Testosterone, The Male Hormone Connection: Treating Diabetes and Heart Disease

Testosterone may help reduce Lp(a), a marker known to increase CHD:
http://www.worldhealth.net/pdf/bookstore/thera6_ch7.pdf

Conflicting study:
Suppression of Endogenous Testosterone in Young Men Increases Serum Levels of High Density Lipoprotein Subclass Lipoprotein A-I and Lipoprotein(a):
http://jcem.endojournals.org/content/82/10/3367.full

It looks like in the suppression study they used a GnRH antagonist to drop T production. I wonder if the decrease in T with subsequent increase in Estrogen caused the increase in HDL? As we know, when Estradiol is too low it can affect cholesterol.

jbruce said:

As we know, when Estradiol is too low it can affect cholesterol.

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Thanks for bringing this up!

In my case, I have low free T (10) and low E2 (5). LDL-P is elevated as is Lp(a), sdLDL-P and APOB. HDL is low normal (43). Not a good profile. Have already taken all the known steps (low carb, niacin, omega 3s, berberine, guggul, etc.) I did not think to consider E2's effect on lipids. It appears sufficient E2 will raise HDL and lower LDL, but too much will cause thrombosis:
http://my.clevelandclinic.org/heart/prevention/estrogen-hormones/default.aspx

This is where TRT would help kill two birds with one stone as long as I again manage H/H and don't allow too much aromatization (I could actually use some now).

But more confounding is that we know exo T raises LDL-C and lowers HDL-C, but do we know if it raises the good (large particle) LDL or bad (small)?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069573/

"In men, neither DHEA nor testosterone affected LDL or HDL particle concentrations.":
http://www.ncbi.nlm.nih.gov/pubmed/20139233

Marco, I wonder why you are not on TRT. I am sure you have good reasons since you are well researched. Clotting or thrombosis concerns?

Check out this thread, Nelson, it will answer your question:

https://www.excelmale.com/forum/thr...isk-of-cardiovascular-events-is-TRT-warranted

Nelson Vergel said:

Marco, I wonder why you are not on TRT. I am sure you have good reasons since you are well researched. Clotting or thrombosis concerns?

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Thrombosis is the biggest concern. For all the benefits I could derive from TRT that become more evident daily, it's studies like these that keep me awake at night preventing me from moving forward:
http://www.ncbi.nlm.nih.gov/pubmed/23925401
http://www.jewishhospitalcincinnati.com/cholesterol/Research/naseer-urology.html
http://cat.sagepub.com/content/early/2013/04/23/1076029613485154.abstract

"If the prevalence of major gene thrombophilias in the general population of Caucasians is ~20%, then a signficant percentage of the population is at risk for thrombotic events when given exogenous testosterone, usually deep venous thrombosis-pulmonary embolus-osteonecrosis. The cost of hospitalization (and who can adequately estimate cost of premature death) for these disorders is usually $50,000 +. Assuming that there are 10 hospitalizations per year for DVT-PE-osteonecrosis, total cost ~$500,000, which would pay for 1,000 screenings of men before testosterone, for Factor V Leiden, Prothrombin gene, Factors VIII and XI, and homocysteine. As physicians, above all, we are taught to do no harm. Screening before giving testosterone is not only ethical, but probably cost-effective in preventing otherwise serious morbidity and mortality."

But then, here are some good ones:
http://www.ncbi.nlm.nih.gov/pubmed/8228555
http://www.ncbi.nlm.nih.gov/pubmed/8844628

Conflicting evidence makes the procrastination to take the plunge worse.
http://www.ncbi.nlm.nih.gov/pubmed/18591887


Thus far, we have found no evidence of a clear genetic component to my clotting disorder, but that doesn't mean there isn't one. As I mentioned in another post, I think there may be some as-yet unknown chronic infection/immune system inflammation that is causing a hypercoagulable state so I am looking into this again.

From my research, it appears that T is both pro and antifibrinolytic depending on many factors, dose being one. It seems to be a mediator. I'm sure there are plenty of men on anticoagulants and TRT long term and have had no incidents of clotting.


Other than management of H/H, isn't the REAL problem with TRT and clotting elevated E2????

Marco, you are an interesting case indeed. I am interested to observe your next step as, aside from the clotting concerns, you would certainly be a good candidate for TRT.

Regarding your question: "But more confounding is that we know exo T raises LDL-C and lowers HDL-C, but do we know if it raises the good (large particle) LDL or bad (small)?"- I believe that lipids are negatively affected by exo T when taking superphysiological doses. I know that after starting TRT myself, my lipids improved significantly. HDL is the highest it has ever been, and my LDL is always on the lower end. I do not currently take fish oils (for no reason other than I am a minimalist when it comes to supplementation). I am not sure regarding the particle size and which one is affected but this would indeed be interesting to research. I think I would be more worried about the Low E versus high-normal T when it comes to cholesterol. To be conservative you can aim for 700-800ng total T with hopefully a significant increase in Free T to get you right.

I have the same problem with low E, I tested at 9pg (Estradiol) and this was without taking anastrozol which I discontinued.

jbruce said:

Marco, you are an interesting case indeed. I am interested to observe your next step as, aside from the clotting concerns, you would certainly be a good candidate for TRT.

Regarding your question: "But more confounding is that we know exo T raises LDL-C and lowers HDL-C, but do we know if it raises the good (large particle) LDL or bad (small)?"- I believe that lipids are negatively affected by exo T when taking superphysiological doses. I know that after starting TRT myself, my lipids improved significantly. HDL is the highest it has ever been, and my LDL is always on the lower end. I do not currently take fish oils (for no reason other than I am a minimalist when it comes to supplementation). I am not sure regarding the particle size and which one is affected but this would indeed be interesting to research. I think I would be more worried about the Low E versus high-normal T when it comes to cholesterol. To be conservative you can aim for 700-800ng total T with hopefully a significant increase in Free T to get you right.

I have the same problem with low E, I tested at 9pg (Estradiol) and this was without taking anastrozol which I discontinued.

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With me, nothing can ever be simple when it comes to my health. It never has been and never will be. Part of that is because I'm a typical Type A OCD that wants control of everything and has to know everything! The only good part of that is that maybe some of my knowledge will rub off on others and help them.

I was recently taking calcium-d-glucarate and stopped a week ago as it is known to decrease estrogen. Am retesting E2, FT, TT, tomorrow to see if it makes a difference.

I am taking a boatload of natural anticoagulants (bromelain, lumbrokinase, nattokinase, papain, krill & fish oil, ginkgo, etc.). At this point, I am on hold pending the outcome of various immune and infectious disease testing to determine a link to a coagulable state. If so, then I would looking into treating it with antimicrobials + pharmaceutical anticoagulants (i.e. heparin). With a anticoagulant med, at least there would be some insurance when on TRT. I could then do a trial of TRT at half the prescribed dose of 200mg/week, monitor every 2 weeks (CBC, CMP, hormone profile, coagulation panels), do TPs, and evaluate from there.

i tend to have unusual medical issues around medications as well.. all i know is i am taking a very small dose of testo and my hdl dropped from mid 40's down to 28.. when that occurred i was only taking 20mg a week.. i am a female bodied person so that is why such a low dose..but i feel better actually on a higher dose..but am too paranoid to increase the injections.. yet i did find with the compounded gel my HDL didnt drop nearly as much as with the low dose injections..and oddly my testo levels where higher with the gel without the drastic HDL side effect.. wondering Marco if you might get benefit from gel without as many of the risks? can they measure your clotting factors before and after to see what the impact is?

Brooksy Chuck said:

i tend to have unusual medical issues around medications as well.. all i know is i am taking a very small dose of testo and my hdl dropped from mid 40's down to 28.. when that occurred i was only taking 20mg a week.. i am a female bodied person so that is why such a low dose..but i feel better actually on a higher dose..but am too paranoid to increase the injections.. yet i did find with the compounded gel my HDL didnt drop nearly as much as with the low dose injections..and oddly my testo levels where higher with the gel without the drastic HDL side effect.. wondering Marco if you might get benefit from gel without as many of the risks? can they measure your clotting factors before and after to see what the impact is?

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Thanks to you, just started BERGAMET MEGA to help raise HDL. http://www.bergamet.com/
I am thinking (and hoping) the opposite for me - that the low free T and E2 is causing my dyslipidemia and may even have a hand in my coagulation issues. This is going to be a real experiment and lots of monitoring. I would start with an injectable so as to be able to measure an exact amount for each dose. Would never consider any other entry method unless a last resort. Have you tried the Bergamet product yet?

yes i started on some bergamot last friday. i was taking niacin and had a dr I trust tell me he was taking it in the past.. the funny thing is he said it will alter your numbers but studies show it only alters the numbers it doesnt stop the plaque.. he said niacin can also cause gout..which is the last thing i need! so i stopped the niacin ad staying on the bergamot.. i am not taking the bergamet though.. maybe i should have gotten that one.. i just ordered jarrows bergamot it was a bit more cost effective for me. it would be great if the T helps your lipids! seems to work for alot of folks and that is cool! i guess for alot of transpeople the HDL takes a dive and no one knows the real deal with this- it's a drag but like you said things are a real experiment and lots of monitoring! we can compare notes about the bergamot any reason you decided to order the brand name ?

i would really like to take about 40 to 50mg a week of IM or sq testo.. that would be fun for me! but i am being a bit cautious and frustrated- i hope you need what you need Marco!

Brooksy Chuck said:

yes i started on some bergamot last friday. i was taking niacin and had a dr I trust tell me he was taking it in the past.. the funny thing is he said it will alter your numbers but studies show it only alters the numbers it doesnt stop the plaque.. he said niacin can also cause gout..which is the last thing i need! so i stopped the niacin ad staying on the bergamot.. i am not taking the bergamet though.. maybe i should have gotten that one.. i just ordered jarrows bergamot it was a bit more cost effective for me. it would be great if the T helps your lipids! seems to work for alot of folks and that is cool! i guess for alot of transpeople the HDL takes a dive and no one knows the real deal with this- it's a drag but like you said things are a real experiment and lots of monitoring! we can compare notes about the bergamot any reason you decided to order the brand name ?

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We are all lab rats! The Bergamot I got I researched and is supposedly the exact formulation used in the research and has the higher % of the extract per serving than anyhere else. We'll see. Been down this path before with no results on other stuff.

Whoever finds a no pharmaceutical, no flushing, no liver dysfunction HDL boosting supplement will make lots and lots of money.

crossing our fingers it works! i dont care about the money. i just want good health and happiness.. and i guess those dont really come in pills, huh?