Low-T Drugs Don’t Cause Heart Attack

July 3, 2014

On the heels of the FDA mandated label warnings for testosterone products, a new study published July 2nd shows no increase in heart attacks, and even indicates a protective effect of Testosterone Replacement Therapy. THE WALL STREET JOURNAL Wednesday, 02 Jul 2014 12:24 PM Although recent research has linked testosterone therapy with a higher risk for heart attack and stroke, a new study involving more than 25,000 older men suggests otherwise. Read more…

Posted in Blog, Medical News by rishman
July 1, 2014

One of the first things I hear from people when I ask them about their diet is “I don’t eat too much red meat.”   For many Americans, red meat intake is far less concerning than the fact they are eating way too many carbohydrates. In fact, the excess body fat we gain from avoiding red meat and eating more carbs (in those highly touted “whole grains”) can overshadow any detrimental effect that red meat might have.   It’s true that red meat and the associated saturated fat (also found in dairy) can lead to an increase in certain inflammatory markers. It should not be consumed in excess.   The real culprit, however, is processed meats — those preserved by smoking, curing, salting or the addition of chemical preservatives. In a 2010 article in Circulation (The Journal of the American Heart Association), a meta-analysis of 20 studies revealed that processed meats (like bacon, salami, sausages, hot dogs and processed luncheon meats) were associated with   •a 42% increase in coronary heart disease •a 19% increase in the risk of diabetes   Unprocessed meat from beef (including hamburgers), lamb, pork, and game showed no such association.   So here’s the bottom line: Lean red meat once or twice a week is OK. Try to make it organic, free range or gra

Posted in Blog, Medical News by rishman
June 30, 2014

Raymond Ishman, M.D. President, Cenegenics Philadelphia Director of Quality Assurance, Cenegenics Elite Health It seems like we are regularly hearing more bad news about testosterone. However, the news bites, ads by lawyers and even the FDA announcement itself deserve additional perspective. Decisions based on fear and limited information are likely to cause harm, in this case, to individuals in whom testosterone replacement therapy (TRT) is appropriate and often life changing. On June 19th, the FDA announced that manufacturers of testosterone products must add a general label warning about the increased risk for venous thrombosis (blood clots) because of post marketing reports of blood clots. This type of clot can occur in the legs and pelvis and potentially lead to pulmonary embolism (blood clots in the lung). Blood clots are not unusual in individuals not on TRT. This issue is unrelated to two recent controversial studies, which appear to have significant flaws, showing an increased risk of heart attack with TRT. A subsequent study has shown a marked r

Posted in Blog, Medical News by rishman
June 6, 2014

The news was enough to make a testosterone induced manly man shrivel. It was late last year that JAMA, the Journal of the American Medical Association, published the results of research that claimed that men who use testosterone supplementation have a 29 percent greater chance of dying from a heart attack or stroke within three years of use. Until the study, testosterone was the hottest medical product on the market. You couldn’t listen to talk radio or watch a sporting event without being asked if you had “low-T” during the commercial break. That would explain why you were sitting on your couch instead of playing basketball, having sex and generally enjoying your life. The announcer then promised that a gel, a pill, or an injection would transform you from a disinterested lump of flesh into a man again. Now those ads have been replaced new ones from law firms looking to sign up clients for class action lawsuits. Read more.

Posted in Blog, Medical News by rishman
May 22, 2014

Raymond Ishman, M.D. President, Cenegenics Philadelphia Director of Quality Assurance Cenegenics Elite Health Two recent studies, both with significant flaws, have garnered a great deal of attention from the media as well as opportunistic lawyers by questioning the safety of testosterone therapy. The Veteran’s Administration study published in the November issue of JAMA (the Journal of the American Medical Association) is the most controversial, with experts from all over the world calling for JAMA to retract the study. See Experts Call for Retraction of Flawed Testosterone Study. In contrast to these negative studies, a new retrospective study presented at the American Association of Clinical Endocrinologists (AACE) 23rd Annual Scientific and Clinical Congress has found that testosterone therapy in men was not associated with an increased risk for heart attack or stroke, and may even be protective. In the latest study, nearly 20,000 men with low testosterone received testosterone therapy over a 5-year period (2009–2014) at hormone clinics across the US. The researchers found that the risk for heart attack was 7-fold lower, and the risk for stroke was 9 times lower in patients treated with testosterone compared wi

Posted in Blog, Medical News by rishman
April 26, 2014

Raymond Ishman, M.D. President, Cenegenics Philadelphia Director of Quality Assurance Cenegenics Elite Health The article released in November of 2013 in The Journal of the American Medical Association (JAMA), “Association of Testosterone Therapy With Mortality, Myocardial Infarction, and Stroke in Men With Low Testosterone Levels” has caused a great deal of anxiety in those currently on, or considering, testosterone replacement. Many experts in the field, including Cenegenics, have cautioned patients and doctors not to overreact to these results until the issue is better defined because of multiple flaws in this study. Throwing all caution aside, lawyers have been advertising in the media, encouraging lawsuits and creating the perception that testosterone replacement is harmful.

Now, however, the backlash by experts in the field has gone to a whole new level. Twenty-five medical societies in the US and around the world have joined the Androgen Study Group to petition JAMA to retract this misleading study.

Respected Harvard urologist and Chairman of The Androgen Study Group, Dr. Abraham Morgentaler, stated, “Gross data mismanagement led to unreliable results that contradicted 30+ years of medical literature, producing a media frenzy t

Posted in Blog, Medical News by rishman
April 16, 2014

Raymond Ishman, M.D. President, Cenegenics Philadelphia Director of Quality Assurance, Cenegenics Elite Health You’ve probably heard that over the counter and prescription anti-inflammatory medications, or NSAIDs, such as Advil (ibuprofen), Aleve (naproxen), Celebrex and a host of others typically used to treat pain and arthritis symptoms, are associated with an increased risk of heart attack and stroke. These types of medications can also cause fluid retention, worsen high blood pressure and cause stomach ulcers. If that wasn’t bad enough, these popular medications have now been linked to atrial fibrillation (a-fib), a dangerous irregular heartbeat that can lead to stroke, heart attack and heart failure. This shouldn’t be particularly surprising considering what we already knew about these drugs. Non-steroidal anti-inflammatory drugs and the risk of atrial fibrillation: a population-based follow-up study was published April 8, 2014 in the British Medical Journal. The study followed 8423 men and women with an average age of 68.5 for roughly 13 years. Current and recent (within 30 days) users of these medications had nearly a 2 fold increased risk of atrial fibrillation compared to non-users. While we don’t know if the effect is similar in younger individuals, the study population age group is alre

Posted in Blog, Medical News by rishman
March 6, 2014

Letter to the Editor in JAMA Journal of the American Medical Association – March 5, 2014 re: Deaths and Cardiovascular Events in Men Receiving Testosterone Abraham Morgentaler, MD; Abdulmaged Traish, PhD; Ravi Kacker, MD To the Editor: As clinicians and researchers in the testosterone field, we found surprising the results reported by Dr Vigen and colleagues of increased deaths and cardiovascular events in male veterans receiving testosterone following coronary angiography because these results contradict the literature spanning more than 20 years. Should testosterone therapy be considered unsafe based on this study? We do not believe so. This study was not a straightforward 2-group comparison in which there were a higher number of events in men who received testosterone. Rather, this was a complex retrospective study with a messy data set, containing a serious flaw that distorted the conclusion. The authors wrote, “… the Kaplan-Meier estimated cumulative percentages with events were 19.9% in the no testosterone therapy group vs 25.7% in the testosterone therapy group …” at 3 years following coronary angiography. However, we note the raw rate of events in the testosterone group was only 10.1% (123 events in 1223 men) compared with 21.2% (1587 events in 7486 men) in the no testosterone group. The authors neither acknowledged these data favoring the testosterone group

Posted in Blog, Medical News by rishman
February 20, 2014

The February 2014 edition of Town and Country magazine features a compelling, well-balanced article on the experiences of two very different people who turned to Cenegenics to help them take control of their lives.

  • A menopausal woman who, despite taking good care of herself, found that she was emotionally labile, depressed, with difficulty concentrating and sleeping. At the age of 47, her vitality was slipping away.
  • A 52-year old man, an older father with younger children, on a quest to regain his youthful vigor so he could enjoy life, keep up with his children and eventually, their children.

Both wanted to regain their vitality, but not at the expense of long-term health. They did their homework, looking beyond the hype going directly to the medical evidence. Their findings might surprise you. Along the way, both realized that long-term health and vitality isn’t just about hormones. Using the comprehensive Cenegenics approach, they transformed their lives. Read the full Town and Country article.

Posted in Blog, Medical News by rishman
February 3, 2014

Raymond Ishman, M.D. President, Cenegenics Philadelphia Director of Quality Assurance Cenegenics Elite Health A recent study titled “Increased Risk of Non-Fatal Myocardial Infarction Following Testosterone Therapy Prescription in Men” was published on January 29th in the journal PLoS ONE and funded by the National Institutes of Health. It tracked about 56,000 older and middle-aged men who were prescribed testosterone between 2008 and 2010. The study looked specifically at their rate of heart attacks in the year before receiving their new prescriptions, and in the three months after. The new study compared men receiving a prescription for testosterone to a separate group of 170,000 older and middle-aged men who filled prescriptions for Viagra and Cialis, who did not experience more heart attacks. Men 65 and older had double the rate of heart attacks in the months after starting testosterone, as did those younger than 65 with a previous diagnosis of heart disease. One might expect that those older than 65 might have an increased likelihood of unsuspected heart disease simply based on advanced age. Problems with the study: •This was an observational study, not placebo controlled. Such studies can raise cause for concern but cannot be considered proof of concept. •The study only compared men given testosterone prescriptions to men given prescriptions for Viagra and Cialis.

Posted in Blog, Medical News by rishman