Long term testosterone use may increase risk of suicide

[Nelson Vergel]

I am posting this as a way to discuss something that has never been discussed before

Testosterone Therapy is Associated With Depression, Suicidality, and Intentional Self-Harm: Analysis of a National Federated Database - PubMed

Testosterone use is independently associated with new-onset mental health disorders. Future studies are necessary to elucidate the role that androgen withdrawal plays and whether a causal relationship exists. Nackeeran S, Patel MS, Nallakumar DT, et al. Testosterone Therapy is Associated With...

pubmed.ncbi.nlm.nih.gov

 

[Mark David]

I am posting this as a way to discuss something that has never been discussed before

Testosterone Therapy is Associated With Depression, Suicidality, and Intentional Self-Harm: Analysis of a National Federated Database - PubMed

Testosterone use is independently associated with new-onset mental health disorders. Future studies are necessary to elucidate the role that androgen withdrawal plays and whether a causal relationship exists. Nackeeran S, Patel MS, Nallakumar DT, et al. Testosterone Therapy is Associated With...

pubmed.ncbi.nlm.nih.gov

Wonder what the suicide rate is for men with low T?

 

[Deleted member 43589]

Very interesting conclusion, however there are quite a few very good studies showing the opposite effect on depression. Here is a recent meta-analysis of 7690 identified records, 469 were evaluated against full study inclusion criteria.

"Conclusions and Relevance Testosterone treatment appears to be effective and efficacious in reducing depressive symptoms in men, particularly when higher-dosage regimens were applied in carefully selected samples."

Testosterone Treatment and Alleviation of Depression in Men

This systematic review and meta-analysis evaluates randomized placebo-controlled clinical trials to assess the association of testosterone therapy with alleviation of symptoms of depression in men.

jamanetwork.com

Interesting conclusion from the discussion - Previous studies failed to detect testosterone dose-response relationships for mood, including for depressive symptoms. Our results suggest for the first time, to our knowledge, that better treatment response may require higher dosages, although this finding requires independent replication.

Conclusions
Previous research provided evidence that testosterone treatment is effective in reducing depressive symptoms in hypogonadal or middle-aged men up to age 60 years. This meta-analysis provides important new evidence that testosterone treatment may also be effective and efficacious for eugonadal and older men when higher testosterone dosages are administered.

Something else to consider - Provisional data from CDC’s National Center for Health Statistics indicate that both the number and the rate of suicides in the United States increased 4 percent from 2020 to 2021.

From 2015 to 2019, there were widespread increases in depression without commensurate increases in treatment, and in 2020, past 12‒month depression was prevalent among nearly 1 in 10 Americans and almost 1 in 5 adolescents and young adults.

Trends in U.S. Depression Prevalence From 2015 to 2020: The Widening Treatment Gap - PMC

Major depression is a common and potentially lethal condition. Early data suggest that the population-level burden of depression has been exacerbated by the COVID-19 pandemic. Prepandemic estimates of depression prevalence are required to quantify ...

www.ncbi.nlm.nih.gov

Society plays a key role in depression diagnoses​

A June 2022 study in the American Journal of Preventative Medicine found that completed suicide rates among men were much higher among men with no known history of mental illness. Men are relatedly less likely to be diagnosed with mood disorders, including anxiety and depression.

Men Are More Likely to Die by Suicide, but Less Likely To Have Depression Diagnosis

Exploring the disconnect: investigate the reasons behind the higher suicide rates and lower diagnosis rates of depression and anxiety in men.

healthcity.bmc.org

Conclusions​

Low serum total testosterone, but not calculated free testosterone, was associated with incident depression in this sample of older men.We designed this large, prospective cohort study to investigate if low circulating T and its metabolites are associated with the development of depressive symptoms in men free of depression at study entry. We hypothesized that men with low total and calculated free T, DHT and E2 would be more likely to develop clinically significant depressive symptoms over time.

Prospective longitudinal study of testosterone and incident depression in older men: The Health In Men Study

Depression in older men has been associated with low circulating testosterone concentration but data from prospective studies are limited.We conducted…

www.sciencedirect.com

Conclusions Hypogonadal men showed an increased incidence of depressive illness and a shorter time to diagnosis of depression. Further prospective studies are needed to confirm these preliminary findings and to clarify the role of testosterone in the treatment of depressive illness in older men.

Increased Incidence of Diagnosed Depressive Illness in HypogonadalOlder Men

Context Age-associated hypogonadism (testosterone deficit) occurs in 30% of men after the age of 55; it is associated with decreased muscle mass, bone mineral density, and libido, and with anorexia, fatigue, and irritability. Although some of these symptoms overlap with those of depression,...

jamanetwork.com

Discussion
Age-associated testosterone deficiency is a common condition in oldermen, occurring in 30% after the age of 55. Total testosterone levels peak in early adulthood, and then decrease by approximately1% per year after the age of 40.

 

[Cataceous]

...
Low serum total testosterone, but not calculated free testosterone, was associated with incident depression in this sample of older men. ...

To me this suggests that the association is with SHBG, not testosterone. Lower SHBG is known to be linked to various health issues.

I am posting this as a way to discuss something that has never been discussed before
...

I wonder if it's reflecting a lot of inappropriate treatment? I can easily see TRT doing more harm than good to a lot of guys with low-normal to normal levels; the overall hormonal disruption is significant.

 

[JmAch]

Interesting post....I have been on TRT for over 10 years now, and for me, I believe it has saved my life! Before addressing my T issue AND getting it "dialed in", I was in a very bad place (which in hindsight was some bad depressive issues, even leading to a failed suicide attempt). I was just lethargic, sad, couldn't get past any problems....just felt low and in a rut every day. Post- attempt, I did the standard depression pills (Zoloft, etc.) and therapy....which after about 6 months I recognized as a complete joke! Left all that ASAP. No offense to those who need it or benefit from it, but for me I realized getting in the gym/ exercise, and prioritizing the best things in my life was the key.....and TRT only helped me get there and achieve better and better things. I feel great now! I have a best friend now on TRT and working slowly on getting levels balanced, and it has made nothing but positive effects on his life so far as well. Just my two-cents.

 

[Systemlord]

I wonder if it's reflecting a lot of inappropriate treatment?

An older guy at work on Friday told me his doctor changed his protocol from every 2 weeks, to every 3 weeks, because his levels were to high, and so in the middle of week 2 he’s at 188 ng/dL and feeling depressed and fatigued.

His doctors reasoning for the infrequent injections is there’s risks, so allowing the levels to drop low is safer, according to his doctor.

 

[Deleted member 16042]

An older guy at work on Friday told me his doctor changed his protocol from every 2 weeks, to every 3 weeks, because he levels were to high, and so in the middle of week 2 he’s at 188 ng/dL and feeling depressed and fatigued.

His doctors reasoning for the infrequent injections is there’s risks, so allowing the levels to drop low is safer, according to his doctor.