Marketing, prescribing testosterone and growth hormone for aging is disease mongering

March 24, 2015

(Boston) - The marketing, prescribing and selling of testosterone and growth hormone as panaceas for aging-associated problems is disease mongering. So assert Thomas Perls, MD, MPH, FACP, a geriatrician at Boston Medical Center and professor of Geriatrics and Medicine at Boston University School of Medicine; and David Handelsman, MB BS, FRACP, PhD, professor of Reproductive Endocrinology and Andrology, director of the ANZAC Research Institute, University of Sydney and Andrology Department, Concord Hospital. Their editorial is published in this month's Journal of the American Geriatrics Society.

Disease mongering is inventing new broader definitions of disease in conjunction with widespread marketing to increase sales of specific drugs and therapies. "The mass marketing of testosterone by direct-to-consumer advertising coupled with lax professional society guidelines have encouraged the disease mongering of testosterone prescribing for contrived indications, that is, common features of aging rather than disorders of the reproductive system that prevent testosterone production and therefore warrant replacement therapy," said Handelsman. "Marketing campaigns such as 'low T' contributed to a more than 10-fold increase in U.S. testosterone prescribing between 2000 and 2011. The epidemic of testosterone prescribing over the last decade has been primarily pushing testosterone as a tonic for sexual dysfunction and/or reduced energy in middle-aged men, neither of which are genuine testosterone deficiency states."

"Clearly, previous attempts to warn doctors and the public of this disease mongering that is potentially medically harmful and costly have not been effective. Now however," said Perls, "with the FDA's recent dual commission findings that testosterone treatment is not indicated for age-associated decline in serum testosterone, alternatively called 'andropause,' 'late-onset hypogonadism' and marketed as 'low T,' we have the opportunity to highlight why hormone replacement (also euphemistically called "bioidentical hormone replacement") for aging with not only testosterone but also growth hormone is disease mongering, that the conjured benefits are unfounded and are far outweighed by the risks, and to provide suggestions about how this deceptive practice can be stopped."

The authors point out that for many men, testosterone does not decline with age among men retaining excellent general health, and if it does, the decline is due to common underlying problems such as obesity and poor fitness. Those who hawk testosterone and growth hormone have developed advertising and in some cases professional-appearing questionnaires that focus on common complaints among older men such as decreased energy, feeling sad, sleep problems, decreased physical performance or increased fat.

Additionally, the authors highlight that many times, a testosterone level won't even be obtained and the patient is told that, simply based on these common symptoms alone or with minor reductions in serum testosterone, they have "late onset hypogonadism," or that their erectile dysfunction may be improved with testosterone treatment.

In the case of growth hormone, the FDA requires that doctors perform a test to demonstrate that the body does not produce enough growth hormone. "Those who market and sell HGH for these common symptoms nearly never perform the test because if they did a properly performed test, it would almost never be positive because the diseases that cause growth hormone deficiency in adults, such as pituitary gland tumors, are very rare," said Perls.

Health Canada, Canada's FDA, recently echoed the FDA's committee findings that age-related hypogonadism has not been proven to be a disease-justifying treatment with testosterone.

On March 3, the FDA indicated that it is following through with their Committee's recommendations and is now requiring changes to the guidelines that accompany testosterone products. The FDA indicates that testosterone is not to be used for aging and manufacturers must provide the warning that there is a possible increased risk for heart attack, stroke and death with testosterone use. For more information, click here. Both the FDA and Health Canada also warn of an increased risk of blood clots in the legs and lungs.

Growth hormone is well known for its side effects, including joint swelling and pain and diabetes. Ironically, opposite of advertised claims, growth hormone accelerates aging, increases cancer risk and shortens life span in animal studies.

Perls and Handelsman call upon professional medical societies and governmental agencies to take definitive steps to stop disease mongering of growth hormone and testosterone for conjured-up deficiencies.

"These steps include the banning of 'educational' and product advertising of testosterone for these contrived indications," said Perls. "Furthermore, the FDA and Health Canada should require a physician's demonstration of a disease process proven to benefit from testosterone administration in order to fill a lawful prescription for testosterone."
-end-
About Boston Medical Center

Boston Medical Center is a private, not-for-profit, 482-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. It is the largest and busiest provider of trauma and emergency services in New England. Committed to providing high-quality health care to all, the hospital offers a full spectrum of pediatric and adult care services including primary and family medicine and advanced specialty care with an emphasis on community-based care. Boston Medical Center offers specialized care for complex health problems and is a leading research institution, receiving more than $118 million in sponsored research funding in fiscal year 2014. It is the 11th largest recipient of funding in the U.S. from the National Institutes of Health among independent hospitals. In 1997, BMC founded Boston Medical Center Health Plan, Inc., now one of the top ranked Medicaid MCOs in the country, as a non-profit managed care organization. It does business in Massachusetts as BMC HealthNet Plan and as Well Sense Health Plan in New Hampshire, serving more than 315,000 people, collectively. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet - 14 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit http://www.bmc.org.

Boston University Medical Center

Related Aging Articles from Brightsurf:

Surprises in 'active' aging
Aging is a process that affects not only living beings.

Aging-US: 'From Causes of Aging to Death from COVID-19' by Mikhail V. Blagosklonny
Aging-US recently published ''From Causes of Aging to Death from COVID-19'' by Blagosklonny et al. which reported that COVID-19 is not deadly early in life, but mortality increases exponentially with age - which is the strongest predictor of mortality.

Understanding the effect of aging on the genome
EPFL scientists have measured the molecular footprint that aging leaves on various mouse and human tissues.

Muscle aging: Stronger for longer
With life expectancy increasing, age-related diseases are also on the rise, including sarcopenia, the loss of muscle mass due to aging.

Aging memories may not be 'worse, 'just 'different'
A study from the Department of Psychological & Brain Sciences in Arts & Sciences adds nuance to the idea that an aging memory is a poor one and finds a potential correlation between the way people process the boundaries of events and episodic memory.

A new biomarker for the aging brain
Researchers at the RIKEN Center for Biosystems Dynamics Research (BDR) in Japan have identified changes in the aging brain related to blood circulation.

Scientists invented an aging vaccine
A new way to prevent autoimmune diseases associated with aging like atherosclerosis, Alzheimer's disease, and Parkinson's disease was described in the article.

The first roadmap for ovarian aging
Infertility likely stems from age-related decline of the ovaries, but the molecular mechanisms that lead to this decline have been unclear.

Researchers discover new cause of cell aging
New research from the USC Viterbi School of Engineering could be key to our understanding of how the aging process works.

Deep Aging Clocks: The emergence of AI-based biomarkers of aging and longevity
The advent of deep biomarkers of aging, longevity and mortality presents a range of non-obvious applications.

Read More: Aging News and Aging Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.