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Testosterone: Can you have too much of a good thing?


Arnold Schwarzenegger, Florence Griffith-Joyner, Mark McGwire and Ben

Arnold Schwarzenegger, Florence Griffith-Joyner, Mark McGwire and Ben Johnson are all famous athletes who were alleged to have used testosterone. If testosterone can help, and it is a substance that is produced naturally in our bodies, then it can’t be that bad, right?

Let’s take a look at what testosterone is, and what happens when we take “a little extra.” Testosterone is the steroid hormone that is associated with male virility, but it is produced by both men and women naturally. Medically speaking, testosterone directs the cellular machinery of our bodies to ultimately maintain male secondary sex characteristics and to “exert an important protein-anabolic, growth promoting effect.” (Ganong’s Review of Medical Physiology, 24e). In plain English, testosterone promotes the growth of muscles and bones. It also promotes the male “look” of the human body. When produced naturally, testosterone regulates important metabolic processes. But when it is taken exogenously as a supplement, testosterone’s effects are difficult to control, and it may result in unforeseen and undesirable consequences.

So what happens if we take exogenous testosterone? For men, fertility can be diminished and may not return for months or even a year after discontinuation of the exogenous testosterone (Knuth, Maniera, Nieschlag Fertil Steril, 1989;52(6):1041). Exogenous testosterone use may also cause enlargement to the heart and the prostate gland. Gynecomastia (breast development in men) may also occur with high testosterone levels as some of the testosterone is converted to estradiol.

Conversely, in women, pharmacological testosterone will promote male-type secondary sex characteristics, such as hair growth, genital changes, voice changes and male pattern hair loss. Several other effects have been described, such as mood disorders and aggressive behavior,stimulation of red blood cell production, increase in the LDL cholesterol, and toxicity to the liver. There has been some case reports of young men using anabolic steroids suffering sudden cardiac death, and there is speculation that higher doses of testosterone may result in prostate cancer -- although this has not yet been proven (Fernandez-Balsells et al. J Clin Endocrinol Metab. 2010;95(6):2560. The balance of hormones in our bodies is a complex system of feedback mechanisms. Although attempts to restore normal physiological levels of testosterone in those deficient is becoming a routine part of medical practice, taking testosterone to achieve a desired physique or enhance athletic performance poses significant risks, much of which is known but a great deal of which remains uncertain.

Article by John Cook