Blood panel, how's mine look?

[Vince]

That smoking analogy is only meant to highlight that a possible risk factor should not be dismissed just because causality is not yet established.

Testosterone levels are associated with a U-shaped mortality curve in some studies, particularly in men. Research indicates that both low and high serum testosterone levels are linked to increased all-cause mortality, while mid-range levels are associated with lower risk. For example, a 2011 study in the Journal of Clinical Endocrinology & Metabolism found that men with testosterone levels in the lowest and highest quartiles had higher mortality rates compared to those in the middle quartiles, with low testosterone linked to cardiovascular and metabolic issues, and high levels potentially tied to other risks like prostate issues or behavioral factors. [Grok]​

You are fortunate that basic TRT works well for you. Don't lose sight of the fact that many are not so lucky. You can help the ones who are stuggling by encouraging a low-and-slow approach. There's little to lose and much to gain.

I agree that twice-weekly TC injections appears to be a relatively successful protocol. Interestingly, Xyosted probably offers similar variation in serum testosterone with once-weekly injections due to its half-life being about double that of generic TC.

It turned out to be rather simple. When androgen levels are low, the androgen receptor is encouraged to “go solo” in the cell. In doing so, it activates the pathways that cause cancer cells to grow and spread. However, as androgens rise, the androgen receptors are forced to “hang out as a couple,” creating a form of the receptor that halts tumor growth.

 

[Vince]

AI Overview
When androgen levels are low, androgen receptors act as solo molecules, promoting cancer cell growth and spread. However, as androgen levels rise, the receptors form pairs, creating a form that inhibits tumor growth. This mechanism explains why, paradoxically, high androgen levels can be beneficial in treating certain advanced prostate cancers.

Here's a more detailed explanation:

• Low Androgen Levels:
  In the absence of sufficient androgens, the androgen receptor functions as a single unit, activating pathways that encourage cancer cells to proliferate.
• High Androgen Levels:
  When androgen levels increase, androgen receptors pair up (dimerize). This dimerization leads to a change in the receptor's activity, shifting its function from promoting cancer cell growth to inhibiting it.
• Bi-Polar Androgen Therapy (BAT):
  This treatment approach leverages this mechanism. By administering high-dose testosterone injections, BAT forces the receptors to dimerize, potentially halting or slowing down tumor growth in advanced prostate cancer.
• Clinical Significance:
  Understanding this paradoxical effect of androgens on prostate cancer is crucial for developing effective therapies. It explains why, in some cases, reducing testosterone (hormone therapy) can initially be beneficial, while in others, increasing testosterone (BAT) can be more effective, according to some studies.

 

[Vince]

Just had this picture taken of me at work.

 

[Cataceous]

I also see that early on I was using Androgel and measured TT ~600 ng/dL and E2 ~20 pg/mL, an even lower rate of aromatization, perhaps due to the DHT.

How did this feel? I would think this, with some daily hCG added to bump the numbers up a little and fill in some gaps, ought to be a decent protocol for you.

The Androgel experience ended up being poor, primarily due to absorption issues. After that decent TT measurement the next one was 160 ng/dL. Even as a trough value that's not viable. Injections were an improvement, yet far from "the answer".

Admittedly one of the few things I've haven't tried is a low daily dose of hCG. This would better mimic normal LH background levels, yet it ignores the LH pulses seen in normal physiology. In any case, I strongly suspect that some of us also need our GnRH signaling, maybe kisspeptin as well, and possibly other things not even on the radar yet.

 

[Guided_by_Voices]

The Androgel experience ended up being poor, primarily due to absorption issues. After that decent TT measurement the next one was 160 ng/dL. Even as a trough value that's not viable. Injections were an improvement, yet far from "the answer".

Admittedly one of the few things I've haven't tried is a low daily dose of hCG. This would better mimic normal LH background levels, yet it ignores the LH pulses seen in normal physiology. In any case, I strongly suspect that some of us also need our GnRH signaling, maybe kisspeptin as well, and possibly other things not even on the radar yet.

If one has both HCG and Kisspeptin on hand, is there a case for alternating them by injecting each once per week? Are they potentially doing similar but slightly different and complimentary/synergistic things?

 

[Vince]

The idea of a U-shaped relationship for longevity is being refined, the current understanding suggests that low testosterone levels are associated with a greater risk of mortality, particularly from cardiovascular disease, while the evidence for increased risk at the higher end of the physiological range is less clear and potentially less pronounced.

Feature Article: May-June 2024 - New Study Linking Low Testosterone to Premature Death in Males - Age Management Medicine Group (AMMG)

Feature Article: May-June 2024 - New Study Linking Low Testosterone to Premature Death in Males

agemed.org

 

[Systemlord]

A one-size-fits-all approach is a doctor who gives all his patients 140 mg TC per week right from the start. And from there his plan is bloodletting to control cases of high hematocrit and AIs to address symptoms of high estradiol. This results in unnecessary suffering by many of his patients. The better approach is to start with 60-80 mg TC/week and titrate as needed. The creators of Xyosted understand this. But others still yield to more-is-better thinking. You are defending the indefensible.



Ok, this is amusing. I haven't had anxiety since around when I started TRT—perhaps one of the biggest benefits of all this hormonal tinkering.

Let me be blunt. You are well-meaning and trying to be helpful, but your posts tend towards vapidity. Many are along the lines of "Here is my protocol and I do great on it." The problem with this is that because you are a moderator your posts carry more weight with newcomers than they should. They encourage men to bypass the low-and-slow approach. "Well if Vince says it's good then why waste time trying lower doses?" Meanwhile I'm trying as hard as I can to counteract this: "Wait a minute, many guys fare much better with physiological doses. Read some of their stories. With this in mind, why not start low and raise the dose only if needed?"



And the cigarette companies used to say "It's only an association. There's no proof they cause cancer."

Is high HCT unhealthy? What about high estradiol? Is it healthy to use AIs to address symptoms of high estradiol? I think it's pretty safe to say that for most men supraphysiological testosterone is less healthy overall than in-range testosterone. The exceptions might include those whose insecurities compel them to maximize musculature; the stress of untreated body dysmorphic disorder could be worse than high testosterone.

Leg strength is linked to longevity. So if higher testosterone dose gives you more strength in your legs….

I have 50% more leg strength with above normal testosterone. You talk about using AI’s, I need no such intervention.

I guess it comes down to genetic lottery.

 

[Cataceous]

If one has both HCG and Kisspeptin on hand, is there a case for alternating them by injecting each once per week? Are they potentially doing similar but slightly different and complimentary/synergistic things?

I'd say it's better to use them concurrently, at least as adjuncts to TRT; they should be strictly complementary. The reasoning is that kisspeptin provides both kisspeptin and GnRH signaling. Negative HPTA feedback affects kisspeptin production more than its action, meaning exogenous kisspeptin should lead to GnRH production even under TRT. Gonadotropin-inhibitory hormone is a possible complication, though its scope is limited and it may have more to do with a starvation response. Under TRT there is also substantial negative feedback from estradiol at the pituitary. This suppresses the production of LH and FSH even with adequate GnRH. Therefore you will not have LH signaling unless you either: 1) manage to have very large GnRH pulses—overwhelming estradiol's negative feedback, as seen in the work of Royal Medical Center; or 2) take a SERM such as enclomiphene to block the inhibitory action of estradiol; or 3) use hCG.

 

[Cataceous]

...
We have a large body of clinical research that has identified benefits of TRT, and has not identified problems associated with HPTA shutdown besides infertility and testicular atrophy. I don't doubt that some men experience subtle or even not-so-subtle issues, but they have yet to show up in research that would cause the world to take it seriously. ...

Coincidentally the main forum page currently has threads by @madman highlighting research with cautionary statements about the effects of androgens on the brain. It might be argued that a lot of this applies only to doses well in excess of the 100-200 mg TC per week that I complain about. However, if integrated exposure is a risk factor then the men on these doses for 10-20+ years could be looking at problems.

* Over time and with exposure to supraphysiological doses of anabolic steroids, there are consequent neurophysiological changes (such as amygdala hypertrophy and alterations in the limbic system), leading to psychological reflexes that cause users to suffer from side effects related to sexual function, such as changes in libido. [R]​

Supraphysiological doses of androgens have been shown to contribute to neurodegeneration, decreased brain-derived neurotrophic factor, increased inflammation, and decreased neuronal density in animal studies, which may correspond to changes in mood, cognition, and aggression. Findings from human studies suggest that similar behavioral and cognitive deficits may occur as a result of prolonged use of androgens. Additional evidence suggests that androgen use, particularly in high doses, may contribute to brain aging and cerebrovascular problems.[R]​

 

[Vince]

Coincidentally the main forum page currently has threads by @madman highlighting research with cautionary statements about the effects of androgens on the brain. It might be argued that a lot of this applies only to doses well in excess of the 100-200 mg TC per week that I complain about. However, if integrated exposure is a risk factor then the men on these doses for 10-20+ years could be looking at problems.

* Over time and with exposure to supraphysiological doses of anabolic steroids, there are consequent neurophysiological changes (such as amygdala hypertrophy and alterations in the limbic system), leading to psychological reflexes that cause users to suffer from side effects related to sexual function, such as changes in libido. [R]​

Supraphysiological doses of androgens have been shown to contribute to neurodegeneration, decreased brain-derived neurotrophic factor, increased inflammation, and decreased neuronal density in animal studies, which may correspond to changes in mood, cognition, and aggression. Findings from human studies suggest that similar behavioral and cognitive deficits may occur as a result of prolonged use of androgens. Additional evidence suggests that androgen use, particularly in high doses, may contribute to brain aging and cerebrovascular problems.[R]​

Thanks for the reply.

The study you're referring in 2011 was using Androgel. Androgel, T level usually peek at over 1000 ng/dL. That's what they are considering a medium range? Definitely need a real study. Not one just using Androgel.

I really don't believe any members are using 200 mg of testosterone weekly. That would be considered a very extreme amount of testosterone.

 

[Cataceous]

...
The study you're referring in 2011 was using Androgel. ...

I really don't believe any members are using 200 mg of testosterone weekly. ...

Wrong on both counts. Follow the links.

Androgen abuse and the brain - PMC

The purpose of this review is to examine the recent evidence regarding the effects of exogenous androgens on the brain. Understanding these effects is of high importance, as the consequences of androgens on the reproductive and endocrine system are ...

pmc.ncbi.nlm.nih.gov

Abusive use of anabolic androgenic steroids, male sexual dysfunction and infertility: an updated review - PMC

The evolving prevalence of anabolic androgenic steroids (AAS) abuse among nonathletes is alarming because of the known harm to an individual’s health. Among the adverse effects of AAS abuse, male infertility and sexual dysfunction have been often ...

pmc.ncbi.nlm.nih.gov

Hi, if anyone can help me out that would be great and much appreciated! I’ve been seeing a Dr. for about five years regarding my T levels and have been on the following regiment, I’m 39 yr old male. -

1x 1ml syringe of Testosterone Cypionate out of a (5ml) 200 mg/ml vial every Wednesday (once a week) into my leg muscles.
1x 0.5 Anastrazole pill on the day of injection (Wendnesday)
1x 0.5 Anastrazole pill on Saturday (mid week)

My level of T and Free T are at great. Good enough levels to where I should have some sort of libido…but I have zero. Not low libido, but as if it’s not even crossing my mind ever anymore. If needing to preform, I can with my partner But it is very mechanical and it’s almost always a fast finish. Faster than ever before.

The thought of too much Anastrozole might be causing this, so the Dr. wants me to try taking out the Anastrazole on Saturday (so it would only be once a week) I’ve not gotten Estro levels checked. Can someone please help me get my life back to normal in this department? Thanks! -J

 

[Vince]

Wrong on both counts. Follow the links.

Androgen abuse and the brain - PMC

The purpose of this review is to examine the recent evidence regarding the effects of exogenous androgens on the brain. Understanding these effects is of high importance, as the consequences of androgens on the reproductive and endocrine system are ...

pmc.ncbi.nlm.nih.gov

Abusive use of anabolic androgenic steroids, male sexual dysfunction and infertility: an updated review - PMC

The evolving prevalence of anabolic androgenic steroids (AAS) abuse among nonathletes is alarming because of the known harm to an individual’s health. Among the adverse effects of AAS abuse, male infertility and sexual dysfunction have been often ...

pmc.ncbi.nlm.nih.gov

I believe when Nelson was building muscle he was injecting a lot of testosterone and nandrolone. I know his dose is now much lower.