How can testosterone affect cognitive performance?

[harryorr]

Hey guys,

I coach alot of middle aged business men, some who are crushing life with really high natural testosterone with solid mental and physical performance. Then others who are still getting by but are prime candidates for TRT and consequently suboptimal mental and physical performance.

So my question is, as mental performance is the main focus for these guys, how does/can TRT improve cognitive performance? and what are the mechanisms for doing so?
Or are cognitive benefits of TRT a biproduct of other affects?

If I haven't provided enough context or you need more specifics please let me know,
Thanks in advance for your insights and knowledge,

 

[Cataceous]

Given the hormonal disruption caused by TRT, it would be foolish for anyone who's not hypogonadal to consider it as a means of enhancing mental performance. It might make more sense to focus on boosting dopamine. Also, when it comes to leadership ability, cortisol appears to be a factor along with testosterone:

Do Your Testosterone And Cortisol Levels Dictate Your Leadership Ability?

Companies that want team leaders to do a better job should consider offering stress-reduction perks like yoga and meditation classes and liberal vacation policies. They should also rethink their corporate culture and try to take pressure off the managers who show the most potential. That’s the...

www.forbes.com

 

[harryorr]

Given the hormonal disruption caused by TRT, it would be foolish for anyone who's not hypogonadal to consider it as a means of enhancing mental performance. It might make more sense to focus on boosting dopamine. Also, when it comes to leadership ability, cortisol appears to be a factor along with testosterone:

Do Your Testosterone And Cortisol Levels Dictate Your Leadership Ability?

Companies that want team leaders to do a better job should consider offering stress-reduction perks like yoga and meditation classes and liberal vacation policies. They should also rethink their corporate culture and try to take pressure off the managers who show the most potential. That’s the...

www.forbes.com

Thanks for your response mate,
Why would it be foolish?

For someone who works a demanding job with intense hours and doesnt manage their stress, would cortisol not be a factor in making them hypogonadal hence inhibiting leadership ability?

 

[Mountain Man]

Thanks for your response mate,
Why would it be foolish?

For someone who works a demanding job with intense hours and doesnt manage their stress, would cortisol not be a factor in making them hypogonadal hence inhibiting leadership ability?

I would think that stress management is job one on this. I am a psychotherapist and specialize in working with men. I always go the stress management route first and if the client will do it, they always get some noticeable results. Moderate exercise, more if they want, good diet and sleep, and some CBT. For CBT, I combine brief periods of meditation, at least 10 minutes per day and more if the guy gets into it and journaling. Journaling for 5 to 10 minutes in morning and evening sessions is optimal, more if something needs to be processed. I have a number of exercise I prescribe for specific issues that will inevitably pop up that facilitate the benefits of journaling. Of course we also look at people, places, and things that cause upset to their lives.

Medication, especially as powerful as TRT, should not be approached lightly. Don’t know about coaches, but as a therapist I cannot make suggestions too bluntly. Funny thing is that a lot of guys will hire a coach for a lot of money when their insurance could get them a psychotherapist for the cost of a copayment.

I tell my client that stress management is a process not an event and they need to work that as if it was physical exercise and do the work whether things are going good or bad. I use metaphors that appeal to male mentality and divide the work into Maintenance and Problem Solving areas and prescribe exercises for both.

Sorry for long response, but the answer is maybe. I would just try other things first. I would assume that high end CEOs want a quick fix. There is no such thing.

 

[Cataceous]

...
Why would [TRT] be foolish?
...

I'm sure you've heard the expression "If it's not broken then don't fix it." Even well-managed TRT can come with a host of side-effects. Are these businessmen ready to surrender their fertility? No? Then you're talking about banking sperm, including hCG, and so on, which increase the treatment's complexity and time demands. In my opinion, TRT for men who aren't clearly hypogonadal would fail in a cost-benefit analysis. The situation might be different if purely physical gains were being sought. But cognitive performance is a lot more complicated, and the effects of testosterone are mixed, particularly when accompanied by HPTA shutdown.

...
For someone who works a demanding job with intense hours and doesnt manage their stress, would cortisol not be a factor in making them hypogonadal hence inhibiting leadership ability?

So address the adrenal issues first, along with any thyroid problems. If hypogonadism and accompanying symptoms remain and no other causes can be found then TRT can be considered. There are also options short of full blown TRT that preserve HPTA function. These include enclomiphene and Natesto.

 

[thyronine]

Given the hormonal disruption caused by TRT, it would be foolish for anyone who's not hypogonadal to consider it as a means of enhancing mental performance.

I've always been astonished at how poorly this point is conveyed by doctors and medicine in general.
The vast majority of men who start TRT are still under the assumption that it is simply replacing testosterone in isolation, or 'replacing what you should have had'.
The reality is anything but:
- partial (complete in some) shutdown of upstream steroids - all of which fulfil important functions independent of their conversion to testosterone; particularly in cognition, the topic at hand.
- altered HPA function via CRH / ACTH modulation, again with cortisol heavily implicated in cognition, assertiveness, etc.
- potential dopamine dysregulation, likely via the estrogen-induced rise in prolactin and serotonin, but it could just be testosterone itself since it's heavily involved in basolimbic regulation.
- raised HCT.
- disruption to diurnal variation / circadian rhythm.
- altered thyroid function.
The list could go on for a while. For men who're truly deficient the above are a worthy trade-off, but for someone with a fully functioning endocrine system who thinks going on TRT will make them 'optimal', the cost:benefit analysis is extrodindarly skewed towards the former.

 

[ivankonst2017]

Starting TRT if you dont really need it will not give you noticable mental benefits.

However you may need TRT even if your total and free testosterone are “within range”, provided you have the majority of low t symptoms.

If you need TRT it will have positive effect on your cognition, but dont expect some dramatic difference, it will benefit mostly your confidence and drive.

 

[harryorr]

t

I'm sure you've heard the expression "If it's not broken then don't fix it." Even well-managed TRT can come with a host of side-effects. Are these businessmen ready to surrender their fertility? No? Then you're talking about banking sperm, including hCG, and so on, which increase the treatment's complexity and time demands. In my opinion, TRT for men who aren't clearly hypogonadal would fail in a cost-benefit analysis. The situation might be different if purely physical gains were being sought. But cognitive performance is a lot more complicated, and the effects of testosterone are mixed, particularly when accompanied by HPTA shutdown.

So address the adrenal issues first, along with any thyroid problems. If hypogonadism and accompanying symptoms remain and no other causes can be found then TRT can be considered. There are also options short of full blown TRT that preserve HPTA function. These include enclomiphene and Natesto.

interesting points, thanks for your opinion

 

[Vtail]

Starting TRT if you dont really need it will not give you noticable mental benefits.

However you may need TRT even if your total and free testosterone are “within range”, provided you have the majority of low t symptoms.

If you need TRT it will have positive effect on your cognition, but dont expect some dramatic difference, it will benefit mostly your confidence and drive.

The main reason I started TRT was due to mind-fog and memory problems. Low T (total and free) was confirmed with blood tests. TRT did not do much for me mentally. Then I explored thyroid issues and it turned out I was low in Free T3 and high in RT3. Supplementing with Cytomel made all the difference for me cognitively - the mind-fog disappeared and memory improved, as did my energy levels in the afternoon. I often wonder if I started with the thyroid first I may never have bothered with TRT. But since I feel good now, I will keep everything as is.

 

[Charliebizz]

The main reason I started TRT was due to mind-fog and memory problems. Low T (total and free) was confirmed with blood tests. TRT did not do much for me mentally. Then I explored thyroid issues and it turned out I was low in Free T3 and high in RT3. Supplementing with Cytomel made all the difference for me cognitively - the mind-fog disappeared and memory improved, as did my energy levels in the afternoon. I often wonder if I started with the thyroid first I may never have bothered with TRT. But since I feel good now, I will keep everything as is.

I met a bunch of people over the years on the forums that correcting thyroid raised t levels to acceptable levels.

 

[ivankonst2017]

Does sustanon once a week make a big difference at the peak? Propionate half-life is very low. 1 day.

The main reason I started TRT was due to mind-fog and memory problems. Low T (total and free) was confirmed with blood tests. TRT did not do much for me mentally. Then I explored thyroid issues and it turned out I was low in Free T3 and high in RT3. Supplementing with Cytomel made all the difference for me cognitively - the mind-fog disappeared and memory improved, as did my energy levels in the afternoon. I often wonder if I started with the thyroid first I may never have bothered with TRT. But since I feel good now, I will keep everything as is.

If you feel good and what you are doing is not causing you health issues - then you are excellent. No point of second guessing.

Yes as I have researched TRT alone may not work if the patient has thyroid issues. My ft3 is not exactly on the upper side of range, but I think its high-normal so it seems I do not need to mess with thyroid. Ive had issues with high reeverse-t3, took micro-dosages of t3 for a few months and stopped it successfully. Supplementing selene has also helped me a lot.

 

[Gman86]

The main reason I started TRT was due to mind-fog and memory problems. Low T (total and free) was confirmed with blood tests. TRT did not do much for me mentally. Then I explored thyroid issues and it turned out I was low in Free T3 and high in RT3. Supplementing with Cytomel made all the difference for me cognitively - the mind-fog disappeared and memory improved, as did my energy levels in the afternoon. I often wonder if I started with the thyroid first I may never have bothered with TRT. But since I feel good now, I will keep everything as is.

Do u have thyroid labs before and after supplementing by any chance? What’s ur current thyroid protocol?

 

[Nelson Vergel]

Testosterone, cognitive decline and dementia in ageing men - Reviews in Endocrine and Metabolic Disorders

As men grow older, circulating testosterone concentrations decline, while prevalence of cognitive impairment and dementia increase. Epidemiological studies of middle-aged and older men have demonstrated associations of lower testosterone concentrations with higher prevalence and incidence of...

link.springer.com

 

[tareload]

I've always been astonished at how poorly this point is conveyed by doctors and medicine in general.
The vast majority of men who start TRT are still under the assumption that it is simply replacing testosterone in isolation, or 'replacing what you should have had'.
The reality is anything but:
- partial (complete in some) shutdown of upstream steroids - all of which fulfil important functions independent of their conversion to testosterone; particularly in cognition, the topic at hand.
- altered HPA function via CRH / ACTH modulation, again with cortisol heavily implicated in cognition, assertiveness, etc.
- potential dopamine dysregulation, likely via the estrogen-induced rise in prolactin and serotonin, but it could just be testosterone itself since it's heavily involved in basolimbic regulation.
- raised HCT.
- disruption to diurnal variation / circadian rhythm.
- altered thyroid function.
The list could go on for a while. For men who're truly deficient the above are a worthy trade-off, but for someone with a fully functioning endocrine system who thinks going on TRT will make them 'optimal', the cost:benefit analysis is extrodindarly skewed towards the former.

 

[tareload]

I coach alot of middle aged business men, some who are crushing life with really high natural testosterone with solid mental and physical performance. Then others who are still getting by but are prime candidates for TRT and consequently suboptimal mental and physical performance.

If I haven't provided enough context or you need more specifics please let me know,
Thanks in advance for your insights and knowledge

Basis or supporting data?

 

[Charliebizz]

I've always been astonished at how poorly this point is conveyed by doctors and medicine in general.
The vast majority of men who start TRT are still under the assumption that it is simply replacing testosterone in isolation, or 'replacing what you should have had'.
The reality is anything but:
- partial (complete in some) shutdown of upstream steroids - all of which fulfil important functions independent of their conversion to testosterone; particularly in cognition, the topic at hand.
- altered HPA function via CRH / ACTH modulation, again with cortisol heavily implicated in cognition, assertiveness, etc.
- potential dopamine dysregulation, likely via the estrogen-induced rise in prolactin and serotonin, but it could just be testosterone itself since it's heavily involved in basolimbic regulation.
- raised HCT.
- disruption to diurnal variation / circadian rhythm.
- altered thyroid function.
The list could go on for a while. For men who're truly deficient the above are a worthy trade-off, but for someone with a fully functioning endocrine system who thinks going on TRT will make them 'optimal', the cost:benefit analysis is extrodindarly skewed towards the former.

Given the hormonal disruption caused by TRT, it would be foolish for anyone who's not hypogonadal to consider it as a means of enhancing mental performance. It might make more sense to focus on boosting dopamine. Also, when it comes to leadership ability, cortisol appears to be a factor along with testosterone:

Do Your Testosterone And Cortisol Levels Dictate Your Leadership Ability?

Companies that want team leaders to do a better job should consider offering stress-reduction perks like yoga and meditation classes and liberal vacation policies. They should also rethink their corporate culture and try to take pressure off the managers who show the most potential. That’s the...

www.forbes.com

What happens when your hypogonadal And trt still gives you mental side effects? That was what always worried me about fully committing to trt. While I do have some benefits I really don’t want to give up. The longer I’m on the worse my mental state has been getting. I’m not sure why as a low shbg guy I feel better with less frequent injections. Maybe has something to do with steady levels from daily’s and dopamine ?

 

[bonder]

What happens when your hypogonadal And trt still gives you mental side effects? That was what always worried me about fully committing to trt. While I do have some benefits I really don’t want to give up. The longer I’m on the worse my mental state has been getting. I’m not sure why as a low shbg guy I feel better with less frequent injections. Maybe has something to do with steady levels from daily’s and dopamine ?

good article to read
thanks