Testosterone Treatment and Alleviation of Depressive Symptoms in Men
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I have been on TRT for several years as a result of a damaged pituitary from a tumor that was removed. I have played with the dosages alongside my doctor, and definitely found that (to a certain extent) it really has an effect on my mood.
From personal experience, I don't know if it would call it an anti-depressent, but it seems to stifle anxiety at the right doses.
Some people say it's a "confidence drug" but my opinion is it performs more like an anti-anxiety drug.
I can have a terrible week of work with little sleep, bump my dose a bit and I calm down - as long as the dose is not high enough to put my estrogen (e2) levels out of whack.
Dosage and duration are extremely important. If you mess either up it can make you moody and full of anxiety.
Many doctors today are incredibly unskilled and uneducated regarding hormones. I know many doctors perscribe trt in one shot per two weeks, and even one shot per month. I had to go through four doctors to find my current who is a specialist and very well educated.
With a half life of about 6 days, test-c should be administered at MINIMUM weekly. Ideally bi-weekly. Dosage should be enough to get you in the 600-1000ng/dl range.
You also need to carefully observe the hormones that coorelate closely with testosterone, like e2. If that goes to high (aka high converter) your mood will be worse.
Some people will also see a rise in hematocrit which thickens the blood and can be a risk factor for a number of things. I do not have this issue as my hematocrit is very stable on or off trt.
My blood pressure has actually dropped on TRT.
If you can do the balancing act it is overall very good.
-- Feel free to ask me anything about TRT and it's effects on mood, hormones, etc. I will try to answer. I have been researching it for years.
What is your experience with side effects (testes shrinkage, hair loss, acne, etc.)?
For someone with recurrent anxiety and depression that has been resistant to other, more conventional, treatment approaches, do you think TRT is worth exploring and how does one find a good doctor?
Shrinkage is not as bad as you would think, in my case maybe 25%. However, my doctor also prescribes HCG to be injected IM bi-weekly. HCG is an analog to LH - the signaling hormone that tells the testes to produce testosterone. As a result mine are still producing a little bit of test to keep their size and prevent atrophy (I am still fertile as a result).
Acne pops up when dosage is going up or down but tends to go away if you maintain a stable dose and blood level concentrations (aka dose timing) for a long period of time.
Most people in my family suffer from depression, and I have in the past. I think most of mine was caused by anxiety though. SSRIs when I was a teen never did anything for me. I now am fine with no drugs for it though. If yours is based in anxiety I strongly believe it will help.
As an anecdotal single data point of how far you can go after keeping my LH levels as low as I could after around eight months straight my testes decreased around 75% in volume.
Same history with family and SRRI use.
Generally, oral anabolic steroids are more hepatoxic than their IV counterparts. So the advantage is that you end up with less liver damage.
If that's the case, wouldn't it make more sense to take the hormones produced by the pituitary that stimulate the production of testosterone? I'm not a doctor, but I suppose that would take away some of the downsides of TRT.
I now keep it in the 700-900/dl range which I have found is where I feel the best. My energy levels in particular are much higher at this range than at 300 where I was frequently tired.
I often notice that in the days during/following good exercise, I not only feel happier, but also more "virile" for lack of a better word, and also more aggressive. I partially attribute this to testosterone increasing.
Do you have any particular opinions on global trends in sperm count reduction? https://www.scientificamerican.com/article/sperm-count-dropp...
I actually remember the first time I took it, I was euphoric for like 24 hours. It was as if all of the sudden I felt like I had control over my life.
I used to freak out over deadlines and staying late at work, and even if mentally I told myself not to worry about it I'd get visible anxiety symptoms like pressured speech and shaking.
On TRT those anxiety symptoms are significantly diminished. I don't freak out over things that aren't life threatening much anymore. It's like my body's response system to danger had it's threshold increased.
For example, I only feel like myself when I'm regularly boxing (competitive, high volume anaerobic+aerobic, physically intense), spending time alone and outside, adhering to a higher fat diet/lower carb diet, occasionally blowing off work to do something else, and so on.
What I take from this is that men respond well to testosterone. There are a number of testosterone boosting activities and foods that might help, including acute treatment when necessary. Glad this is getting recognition.
These are supposed to increase your testosterone levels?
I suppose I am now required to look up references to support the following statements:
1. exercise without over-training boosts testosterone (maybe some middling results here: https://link.springer.com/article/10.1007/BF00441300 ) https://www.sciencedirect.com/science/article/pii/S174360951...
2. Reducing stress increases testosterone http://psycnet.apa.org/buy/2000-13208-002
3. High fat diet increases testosterone https://www.nature.com/articles/4500825 (and probably ref 33)
4. I should have also mentioned that my lifestyle often includes less drinking during these phases https://academic.oup.com/jcem/article-abstract/74/5/957/2875...
5. That i socalize more and skip work more as well. https://link.springer.com/article/10.1007/s00441-005-0006-2
and that taken as a whole, I feel more like myself, increasing self esteem, which may itself help. https://www.sciencedirect.com/science/article/pii/S136466131...
Or you can look for pop blogs. https://www.artofmanliness.com/articles/how-to-increase-test...
But of course, I just googled around for a bit to find one-off papers. It's a good starting point if I wanted to write a research paper on it, but I really don't. I wanted to provide my own experience, and have.
I'm not a doctor, but from my basic undergraduate level understanding of biology I would expect clomid to be highly effective in cases where low testosterone is due to xenoestrogen exposure, among others.
Outside of the T issue, exercise of various sorts has been shown to have a positive effect on mood.
Note that for men in particular, loss of muscle mass as you age is a big health issue, and regular resistance training directly combats that. For (type 2) diabetics, resistance training also seems to improve insulin sensitivity.
How come this isn’t such a big problem for women?
However... I'm not a doctor, nor even particularly knowledgable. But isn't one of the risks of testosterone supplementation a risk that one's own testes will reduce their testosterone production if there's a bunch of exogenous testosterone making its way into the body?
Not that anybody's claiming otherwise, but as promising as this is my best layperson's understanding is that it's not as simple as giving people some testosterone along with their other treatments.
> As long as you a producing a normal amount of testosterone
I can't access the full article, but the abstract simply mentions "testosterone treatment."
I'm not sure if that means your typical testosterone treatment, where testosterone is given to those who have low testosterone... or if they were administering testosterone to people in this trial regardless of their existing testosterone levels, even if they weren't low.
I suspect it's the latter! Which would be interesting.
If it's the former, this barely qualifies as news. We've known for ages that low testosterone is associated with depression. It would be almost hard to believe that anybody would bother to run a study on it in 2018.
The latter possibility is interesting though. It suggests that supplementing testosterone could be an effective way to treat depression even in those who do not have low testosterone.
(We already know that exercise boosts testosterone, and that exercise is an effective treatment for depression, so this is not completely surprising. And yes, I realize that exercise is not a cure-all, nor an option available to everybody)
My brain clearly runs on e2 and not T and having the right amount of e2 present has been life changing as far as my mood is concerned so for guys that run on T, but have low T levels I absolutely get how much of an improvement it could be once they raise their T levels.
1. Testosterone and estrogen have an influence on mental characteristics like disposition, interests, and motivations.
2. Male and female bodied people have on average significantly different levels of testosterone and estrogen.
3. Therefore, male and female bodied people will on average have differences in mental characteristics like disposition, interests, and motivations.
I understand that 3 does not follow from 1 and 2, but have not been able to figure out the reason why.
For example on the androgenic side there is DHT, androstenedione, DHEA, A5, etc. On the estrogenic side there is estetrol, estrodiol, estrone, etc.
DNA encoding in males and females also alters the quantity of non-sex related hormones like T3, T4, TSH in the thyroid for example.
Men and women are indeed different in metal characteristics, but it is often difficult to pinpoint one specific hormone as the cause.
Many hormones influence the release of other hormones. For example, testosterone is converted to estrogen in side of fat cells through a process called aromatization. So a male with too much testosterone, may end up with too much estrogen as well. DHT another androgenic hormone is also converted from testosterone, and testosterone itself is created out of fats in your blood stream.
Many of these hormones are signaling hormones for things like stress, libido, anxiety, etc. A combination of these is what makes up characteristics of a person's personality.
But just because testosterone defficiency in a male (below normal range) can lead to anxiety and depression in some men and exogenous testosterone therapy which brings levels back to baseline shows some evidence of alleviating the depressive and anxiety symptoms, does not mean anything for baseline characterstics of otherwise healthy men or woman.
Hormones obviously have a huge impact on human mood. I think it’s under-studied how dramatic an effect hormone imbalances can actually have, and how to effectively alter hormone levels to successfully improve mood. Seratonin for example is a neurotransmitter but I think can also be considered a hormone, and we’ve all heard of SSRIs.
That would seem to indicate that testosterone/estrogen have (on average) the same response in both male and female bodies, either masculinizing or feminizing.
This is correct. Although there's only so much they can do for those of us transitioning post-puberty (like me) once bones have fused and stopped growing.
As testosterone is stronger than oestrogen, it will override the oestrogen in your body and bring about masculinising changes such as making your adams apple more prominent changing your voice box, a V-shaped upper body, facial structure, body hair, hand and feet size, larger bones, and higher hip growth. Whereas if you only have oestrogen, these effects don't occur at all - really only just wider hip growth.
I think maybe this is a hard pill to swallow for many people because we have proven over and over that we can't trust each other to both know this AND still treat everyone, regardless of how we may be able to classify them, as an individual and to judge each individual by their own actions, desires, and capabilities rather than by the average characteristics of whatever bucket we happen to be considering them to be in at the time.
But none of been willing to explain to me why we know this; when I ask they think I’m trying to make a rhetorical argument that here are differences, and react poorly. I’ve stopped asking them.
How much of our personalities is due to nature and how much is due to nurture is, as far as I am aware, not figured out. It is a very hard problem to separate those influences.
Yes, there are differences between men and women - physical and emotional. But they also respond differently to hormones. When men have low levels of testosterone, they may get a bit depressed; but those "low" levels of T are far higher than what any woman will ever experience, even women who are thriving. So it's pretty clear that male and female brains do not react the same way to these things.
Give the man suffering low testosterone some oestrogen and progesterone, and their mood will lift and vice-versa. Low hormone levels result in depressive symptoms, not what type they are.
And yeah, don't explore this if your testosterone production is still fully functional.
[1] https://newsroom.uw.edu/news/study-testosterone-therapy-does... [2] https://prostatecanceruk.org/about-us/news-and-views/2017/11... [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4647137/
* Eat 4 whole eggs per day (roughly 1 egg per 50 pounds of body weight) and 1/2 cup (dry) cooked oatmeal with a handful of frozen fruit to keep arteries healthy. Cholesterol is like a precursor for testosterone, also the sulfur in egg yolks help preserve and rebuild connective tissue.
* Take a 30-50 mg zinc tablet a couple of times per week (not every day or you'll start feeling queasy). Zinc and other metals are catalysts which speed the chemical reactions in your body, raising metabolism and strengthening your immune system. It's also been linked to higher T levels.
* 1500/1200 glucosamine chondroitin and MSM for joint health. I take Animal Flex which works about twice as well as the next best joint supplement I've found. This also allows you to lift heavier and raise T.
* Lift heavy at the gym 4-5 times per week. For example, 12" box squats with 225 pounds for 15 reps, 315 pounds for 10 reps, stuff like that. The more brutal the exercise, the more your body overcompensates and raises T levels. I benched 225x9 and 300x1 on a 4 day legs/push/pull/shoulders split in my late 20s. Now on a 5 day Mike O'Hearn split for last 3-6 months. Proven lifts: 225x10 and 275x2 bench, 365x3 box squat, 365x3 deadlift but those were all relatively easy because I've been focusing on joint strength and extrapolating 1 RM lately. Planning to test 315x1 bench, 405x1 box squat, 405x1 deadlift at the end of this 3 week on/1 week deload cycle, then will add in heavy 7 sets of 3 and start working towards 405/495/495 over the next year or so. YouTube's been invaluable for reverse-grip exercises and other variations that prevent plateaus, so I'm gaining strength faster now than I was in my 20s (I was also broke then and wasn't focusing on nutrition enough).
* Glutamine 3 times a day to heal leaky gut caused by eating legumes and nightshades for a lifetime, which resulted in acne, joint pain and inflammatory weight gain. Planning to drop to once a day now that my acne is gone.
* Breathe right strips for sleeping. My narrow palette/babyface tightened my airway and left nowhere for my jaw to grow during 20 years of elevated growth hormone from the gym. This affects a lot of people, especially anyone with let's just say geeky facial features.
Figure out any deficits you might have. In my case, sleep apnea and leaky gut had caused (what I think was) hypothyroidism and absolutely killed my mood and motivation over the last few years. The last 3 months or so have been life-changing.
I feel much better but find that I sleep 9 hours a day from all the workouts. I've been congratulated by strangers at the gym who saw my body fat transition over the last year, which really helped my self esteem. There is no secret to getting in shape other than educating yourself and being consistent (not missing workouts or meals). I've never tried over the counter testosterone boosters but might think about them after 45. I won't bother until I hit permanent plateaus.
Disclaimer: I've never had my testosterone levels tested, so this is all anecdotal. YMMV.
Once that happens, there is a transference that can happen over similar classes of proteins which can lead to other sensitivities to grains, dairy etc, starting primarily with gluten and lectins. The transference can even involve the body's own proteins and lead to autoimmune diseases like arthritis. Here's a pretty good article on it:
https://www.amymyersmd.com/2017/06/the-problem-with-grains-a...
My feeling is that what's really going on is that the body can tolerate toxins from any source for a certain number of days, but after that, begins to succumb to them which triggers inflammation. It's a bit like trying to drink alcohol on the third day. Except we don't notice it immediately with food, so we keep eating what we're used to instead of investigating what our cravings mean. That's why eating a variety and rotating meals so you're only getting the same food a couple of times a week is so important.
Keep in mind that I also had quit working out cold turkey for about 5 years and lost about 30-40 pounds (including some muscle) and was drinking too much. I was also getting older and wasn't ready to grow up and be smart about my nutrition. Luckily it only took about 6 months at the gym and eating right to get back to where I was. It actually took longer to work around the various weaknesses and injuries I had acquired, for example having to start over with 135 at deadlift and go up 10 pounds a week to reknit my lower back, than it did to get the size back on my arms and chest.
For the most part nobody seems to talk about all the above, mainly because health and fitness are a young person's game (below 35 generally) and also because holistic effects are not a big part of western medicine yet. My feeling again is that declining testosterone isn't a cause, it's a symptom of all these other systems getting out of whack.
Edit: I forgot to mention above that I'm about to start taking cissus for golfer's elbow. It's apparently highly effective so I'm only going to take it for a week or two and see if it heals it. It apparently thickens the lining of the stomach as well which can help with ulcers, which to me indicates another possible connection between gut health and joint pain. I don't know that I will take it long term like glucosamine/chondroitin however. Hope this helps someone.
"It is not known if AndroGel is safe or effective in children younger than 18 years old. ... AndroGel can transfer from your body to others. This can happen if other people come into contact with the area where AndroGel was applied."
"Signs of puberty that are not expected have happened in young children who were accidentally exposed to testosterone through skin-to-skin contact with men using topical testosterone products like AndroGel."
"Women and children should avoid contact with the unwashed or unclothed area where AndroGel has been applied. If a woman or child makes contact with the AndroGel application area, the contact area on the woman or child should be washed well with soap and water right away."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854760/
I say this half-jokingly, this particular study concludes there are compounds but are currently not showing adverse effects.
Good ol' injectable testosterone is a full order of magnitude cheaper.
Low-T makes you depressed, or correlates with depression. Cue the inevitable "soyboy" epithets and related wankery.
Most asians become lactose intolerant after infancy. Many western europeans don't. Just because the Chinese can handle soy like champs doesn't mean everyone else can.
For anyone down voting, an open question in the paper is “do Asians have factors that might mitigate the phytoestrogens?” They don’t know.
As to evidence that levels are dropping, https://www.healio.com/endocrinology/hormone-therapy/news/pr...
Analyses that don't cherry pick tend to conclude it's pretty safe.
I don't know how much tofu ingestion is required to produce a noticeable effect (such as gynecomastia), but I assume it would have to be a major dietary component. In Asian countries, soybean consumption is much higher than typical in the US, so perhaps more likely to be an issue there. Might be worth a literature search on the subject, but I haven't done that, so I don't know if it's been verified.
"M.M. regularly consults for companies that manufacture and/or sell soyfoods and/or isoflavone supplements, and he is the executive director of the Soy Nutrition Institute[0], a science-based organization that is funded in part by the soy industry and the United Soybean Board."[1]
More people would trust science if more scientists were not whores.
[0] https://thesoynutritioninstitute.com/author/dr-mark-messina/ [1] https://www.fertstert.org/article/S0015-0282(10)00368-7/full...