From the Guidelines
Testosterone supplements are not recommended for a 66-year-old male primarily for weight loss, as the potential benefits do not outweigh the risks, including increased cardiovascular events and other adverse effects 1. When considering testosterone replacement therapy (TRT), it's essential to have a clinically diagnosed low testosterone level (hypogonadism) and be under close medical supervision. The American College of Physicians guideline on testosterone treatment in adult men with age-related low testosterone notes that outcomes did not vary substantially in studies with different baseline testosterone levels or testosterone formulations 1.
Key Considerations
- Low-certainty evidence from 7 trials showed a small improvement in quality of life, but this change may have been driven by improvement in sexual function 1.
- Moderate-certainty evidence from 7 trials showed a small improvement in global sexual function, and low-certainty evidence showed a small improvement in erectile function 1.
- However, low-certainty evidence from 14 trials showed a small increase to no difference in adverse cardiovascular events, which is a significant concern for older men 1.
- Traditional approaches to weight loss, such as reducing caloric intake, increasing physical activity, strength training, and improving sleep quality, are safer and more effective.
Recommendations
- If you're experiencing symptoms of low testosterone, consult your doctor for proper testing and to discuss whether the potential benefits of treatment outweigh the risks in your specific situation.
- For weight loss, focus on traditional approaches, including:
- Reducing caloric intake
- Increasing physical activity (aim for 150 minutes of moderate exercise weekly)
- Strength training 2-3 times weekly
- Improving sleep quality
- Testosterone therapy should only be considered under close medical supervision and with careful monitoring of potential risks, including cardiovascular events, blood clots, sleep apnea, prostate issues, and fluid retention 1.
From the FDA Drug Label
Geriatric Use Clinical studies of testosterone enanthate did not include sufficient numbers of subjects, aged 65 and older, to determine whether they respond differently from younger subjects. Testosterone replacement is not indicated in geriatric patients who have age‑related hypogonadism only (“andropause”), because there is insufficient safety and efficacy information to support such use Current studies do not assess whether testosterone use increases risks of prostate cancer, prostate hyperplasia, and cardiovascular disease in the geriatric population. Geriatric patients treated with androgens may be at an increased risk for the development of prostatic hypertrophy and prostatic carcinoma
The use of testosterone supplements in a 66-year-old male is not recommended due to insufficient safety and efficacy information. Additionally, there is an increased risk of prostatic hypertrophy and prostatic carcinoma in geriatric patients treated with androgens.
- Key points:
- Insufficient safety and efficacy information for geriatric use
- Increased risk of prostatic hypertrophy and prostatic carcinoma
- Testosterone replacement not indicated for age-related hypogonadism There is no information on the use of testosterone supplements for weight loss in a 66-year-old male 2.
From the Research
Safety of Testosterone Supplements for a 66-Year-Old Male
- Testosterone supplementation may be beneficial for older men with low testosterone levels, but its safety and efficacy remain uncertain 3.
- Potential benefits of testosterone replacement therapy include increased lean body mass, heightened libido, increased bone density, and elevation of mood 4.
- However, testosterone supplementation can have unfavorable effects, such as increased hematocrit and prostate-specific antigen levels 3.
Weight Loss and Testosterone Supplements
- Testosterone supplementation has been shown to decrease fat mass and increase lean body mass in healthy older men with low-normal to mildly decreased testosterone levels 3.
- However, the effect of testosterone supplements on weight loss in older men is not well established, and more research is needed to determine its efficacy for this purpose.
Considerations for Testosterone Replacement Therapy
- The decision to use testosterone replacement therapy should be made on an individualized basis, taking into account the patient's symptoms, medical history, and laboratory results 5, 6.
- The Endocrine Society recommends against testosterone therapy for all older men with low testosterone levels, but suggests consideration of treatment for men with consistently low testosterone levels and symptoms or conditions suggestive of testosterone deficiency 6.
- Different forms of testosterone replacement therapy are available, including parenteral testosterone esters, transdermal testosterone gel, and oral testosterone undecanoate, each with its own advantages and disadvantages 7.