that) post, then you’ve been doing buddhist things: an examination of how the mind ticks. That really is buddhism in a sentence. You need to examine those periods where you were energetic and times when you were “lazy”, and figure out what the differences were in your environment and how that might affect your psyche.

      Examine the mind in all its different settings, and at different levels of detail. Not just the outer environment but also internal dialogues too. E.g.: “I just had this kind of thought, that usually means in 30 minutes I’ll switch my mood and not do anything.” “Gee, everytime I watch Shark Tank on CNBC, I ask myself why can’t I start my own business? Then when the show ends I go back to my sedentary ways, why?”

      Anyways I’m reminded of Socrates quote, “The life unexamined is not worth living.”

      So good luck sir. Your quest, if you choose to accept it, is to cultivate your passion into an intense blaze.

  • ThirdWayForward

    How many men are on testosterone therapy in the US?

    I think the program has neglected the economic impact of this therapy, particularly on the auto industry. How much of the sales of pickup trucks are attributable to testosterone therapy?

  • creaker

    It’s too bad people don’t pursue being healthy as aggressively all this all other stuff. Many would likely find that being healthy would resolve many of these other issues.

  • tbphkm33

    Hmm, seems to me that the other half of the species, namely women, have thrived for millions of years without testosterone.

    • Ray in VT

      Well, lower levels.

  • Irene R

    The doctor from Harvard who called in wanted to acknowledge that there is a true population of patients with authentic testosterone deficiency. He urged everyone not to disregard this fact. However, if there is a true problem with testosterone deificiency, my concern is WHY is this so? What is going on in our environment and with our lifestyles that so many of us need to supplement our bodies with something we should be making in sufficient amounts naturally. I have always heard rumors that drug metabolites are in the water table – I am thinking about all the estrogen analogues that women take for birth control. Are factors like this perhaps disrupting the hormone balance in our men? I think hormone phobia is a healthy fear to have, because hormones are very complicated and the body is far more suited to regulate them than doctors with their synthetic replacements.

  • John_Hamilton

    In the advanced, or final stage of an infinite-growth economic system, this is the kind of thing that will appear with greater frequency. If normal products in the realm of food, clothing, shelter, recreation and health care are not growing faster than the population, then frivolous luxury products will appear at an increasing level.

    The frenzy we are seeing about consumer electronics is a good example of growth inducement by hyping “need” for i-phones, i-pads, Facebook, Twitter, I-tunes, Netflix, and ad nauseum.

    The pharmaceutical industry in particular has reached a stage where the need for growth has moved it in a direction of drug pushing, creating diseases where they don’t exist, and offering treatments that do more harm than good.

    The first challenge in the past was to get doctors on board. Now, in the age of Citizens United, the challenge is to get compliant politicians, and hence a compliant FDA. Doctor cooperation is still important, but he who pays the piper calls the tune, no matter how dissonant.

    At some point a hype-induced system will max out. For years I have found TV sports unwatchable due to the relentless hype. I’m old enough to remember when announcers were silent when nothing needed to be said.

    It wasn’t that long ago that former Chicago Bulls coach Johnny “Red” Kerr was the commentator for broadcasts of Bulls games on local TV station WGN. In the early years of Michael Jordan’s time in Chicago, there would be long silences between scores if nothing was happening. It was really refreshing. This was in the late 1980s to early 90s.

    Some may have noticed that body hair is now being hyped as something bad for people’s appearance, popularity, and of course, sexual appeal. Various hair removal products are being pushed to remove this hideous scourge. Next, I suspect, will be the hyping of hair as attractive.

    Human civilization has never been in the predicament we now find ourselves in. Where it will go is unknown, but some things can be predicted as likelihoods. The overall context is one of an infinite-growth economic system on a finite planet under conditions of global climate change of increasing severity.

    We have a political infrastructure, or overstructure, that is for sale to the highest bidder. With a bought political structure, problems caused by the buyers will intensify, such as oil spills, chemical spills, pesticides in the food and water, pharmaceuticals in the ground water, mercury in the fish, floods, storms, forest fires, tornadoes, hurricanes, and on and on and on.

    At some point in the future it will break. A convergence of all these negative factors is inevitable. We will need a couple hundred Super Bowls a year to keep us distracted as we build up to this denouement. Then, who knows? I think it is safe to say that having a lot of testosterone won’t be much help.

    • homebuilding

      Very well stated, John_H:

      Panem et Circensus, just as Juvenal stated

      • John_Hamilton

        Thanks much. I feel like Sisyphus when I write this stuff. Either the mountain is getting steeper or the rock is getting larger. Or I’m just wearing out.

  • homebuilding

    Somehow, widespread, now legal drug and medical procedure advertising to the end consumer is far from any panacea.

    The world was a better place when there were fewer advertisements for EVERYTHING and there were NO medical ads.

    But the genie will never go back in the bottle. Too much money is being made and the public is so incredibly vulnerable. Even the mention of a concern by a ‘celebrity’ can make a massive swerve in public opinion. Just look at our current rate of celiac ‘disease.’ It is now ten times that of Europe–and they live longer…..and the plague of non immunizations….

    I say, let the medical practitioners decide without the table tilting this way or that…..as the Bible says “…by every wind of doctrine.”

  • Nancy Howard

    I am very concerned that men don’t know that prostate cancer, which is usually asymtomatic, thrives on testosterone. Especially for men under 60, no one is screening for this cancer and the results of additional testosterone could be devasting.

  • http://drjohnlapuma.com/about John La Puma MD

    Men don’t feel right, because they have been drugged by overprocessed foods and gender-bending chemicals like BPA. Tom just read the title of my NY Times Op-Ed: “Don’t Ask Your Doctor About Low T: the last thing they need now is a prescription for a risky drug to treat a trumped-up disease. http://nyti.ms/1fpVKjd

    • donny_t

      what about pine pollen?

  • Fred Fletcher-Fierro

    Its a couple of reasons that I have moved to getting 99% of my news through radio and the internet. I don’t have broadcast TV, cable, satellite at my house, I just can’t stand all of the commercials.

  • Fred Fletcher-Fierro

    Very interesting hour Tom and the On Point staff. Funny thing about public radio is that it maybe the only radio news outlet that doesn’t take advertising dollars for testosterone advertising but does a whole hour on it anyways. Having worked in the pharmacy business for six years I got used to people believing that supplements like testosterone work. You couldn’t talk people out that they didn’t work, or any of the other 1,000 supplements that the company would sell.

  • ToyYoda

    Yes, this is quite true. A man’s body wants to maintain a certain level of testosterone. If you increase that level through artificial means then the body responds by decreasing it’s level until the “certain level” is reached. So at high enough levels, the body will stop producing it altogether.

    Once a man stops elevating his levels of T, the body eventually will produce its own but it takes some time for it to do so.

    By the way, I don’t take T, I just read a lot.

    I also work out every day, but don’t take supplements except for nutrition drinks. Anyways, to answer your second question, professional body builders cycle on and off testosterone. There’s a build and recovery phase to bodybuilding. T helps during the building phase, though how, I don’t really know. When recovering (resting) from workout, bodybuilders take another hormone, estrogen.

    That is why when testing for performance enhancing substances, monitors look for elevated T and elevated estrogen. Yes, men and women have both hormones but just at different levels.

    • Judi Kroeger

      Thanks Toy Yoda. That is what I have read. I think one of the benefits of injecting ( or what ever the delivery system is) Testosterone for body builders is it aids in the recovery from a demanding work out, allowing the body builder to hit the gym for any give muscle group, sooner.Thus getting back to the building sooner. I believe they do that mostly right before a competition.

      I also know that when my dad was diagnosed with Prostate Cancer, the urologist stated the body’s production of Testosterone as the main issue, and my dad was on female hormone therapy until he decided what action he wanted to take. I was surprised the doctors on “On Point” said nothing about that.

  • UnkJDM

    Interesting program. But, what about the general problem of DTC (Direct to Consumer) ads?? I understand that the entire concept was approved by the FDA in response to promotion by Pharma (Don Rumsfeld at Pfizer, I believe), and that we as a society might just be better off by a return to the days when this type of advertising was not allowed.

    • ExcellentNews

      Rumsfield? 7 million men taking extra testosterone? That’s a scary combination. Since we could not con the voters to go to war with Iran, maybe we can give them a bit of a chemical aggression push. After all, Halliburton and Exxon bottom lines have been flat since 2008…

  • ExcellentNews

    The radio was buzzing too loud in my head, but I smashed it to pieces so everything is ok now. Time for another T patch… there… ahhhh….

  • ExcellentNews

    Look up “testosterone” and then “gonadotropins” on Wikipedia, and you will appreciate how complex, personal, and still poorly understood is the human hormonal system. It’s not something you can easily tweak with a supplement.

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