The story of how testosterone therapy and anabolic agents helped transform HIV treatment and what it means for men's health today.By Rafael Zara
A Death Sentence That Changed Everything
Nelson Vergel was just 24 years old when doctors basically told him he was going to die. It was 1985, and he had just tested positive for HIV. Back then, there were no treatments. No internet to search for answers. No fax machines to share information. Just fear and the knowledge that most people with HIV died within a year.
"Even remembering those days, I tried to block them," Nelson recalls. "But I'm going to talk about it today."
Nelson had come to America from Venezuela with big dreams. He had an engineering degree and wanted to build a life. Instead, he got a diagnosis that felt like a death sentence. His partner had tested positive behind his back, and Nelson knew he was positive too.
The HIV test had only come out that year. Before that, people were just guessing what was killing gay men. Nobody knew it was a virus until 1984 or 1985. And once they knew, most people in Nelson's community didn't want to get tested. Why find out you're going to die when there's nothing you can do about it?
But Nelson was different. He cried for four days after his diagnosis. Then something inside him said: don't give up. Start researching.
That decision would save not just his life, but thousands of others.
The Horror of Wasting Syndrome
In the 1980s, HIV killed people in a brutal way. The main cause of death wasn't the virus itself. It was wasting syndrome.
Wasting syndrome is exactly what it sounds like. Your body wastes away. You lose muscle mass. You become skeletal. Nelson describes seeing men in his neighborhood who looked like concentration camp victims. They were skin and bones, their bodies eating themselves from the inside out.
"Most people would drop within a year after being told they were HIV positive," Nelson explains. "You'd see them in grocery stores, really skinny. And if somebody didn't call you back, you'd assume they were dying."
The science behind wasting syndrome is terrifying. When your immune system is fighting a virus like HIV, it needs fuel. Where does that fuel come from? Your muscles. The virus literally eats away your lean body mass. And researchers discovered something crucial: once you lost a third of your lean body mass, you would die. It didn't matter if it was from HIV, cancer, or anything else. Lose enough muscle, and you're gone.
Memorial services happened every weekend in Nelson's gay community. People were being kicked out of their families. Hospitals didn't want to treat HIV patients. The ones that did made nurses wear full protective suits. It was a nightmare.
And here's the thing about muscle wasting that most people don't understand: it's not just about looking skinny. Muscle is life. Your lean body mass is directly connected to how long you live. Lose it, and you lose everything.
The Bodybuilders Who Changed Everything
Nelson's life changed when his job transferred him to Los Angeles. LA was different. Bodybuilding was part of the culture there. And it was in LA that Nelson found hope in the most unexpected place: a support group.
The support group was run by Marianne Williamson, the famous author. She wasn't teaching them to feel sorry for themselves. She was teaching them to die with dignity. But Nelson noticed something strange in those meetings.
"There were two guys who came in, and we were all skinny," Nelson remembers. "I had already lost 12 pounds. But these two guys were pumped and looked great."
They had HIV too. But they weren't wasting away. They were muscular and healthy-looking.
Nelson had to know their secret.
"I went to talk to them," he says. "Listen, whatever you guys are doing, I really want to know what you're doing."
And they told him. They were using testosterone and anabolic agents like nandrolone and oxandrolone. These weren't illegal drugs. They were FDA-approved medications. The bodybuilders had discovered that these hormone treatments could reverse muscle wasting.
They even took Nelson to Mexico to get some of these medications. And that's when his life started to change.
"I reversed 35 pounds of weight loss," Nelson says with emotion in his voice. "Bodybuilding saved my life. Bodybuilders saved my life."
Understanding Anabolic Agents: Not What You Think
Here's where we need to clear up some major confusion. When most people hear "anabolic steroids," they think of cheating athletes and roid rage. But that's not the whole story.
Nelson prefers to call them "androgens" or "anabolic agents." And there's a good reason for this. The stigma around these compounds has done incredible damage to medical progress.
First, let's understand what these medications actually are. Anabolic agents are closely related to testosterone, the natural hormone your body produces. Scientists modified the testosterone molecule for two main reasons:
- To slow down how fast your liver breaks it down so it stays in your body longer
- To increase the muscle-building effects while reducing side effects
These are FDA-approved medications. That's important to understand. We're not talking about illegal substances. We're talking about prescription medications that have been studied for decades.
"Most of these molecules were developed 50 years ago," Nelson explains. "We have good data on them."
There are four FDA-approved anabolic agents:
- Testosterone (the one most people know)
- Nandrolone (injectable)
- Oxandrolone (oral)
- Stanozolol (oral)
- Oxymetholone (oral, but has more side effects)
The stigma started when Congress passed the Anabolic Steroid Control Act. This law was created mainly to combat cheating in sports. Baseball scandals. Olympics controversies. The government wanted to stop athletes from having unfair advantages.
But here's what happened: the law shut down almost all medical research on these compounds. Except in HIV treatment. That's where Nelson and other activists kept the science alive.
How Testosterone Therapy and Anabolic Agents Work
Let's break this down in simple terms.
Your body needs muscle to survive. Muscle isn't just for looking good at the beach. It's essential for:
- Fighting off illness
- Maintaining your metabolism
- Keeping your bones strong
- Regulating your hormones
- Living longer
When you have a disease that causes muscle wasting, or when you age and naturally lose muscle (called sarcopenia), you're in trouble. Your body is burning through its most valuable resource.
Testosterone is the primary hormone that helps build and maintain muscle. Both men and women produce it, though men produce much more. As you age, your testosterone levels drop. And when they drop, you lose muscle mass.
Anabolic agents work by enhancing the effects of testosterone. They signal your body to build more lean body mass. They help you keep the muscle you have. They can even help you gain new muscle.
"Within a month, people are gaining weight, strength, energy, mood improvements," Nelson says about the results. "This is not just about muscle. We know that increasing muscle mass increases longevity and survival."
Nandrolone: The Agent That Saved Lives
Let's talk specifically about nandrolone, because Nelson considers it one of the most important medications he's ever encountered.
Nandrolone is an injectable anabolic agent. It used to be sold under the brand name Deca Durabolin, but that brand is no longer available. Now it's made by compounding pharmacies.
Here's what makes nandrolone special:
For Men:
- No effect on liver enzymes (unlike some oral agents)
- Small decrease in HDL cholesterol at proper doses
- Typical dose: 50-100mg per week
- Should be used with testosterone therapy (ratio of 1:1 or 2:1 testosterone to nandrolone)
For Women:
- Can be used at 10-25mg per week
- Less masculinizing effects than testosterone
- Must monitor for voice changes or hair growth at higher doses
One of the most interesting findings is that nandrolone decreases sex hormone binding globulin (SHBG). This protein binds to hormones and makes them inactive. When SHBG goes down, your free testosterone goes up. Free testosterone is what actually gives you the benefits.
Nelson has seen remarkable results in his forums with tens of thousands of members. Men and women report:
- Decreased joint pain
- Better muscle preservation
- Improved mood
- Better sexual function
- Higher energy levels
"There are posters and emerging data on joint pain reduction," Nelson notes. Research groups at Baylor have observed decreased pain in men with joint issues who use nandrolone.
But here's something crucial: all anabolic agents shut down your body's natural testosterone production. That's why nandrolone should always be used alongside testosterone replacement therapy. If you don't, you'll experience sexual dysfunction and other problems.
Oxandrolone: The Oral Option
Oxandrolone (brand name Anavar) is another FDA-approved anabolic agent that Nelson has studied extensively.
What makes oxandrolone unique:
- It's oral (no injections)
- Has an excellent anabolic to androgenic ratio
- Metabolized by the kidneys, not just the liver
- FDA-approved for "treatment of unintentional weight loss due to illness"
Dosing:
- For men: 20mg per day
- For women: 5-10mg per day
- Typically cycled for 12 weeks
The cycling is important. You don't stay on oxandrolone continuously. You use it for 12 weeks, gain the benefits, maintain good exercise and diet habits, then come off.
Results from clinical studies show weight gains of 3-3.5 kilograms (about 7-8 pounds) of lean mass. That might not sound like much, but gaining 7 pounds of pure muscle is incredibly difficult. Ask anyone who's tried.
However, there's controversy. In June 2023, the FDA issued a warning about oxandrolone and liver toxicity. This warning referenced a meeting from 1984. Nelson investigated this thoroughly.
"They have no data," Nelson states firmly. "We have a lot of safety data. All the studies done on oxandrolone, even in pediatrics, showed that liver enzymes might go up temporarily. But they resolve to baseline after stopping."
Nelson sent a letter to the FDA summarizing all the safety data. The studies show minimal liver enzyme elevations that resolve after treatment stops. The warning seems based more on stigma than science.
Many physicians stopped prescribing oxandrolone after this warning, but it's still available through compounding pharmacies. It hasn't been removed from the list of medications that can be compounded.
The Coming Crisis: GLP-1s and Muscle Loss
Here's why this information matters right now, even if you don't have HIV.
We're in the middle of an obesity epidemic. And the new miracle drugs – GLP-1 agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) – are changing everything.
These drugs work incredibly well for weight loss. But there's a problem nobody's talking about enough: they cause significant loss of lean body mass along with fat loss.
"The loss of lean body mass happens more so with GLP-1s," Nelson warns. "Even though they're great, even though they're amazing miracle meds, there should be adjunct therapies."
Think about what's happening. Millions of people are taking these weight loss drugs. They're losing fat, which is good. But they're also losing muscle, which is bad. And we already know that muscle loss is directly connected to mortality.
Nelson sees a future crisis: "We are entering a new epidemic, and that epidemic is going to be treating obesity for an epidemic of sarcopenia and osteoporosis from what I believe like we've never seen before."
His solution? Use anabolic agents alongside GLP-1s to preserve muscle while losing fat.
"Nobody's doing that study," Nelson says with frustration. "I've checked. I went to clinicaltrials.gov. Nobody is studying nandrolone use with GLP-1s. And it's time."
The logic makes perfect sense. You want to lose fat but keep muscle. GLP-1s help you lose both. Anabolic agents help you keep muscle. Combine them appropriately, and you might have the best of both worlds.
The Myths That Keep Men from Getting Help
Nelson has spent decades fighting stigma around hormone optimization. Here are the biggest myths he encounters:
Myth 1: Hormones make you aggressive
This is probably the most damaging myth. People think testosterone and anabolic agents turn men into angry, violent people. The truth? Most men on proper hormone therapy report better mood, better coping skills, and improved relationships.
"Most people on testosterone or any of these products actually feel better," Nelson says. "Their mood is better. Quality of life is better. They relate to people better."
Myth 2: Hormones will destroy your liver
While some oral agents can affect liver enzymes, this is dose-dependent and usually temporary. Nandrolone has no effect on liver enzymes. Proper monitoring and appropriate dosing make this a manageable concern.
Myth 3: Hormones increase prostate cancer risk
This fear has kept many men from seeking help. But the research doesn't support this blanket statement. Appropriate testosterone therapy under medical supervision is not the danger it was once thought to be.
Myth 4: Hormones are only for bodybuilders
This might be the most harmful myth of all. Hormone optimization isn't about getting huge muscles. It's about maintaining the lean body mass your body needs to survive and thrive.
Myth 5: Estrogen is bad for men
Many doctors prescribe estrogen blockers for men on testosterone. Nelson has read all the research on this topic and disagrees strongly.
"Estrogen is an enhancer of effects of testosterone," he explains. "Many doctors are blocking estrogen in men with anastrozole. That's actually counterproductive."
Only about 0.4% of testosterone converts to estrogen. Your body does this on purpose. Men with higher estrogen actually have better sexual libido and function. Blocking estrogen can cause more problems than it solves.
Getting the Right Tests
If you're considering hormone optimization, you need proper testing. Nelson sells affordable lab tests through his company, and he's seen thousands of results. Here's what you need to know:
Testosterone Testing: Use liquid chromatography/mass spectrometry (LC/MS), not immunoassay tests. Immunoassay tests are cheaper and faster, but they have problems. They can pick up other androgens and report them as testosterone, giving falsely high readings.
Liver Function: Don't just look at AST and ALT. These can be elevated from resistance exercise alone. Add GGT (gamma-glutamyl transferase) testing for a more accurate picture.
Kidney Function: Standard tests measure creatinine, but if you have high muscle mass, your creatinine will naturally be higher. Add cystatin C testing for a corrected GFR (glomerular filtration rate) that accounts for muscle mass.
Important Discovery: Nelson has found that androgens dramatically decrease lipoprotein(a), a genetic risk factor for heart disease. Most people don't know this. While androgens can lower HDL cholesterol, they also lower triglycerides and this dangerous lipoprotein.
Why Access is the Biggest Problem
Nelson's forums have tens of thousands of members. The number one question people ask isn't about dosing or side effects. It's this: "Where can I find a doctor who will help me?"
"That really is the biggest barrier," Nelson confirms. "People don't know where to go."
Many men have doctors who dismiss their concerns. They're told their symptoms are "all in their head." Or doctors refuse to prescribe these medications because of stigma or fear.
The situation got worse when pharmaceutical companies stopped making nandrolone and oxandrolone. They didn't stop because of safety issues. It was a business decision. But this forced patients to rely on compounding pharmacies.
Compounding pharmacies, like Empower Pharmacy in Houston, now make these medications. They're legal. They're properly regulated. But many doctors don't know these options exist.
Nelson offers this advice: "Search inside Facebook. There are groups galore. Reddit is also good. Google has changed. All the good information is now on the second or third page because of ads."
The Future of Hormone Optimization
Nelson sees both hope and concern for the future.
The hope: More urologists and specialists are becoming experts in hormone optimization. HIV doctors in particular have 30+ years of experience using these compounds safely. Knowledge is spreading.
The concern: There are threats to compounding pharmacy access. About 60-70% of patients getting hormone treatments use compounded products because they're more affordable. If regulations limit compounding, millions could lose access to care.
"I'm preparing my activist efforts," Nelson says. "Access to hormones, affordable hormonal treatments, may be affected by decisions from legislators that have stigma in their heads."
Another concern is that sarcopenia (age-related muscle loss) finally got an official diagnosis code in 2016. But there's still no medication officially indicated for it. We have the tools. We have decades of safety data. But stigma keeps these medications from being widely used.
What You Can Do Now
If you're a man concerned about muscle loss, hormone levels, or aging, here's what Nelson recommends:
1. Get Your Body Composition Tested: Get a DEXA scan. It costs around $60-70 in most cities. Search "DEXA scan" and your city. Companies like DexaFit offer them without a prescription. This is the only accurate way to know your lean body mass.
2. Find a Knowledgeable Provider: Look for urologists who specialize in men's health. They're more likely to understand hormone optimization. Ask specifically about their experience with testosterone therapy.
3. Don't Self-Treat: While Nelson believes in body autonomy, he strongly recommends working with a physician. "You should be under the guidance and protection of a physician that you trust," he says. These medications need monitoring and proper dosing.
4. Understand the Basics
- All anabolic agents should be used with testosterone therapy
- Proper monitoring of blood work is essential
- These are not continuous treatments (except testosterone)
- Side effects are dose-dependent and manageable
5. Join a Community: Nelson's ExcelMale.com forum has 45,000 members. There's a women's section too. His Facebook group has over 32,000 men discussing testosterone replacement therapy. He also created one for women on Facebook.
These communities share doctor recommendations and real-world experiences.
Here are the links to the Facebook groups:
Men: Log into Facebook
Women: Log into Facebook
6. Exercise and Eat Right: Anabolic agents are not magic pills. "Unless you're exercising and eating right, you're wasting your time," Nelson says. Combine hormone optimization with resistance training and adequate protein.
A Final Message of Hope
Nelson Vergel was told he wouldn't live past 30. He's now in his 60s and thriving. He lost three partners to AIDS. He watched friends die every week for years. He had to hide his diagnosis at work for fear of being fired.
Through all of that, he never gave up. He researched. He experimented. He activated. He educated doctors. He faxed information before fax machines were common. He built online communities before Google existed.
"Sometimes being in the right place at the right time," Nelson reflects. "Sometimes being curious and not giving up. Sometimes the power of community really saves everything."
Today, HIV is manageable like diabetes. People with HIV live normal lives. That happened because of activists like Nelson who refused to accept death as inevitable.
Now he's fighting a new battle: getting anabolic agents recognized as legitimate medical treatments for muscle preservation. The stigma is slowly breaking down. More doctors are learning. More research is being done.
If you're struggling with muscle loss, fatigue, low energy, or the effects of aging, know that options exist. Hormone optimization isn't about vanity. It's about survival. It's about quality of life. It's about having enough lean body mass to fight off whatever challenges life throws at you.
The science is there. The medications are FDA-approved. The experience is there. What's needed now is for more men to understand their options and for more doctors to let go of outdated stigmas.
Nelson Vergel turned a death sentence into a life of advocacy and hope. His message is clear: muscle matters, hormones matter, and you don't have to accept decline as inevitable.
Take Action Today
If you're concerned about your hormone levels or muscle loss:
- Schedule bloodwork – Get your testosterone levels checked (free and total), along with a complete metabolic panel. A good place in DiscountedLabs.com
- Get a DEXA scan – Know your actual lean body mass and bone density numbers. Google full body DEXA in your city.
- Find a specialist – Look for urologists experienced in hormone optimization
- Join the conversation – Visit ExcelMale.com or search Facebook for men's hormone health groups
- Educate yourself – Read the research. Understand what these medications actually are and how they work
- Talk to your doctor – Bring information. Ask questions. Advocate for yourself
Your muscles are your life. Don't let stigma keep you from exploring all your options. The research exists. The treatments exist. The knowledge exists.
All you need is the will to take action.
Disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any hormone therapy or making changes to your health regimen. Anabolic agents are prescription medications that require proper medical supervision and monitoring.
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