We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Promotion of “Low T” and the Role of Testosterone Clinical Trials

C. Mary Schooling, PhD1,2; Gabriel M. Leung, MD1; Lin Xu, PhD1
[+] Author Affiliations
1School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
2City University of New York (CUNY) School of Public Health, New York, New York
JAMA Intern Med. 2014;174(2):305-306. doi:10.1001/jamainternmed.2013.12750.
Text Size: A A A
Published online


To the Editor Braun1 provides a fascinating insight into the means by which vested interests have promoted a new condition of “low T” among older men and a climate of opinion where testosterone therapy is seen in a positive light, very similar to the marketing of estrogen to older women in the late 20th century. Schwartz and Woloshin2 draw attention to the current lack of evidence of meaningful, overall benefit from testosterone therapy, largely echoing the Institute of Medicine (IOM) report from 2004: “there is not clear evidence of benefit [from testosterone therapy] for any of the health outcomes examined.”3(p99) The IOM also specifically recommended only small-scale trials of testosterone therapy, where no other treatment was available.3 Schwartz and Woloshin2(p1462) now recommend a “large-scale randomized trial to demonstrate that testosterone therapy does more good than harm.” Given the current climate of opinion, genuine uncertainty in the expert medical community over whether testosterone therapy will be beneficial undoubtedly now exists. However, the evidence of harm from testosterone therapy has, since 2004, accumulated, but for the very reasons given by Braun,1 has also had less “air time.”


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





February 1, 2014
Lisa M. Schwartz, MD, MS; Steven Woloshin, MD, MS
1The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
JAMA Intern Med. 2014;174(2):306-307. doi:10.1001/jamainternmed.2013.12733.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...