Longevity Doctor: 'Fountain of Youth' Medicine Hyped by Big Pharma Might Cause Premature Aging, Death
Are you a man experiencing decreased sex drive? Are your erections less strong? Is your body fat increasing and your muscle mass decreasing? Are you fatigued and lack energy? Are you sad and grumpy and experiencing less mental clarity? If so, a lot of marketing these days claims you may be suffering from "Low T"—low levels of the testosterone, the male hormone.
While a decrease in sex drive, muscle mass and energy are part of the aging process, for men and women, slick marketers in the last few years have told men the signs are actually from their waning testosterone and reversible if they supplement their testosterone deficiencies. Promising men the fountain of youth through replacing their testosterone deficiency is a $1.6 billion market for AbbVie, Eli Lilly and other drug companies that are aggressively marketing treatments for Low T.
According to Boston University School of Medicine longevity expert Thomas Perls the "stay young" claims are not only erroneous, they can be downright harmful to men. Recently AlterNet caught up with Perls to learn more about the dangers of marketing testosterone for "deficiencies" when the drugs are likley neither safe or effective.
Martha Rosenberg: In the recent paper you cowrote with David J. Handelsman, chief of endocrinology at the ANZAC Research Institute at the University of Sydney you cite "disease-mongering." Could you elaborate on the concept?
Thomas Perls: Disease-mongering is inventing new broader definitions of a disease or even the invention of a disease in conjunction with widespread marketing to increase sales of specific drugs and therapies. In combination with direct-to-consumer advertising, it can be a "medicalization" of common complaints that should have nothing to do with the drug being sold. Disease-mongering has boosted U.S. sales of testosterone from $324 million in 2002 to $2 billion in 2012.
MR: Your paper suggests that the increasingly common diagnosis of "Low T" in men and the prescribing of testosterone for "anti-aging" is more dollar-driven than medicine-driven.
TP: True instances of testosterone deficiency such as hypogonadism are rare—less than one half of one percent of men have this problem. Since massive marketing campaigns emerged in the late 1980s claiming that common symptoms like lack of energy, poor sleep, poor libido could be treated with testosterone, the number of men labeled with this disease sky-rocketed. The new syndrome of aging-related low testosterone was facilitated by doctors' organizations that allowed new and much less rigorous and specific definitions of hypogonadism. Some of these consensus panels were sponsored by pharmaceutical companies making and marketing testosterone.
MR: This disease-mongering is not just a question of people wasting money on drugs they don't need. There are actual risks that you cite.
TP: This month the FDA mandated a labeling change on testosterone products to inform people of possible increased cardiovascular risks including heart attack, stroke and death. While the FDA says these cardiovascular risks may be correlated with testosterone products, Health Canada says the risks are correlated with testosterone. Both agencies warn of an increased risk of blood clots in the legs and lungs.
MR: You write in your paper that underlying problems should be treated in men complaining of Low T.
TP: Men who are in excellent general health tend to have no decline in their testosterone, but men with common underlying problems such as obesity and poor fitness may. The irony is that the poor fitness level puts these male patients at risk for heart attack and stroke and they are being given a drug that puts them at further risk.
MR: You were asked to be an expert by the Drug Enforcement Administration to review patient records from so-called "anti-aging" clinics that were potentially illegally prescribing and selling testosterone, other anabolic steroids and human growth hormone. What did you find?
TP: Many of the clients of these clinics were going to these clinics for body building and were taking high doses of these drugs. As a result, I observed typical side-effects including dangerously low levels of good (HDL) cholesterol, cardiac rhythm disturbances like atrial fibrillation and symptoms of coronary artery disease. And the vast majority of these clients were in their 20s and 30s.
Records also showed psychiatric effects in these patients including violent behavior (“roid rage”), impulsiveness, psychoses in patients with bipolar disease, and suicides.
MR: That is shocking. Have you personally treated patients with side-effects apparently induced from testosterone treatment?
TP: Yes. I have helped treat patients who had a history of psychiatric illness in whom the testosterone flipped them into a psychotic mania. I have fielded many calls from people desperate for help after being, in my opinion, duped into taking drugs like testosterone and growth hormone for anti-aging or age-management.
MR: Your paper also covers the widespread marketing of growth hormone for the same thing—treating complaints that some doctors and clinics attribute to aging like decreased energy, muscle mass and sex drive. Yet, you write, growth hormone not only doesn't help, it could facilitate aging.
TP: It is well known that growth hormone has side-effects like joint swelling, pain and diabetes. Ironically, growth hormone accelerates aging, increases cancer risk and shortens life span in animal studies. It produces the opposite of the anti-aging claims. Various marketers of growth hormone refer to "20,000" studies showing the effectiveness of growth hormone against aging and who I believe, prey on gullible people.
MR: Many remember how aggressively "hormone replacement therapy" was marketed to women, until 12 years ago when it was linked to an increased risk of breast cancer, strokes, heart attacks, blood clots and even lung and ovarian cancer. Were no lessons learned?
TP: Actually marketers did learn from watching a hormone marketed to prevent the ills of aging. They invented the term "andropause" for a condition that numerous endocrinology experts state does not exist and began selling testosterone.