An Arizona man alleges the heart attack he suffered in August 2012 was caused by  Depo-Testosterone, which he had been using for seven months.

Plaintiff Robert W. filed the testosterone side effects lawsuit against Pfizer Inc., the maker of Depo-Testosterone.

Robert’s testosterone lawsuit is one of thousands that comprise a multidistrict litigation going on now in a federal court in Illinois. Generally, the plaintiffs in these testosterone lawsuits are men who suffered strokes, heart attacks or other cardiovascular side effects and now allege that those complications resulted from their use of testosterone products.

Part of the plaintiffs’ argument is the allegation that some pharmaceutical companies marketed their testosterone products as remedies for a set of symptoms that is not associated with any actual medical condition but instead are just the natural symptoms men experience as their testosterone levels naturally decrease with age. The plaintiffs say that some companies treated this set of symptoms as its own medical condition referred to as “Low-T” so that they could promote testosterone products as the remedy.

This marketing amounted to improper over-promotion of the drugs, the plaintiffs say. They allege pharmaceutical companies improperly promoted their testosterone products for uses other than those approved by the FDA.

The FDA addressed this situation in a March 2015 announcement. The agency reminded patients, doctors and pharmaceutical companies that testosterone replacement therapy is approved only to treat the loss of testosterone caused by disorders of the testicles, pituitary gland, or brain that result in a condition known as hypogonadism.

The agency noted that it is aware of the trend of prescribing testosterone as essentially a lifestyle drug, and it discouraged physicians from writing such prescriptions. The agency also reminded readers that testosterone products have not been evaluated in terms of safety or effectiveness when used merely to treat symptoms of aging.

In the same document, the FDA announced it was requiring manufacturers of testosterone products to add information to their labeling that addresses the possible increased risk of heart attacks and stroke in patients who take testosterone. The agency cited the results of multiple studies of testosterone use in aging men, some of which showed an increase in the incidence of heart attack, stroke or death.

A new report suggests the marketing effort for testosterone as a Low-T remedy has extended to physicians’ educational seminars funded by the makers of testosterone products. The investigation conducted by the Milwaukee Journal Sentinel in cooperation with MedPage Today revealed that the material in some continuing medical education seminars encouraged physicians to prescribe testosterone products for uses not approved by the FDA.

Doctors are required to take continuing medical education courses to maintain their licenses. Some of these coursed are funded by pharmaceutical companies and offered to doctors free of charge.

In some of the courses investigated, the course materials heavily emphasized the negative health effects associated with low testosterone – without alleging any causal connection. One lecturer told physicians that it is safe to prescribe testosterone for patients with prostate cancer, even though testosterone is known to aggravate prostate cancer.

The investigation notes that in just the past three years, over 2,500 testosterone lawsuits have been filed in federal court alleging that pharmaceutical companies knowingly promoted testosterone products for uses not approved by the FDA.