What is TRT and What is NOT TRT

[tareload]

convince you that testosterone is dangerous

Never said that. What I said and implied many times is your thinking and logical trainwrecks are dangerous. Hand waving seems to come to you naturally. Easy to do with your TOT Podcast crew. In the real world of scholarship it is not going to cut it.

 

[tareload]

Like I said tell it Abraham Morgenthaler, Mohair Kera, and Bhasin among others ... And yet you think yourself smarter than those men.

Your logical fallacies and ladder of interference is up there with Danny. Why did you guys actually split? Seem a perfect match.

Why can't your stay on the topic and debate the substance?

 

[Charliebizz]

No need it's a waste of time discussing anything with Joseph Hernshaw. No more wasted of time on here. If read a lot and Joseph Hearnshaw want to convince you that testosterone is dangerous then I'll leave you to listen to that. No need to try to prove otherwise. Abraham Morgenthaler and Bhasin among others including Mohit Kera disagree with Joseph Hearnshaw read a lot.

It’s actually not a waste of time. This debate can actually help tons of men. We almost need a moderator for the two of you guys though. Let’s start here.

@readalot what is your end game in the debate with @RobRoy. What are we trying to prove about trt And and it’s risks ? Because the traverse study you guys are citing doesn’t seem to have much relevance to the original topic of ”what is trt and what is not “

 

[tareload]

It’s actually not a waste of time. This debate can actually help tons of men. We almost need a moderator for the two of you guys though. Let’s start here.

@readalot what is your end game in the debate with @RobRoy. What are we trying to prove about trt And and it’s risks ? Because the traverse study you guys are citing doesn’t seem to have much relevance to the original topic of ”what is trt and what is not “

1. Elevated Hct (erythrocytosis secondary to TRT) completely harmless. No mention of any limit or any ceiling. It is just more oxygen in the blood. Why do these guys never EVER tie together plasma viscosity + Hct yields whole blood viscosity. Think you better understand your individual patient's inflammation and plasma proteins before telling him an Hct of 58% is great?

2. Elevated E2. Same. Let it go wherever it wants. No concerns.

3. SUPRAPhysiologic Testosterone dosing is not only fine it is actually required nowadays for men to properly benefit from TRT. Full stop. Think about this statement.

4. Supraphysiologic fT3 levels are needed. Optimal fT3 levels are the top quartile at least. WTF?

5. DHT blah blah ditto. No risks here.

Let's start there. If you have been following along @Charliebizz these are the big ones over last 5 years here and on TNation.

Never any measure of caution or safety margin. Just blanket statements and hand waving. And then when a patient has a stroke, DVT, PE, high BP there is always an excuse. Does not seem like a great way to establish a standard of care.

Surely you have seen the debate between Saya and RobRoy a while back. There is nothing new here actually. The logic is "I state it hence it must be so". No room for individual variability and case by case prudence. You can see the disdain and ridicule the TOT crew had for the "puny" intervention done in the TRAVERSE trial on their podcast and they mimic their God Rouzier and his "cute" little comments about a little bit of AI and little bit of T blah blah. I can tell you a FT of 20-30 ng/dl is not going to be wise for some patients. Why won't you concede this @RobRoy?

Why do you continue with all the blatant macho shit? A responsible medical practicioner with clinical experience would conclude you are retarded or reckless.

 

[Charliebizz]

1. Elevated Hct (erythrocytosis secondary to TRT) completely harmless. No mention of any limit or any ceiling. It is just more oxygen in the blood.

2. Elevated E2. Same. Let it go wherever it wants. No concerns.

3. SUPRAPhysiologic Testosterone dosing is not only fine it is actually required nowadays for men to properly benefit from TRT. Full stop.

4. Supraphysiologic fT3 levels are needed.

5. DHT blah blah ditto. No risks here.

Let's start there. If you have been following along @Charliebizz these are the big ones over last 5 years here and on TNation.

Never any measure of caution or safety margin. Just blanket statements and hand waving. And then when a patient has a stroke, DVT, PE, high BP there is always an excuse. Does not seem like a great way to establish a standard of care.

Surely you have seen the debate between Saya and RobRoy a while back. There is nothing new here actually. The logic is "I state it hence it must be so". No room for individual variability and case by case prudence. You can see the disdain and ridicule the TOT crew had for the "puny" intervention done in the TRAVERSE trial on their podcast and they mimic their God Rouzier and his "cute" little comments about a little bit of AI and little bit of T blah blah. I can tell you a FT of 20-30 ng/dl is not going to be wise for some patients. Why won't you concede this @RobRoy?

Why do you continue with all the blatant macho shit? A responsible medical practicioner with clinical experience would conclude you are retarded or reckless.

laid Out like that I would love for @RobRoy to answer each of those questions/statements with an in-depth response. And leave the name calling and bullshit out.

 

[Charliebizz]

1. Elevated Hct (erythrocytosis secondary to TRT) completely harmless. No mention of any limit or any ceiling. It is just more oxygen in the blood.

2. Elevated E2. Same. Let it go wherever it wants. No concerns.

3. SUPRAPhysiologic Testosterone dosing is not only fine it is actually required nowadays for men to properly benefit from TRT. Full stop.

4. Supraphysiologic fT3 levels are needed.

5. DHT blah blah ditto. No risks here.

Let's start there. If you have been following along @Charliebizz these are the big ones over last 5 years here and on TNation.

Never any measure of caution or safety margin. Just blanket statements and hand waving. And then when a patient has a stroke, DVT, PE, high BP there is always an excuse. Does not seem like a great way to establish a standard of care.

Surely you have seen the debate between Saya and RobRoy a while back. There is nothing new here actually. The logic is "I state it hence it must be so". No room for individual variability and case by case prudence. You can see the disdain and ridicule the TOT crew had for the "puny" intervention done in the TRAVERSE trial on their podcast and they mimic their God Rouzier and his "cute" little comments about a little bit of AI and little bit of T blah blah. I can tell you a FT of 20-30 ng/dl is not going to be wise for some patients. Why won't you concede this @RobRoy?

Why do you continue with all the blatant macho shit? A responsible medical practicioner with clinical experience would conclude you are retarded or reckless.

serious question. Did we get a definitive answer out of the saya vs rob roy debate on serum levels of dht ? I’m personally running cream and my dht is way above top of range. I have zero of the side effects of “high dht”. I know that doesn’t mean I won’t have any long term health issues from it. But if it was truly a problem wouldn’t I get even the hint of a side effect ?

 

[SteveCleves]

I would actually love to see these 5 points directly addressed on the next tot roundtable. @RobRoy
No name calling, etc. just go through each 5. It’s got to be better than jay and Kominiarek talking politics.

 

[Charliebizz]

I would actually love to see these 5 points directly addressed on the next tot roundtable. @RobRoy
No name calling, etc. just go through each 5. It’s got to be better than jay and Kominiarek talking politics.

I have seen him answer most of these questions in all his podcasts ans online. The fact of the matter is I don’t think you can “prove“ a damn thing one way or the other because nobody is running these studies the way we need them to be ran to come to a conclusion that there is no risk.

 

[tareload]

I have seen him answer most of these questions in all his podcasts ans online. The fact of the matter is I don’t think you can “prove“ a damn thing one way or the other because nobody is running these studies the way we need them to be ran to come to a conclusion that there is no risk.

You can use your brain, fundamentals we know. Hence, when there is uncertainty...what is in order?

Caution and margin of safety. Not blanket statements giving the incorrect message of 100% certainty because I said so.

That is the funny thing about morbidity and mortality with cardiovascular disease. A guy found dead or laid up in the hospital is not going to have the message "TOT" killed him / hurt him although the case studies and anecdotes of bodybuilders should give one pause. That is the extreme end. No, the signs of premature death from too much T, too much Hct, too much Hct will be subtle. Wear and tear.

I am using more T than I need right now. What is my point? Make sure you weigh the pros and cons for yourself. There are cons. That was my motivation for starting this thread in the first place.

We are dealing with a continuous variable space with cumulative androgen intake. Watch your blood pressure, resting heart rate, heat rate recovery.

 

[tareload]

The fact of the matter is I don’t think you can “prove“ a damn thing one way or the other because nobody is running these studies the way we need them to be ran to come to a conclusion that there is no risk.

And to their [TOT Land] credit Danny did mention one time when he was still friendly with RobRoy that they concede they have no idea the long term ramifications of this modestly large uncontrolled experiment they are running in their practices. Something like "we can't tell you there is no long term harm." The old me would go find it on TNation but now that they have banned me I can't access it and I sure ain't making another account.

So RobRoy agrees; he just ought to come out and make it explictly clear for guys who are considering or actively pursuing that that path.

 

[tareload]

Shear stress and plaque development

Although traditional cardiovascular risk factors ‘prime the soil’ for atherogenesis systemically, atherosclerosis primarily occurs in a site-specific manner with a predilection towards the inner wall of curvatures and outer wall of bifurcations ...

www.ncbi.nlm.nih.gov

The definition of low wall shear stress and its effect on plaque progression estimation in human coronary arteries - Scientific Reports

Wall shear stress (WSS), the frictional force of the blood on the vessel wall, plays a crucial role in atherosclerotic plaque development. Low WSS has been associated with plaque growth, however previous research used different approaches to define low WSS to investigate its effect on plaque...

www.nature.com

Wall shear stress and its role in atherosclerosis

Atherosclerosis (AS) is the major form of cardiovascular disease and the leading cause of morbidity and mortality in countries around the world. Atherosclerosis combines the interactions of systemic risk factors, haemodynamic factors, and biological factors, in which biomechanical and...

www.frontiersin.org

Summary and prospect​

In summary, WSS plays an important role in the occurrence and development of atherosclerosis. The complex blood flow in arteries forms rich WSS vectorial features (99), including the newly proposed WSS topological skeleton to identify and classify the WSS fixed points and manifolds in complex vascular geometries. CFD modeling represents one of the attempts to simulate these complex hemodynamic conditions to investigate the impact of WSS on atherosclerosis. Low WSS is the factor of early plaque formation, and high WSS promotes the transformation of plaque to high-risk phenotype, that is, low WSS induces the occurrence and development of plaque, while high WSS is related to plaque instability. WSS acts as a link between blood flow dynamics and the biology of various cardiovascular diseases (99). Low WSS and high WSS are involved in the loss of physiological flow alignment of endothelial cells, the increase of low-density lipoprotein accumulation, the proliferation and apoptosis of smooth muscle cells, the high expression of inflammatory factors and adhesion molecules, and the abnormal activation of platelets, which promote the occurrence and development of atherosclerosis. Overall, WSS can potentially provide insight into the onset of initial lesions and progression to more advanced lesions, playing a crucial role in regulating hemodynamically directed atherosclerotic vascular disease. Understanding the detailed mechanisms by which WSS regulates hemodynamically directed vascular disease will help us elucidate the pathogenesis of atherosclerosis and develop potential therapeutic strategies for atherosclerosis, as shown in Figure 2. The current clinical detection methods can assist in the secondary prevention after the occurrence of lesions, while more prognostic research is needed in the primary prevention process. The regulatory role of WSS in atherogenesis remains to be investigated. Combining clinical imaging techniques with CFD allows for detailed examination of local morphological and biomechanical characteristics of atherosclerotic lesions to identify more effective WSS-based hemodynamic indicators, so as to close the gap of knowledge currently limiting the use of WSS as a bio-marker for diagnostic and prognostic purposes. Ultimately, WSS will be used as a biomarker of vascular status and atherosclerotic lesion burden to identify early plaque and monitor plaque stability, and provide a rationale for a paradigm shift towards pre-emptive treatment strategies.

What are the odds we can get governance boards to approve a 5 year RCT with the treatment arm being Hct above 58% from testosterone intervention? Should learn some things. Make sure we properly characterize whole blood viscosity. Let's also make sure all the participants have a BMI above 35 just for some real fun.

What do you think @RobRoy? You game?

 

[FunkOdyssey]

4. Supraphysiologic fT3 levels are needed. Optimal fT3 levels are the top quartile at least. WTF?

There seems to be a live fast, die fast relationship with thyroid hormone. In every study I've seen that looks at thyroid levels and longevity, people with low-normal levels or even subclinical hypothyroidism seem to live the longest compared to those with high levels.

 

[SteveCleves]

Multiple studies revealed a reduction in atrial fibrillation as well as arrhythmias with testosterone therapy. Testosterone therapy has not been shown in any randomized controlled trial to increase the risk of venous thromboembolism and in fact multiple studies as well as systematic reviews and meta-analysis have not shown any association between testosterone use and VTE. Long-term testosterone therapy has also been shown to improve renal function and delay progression of chronic kidney disease.

Were any of these studies of non clinically hypogonadal men who then had their T levels raised to Supra physiological levels? That’s what “non woke” TRT is right? Take T without any worry about the ultimate end point t levels as long as symptoms are resolved? Has that ever been studied?

Mind you, I’m not at all saying that it is not safe. Not at all. It may very well be completely safe. But we have absolutely no hard data to back that position up. It seems like what we have are studies of hypo gonadal men who are given main stream treatments and the results of those studies are extrapolated out. Rational and meaningful questions like the ones readalot raised are dismissed by appeals to authority or by claiming absence of evidence is evidence of absence(appeal to ignorance).

IMO, The only TRT influencer(for lack of a better term) that seems to sanely handle this is the anabolic doctor. Who freely admits the unknowns of TRT and who constantly talks about the measures he follows and that he suggests people follow to mitigate risks etc. I would imagine he’s said “guys we just don’t know about this” more in one video than most others have said in all of their videos combined.

 

[tareload]

There seems to be a live fast, die fast relationship with thyroid hormone. In every study I've seen that looks at thyroid levels and longevity, people with low-normal levels or even subclinical hypothyroidism seem to live the longest compared to those with high levels.

Of course. But it takes a high IQ individual like yourself to realize this. There is no free lunch; pay and pay dearly for performance.

Cue the exergy/availability balance discussion you will never hear on TOT Roundtable. That is pussy communist sh*t.

I think my sarcasm is getting to be a little much. Sorry I will tone it down but the flippant nature of the way these people deal with this stuff and people's health infuriates me.

And I guess you are only partially right about me @FunkOdyssey. I am firmly in supra land the last few months and I am still pissed. So it must not be jealousy just I am a sensitive asshole. Note to self to check my E2 soon.

 

[Charliebizz]

Of course. But it takes a high IQ individual like yourself to realize this. There is no free lunch; pay and pay dearly for performance.

Cue the exergy/availability balance discussion you will never hear on TOT Roundtable. That is pussy communist sh*t.

I think my sarcasm is getting to be a little much. Sorry I will tone it down but the flippant nature of the way these people deal with this stuff and people's health infuriates me.

And I guess you are only partially right about me @FunkOdyssey. I am firmly in supra land the last few months and I am still pissed. So it must not be jealousy just I am a sensitive asshole. Note to self to check my E2 soon.

I get your point and I feel the same way. but also can be some merit to The theories of cellular resistance and the serum not reflection what’s going on in the tissues. the fact is we haven’t been able to prove that and prove that doing that will “do no harm”. I think that part of your argument keeps getting lost in translation on the “tot” camps side

 

[Charliebizz]

Of course. But it takes a high IQ individual like yourself to realize this. There is no free lunch; pay and pay dearly for performance.

Cue the exergy/availability balance discussion you will never hear on TOT Roundtable. That is pussy communist sh*t.

I think my sarcasm is getting to be a little much. Sorry I will tone it down but the flippant nature of the way these people deal with this stuff and people's health infuriates me.

And I guess you are only partially right about me @FunkOdyssey. I am firmly in supra land the last few months and I am still pissed. So it must not be jealousy just I am a sensitive asshole. Note to self to check my E2 soon.

Sorry for how bad my sentence structure and grammar is. My phone has gotten wet and my Screen isn’t functioning correctlu

 

[tareload]

think that part of your argument keeps getting lost in translation on the “tot” camps side

Good point. Good news is that the course they need to start with is free online now:

Syllabus | Chemical Engineering Thermodynamics | Chemical Engineering | MIT OpenCourseWare

MIT OpenCourseWare is a web based publication of virtually all MIT course content. OCW is open and available to the world and is a permanent MIT activity

ocw.mit.edu

@Nelson Vergel can give you some good stories I bet.

Then you can dig a little deeper...

https://web.mit.edu/2.813/www/Class%20Slides%202012/Exergy.pdf

A Thermodynamic Measure of Sustainability

A novel thermodynamic approach to the quantification of the “degree of sustainability” is proposed and discussed. The method includes a rigorous -and innovative- conversion procedure of the so-called externalities that leads to their expression in terms of the exergy of their equivalent primary...

www.frontiersin.org

 

[SteveCleves]

And I guess you are only partially right about me @FunkOdyssey. I am firmly in supra land the last few months and I am still pissed. So it must not be jealousy just I am a sensitive asshole. Note to self to check my E2 soon.

Drop the a-bombs you’re raging bro.

 

[tareload]

Drop the a-bombs you’re raging bro.

Debating the stanozolol next. Not man enough for the a-bombs.

 

[Charliebizz]

Debating the stanozolol next. Not man enough for the a-bombs.

The thing that also gets lost in translation is when body building is brought up. most Guys that have long term complications, strokes and heart attacks are messing with various compounded. And even if they are running just test only cycles most of them are nuking estrogen levels with a.I. so Really in the body building world how many guys are dropping dead from test only cycles.? I’m genuinely asking