Many US Men Beginning Testosterone Therapy Have Normal Levels

J. Bradley Layton, PhD Postdoctoral Research Associate University of North Carolina at Chapel Interview with:
J. Bradley Layton, PhD
Postdoctoral Research Associate
University of North Carolina at Chapel Hill What are the main findings of the study?

Dr. Layton: Use of testosterone testing and treatment had greatly increased over the past decade, with more pronounced increases seen in the United States than in the United Kingdom. The increases in testing in the UK seem to be targeted, identifying more men with reduced testosterone levels, but the increases in the US seem to be identifying more and more men with normal levels. Many of the men who begin testosterone treatment in the US appear to have normal testosterone levels to begin with. Were any of the findings unexpected?

Dr. Layton: We were surprised to see such vast differences between the US and UK in terms of use of testosterone drugs and testing. Testosterone testing has increased in both countries, but it has been much more pronounced in the US. And while use of testosterone in the US has quadrupled, it has only increased by about 30% in the UK. What should clinicians and patients take away from your report?

Dr. Layton: Many individuals, particularly in the US, appear to be initiating testosterone treatment without meeting diagnostic criteria for true hypogonadism. The medical appropriateness of treatment should be considered carefully before beginning testosterone medications. What recommendations do you have for future research as a result of this study?

Dr. Layton: Researchers should investigate the potential risks of widespread testosterone treatment, and determine if there is any benefit to treating men without clearly defined hypogonadism.


J. Bradley Layton, D. Li, J. Sharpless, T. Stürmer and M.A. Brookhart, S.S. Jick, C.R. Meier. Testosterone Lab Testing and Initiation in the United Kingdom and the United States, 2000-2011. Journal of Clinical Endocrinology & Metabolism, January 2014

Last Updated on January 10, 2014 by Marie Benz MD FAAD