An Insider's Story on Low T

A pharmaceutical ghostwriter comes out of the shadows to explain how drug companies market their products and why he now worries it could end up hurting you

By Tisha Thompson and Rick Yarborough
|  Friday, Jul 19, 2013  |  Updated 3:18 PM EDT
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This article originally appeared on NBCWashington.com

You've probably seen the commercials.  Middle-aged men who tell you they have low testosterone.

The commercials call it “Low T.”  Doctors call it hypogonadism. But Stephen Braun calls it dangerous.

“I really feel the public’s health is in danger,” he told the News 4 I-Team.

If you’ve ever read anything on Low T, there's a good chance Braun wrote it. He's not a doctor but what's called a pharmaceutical ghostwriter.

He explained, "Typically you won't see my name. You'll see a doctor's name on them. And in every case there's a drug company behind that with an agenda."

Braun said some men really do need testosterone replacement therapy because of surgery or a genetic condition.

It used to require painful shots, but about five years ago drug makers started selling an easy to use gel.

“They looked around to see how they can expand their market,” Braun said.  “One way would be to redefine the disease so more guys could be diagnosed with this condition."

Braun says he was asked to write pamphlets and articles for women’s magazines. “I was given some materials that came from the drug company with talking points,” he said. Those notes included instructions for trying “to get women to diagnose their partners because guys tend not to go the doctor, but women do.”

He said everything he wrote warned of the same, vague symptoms. Being moody. No energy. A low sex drive.

“What I produced was the truth, but it wasn't the whole truth," he said.

Braun has now admitted he left out a big piece of critical information – there’s never been a long term study on whether Low T drugs can cause dangerous side effects.

He and a growing number of doctors worry Low T may be for men what hormone replacement therapy was for women, when millions of menopausal women were prescribed drugs only to learn more than a decade later those drugs can cause breast cancer, stroke and heart disease.

Dr. Michael Irwig is the Director of Andrology at George Washington University and specializes in treating men with low testosterone.  “The truth is we don't know long-term what the exact risks and benefits are."

Dr. Irwig says men now flood his office asking about Low T.  More than half end up having other problems like diabetes and obesity requiring a different solution -- diet and exercise.

"It's a lot easier to take a pill or take a medicine than to change somebody's lifestyle," Dr. Irwig noted.

Which may be why a recent study published in the Journal of the American Medical Association found prescriptions for testosterone have tripled in the past decade. That same study found 25 percent of last year's patients who received those prescriptions had never even been tested for low testosterone, worrying some doctors’ patients may be taking a drug they don't even need.

The maker of one of the most popular Low T drugs, AndroGel, told the News4 I-Team its medication “has more than 10 years of clinical, safety and published and post-marketing data, with therapeutic risks well documented in the prescribing label.”

The company says, “Disease state awareness initiatives serve an important role by enhancing awareness of health conditions, educating patients about treatment alternatives and referring consumers to qualified health care practitioners.”

But Braun worries too many men are possibly risking their long-term health and knows he could be putting his career on the line by speaking out. "Unfortunately, I think I have helped fuel a misguided experiment on public health, which I don't feel great about, but if I can say something about it now, maybe fewer guys will just leap into this without knowing."

DRUG COMPANY STATEMENTS:

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