WHAT ARE THE POSSIBLE SIDE EFFECTS OF TESTOSTERONE THERAPY?

All forms of Testosterone Replacement Therapy (Pellet Therapy, Injections, Topical Creams carry the same possible side effects:

• Estradiol conversion

  • Some testosterone can convert into estrogen (more common in over-weight individuals). Higher estrogen levels in men can lead to fatty growth around the breast area (gynecomastia). Dr. Garcia usually prescribes medications to minimize this from occurring..

• Dihydrotestosterone (DHT) conversion

  • Some testosterone can convert into DHT (Dihydrotestosterone). Too much DHT can lead to male pattern hair thinning (androgenic alopecia), and swelling of the prostate (benign prostatic hypertrophy). Sensitivity to DHT can also lead to recurrence of acne and oily skin. Dr. Garcia also offers supplements and prescriptions to decrease the production of/block the effects of DHT.

• Effects on the Prostate Gland

  • Some physicians use to believe the testosterone replacement therapy could lead to prostate cancer. Well, if this were true, we’d all see a lot of 15-20 yr old men with prostate cancer (because this is when testosterone is the highest in our life). The notion that testosterone replacement therapy can lead to prostate cancer has been dismissed.

  • However, if a patient develops undiagnosed prostate cancer, then testosterone replacement therapy can cause it to grow faster. If you have a history of prostate cancer or an elevated PSA (prostate specific antigen), it is important to let Dr. Garcia know this before treatment.

• Increased Red Blood Cells (Secondary Polycythemia)

  • Testosterone replacement therapy may increase the production of red blood cells from the bone marrow. This can be beneficial is someone has low red blood cells to begin with (anemia). However, it can be harmful if they develop higher than normal red blood cells (secondary Polycythemia). If the red blood cell concentration becomes too high, then blood becomes to thick (viscous) and it can be more difficult for the heart to pump it throughout the body. If this occurs with the circulation in the brain, it can lead to migraines and potentially strokes. If this occurs with the circulation in the heart, it can lead to chest pain and potentially heart attacks. Other effects of polycythemia include flushing and joint pains. Dr. Garcia closely monitors the red blood cell count of his patients, and if the levels get too high, he will offer a phlebotomy to remove unnecessary amounts of blood.

  • Patients who have untreated sleep apnea (ie excessive snoring at night) and long-time smokers, tend to already have high red blood cell counts. These individuals may have to have frequent labs drawn (complete blood count) to assess their red blood cell count, and if too high, more frequent phlebotomies may have to be done if they wish to continue therapy.

• Changes in Mood

  • If Testosterone levels become too high, sometimes, irritability and aggression may occur. This is rarely encountered when testosterone is offered under the supervision of a medical professional. If these symptoms occur, we usually recheck the testosterone level to confirm that that high levels may be the cause. All it takes is time to allow the testosterone levels to decrease into a more comfortable therapeutic level.

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