More stuff in the media recently accusing Alberto Salazar of drug use. Summer 2015 on the press communications page of TheETG website I put an email back-and-forth that I had engaged in with David Epstein, author of the Propublica article that got global attention and hoopla emanating from a BBC “documentary” about Alberto Salazar and Nike Oregon Project.
To accept the things stated in his article, logically one had to first accept his not so passive assertion that no doctor in America would prescribe testosterone to a heart failure patient. Mr Salazar being that patient.
That seemed pretty foolish to me. So I confronted him via email with data.
He was displeased.
My facebook post……June 26, 2015
The last couple days I’ve been engaged an email exchange with David Epstein, author of the Propublica article.
He is defending the portion of his article about coach Alberto Salazar using testosterone for treatment of heart failure.
Most of the innuendo about Salazar and Nike Oregon Project athletes communicated in the article depends on readers accepting this portion of the article, implying that he may be giving it to the athletes as well in microdoses.
David Epstein has been defending this portion of his article by dismissing the study I sent him showing that testosterone is used effectively in heart failure patients in the United States…….such as Alberto Salazar who had a massive heart attack several years ago in front of his athletes near the track at Nike headquarters.
That study is on my facebook page [posted Friday June 26] and TheETG website on the Press & Media Communications page. He dismissed the study as being a decade old and having too few subjects, and that there are larger studies showing harm in testosterone use for heart patients.
Below is the response I sent him this afternoon……..
Ya, however the point is your characterization in your article.
You asked cardiologists…….”whether testosterone would ever be prescribed to treat a heart condition.”
The study I provided you obviously says yes.
You clearly left the reader with the suggestion that the answer was no.
You didn’t do proper fact checking or you disregarded the truth.
The problems with the study sited to you by the cardiologists in relation to your implied assertion in your article that no doctor would prescribe testosterone for fear of heart related downside………
—– “Men with a history of MI prior to the first prescription for TT or PDE5I were excluded from the post-prescription analyses.”
—– “Taken together, the evidence supports an association between testosterone therapy and risk of serious, adverse cardiovascular-related events–including non-fatal myocardial infarction–in men. However, there is some evidence that low endogenous testosterone levels may also be positively associated with cardiovascular events.”
—– “our study has limitations related to use of a health-care database that did not include information on the serologic or diagnostic indications for treatment. It also identified only subjects with non-fatal MIs, typically representing about 75% of the total incidence, and was based on the diagnosis of an attending physician, rather than a structured evaluation as might occur in a randomized trial. “
—– “Among older men, the two-fold increased risk was associated with TT prescription regardless of cardiovascular disease history, although this analysis was based on relatively small numbers of MI cases in each subgroup.”
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The information below provides sufficient contradictory information about……..”whether testosterone would ever be prescribed to treat a heart condition.”……suggesting that you should -not- have suggested in your article that no doctor would prescribe testosterone for Alberto Salazar. You didn’t do proper fact checking or you disregarded the truth.
WebMD News [Wednesday July 2, 2014]
Study: No Link Between Testosterone, Heart Attack
Finding runs counter to some prior reports; much larger trials are needed, experts say
By Mary Elizabeth Dallas
“Although recent research has linked testosterone therapy with a higher risk for heart attack and stroke, a new study involving more than 25,000 older men suggests otherwise.”[Jacques Baillargeon, an associate professor of epidemiology at the University of Texas Medical Branch at Galveston]—“…..there is a large body of evidence that is consistent with our finding of no increased risk of heart attack associated with testosterone use.”
“In fact, men at greater risk for heart problems who used testosterone actually had a lower rate of heart attacks than similar men who did not receive this treatment, the researchers said.”
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The information below provides sufficient contradictory information about……..”whether testosterone would ever be prescribed to treat a heart condition.”…..suggesting that you should -not- have suggested in your article that no doctor would prescribe testosterone for Alberto Salazar. You didn’t do proper fact checking or you disregarded the truth.
Mayo Clinic……
What are the heart risks associated with testosterone therapy?
by Todd B. Nippoldt, M.D.
“…two recent studies have also reported a lower risk of death in men who were receiving testosterone than in those who were not.”
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The information below provides sufficient contradictory information about……..”whether testosterone would ever be prescribed to treat a heart condition.”…..suggesting that you should -not- have suggested in your article that no doctor would prescribe testosterone for Alberto Salazar. You didn’t do proper fact checking or you disregarded the truth.
U.S. Food & Drug Administration
January 31, 2014
“At this time, FDA has not concluded that FDA-approved testosterone treatment increases the risk of stroke, heart attack, or death. Patients should not stop taking prescribed testosterone products without first discussing any questions or concerns with their health care professionals. Health care professionals should consider whether the benefits of FDA-approved testosterone treatment is likely to exceed the potential risks of treatment.”
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The information below provides sufficient contradictory information about……..”whether testosterone would ever be prescribed to treat a heart condition.”…..suggesting that you should -not- have suggested in your article that no doctor would prescribe testosterone for Alberto Salazar. You didn’t do proper fact checking or you disregarded the truth.
M.Stout, et al
Testosterone Therapy During Exercise Rehabilitation in Male Patients With Chronic Heart Failure Who Have Low Testosterone Status
American Heart Journal….Volume 164 #6…2012…..page 893
“This study assessed the feasibility of a 12-week program of exercise, with and without intramuscular testosterone supplementation, in male patients with chronic heart failure and low testosterone status and collected preliminary data for key health outcomes.”
“This study shows for the first time that testosterone supplementation during a program of exercise rehabilitation is feasible and can positively impact on a range of key health outcomes in elderly male patients with CHF who have a low testosterone status.”