Fountain of Youth: The Low T Industry Cashes in on Some Dubious Science

Joshua Carr is 54 and in solid shape, with a healthy weight and average build. He'd been feeling a bit tired in the days before he got his blood drawn for his yearly physical, but he didn't volunteer that to his family doctor because he didn't have illusions about his age. He didn't eat as much or work out as hard, but that was just the years adding up.

The doctor told Carr his blood work was fine, but by the way they needed to talk about something. There's a gravity in his voice that gave Carr pause. "You have low T," the doctor said, showing him a chart with corresponding age and testosterone levels. "See, you're at this number, and it should be in this range. Go see a urologist."

Carr, who asked that we not use his real name, was surprised at the diagnosis. Low T. He'd never heard of it before, but there it was, a chart showing that men his age ideally have a total testosterone level of about 600 ng/dl -- nanograms per deciliter -- of blood. His levels were about half that, although, considering that 400 to 800 ng/dl is an acceptable range for the average man, he was only borderline low.

He scheduled an appointment with a Houston urologist, who confirmed he had low testosterone disease and prescribed a cream called Testim. This cure, which he was supposed to rub on his arms and shoulders after he showered in the morning, had the potential to kick his testosterone up to what it was in his teenage years.

Just be careful not to touch family members, the urologist warned -- a woman comes into contact with it and she could grow a beard. Exposing young boys to too much testosterone will stunt their growth because it tricks their bodies into thinking they're pubescent ahead of time. As for prepubescent girls, he didn't need to go into detail. Testosterone is just no good.

Other than proper application etiquette, they didn't discuss the potential side effects of using Testim, the increased risk for cardiovascular-related disease: strokes, pulmonary embolisms, blood clots, heart attacks and death. So Carr decided to try it.

At first he thought he felt a small energy boost. It wasn't much, but he thought he'd take it. He exercised more and slept less. After a while, he realized he wasn't really sleeping much at all, and it was because he was feeling more anxious than he'd ever felt before in his life. His skin turned an angry, fake-tan red, so instead of applying Testim daily, he cut back to once every two or three days.

Carr used Testim for about a year, from late 2012 to the end of 2013, when he got another checkup and his blood test came back showing testosterone levels of about 2,000 ng/dl -- way too high. His doctor ordered him to stop the treatment immediately. A few months after that, as Carr prepared for bed one night, he was seized with a massive chest pain. He lost feeling in his left arm and nearly passed out.

Heart attack, he thought as he was rushed to the hospital.

Turned out he was right.

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American men have tried ways to slow down, even stop, the effects of aging for generations. John R. Brinkley, the "Goat Gland Man," became a Texas legend for transplanting slivers of goat glands into men's testicles in the 1920s and '30s, a piece of quackery he advertised on an unregulated Mexican radio station that blasted country music across the Rio Grande. Near the end of the centry, testosterone therapy -- minus the goats -- had become less invasive but still lacked Food and Drug Administration approval.

That changed in 1995, when the FDA passed off on a skin patch for men with a testosterone deficiency. Unimed Pharmaceuticals put AndroGel, a low T gel, on the market five years later, estimating its consumer base to be four or five million men who have low testosterone. Two years later, Unimed revised its numbers: The market had grown to about 20 million. The FDA estimated that in 2010, 1.3 million men took testosterone. That number has since increased by a million.

At last the floodgates opened for smart salesmen to sell testosterone -- and agelessness -- to the masses.

One injection chain, Dallas businessman Mike Sisk's Low T Center, is the face of the new wave of interest in testosterone therapy. It has more than 50 locations throughout the country, including eight in Houston. The company's flagship branch, the Low T Center in Southlake near Dallas, definitely looks the part of a testosterone oasis. Framed football jerseys hang on the walls between flat-screen TVs tuned to ESPN, while coffee tables in the waiting room are spread with glossy copies of Sports Illustrated and Car and Driver. Making a client feel at home in his "man cave" is customer service 101, Sisk says, but the message on Low T Center's website proposes a challenge that is just a tad adversarial: "Time to man up. Stop by today."

Other testosterone providers in Houston run the gamut from primary care physicians to wellness-spa gurus who tackle low T with a mixture of medicine and meditation. For decades, traditional urologists and endocrinologists have been treating hypogonadism, a real medical condition in which pituitary gland signals from the brain fail to reach the balls.

But the specialists say interest in testosterone therapy has only shot up within the past five years or so, something they attribute to the barrage of advertisements from pharmaceutical companies and the growth of quick-fix clinics acting as testosterone dispensaries. Unlike menopausal women, middle-aged men don't experience a sudden, dramatic drop in hormones, but they might feel tired, depressed, not as aggressive or virile. It's natural, but now more than ever, men are getting the message that they don't have to live with it. By 2017, national sales of low T creams, gels and injections will exceed $5 billion, predicts Global Industry Analysts.