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Testosterone Replacement Therapy and Blood Clots

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At Vein Specialists of the South, we view the news with you in mind. A growing number of men are using Testosterone Replacement Therapy (TRP). When I read about a new study, I wanted to bring it to your attention. One of our goals is for you to enjoy Better Veins For Life.

If you are taking testosterone replacement therapy (TRP), you may be increasing your risk of developing blood clots. JAMA Internal Medicine published a study which found a correlation between testosterone replacement therapy (TRT) and an increased risk of blood clots. This study has prompted numerous opinion pieces and health reviews. We felt it was important to include our input on this topic.

About Testosterone Replacement Therapy (TRT)

Testosterone replacement therapy (TRT) is approved for men with significantly low levels of testosterone due to injury, disease, or genetics. Low testosterone levels can lead to fatigue, low sex drive, reduced muscle mass, erectile dysfunction, and a general feeling of “haziness” during the day. Treatment consists of oral prescriptions or injections.

However, all types of ‘Low T’ are not the same. There is a difference between ‘low testosterone levels’ due to a condition such as hypogonadism, and normal factors such as age. Do you feel like you have lost the vigor of our youth? The vitality of your 20s can diminish, as the years pass, leading you to feel tired and stressed Bellies become rounder. Muscles become softer.. You may feel fatigued with complaints of a low labido.. What happened? Where is the exuberance and excitement? TRT promises a reclamation of the past, but does it deliver? More importantly, is it safe?

What is the concern with TRT?

Testosterone decreases with age, about 1-2% per year after the age of 30 in a process termed “andropause.” Other factors for testosterone loss include obesity, low activity level (e.g. sedentary lifestyle), and genetic disposition. So if you feel you are not the man you were and you seek a solution, you are not alone.

In the past two decades, testosterone therapies have quadrupled, earning it the term “T-fad” by many. You may have sought, or been advised of, TRT as a solution to issues listed above. T-clinics have popped up all across the country; it seems like a cure-all for men.

Adjusting hormones for men and for women, by either natural or medical means, is known to increase health risks like venous disease and blood clots. For women, pregnancy is a natural cause. Hormonal birth control is another culprit. A number of prescribed, as well as over-the-counter, medications can ‘increase your risks of blood clots’ as a side effect.

Yet, as the JAMA article states, there is a very real risk of venous thromboembolism (VTE) from TRT.  According to the research, the risk for VTE rises among all men, marginally higher in men under 65 years of age, when undergoing testosterone replacement therapy. Even six months after treatment, the risk was twice as high for men with or without hypogonadism.

What is a venous thromboembolism (VTE)?

VTE is a blood clot in the deep or superficial veins of the legs, pelvis or arms. If the clot dislodges and travels to the lungs, it is known as a pulmonary embolism (PE). Deep Vein Thrombosis (DVT) is asymptomatic only about 50% of the time. If your DVT is asymptomatic your first sign could be a life threatening PE.

How would I know if I had a blood clot (VTE)?

As mentioned previously, some DVT are asymptomatic. If you have a symptomatic VTE in your leg you may complain of muscle cramps which seem to have no cause (such as from exercise) and hurts especially at night (often in the calves). Also, there may be pain, swelling, and redness or discoloration, and the area may feel warm to the touch. If you have these symptoms you should seek a medical evaluation,

If you have concerns, Vein Specialists of the South can help. Our clinical team has the training and expertise offering vein evaluations to detect and address deep and superficial vein including the presence of VTE before it leads to more dangerous consequences.

It’s also important to note that blood clots may present with no symptoms what-so-ever, which makes it all the more vital for you to seek an evaluation from our vein specialists especially if you have visible varicose veins, spider veins and leg swelling. Our ‘Walk in Walk Out Vein Evaluations’ include a history, physical exam and an ultrasound to detect venous disease and blood clots.

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SCHEDULE A CONSULTATION

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HAVE YOUR LEGS EVALUATED

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ENJOY BETTER LOOKING BETTER FEELING LEGS

SCHEDULE A CONSULTATION

HAVE YOUR LEGS EVALUATED

ENJOY BETTER LOOKING BETTER FEELING LEGS

How does testosterone replacement therapy lead to an increased risk of blood clots?

Many factors can increase the risk of you developing a VTE. Many years ago Dr. Vircow described three factors commonly associated with increased VTE risks. The Vircow’s Triad includes: limited mobility, blood clotting disorders and damage to the vein wall. TRT increases the red blood cell and platelet production both which increase your blood clot risks. An elevated red blood cell count thickens the blood and slows the venous flow from the legs. Platelets are tasked with beginning the clot process stopping bleeding when there is an injury. If your red blood cell and platelet counts are high there is an increased risk that a clot may form in your deep or superficial veins..

Do you really need testosterone replacement therapy?

Not everyone who undergoes testosterone replacement therapy experiences ill side effects. You may have been recommended by a friend or colleague who spoke highly of its results. However, before jumping on the bandwagon, speak with your primary care physician about your concerns and possible alternatives such as dietary and activity changes.

Above all, we want you to be safe. If your physician determines that you have low testosterone requiring TRT, schedule a vein screening with Vein Specialists of the South. We can work with you on therapies to reduce your risk of blood clots and evaluate your vein health. This is just as vital as routine lab work while taking prescription medications for cholesterol or blood pressure.

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Concerned About Blood Clots with Testosterone Replacement Therapy?

Whether you have symptoms of blood clots or not, if you’re on testosterone therapy, we recommend you come see us at one of our three convenient locations in South Atlanta, Macon, or Warner Robins, GA.

Just as our name states, Vein Specialists of the South (VSS) is focused on vein evaluation and care in Georgia. For nearly 30 years, VSS has evaluated and treated countless patients with varicose veins, spider veins, blood clots, and more. Passionate about education and prevention, we offer numerous resources and educational opportunities to the local community alongside conservative self-care and prevention guidance.

Contact us for a consultation. We’re here to help!

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