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Welcome to The Medical Minute with Dr. Ray Andrew. Today's Medical Minute is about atrial fibrillation. The rate of atrial fibrillation increases with age, especially in men. Atrial fibrillation is 50% more common in men than it is in women. Some researchers, noting that testosterone deficiency also increases with age, wondered if there might be a link between testosterone deficiency and one's risk of developing atrial fibrillation. Atrial fibrillation is quite common in America and is an important risk factor for stroke, so let's see what these researchers found out.
This study was published in 2017. The researchers note that their group, and others, have reported that normalization of testosterone levels after testosterone replacement therapy is associated with a significant decrease in all causes of death, heart attacks, and stroke. In addition, they found that testosterone replacement did not increase blood clots or pulmonary emboli.
For the purposes of this study, they are considering total testosterone to be low when the reported value is less than the lower limit of the normal laboratory reference range of the test result. In other words, whatever the laboratory reported as the lower limit of normal is what they considered low. As I have mentioned elsewhere, this is an abysmal standard to follow, inasmuch as studies have also shown that levels of testosterone even as low as six or seven hundred, increase risk of heart attack, but laboratory reference ranges are often reported as low as 250 or 300, which is pitiful.
They studied men in the VA system who received any form of testosterone, whether through injection, gel, or patch. They did not study pellets, because pellets are bioidentical hormones and therefore not approvable by the FDA, and therefore they're not part of the VA system.
Looking now at the study results, they found that the incidence of atrial fibrillation was higher in men who failed to achieve what they're calling normal testosterone levels on testosterone replacement. The increase in the incidence of atrial fibrillation in men appears to coincide with a decrease in serum testosterone levels. This study suggests an anti-arrhythmogenic property for testosterone. In other words, testosterone protects men and women against rhythm disturbances of the heart.
Another study that included 1,251 participants found that the risk of atrial fibrillation increased by 30% and 350% in men 55 to 69 and over 80 years of age respectively, with every one standard deviation decrease in total testosterone. Again, they're looking at statistics, but demonstrating basically that the lower the testosterone, the higher the risk of atrial fibrillation. Again, they found that the incidence of atrial fibrillation was significantly higher among participants with low total testosterone who received no treatment compared with those whose testosterone levels normalized on treatment. They also note that a previous study they performed showed a significant decrease in the incidence of stroke by normalizing testosterone.
Of course, they note that this is just an observational study, not a double blind placebo controlled trial, so they can't say that it proves that testosterone prevents atrial fibrillation. However, we don't need to wait for placebo-controlled double-blind trials to prove that having healthy levels of testosterone are best for human heath. Thousands of years ago, the human body was designed to run on testosterone, so it should come as no surprise that low testosterone levels would be associated with numerous diseases, and that restoring healthy levels of testosterone would improve health and longevity.
The bottom line is, if you have atrial fibrillation, be sure to get your testosterone level checked and normalized with testosterone replacement. This will reduce your risk of ongoing atrial fibrillation and other arrhythmias and diseases. If you want to avoid atrial fibrillation, make sure your testosterone level is optimal at all times. If your goal is to live as healthy as you can for as long as you can, give us a call. We can help you.