Testosterone replacement therapy is approved to treat low testosterone levels in cases where the body is not making enough hormone due to a medical condition known as hypogonadism. Men may have used it for symptoms of “Low-T”, a term coined by the pharmaceutical industry which is not an approved diagnosis.
Testosterone replacement therapy has been linked to serious side effects including blood clot formation which can cause:
- Cerebrovascular accident (CVA) or Stroke
- Deep vein thrombosis (DVT)
- Venous thromboembolism (VTE)
- Myocardial infarction (MI) or Heart Attack
- Pulmonary embolism (PE)
Any of these events can be debilitating or life-threatening and may lead to death.
Testosterone and Blood Clots
Testosterone increases the chance of clot formation in two ways. A common side effect of testosterone therapy is polycythemia which increases the body’s supply of hemoglobin and hematocrit, affecting the blood cells. This can increase the blood pressure and thicken the blood slightly.
Thicker and slower moving blood causes the blood cells to “bump” into each other more often and clump together as a blood clot. Testosterone is also known to increase production of thromboxane, a blood vessel constrictor which also may increase the risk of clot formation.
Testosterone also changes the body’s metabolism of cholesterol and may lead to the formation of plaques in the arteries and veins. As the blood is restricted in moving past the plaques, it can create blood clots and in some cases, the plaque may become loose. In either case, a solid or semi-solid particle can travel to the brain and cause a stroke.
In most cases, clots are formed in the legs in a condition known as deep-vein thrombosis (DVT). When a clot has formed and breaks loose, it can become known as a venous thromboembolism (VTE). These clots can travel to the brain, heart or lungs and can be fatal as a stroke, heart attack or pulmonary embolism.
A 2013 study published in Clinical and Applied Thrombosis/Hemostasis showed a link between DVT hospitalization and testosterone use. The risks may be particularly high in the first six months of treatment but overall, may increase the risk of a clotting event by about 60%.
Many of the men who are using testosterone replacement products have never been tested for low testosterone levels. A large percentage of testosterone products may be in use for naturally occurring symptoms of aging, by men who have not been made aware of the serious risks.
Testosterone and Stroke
Taking testosterone may increase the risk of cerebrovascular accident (CVA) or stroke because of an increased chance of clotting. In addition, changes in the body’s cholesterol metabolism may increase the risk of atherosclerosis.
A stroke or CVA is the occurrence of a sudden blockage of the arteries that supply blood and oxygen to the brain. When the supply of blood and oxygen to the brain is blocked, the brain tissue cannot survive. CVAs are most often caused by blood clots that have developed elsewhere in the body but may also be caused by arterial or venous plaques from atherosclerosis that have broken off, producing a piece that may lodge in an artery.
Strokes occur suddenly and are not always treatable. In some cases, a CVA will cause permanent damage to the brain and may even result in death. Damage to the brain can result in physical disability which is permanent.
Symptoms of stroke include:
- Sudden numbness or weakness of face or limbs (arm or leg), often on only one side of the body
- Sudden confusion or difficulty speaking
- Sudden dizziness, loss of balance or coordination
- Sudden headache
Symptoms of stroke should be treated as a medical emergency. In some cases, though not always effective, immediate treatment will help to reverse some of the effects of a stroke.
The FDA announced an investigation in January of 2014 regarding severe adverse events caused by testosterone, particularly heart attack and in June of 2014 the FDA began requiring a warning regarding the risk of clot formation on all testosterone products. In 2015, a warning about heart attack risks was added to all testosterone product labelling.
Severe Side Effects of Testosterone Replacement Treatment
All medications carry some side effects. Most of the side effects caused by testosterone are hormonal type side effects and are mild to moderate, however some of the side effects of testosterone can be life-threatening.
Life-threatening events caused by testosterone treatment can include:
- Deep vein thrombosis
- Venous thromboembolism
- Heart attack
- Pulmonary Embolism
Testosterone Blood Clot or Stroke Lawsuits
Many men who have used testosterone replacement therapy have experience serious adverse events such as heart attack, pulmonary embolism and stroke which may have been caused by blood clots and some of which resulted in death. Up to half of all men taking testosterone have never been tested for “Low-T”, but took the medication without understanding the risks.
Many of these men or their loved ones have filed testosterone lawsuits for injuries caused by replacement therapy. Some testosterone settlements have been offered but more lawsuits remain in federal, state and local courts and more may be expected.