Misleading Testosterone Study Challenged

November 25, 2013

Misleading Testosterone Study Challenged

Steven F. Hotze, M.D., David Sheridan M.D.

November 24, 2013

“Beware of statisticians!”

On November 6, 2013, the Journal of the American Medical Association (JAMA) published a study on the effects of testosterone in veterans who had known heart disease. The study purported to demonstrate that testosterone therapy in veterans had increased their risk of heart attacks, strokes and overall mortality when in fact the raw data reveals just the opposite conclusion. News media from across the country picked up this story and began to warn about the supposed dangers of testosterone.

The Wall Street Journal (WSJ) wrote “Of the men, 1,223 had testosterone therapy—and nearly 26% of them suffered a heart attack, stroke or died for any reason within the next three years. That compared with 20% of those not taking testosterone.” This statement was derived from a sentence in the result abstract which reads, “The absolute rate of events were 19.9% in the no testosterone therapy group vs. 25.7%  in the testosterone therapy group.”

The raw data presented in this study does not support these conclusions; in fact just the opposite conclusions should have been reached.

So let’s look strictly at the numbers that are given.

This was a retrospective study of 8,709 males who were being treated at the VA medical facilities, who had undergone a coronary angiography and whose total testosterone levels were <300ng.dL. They were divided into two groups; 7,846 patients who were not treated with testosterone and 1,223 who underwent testosterone therapy. The average follow up was 27.5 months. Let’s look at the data presented in the study and do our own analysis.

Group 1: 7,846 no testosterone  therapy    Group 2: 1,223 received testosterone

1) 681 died (9.1% mortality rate)                     1) 67 died (5.5% mortality rate)

2) 420 had MI (heart attacks) (5.4%)               2) 23 had MI (heart attacks) (1.9%)

3) 486 had CVA (strokes) (6.2%)                     3) 33 had CVA (strokes) (2.7%)

4) 1,587 total events from (1-3) (20%)             4) 123 total events from (1-3) (10%)

Analyzing the data reported, the group of veterans treated with testosterone had a lower mortality rate, as well as a lower incidence of both heart attacks and strokes, and a lower incidence of combined adverse events. It is just simple math that leads to these results.

The aging process involves the inevitable decline of naturally occurring hormones including testosterone. It has been demonstrated in numerous studies that men with the high levels of testosterone have less cardiovascular disease, and a decreased incidence of diabetes and hypertension as compared to men with low levels of testosterone. The decline in testosterone adversely affects men’s initiative, assertiveness, sense of well-being, self-confidence, moods, goal orientation, drive, decisiveness, and analytical ability. These are all brain functions. Supplementation with physiological doses of testosterone restores these behavior patterns.

Testosterone enhances the conversion of T4 to the active thyroid hormone, thus raising the metabolism. It also improves muscle tone, mass and strength, libido and sexual ability.

Even if the results of the study that were published were correct, there are several problems that would make the conclusion questionable.

1. There was no standardized dose of testosterone mentioned. Testosterone was prescribed in gels, injections and patches. It was not noted whether the testosterone was bioidentical or methyl testosterone. 2. The follow up blood levels of those treated with testosterone averaged 332 ng/ld. after an initial average of 175 ng/ld. This is still a very low level of testosterone. Studies have demonstrated that health benefits begin to occur when testosterone levels are above 550ng/dL. 3. There were no estradiol levels reported for the men taking testosterone therapy. It must be assumed that estradiol levels were not checked. This is a serious oversight which indicates that those administering the study are unaware of the adverse effects of elevated estradiol in men. Testosterone may be converted to estradiol by the enzyme aromatase. This is especially common in men who are overweight. There is no mention of the average body mass index of the treated patients. Elevated estradiol levels increase the risk of clots, leading to strokes and heart attacks.

It is unfortunate that this study was accepted for publication without doing a thorough analysis of it methodology and conclusions. Because of the media attention that it was given to this study, there may be millions of men who will be denied the benefits of bioidentical testosterone replacement therapy by their physicians.



Leave a Reply

Your email address will not be published. Required fields are marked *

Contact Us

"*" indicates required fields

By filling out the above, you agree to receive educational, informative emails on alternative medicine and hormone balancing. You will have the option to unsubscribe at any time.


AboutHotze Health & Wellness Center

Since 1989, Hotze Health & Wellness Center has helped over 33,000 patients get their lives back using bioidentical hormones that restore hormones to optimal levels, strengthen immune systems, and increase energy levels. Our treatment regimen addresses the root cause of hypothyroidism, adrenal fatigue, menopause, perimenopause, low testosterone, allergies, and candida.

Led by best-selling author, radio host and leading natural health expert, Steven F. Hotze, M.D., our medical team has over 100 years’ combined medical experience backed by a staff of nearly 100 caring professionals who provide an environment of hope and extraordinary hospitality for each of our patients, who we call our guests. It is our deepest desire to help you obtain and maintain health and wellness naturally so that you may enjoy a better quality of life, pure and simple.



Do you want to live a healthy, happy, purpose-driven life? Do you want to restore your health so that your loss of energy, weight gain, joint pain, depression and lack of drive or motivation won’t hold you back from achieving your personal and professional goals?

Dr. Steven Hotze wants that for you, too. In fact, in his powerful and passionate video entitled, “What I Believe”, Dr. Hotze shares how his Christian worldview and pivotal experiences have ignited a deep desire to offer the message of hope and optimal health to all who need to hear it.

Follow Us

As seen on:

  • ABC
  • Fow News Channel
  • NBC
  • CNN
  • The Biography Channel
  • Bloomberg Businessweek
  • The Early Show
  • Good Morning Texas
  • Great Day Houston

Our Doctors

At Hotze Health & Wellness Center, our doctors are changing the way women and men are treated through the use of bioidentical hormones. Our natural treatments have helped over 33,000 individuals with hypothyroidism, adrenal fatigue, menopause, perimenopause, low testosterone, allergies, candida, detoxification and nutritional deficiencies.

Meet our doctors

Guest Testimonials

Kathyrn R.

"After a traumatic accident, I was told that I was in early menopause in my 20s and could never have children, however after restoring my hormones, I am now expecting baby #7!”

Read More guest testimonials
Pam White
Pam White
At Hotze Health and Wellness YOU can truly find restoration of your health and vibrant life! You will find the most caring and effective healthcare available! Don't hesitate call them today!!!
Ron Guidry
Ron Guidry
Doctors are not the final authority in our journey of achieving/maintaining health and wellness but having a good team of doctors in your support and guidance community is not only helpful it is wise and also essential. The team and staff at Hotze Health and Wellness are health professionals that you can trust to help you navigate all the misinformation that may be keeping you separated from your optimal level of health.
Caral Reeves
Caral Reeves
Hotze Beauty is a first class facility! Extreme level of professionalism , knowledge & genuine care❤️‍🩹
Julie Hryszko
Julie Hryszko
I’ve been a guest at this facility for 15 years. They are the most efficient, thorough and caring group of individuals I’ve ever experienced. Dr Hotze looks to change the way a typical doctor treats patients and looks for root causes to eliminate medical issues instead of treating “symptoms”. My life has improved 100% since my initial visit. The cost of the treatments are worth it.
Shavon Sisson
Shavon Sisson
Always a great experience dealing with everyone at Hotze Heath and Wellness! Everyone is kind and helpful.
Kori Misson
Kori Misson
I cannot accurately describe in words how I feel about this practice and the entire staff. I have had quite a few health issues throughout the years, rheumatoid arthritis, sjogrens, weight gain, hair loss, irritability, and that is just the beginning. I had pretty much given up on feeling good, just decided to "live with it" and hope for the best. Two very close friends love the Hotze Wellness Clinic and they have experienced life changing health. Made my appointment and from the beginning I felt heard. Not a in and out fast food style practice. They are looked and are looking at my entire body for overall health and wellness. Connections from mind and body to clinical blood work, even dental questions....they care and I feel as if I can trust them. I am on a path to complete wellness and my goal is to have my RA back in remission as it once was....make yourself a priority. Having hope is an incredible feeling!