Testosterone therapy and the heart: New research finds no increased risk
wsj.com
wsj.com
I think the key things to remember here are:
*Monitoring your own response to the therapy is key, whether you're a middle-aged man getting shots of Sustanon at your doctor's office or a professional bodybuilder running over a gram of androgens every week. There is no substitute for regular bloodwork. Some people's livers handle this shit better than others'.
*Contra some of the posts on this thread, not all PEDs are going to permanently shut down your HPTA. In fact, basically nothing is. People decide that they're "permanently damaged" because they expect PCT to fully take care of the shutdown and then can't ride out a few weeks of cold turkey. The testes restart, but they're like a diesel engine; it takes a while to get them going again.
*On a similar note, not all PEDs are going to automatically kill you. Some, like methenolone, are if anything beneficial to overall health and longevity. Others, like halotestin, are probably going to take years off your life. Do your own research and, again, get bloodwork done regularly.
*Finally, it's interesting to hear comments from people saying the "wanted to punch everyone", etc, when they started TRT. At TRT doses, most men experience a sense of calm and confidence, rather than irascibility.
Yup. When off the stuff I’m super irritable. On it I’m calm. Too bad it turned my blood into 140w gear oil. I’ve been waiting 6mps to get into an endo who up and quit and now I’m waiting more.
Adding testosterone also raises estrogen (estradiol) which causes irritability. It is hard to find a balance where both are in check.
1.Taking PED's is amazing.
2.Permanently shutting off your own test production is complete nonsense.
3.PCT did nothing for me. When you come off expect to feel low. Bridge with HGH.
4.Arimidex etc. is not always necessary. I never bothered and had no problems.
5.Microdosing is complete bollocks.
5.Be sensible. Unless you are going for peak athletic performance look for other ways to increase your testosterone levels etc.
6.Start slowly and build up your dose and the compounds as you require.
7.Tren is the absolute last thing to try.
8.There is no magic bullet. Results take work and dedication.
Questions? Details? Disagree? Comment..
I feel like we need more research on the negative effects long term of specific PEDs. I’m not willing to sacrifice any years on the backend of my life for the appearance of myself now, but if I had guarantees that managed properly I wouldn’t change my lifespan negatively I would consider it.
The other whole aspect is how these affect you mentally. Like the classic “roid rage”, is that avoidable if you take a manageable dose or is something like that inevitable with taking drugs that manipulate your hormones?
Can you point to anything? The market and the internet are full of "increase your testosterone naturally" scams. It's very difficult to separate signal from noise.
If there are no major health consequences then what's there even to consider outside of cost?
Opiate neuroreceptors autodownregulate, for one, so that means tolerance/dependency gets worse over time. That doesn’t happen with testosterone at all. Also, TRT would not have diminishing returns, after you get past the first few weeks. Some of that is tuning E2 levels, etc; most of it is psychological result of expectations (think placebo effect).
You risk issues at common doses, like cardiovascular damage (which tend to be higher doses than TRT), but these issues don’t compare with opiates.
Low T levels can massively negatively impact someone's life, if that can be addressed by supplementing testosterone people should be able to do so. If higher levels can benefit someone then they should be able to supplement it also.
I didn't interpret their question as hostile, this might be a case of you projecting. You felt enraged at the question, responded hastily and labelled them in a certain way. Try not to do so in the future.
https://news.ycombinator.com/newsguidelines.html
Unrelated, but while I have you: Could you please stop creating accounts for every few comments you post? We ban accounts that do that. This is also in the site guidelines.
You needn't use your real name, of course, but for HN to be a community, users need some identity for other users to relate to. Otherwise we may as well have no usernames and no community, and that would be a different kind of forum. https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...
If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.
Theoretically, you are wiser at 55. /s
On the other hand, there is no way to know at the individual level all the healthy habits that would come with TRT. This discussion is always from the point as if everyone is optimally healthy when reality is the opposite. Even just getting bloodwork done so much more than you would without TRT is a huge factor. No one is taking TRT and then playing video games and eating pizza all day.
The real downside to me though is having to get a supply of testosterone for decades. We are just so irrational on this subject that who knows what will happen in 10 years. The proposed hoops to have to jump through that are being debated right now are completely insane. Having to see a doctor in person once a month would be utterly ridiculous.
Severe testosterone deficiencies respond very well to treatment. Going from 55 year old to 25 year old levels isn’t as dramatic.
TRT forums are full of people with normal or low-normal who thought TRT was going to solve all of their problems and make them feel young again, only to be disappointed that they don’t really feel much of anything after a while. However, now they’re stuck on it for life because their endogenous production has dropped off.
That is the broscience consensus, but it's not as bulletproof as people like to believe. It will probably work for a 25 year old after 1-2 months of dabbling, but the TRT forums are full of stories where these tricks don’t work or stop working after extended use.
The tricks are not guaranteed like some of the forums or sketchy TRT clinics will claim. Atrophy can be permanent after relatively moderate periods, even with all of the HCG and SERM tricks.
I dislike questions that challenge pushing the limits of our existence.
My experience is that I have a slightly better mood, BUT, I have increased libido that does a crazy spike about halfway through the cycle (where I feel a raging insatiable teenager), followed by a significant drop in both mood and libido. It’s rather annoying, but better than the alternative.
Also this study means nothing to me. They're looking at a few overall risk factors. There are potentially thousands of factors to consider, all interrelated and deeply codependent. Such is human biology.
Science at large still doesn't truly know how hormones work and interact in their totality within the human body.
Meanwhile, many cardiologists and doctors still buy into the saturated fat myth and myopic "all cholesterol is bad and will lead to heart problems" myth perpetuated by the sugar industry decades ago. So I'm not taking anyone's word yet on any of this.
Ironically, bodybuilders tend to be an amazing source of bleeding edge anecdata on all of this stuff.
Cream for skin is same thing but over the course of a day. Plus it’s crazy expensive.
Eventually decide it’s not worth it and start finding out why levels are low and try and fix underlying causes.
TRT forums are kind of fascinating because they're full of people who though (or, sadly, were convinced by TRT clinics) that TRT was going to be amazing, solve all of their problems, and make them feel like 20 year olds again.
Then the realities of getting your hormones from imperfect exogenous sources and dealing with all of the imperfect complications thereof set in. A lot of disappointed stories from people who feel marginally better but thought it was going to cure every struggle in their lives. Unfortunately, a lot of people with depression issues also end up in TRT clinics because hypogonadism is a more palatable diagnosis than mental health issues for many.
https://www.researchgate.net/figure/Multiple-dose-pharmacoki...
While we know all about esters, doctors think “lmao just give a 3 day half life every 14 days bro” which is why people like this end up screwed.
The worst is psych meds. They put people on monthly injections for anti-psychotics despite the fact that they clearly don’t last a month. Those patients then end up going insane for the last week of every month putting everyone at risk. Two week injections would solve it, but no. Monthly.
Medicine as a field just doesn’t seem to realise how much of a difference dosing interval makes. Whereas recreational users know because daily vs weekly is ridiculous obvious through side effects.
Your math is way off. A TRT dose of testosterone is going to be something like 70-125mg/week. A bodybuilding dose is going to be ~250-350mg/week (often used in conjunction with other compounds like Deca-Durabolin, Trenbolone, Primobolan, Anavar, etc).
An extremely aggressive bodybuilding regimen for a highly experienced anabolic steroid user is rarely going to clear 10x the total milligrams of all AAS compounds injected/ingested when compared to low-dose TRT.
Also, in any human regardless of age and sex, adding a typical TRT dose of testosterone to your system is definitely going to add immediate and noticeable muscle mass.
There are also a lot of secondary effects that people underestimate. For example, the extra testosterone (beyond normal levels) will result in excess estrogen, which can grow excess breast tissue in males. There are medications that can interrupt this process, but getting the dosage right is difficult and many people fluctuate around ideal values. Fluctuation and low estrogen values will cause significant mental health effects. Again, these are theoretical avoidable under perfect conditions yet almost everyone ends up with some of it eventually. I had a friend who tried using testosterone all the “right” ways with excessive lab tests, HCG, cycling, SERMs, AIs, and everything else. It still ended up destabilizing his mental health and making him prone to anger and bouts of sadness/crying. He denied it for a long time because he thought it couldn’t possibly be his by-the-book protocol, but eventually we got him to admit it was a problem. Denial runs deep.
Basically: Don’t go down this path unless you accept that it’s going to have significant downsides and consequences, many of which are long lasting or permanent. And definitely don’t dabble in taking testosterone or steroids as an early step in a weightlifting career or as a trial to see if it gives you a boost. The consequences can/will be permanent for the rest of your life.
Can, not will. You're right though to point out that the body loves homeostasis and will downregulate endogenous testosterone production if serum levels are high from supplementation. Testicular atrophy from extended use is a real potential problem.
Unfortunately, TRT clinics are like the Internet Viagra doctors: they are drug dealers with an MD.
If you have low testosterone then see an endocrinologist or a urologist for treatment. There are certainly cases where exogenous testosterone injections are indicated, but depending on the kind of hypogonadism in question there can be better alternatives that don't involve injections or infertility.
It's worth noting that the secular testosterone decline is not a "new normal," but rather basically every man in the West is suffering from some kind of hypogonadism. We can speculate about the causes, but the precipitous drops in average population serum testosterone levels measured over the past decades is anything but natural or normal.
> many of which are long lasting or permanent
True, but not all of the permanent effects are negative. Exogenous testosterone causes muscle cell nuclei to multiply, and there is a permanent anabolic effect as a result. It's nowhere near as dramatic as being on exogenous androgens, but it's still significant.
Any supplementation will, by definition, raise serum levels higher than they were before the extra testosterone was added.
This is what causes the downregulation, so of course it will happen. Like I said, people like to be in denial about this because it doesn’t necessarily happen right away, but it happens.
> True, but not all of the permanent effects are negative.
That’s a weird way of looking at it. Those extra muscle nuclei won’t be of much use if you discontinue TRT and your endogenous system is too atrophied to keep up with basic bodily needs. You have to look at the big picture.
Your comment is a good example of the denial I was talking about: For whatever reason, some people don’t want to believe that the negative effects will happen to them, and they want to ignore the consequences or change the subject to only talk about the positives.
Does this apply to Longfolia leaf (Tongkat Ali)?
No -- Tongkat and other naturally occurring compounds like Fadogia increase testosterone by stimulating the body's production of Luteinizing Hormone, which in turn spurs the testes to produce more testosterone.
If you want to know more about this, the Huberman Lab podcast has visited the topic several times. His view is that Tongkat and Fadogia are safe to take for long periods of time without interruption ("cruise") and he has stated that he himself takes them as a supplement.
Hypogonadism means the gonads don't produce enough testosterone naturally.
So yeah, if you give testosterone to a bunch of old, fat, unhealthy [1] men with hormonal problems, it might help them lose weight and keep them alive longer.
[1] No offense, just calling it like I see it
Adipose tissue also inhibits testosterone production. So anyone who has high body fat should reduce that.
If you were on TRT and wanted to restore fertility, it's a good way to do it. You probably wouldn't want to be on it permanently since it has some mood side effects due to it's estrogen blocking effects.
It’s difficult to quantify risk because the people who die are always celebrity coke heads. They tend to die during binge sessions where they’ve slammed 5g of cocaine and had 12 shots.
Steroids increase BP so you need to manage that and you can’t be doing things like cocaine or drinking. The more you take, the worse your BP. That and the cocaine will be the killer.
I’m yet to see anything obviously harmful about testosterone. Some of the drugs that have branched off it have signs of harm but that might be due to increased strength or changed structure.
People are talking about your penis shrinking or whatever. Your testes do shrink but it’s not permanent. You need to make sure all traces of the drugs are out of your body before the system will start back up and that’s where people get stuck. Some drugs have metabolites that can last years. Testosterone isn’t the same but still takes time depending on the half life of the form.
Ironically women have the easiest time of it. Their hormone system doesn’t care about testosterone so they can go on and off whenever they want. The downside for women is the androgenisation. They start growing facial hair, deepening their voice and enlarging their clit. That’s a dealbreaker for most women for obvious reasons so a woman would need to be seriously committed to this.
For men, having a thicker beard and masculine features is a good thing so that’s fine. It will accelerate your rate of hair loss though.
It affects your personality. You are happier, braver, more focused and more aggressive. You feel like the leader of the pack no matter how pathetic you are. That confidence might be good or bad for you. You’ll be a lot more likely to approach women because you are continously aroused. You may be more of a cunt.
In summary, like all things it is a trade-off. You might die, but you’ll be the best you could ever be at physical sport. If you don’t care about sport then that’s not a great trade. Some people do drugs at weekends and kill themselves for parties. Lots of people make trades. This isn’t a casual trade to make, you need to think it through.
Not to nitpick, but this actually isn't true. A lot of these women don't run testosterone, but do run PEDs like Anavar (oxandralone) or SARMs like Ostarine that have a very high anabolic-androgenic ratio.
> Their hormone system doesn’t care about testosterone so they can go on and off whenever they want.
Their hormone system does, in fact, care about testosterone. The difference, however, is that women naturally produce an infintesimally small amount amount of testosterone compared to men, so post-cycle effects and treatment protocols will be vastly different.
Women are allowed testosterone for menopause as well which is really bullshit. They can get it over the counter while a man faces deep scrutiny if his hormone levels have dropped with age.
The difference is that there aren't alternatives to GAHT for transgender people, while cis men routinely overestimate how much upping their low-normal testosterone levels might do for them, wanting to shut down their HPG axis when almost any other intervention starting from being physically active for 15 minutes more a day, would do more for them.