Compounded Testosterone Troches to Optimize Health and the Testosterone Controversy

    February 2016 in “ PubMed ”
    Michael A S Guth
    TLDR Properly administered testosterone therapy is safe and effective but often not covered by insurance.
    The document reviewed the use of compounded testosterone troches for testosterone replacement therapy (TRT) in aging men experiencing andropause, which is characterized by declining testosterone levels and increased inflammatory biomarkers. It highlighted that while some studies suggested TRT could cause cardiovascular events, most clinical studies found no adverse effects on myocardial infarction risk when estradiol and dihydrotestosterone levels were properly controlled. The therapy, which includes an aromatase inhibitor and a 5α-reductase inhibitor, was noted for its cost-effectiveness and ability to raise testosterone levels to an optimal range. Despite its benefits and links to improved health outcomes, such as reduced risk of Type 2 diabetes, insurance coverage for compounded medications like testosterone troches was often denied, and some physicians were hesitant to prescribe TRT due to controversies stemming from poorly designed studies.
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