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Is Testosterone Therapy Dangerous? Dr. Mark Richards Comes to the Treatment's Defense

November 13, 2013 - WASHINGTON, DC

Recently, a study was published in the Journal of the American Medical Association (JAMA) showing a conclusion suggesting that men who had received testosterone therapy had a higher risk of myocardial infarction (MI), stroke, or death. According to Dr. Mark Richards, a hormone specialist and plastic surgeon in Washington, DC, the study uses statistical manipulation to create false results and provide a misleading conclusion. The study, entitled "Association of Testosterone Therapy with Mortality, Myocardial Infarction, and Stroke in Men with Low Testosterone Levels" retrospectively followed men with low testosterone levels who underwent coronary angiography in the Veterans Affairs (VA) system between 2005 and 2011. Dr. Richards notes that these men, who were receiving "T treatment" had measured levels that averaged (~330ng/dl) which, according to the Washington, DC plastic surgeon, is "about 40% under the minimum required for heart health as defined in a recent Clinics of Cardiology Study."

Dr. Richards also argues that when reviewing the results of the study, "the rates of heart attack, death and stroke were approximately twice as high in the group not treated with testosterone," noting that the study's own reported numbers presented in the results section of the Abstract reveal that of the 1223 men who received some form of testosterone therapy, there was a 5% mortality rate, a 1.8% heart attack rate, and a 2.7% stroke rate. Conversely, he points out that of the 7486 men who did not receive testosterone therapy, there was a 9% mortality rate, a 5.6% heart attack rate, and a 6.5% stroke rate. Dr. Richards says the authors of the study manipulated the data from their research in order to support a false conclusion. He explains, "[the authors] used a method called inverse probability treatment, weighting to adjust for differences in demographics and prior risk factors for stroke or heart attack to theoretically account for potential confounding variables that might affect the outcome. In this case, they used over 50 variables to compute this weight."

Arguing in support of testosterone treatments, Dr. Richards highlights some key information, noting that "decades of high quality prospective epidemiologic studies have shown a strong correlation between low testosterone levels in both sexes and disease and death rates. In particular, strong correlations exist between low testosterone and heart disease, diabetes/metabolic syndrome, breast and prostate cancers, atherosclerosis, depression, fatigue, loss of muscle mass, increased intra-abdominal fat, cognitive failures including Alzheimer's disease, loss of mobility, loss of libido, decreased sexual function, and menopausal symptoms." He stresses that many of these diseases have actually been proven to be prevented, improved, or cured with bio-identical human testosterone supplementation.

The study's conclusion can be misleading and confusing to physicians, as well as the public, says Dr. Richards. He says there has been much success with hormone treatment using highly compressed, sterile hormone pellets placed deep within the body's fat. Dr. Richards explains these pellets are placed while using local anesthesia, and can dissolve completely, usually over a period of three to five months. He says this treatment has been used in the US since 1939, but because the pellets cannot be patented, and are therefore considered to not be profitable, they are not widely well-known. Although molecularly identical human testosterone modalities are thought to be less than ideal, they have still been able to provide adequate treatment that has been scientifically proven to be very helpful in treating disease states common to aging populations, he says.

Dr. Richards advises patients and physicians alike to be cautious when reviewing medical studies such as the one published in JAMA, stating, "The misleading article in JAMA serves to remind us that news headlines must always be tempered by reality."

About Mark E. Richards, MD

Dr. Mark Richards is a board-certified plastic surgeon in Washington, DC. He is also a practitioner in hormone therapy, using time-released bio-identical hormone pellets to improve effects of aging that cannot be treated with cosmetic surgery, such as energy levels and psychological health. Dr. Richards also offers his knowledge on the topic to assist physicians interested in offering hormone therapy to help their patients. He is available for interview upon request.

To learn more about Dr. Mark Richards, his plastic surgery practice, or hormone therapy, please visit or

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Dr. Mark E. Richards
11300 Rockville Pike Suite 912
N. Bethesda, MD 20852
(301) 468-3458

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