As an M.D. and Ph.D., I realized my lab results were alarming. Other patients might not
Last year, I joined the millions of American men now on testosterone therapy — a treatment whose use has quietly tripled over the past two decades, often at doses far above Endocrine Society guidelines.
Within weeks, I felt younger, stronger, and sharper. But within months, I was at serious risk of right-heart failure.
I didn’t come to testosterone casually. In 2022, I had surgery for chronic thromboembolic pulmonary hypertension — six hours on the table with my body cold and bloodless. Afterward, my oxygen saturations crept up from a pre-op 83% to about 94%-95%, which is close to normal, but my energy lagged. I’d seen so many men my age look younger, move better, and swear they “felt like themselves again” after starting testosterone. I wanted in.
The first clinic I visited promised to raise my testosterone from its very low 100 ng/dL to 1,200 — well above the normal range of 300-800 for healthy men, and far above the approximately 400-500 that’s typical for men my age. I passed.
Instead, I found an online provider who, after a brief video consult, prescribed 26 milligrams of testosterone daily. For context, the human body naturally produces the equivalent of about 4-7 mg per day. The Endocrine Society generally recommends replacement doses of 75-100 mg weekly for injections — not 182 mg weekly, which is what I was on.
With an M.D. and Ph.D. to my name, I thought I was pretty smart. I typically do literature searches for my patients. But I didn’t catch the magnitude of that difference right away.
…
But four months in, the warning signs appeared. My hematocrit, already slightly elevated at 48% post-lung surgery, shot up to 59.8%. Blood that thick strains the heart, especially the right side, which pumps through the lungs’ fragile vessels. Above 54%, pulmonary vascular resistance doesn’t just increase — it spikes. I’d been in right-heart failure three years earlier. I knew what that road looked like.
Read the full story: Testosterone made me feel 30 again — until it nearly broke my heart (Stat)