How the Low T Industry Is Cashing in on Dubious, and Perhaps Dangerous, Science
Alex Truman didn't think something was wrong until he returned to the gym. Before fathering his two kids, he worked out regularly and even made an early career of exercise. He had two degrees in health and fitness and ran gyms on the East Coast before he moved to Dallas and got into sales. Lean and square-jawed, he knew his body. But in his late 30s, it was betraying him. At 37, he was taking cholesterol medicine. "I didn't have an awful diet," he says, "but I liked beer, I liked pizza." He yearned to feel better.
Illustration by Jeff Drew Sellers of testosterone therapy play -- some say prey -- on men's insecurities.
He headed back to the weights and machines where he'd spent much of his 20s. He'd lift and lift, but something was different. Back in the day, all his effort would produce tangible results: bigger, defined muscles in his arms and legs, more strength and less fat. Now, results like that eluded him. "I'd go five to six days a week," Truman says, "and not see any progress." He'd go running and wear out easily. "It was really pissing me off because I had it before."
Beyond the workouts, he just felt so tired. At 39, he shared a bedtime with his kids, and waking up in the morning was difficult. But Truman says it wasn't normal fatigue, echoing the sentiments of many men in his position. He felt as though he had pushed through an all-nighter for a test in college -- only he felt that way all the time no matter how much he slept.
Many men (and their doctors) would call this aging, but Truman believed something was truly wrong. So did his wife at the time, and she told him so. "Why don't you go get checked for low testosterone?" she asked. "I hear the commercials all the time."
The commercials for the treatment of low testosterone, or "low T," are ubiquitous, even becoming a punch line on The Ticket, the Dallas sports radio station that profits from the low T industry's advertising. All the commercials ask men if they're feeling tired, depressed or just plain run-down, especially in the bedroom; these are the "symptoms" of "low T." Then the commercials offer a possible cure: testosterone therapy. It can be in the form of gels, pills or injections, but the upshot is the same -- taking the hormone can make a man feel younger, healthier or just plain better, almost like he's back in college.
There are many testosterone providers in the Dallas-Fort Worth area -- indeed, men can get it from their regular doctors. By 2017, national sales will reach more than $5 billion, predicts Global Industry Analysts.
No place in North Texas is more prepared to cash in on those sales than the Low T Center, Mike Sisk's metastasizing chain of testosterone replacement clinics. Low T Center has sponsored race days at Texas Motor Speedway and planned to sponsor a high school football stadium, but that deal fell through. (Testosterone supplements are banned from high school athletics.) Sisk aims to have 60 clinics open across the country, one-fourth of those in DFW, by year's end, and he says he'll open another 60 next year.
After Truman's wife mentioned the commercials about two years ago, he headed to the first Low T Center location, in Southlake. A pretty, petite receptionist in black scrubs welcomed him. Signed jerseys hung on the walls. In a waiting area that employees call the "man cave," a flat-screen TV was tuned to ESPN. In a small room, a physician's assistant drew Truman's blood to test how many nanograms of testosterone he had for every deciliter of his blood.
The Low T Center will treat any man age 25 or older with a level of 350 ng/dl or lower, a common practice at testosterone replacement clinics. At the center, the man also has to exhibit "symptoms" of low T, which are outlined in one of the clinics' commercials: being "tired," "run-down" or "irritable." Employees say they turn away anywhere from 30 to 50 percent of the men who come in because they don't meet these criteria.
Truman passed the symptoms test when he told the assistant about his early bedtime and his inability to gain strength no matter how much he lifted. Then he waited for his lab report in the man cave. About a half-hour later, he got the news. "I think my number was like 70, 75," he says, "which is the equivalent to about an 80-year-old man, which is like, 'Wow, that explains a lot.'"
Usually the clinics will perform only one test to verify a man's low testosterone level, but because Truman was so low, he came back the next morning for another test. He was still below 100, he says. He received his first injection of testosterone, which the Low T Center gets from pharmaceutical giant Pfizer, Inc., that day. It seemed simple.
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