Map of life expectancy at birth from Global Education Project.

Wednesday, February 11, 2015

Manufacturing Disease

An interesting essay in JAMA today by Marc Garnick, which I believe you cannot read because you are mere common rabble. So I'll tell you what it says, or at least a simplified version.

In between the ads for CTCA, which I discussed yesterday, you may see ads touting the horrors of "Low T," a "disease" that purportedly afflicts men as they age and which leaves them weak, tired and limp of member (if you know what I mean). You may separately see commercials touting specific testosterone products.

So here's the real deal. Testosterone as a medication was approved for people who had disorders of the testicles or pituitary (which stimulates the testicles to produce testosterone). If you really aren't making testosterone, yes you have a problem. However, it is normal for testosterone levels to fall as men age and there is no evidence whatsoever to support any benefit from testosterone replacement therapy (TRT) in such normal aging. An FDA advisory committee recently also found that there are indications of possible cardiovascular risk from testosterone "therapy." The committee voted 20 to 1 in favor of limiting the indication for TRT to people with classic hypogonadism, adding a statement about cardiovascular risk to the label, along with a statement that safety and efficacy of TRT in age related hypogonadism has not been established.

So what's going on here? From just 2010 to 2013 the number of prescriptions for TRT in the U.S. increased by 1 million. The drug industry invented a fake disease; used television advertising to persuade the public, including physicians, that it exists; and then started selling products to treat it. They could do this because the ads that just try to convince you that the disease of Low T exists, which don't name a specific product, aren't regulated by the FDA.

When TRT is legitimately used, guidelines call for initial assessment of testosterone levels, which have to be below a certain value; and continued monitoring during treatment. But many men who receive TRT have no claim for a testosterone test on their insurance record.

So what we have here, folks, is a scam. There is no end to them.

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