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<blockquote data-quote="Rand McClain DO" data-source="post: 89206" data-attributes="member: 90"><p>Hi Marco, I have not seen suppression of thyroid production with the use of L-carnitine. I have seen L-carnitine used to increase time to exhaustion in both novice and well-conditioned athletes. The MOA appears to be the preferential use of fat over glycogen for use as energy. If you are using thyroid replacement, you are overriding the need for endogenous production so supplements that are purported to affect your production should not be a concern. If you notice an increased need for thyroid replacement when using the supplement(s) (L-carnitine), I would simply increase the thyroid dose. Ie, you have already "crossed the line" of replacement therapy, so even if the supplement affected your endogenous thyroid, practically speaking, it does not affect anything except the strength of the pill you are already taking.</p><p></p><p>BPC-157 shows much promise in the repair of tendons. The rat studies are impressive and BPC-157's use in the humans that I know is equally impressive. I know bodybuilders and strength athletes ("Strongmen") who have used it successfully through daily dosing (usually 250 mcg either directly into the tendon or in a triangular pattern that straddles the tendon). I do not see as much success with TB500 for MSK injuries, but, as you note, these peptides are not within the scope of a US physician's practice, so my observations are just that and by chance rather than intent (mine anyway).</p><p></p><p>First and foremost, when it comes to TRT, the question is whether you have symptoms and signs of low T. The numbers (lab assays) are secondary (we treat people, not numbers). Libido, energy, sense of well-being are all personality driven in large part, so often times, ironically, those with the lowest T levels or who have had them the longest are the last to come seeking help because their personality has kept them going. And, patients often mistakenly compare themselves to others rather than a younger version of themselves when self-evaluating whether they have an issue. The "dead giveaway" more often than not is body composition changes. Personality (at least directly) does not drive one's body composition, and I typically see an athlete who knows how to and is doing all the right things but is struggling with body composition. That's when the low-T gets their attention. I understand the desire not to "throw in the towel", but I ask you to reconsider the way you look at it. If you would be served by testosterone replacement, why wouldn't you use it the same way you would use other means of helping yourself to feel, look and be better? Sure, it is one more thing you would be "dependent" upon, but no worse than having to train, eat, sleep, brush your teeth, shower, use the restroom, shave (maybe), etc.. Certainly, one thing we know for sure is that the situation is not going to get any better with time/age. In my experience, using a SERM may actually lead to some increase in endogenous production of T, but, assuming you do not have SE's from the SERM, the resultant T increase is inconsequential to quality of life. Ie, one doesn't feel or get an effect from the increase in T. It is fair for me to comment that certainly use of a SERM is "un-natural" and could be considered "throwing in the towel", so why not go straight to supplementation with something more effective (why fly from LA to SF via NY when you can take a straight shot from LA to SF?) (also, it's "natural" to get sick and die one day so I think we might agree that "natural" isn't necessarily all that it is cracked up to be). If you are intent on giving it a try however, then consider clomiphen citrate and/or hcg to get the endogenous production up and to see how you feel. If Clomid gives you unwanted SE's you could try anastrozole instead.</p></blockquote><p></p>
[QUOTE="Rand McClain DO, post: 89206, member: 90"] Hi Marco, I have not seen suppression of thyroid production with the use of L-carnitine. I have seen L-carnitine used to increase time to exhaustion in both novice and well-conditioned athletes. The MOA appears to be the preferential use of fat over glycogen for use as energy. If you are using thyroid replacement, you are overriding the need for endogenous production so supplements that are purported to affect your production should not be a concern. If you notice an increased need for thyroid replacement when using the supplement(s) (L-carnitine), I would simply increase the thyroid dose. Ie, you have already "crossed the line" of replacement therapy, so even if the supplement affected your endogenous thyroid, practically speaking, it does not affect anything except the strength of the pill you are already taking. BPC-157 shows much promise in the repair of tendons. The rat studies are impressive and BPC-157's use in the humans that I know is equally impressive. I know bodybuilders and strength athletes ("Strongmen") who have used it successfully through daily dosing (usually 250 mcg either directly into the tendon or in a triangular pattern that straddles the tendon). I do not see as much success with TB500 for MSK injuries, but, as you note, these peptides are not within the scope of a US physician's practice, so my observations are just that and by chance rather than intent (mine anyway). First and foremost, when it comes to TRT, the question is whether you have symptoms and signs of low T. The numbers (lab assays) are secondary (we treat people, not numbers). Libido, energy, sense of well-being are all personality driven in large part, so often times, ironically, those with the lowest T levels or who have had them the longest are the last to come seeking help because their personality has kept them going. And, patients often mistakenly compare themselves to others rather than a younger version of themselves when self-evaluating whether they have an issue. The "dead giveaway" more often than not is body composition changes. Personality (at least directly) does not drive one's body composition, and I typically see an athlete who knows how to and is doing all the right things but is struggling with body composition. That's when the low-T gets their attention. I understand the desire not to "throw in the towel", but I ask you to reconsider the way you look at it. If you would be served by testosterone replacement, why wouldn't you use it the same way you would use other means of helping yourself to feel, look and be better? Sure, it is one more thing you would be "dependent" upon, but no worse than having to train, eat, sleep, brush your teeth, shower, use the restroom, shave (maybe), etc.. Certainly, one thing we know for sure is that the situation is not going to get any better with time/age. In my experience, using a SERM may actually lead to some increase in endogenous production of T, but, assuming you do not have SE's from the SERM, the resultant T increase is inconsequential to quality of life. Ie, one doesn't feel or get an effect from the increase in T. It is fair for me to comment that certainly use of a SERM is "un-natural" and could be considered "throwing in the towel", so why not go straight to supplementation with something more effective (why fly from LA to SF via NY when you can take a straight shot from LA to SF?) (also, it's "natural" to get sick and die one day so I think we might agree that "natural" isn't necessarily all that it is cracked up to be). If you are intent on giving it a try however, then consider clomiphen citrate and/or hcg to get the endogenous production up and to see how you feel. If Clomid gives you unwanted SE's you could try anastrozole instead. [/QUOTE]
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