33 men is not much of a study IMO... 27 of them 80mg tablets, are 80mg available currently? or a the MUCH MUCH higher doses that are RX right now? ALOT of unknowns. are we really to believe ORAL LARGE DOSES are LESS harmful than injections of same compound that completely bypass the liver? how could this be? is having high testosterone for longer periods of time like injections allow THAT much worse for the liver? or perhaps the one study on lymphatic absorption we are giving WAY to much credit for being correct?
even at the VERY low dose of 80mg quote from the study on 33men 27 on only 80mg "However, there have been documented reports of gastrointestinal intolerance, increased hematocrit, increased hypertension, and decreased HDL cholesterol levels which changed when increasing dosage". so this is not zero, why did the doctor say NONE? what about triple that dose and more that is normally taken? this study also puts alot of emphasis on correcting blood markers with lowering dose and i dont think in the USA you can even get 80mg to start with nevermind taking less of them a day.
yes dht is very genetic(just like estrogen conversion), that being said, bald men have more heart attacks. this is known..Ive seen it with my own eyes, chances are majority of people you know who had a heart attack have male pattern baldness and even more with gys who lost it earlier it seems.. is it directly T? no, but having higher dht(which oral increases the most according to your study) makes you more prone to heart attacks so if raising your T you raise DHT you are more likely to have a cardiac event.. again, there is a reason bald men usually have more Test and are ALOT more likely to have a heart attack. IF oral test is causing a LARGER increase IN DHT as your study says I would bet that this will lead to higher and more severe cardiac events. again, time will make this more certain. but again INJECTIONS cause elevated liver enzymes too and def arent absorbed in the stomach.. that is to say there is no logic that oral test would be BETTER (esp when doses are SOOOO high) than injections from a liver enzyme point of view and infact likely much worse as other
oral testosterone has been proven to be.. if its relative to serum T and time than folks should really consider lower less frequent doses of injectable T. ASSUMING that the factor is the multi troughs of low T per day thats making the difference.
remember we dont have SERIOUS science that confirms anything about lymphatic absorptions and appears to be hypothetical for the most part.
again, have you not talked to men on trt? do they not often have worsening liver function? why is this so common? by what mechanism can injections worsen liver and oral be even worse for liver but a high dose ester not be bad for the liver? just doesn't equate.. and i guess my issue is fancy DRs trying to sell something and despite what DECADES of research says they use the companies small data set or 1 small poorly done study (ie no control) to say something they more than likely know to be false but CAN say otherwise as have SOME literature to indicate as much..
they can say all the theories they want about oral but in reality they are taking HUGE doses, if not processed by the liver were is all that extra testosterone going? doesnt disappear and no sign of it showing up in feces is there? its pretty absorbable so I dont think folks are only absorbing 5% of the dosage, do you? any data on testing feces? or jus the 1 study from park? anyway, time of course will give us answers, im just very sceptical. would be interesting to talk to a dr who RX alot of oral T and see what types of blood markers they see change..(although great Drs its heard to get that type of info as they feel they are just guessing so they won't say anythingas unethical).
that is all to say, new forms are great, we just have to be honest about risks and what we ACTUALLY know and observe in post marketing data vs what drug company says or the fancy salesman DRs say.. i've just been around long enough to know that every "new" thing that has 0 side effects and all the benefits we usually find out that its not the case.
im all for TRT dont get me wrong, but there is little nuance in alot of what the Dr said which is disingenuous to put it mildly. yes MANY guys on any form of TRT can have improved liver function and cardiac health, but many people have much the opposite. many things at play, dosage, modality, but also BMI and changes in BMI from trt. that is to say a big if not majority of benefits of TRT come down to body comp and mental effects. There is no free lunch and everything has draw backs, to not address that or accept it is just silly. super high test is going to increase IGF and if you have high IGF chances are your not going to be 85+yo, thats ok for some people, but shouldnt be ignored.. i guess just get tired of clinics and fast talking Salesman tell half truths and downplay REAL risks and ignore decades of data because some DR gave his patients testosterone and made the loose 50lbs of fat and completely change lifestyle as men on TRT often do (or maintain there active lifestyles). Which of course makes it hard to compare apples to apples when BMI or body comp changes as that has a host of benefits unrelated to test itself.
anyway, as i said time will tell and i will be happy to hear of guys having better liver function on oral T and full symptom relief.. unfortunate very few clinics actually order liver panels