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Supplemental testosterone can make men stronger and thinner, and help them have better sex. So what’s the downside?

By Dan Carlin


Everyone knows that the anabolic steroid testosterone (T) is banned in professional sports. But many people don’t know that middle-aged men who aren’t pro athletes are perfectly free to use it—T is a legal prescription drug. So pharmaceutical companies are rushing to market T to aging baby boomers, who, as usual, are challenging the status quo for everything related to aging.


There’s just one problem: While T can help its users feel younger, that’s not the same as actually being healthier, and it’s far from clear that supplemental T is actually beneficial.


The advantages of supplemental T are obvious: more muscle mass, easier weight loss, increased libido and more day-to-day energy. The risks are less obvious: potential mood swings, sleep apnea, liver injury, blood clots and accelerated vascular disease.


There is solid support for the idea that supplemental T can help males with unusually low testosterone levels. According to a 2010 summary review on this subject in the Journal of Endocrinology and Metabolism, 6 percent of men surveyed (as identified by low morning T levels and associated physical findings) would benefit from more T. In their case, the benefits of supplemental T outweigh the risks.


You might ask, what about the other 94 percent of men? If T makes you slimmer, stronger and happier, why shouldn’t we all use it?


Maybe we should. But there is one very large unknown: We don’t know how long a 55-year-old body can tolerate the elevated T levels of a 25-year-old. Because supplemental T is relatively new, there are no long-term studies on its sustained use in older men. And I don’t think you want to be the guinea pig on this issue.


Here’s why: As our cells age, their ability to efficiently metabolize food, build new proteins and eliminate dangerous free radicals declines. Older cells are also closer to their Hayflick Limit (named for the distinguished microbiologist Leonard Hayflick, who correctly noted that our cells are not immortal, but have a finite number of reproductions, after which they die). We know that T is a powerful stimulus to which our cells respond. What we don’t know is how older, partially damaged or inefficient cells respond.


Think of it this way: It’s possible that added T in an older man is a lot like flooring the gas pedal on a 55-yearold car. The car will go faster, no question. But the chance of a major breakdown is much greater than if you drove at the speed a 55-yearold car would typically go.


The design of our bodies is infinitely complex and fundamentally ingenious. Throughout the stages of our lives, our bodies meet the challenges of growth, reproduction and survival. I suspect that the falling T levels we see as a result of aging are a natural function meant to protect our aging cells from unnecessary injury and early death.


For the moment, I’d advise the 94 percent of men with normal T levels to hold off taking supplemental T. We’ll know a lot more in the next few years. Until then, take a look at the advice in the sidebar below. There’s nothing revolutionary about it—no miracle like the one T is supposed to offer. But it does have the advantage of working every time.


This article originally appeared in the December/January 2013 issue of Worth.

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