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  1. #1
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    Default Long Term effects of TRT

    I mentioned in another thread that I have low T and I am researching TRT before jumping in.

    Most of my reading has been done from scholarly articles and medical journals rather than random forums, and I have found so far that:

    - the short to medium term benefits of TRT are well documented - increased strength, vitality, and sexual performance
    - TRT is not a fountain of youth (though the way some people talk about it you'd think it is)

    But the long term effects are not clear. It appears that there were two studies done that correlated TRT and increased chance of prostate cancer and cardiovascular disease, but that those studies were far from conclusive:

    "The estimated likelihood of adverse effects of long-term TRT is still essentially unknown, as overall high-quality evidence based upon prospective randomized trials to recommend for or against its use in most men with testosterone deficiency (TD) is lacking. Evidence to suggest that TRT increases cardiovascular morbidity and mortality risks is poor, as results vary across study populations and their baseline comorbidities."

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4212439/

    In other words, the populations used in the studies had other morbidity factors (maybe genetics, obesity, sedentary lifestyle, etc) that evidently weren't well accounted for.

    So as far as I can tell the jury is still out on TRT long term effects. Does anyone have any information to the contrary?

    Right now my opinion is leaning towards the following:

    "the short and medium term known benefits of TRT outweigh the unknown long term effects of TRT. Furthermore, any potential negative long term effect of TRT will likely be of smaller magnitude than the negative long term effects of life without it, or at least will have a smaller magnitude than other morbidity factors in my life"

  2. #2
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    My take on it

    Quote Originally Posted by apamburn View Post
    Most of my reading has been done from scholarly articles and medical journals rather than random forums, and I have found so far that:

    Medical Journals also want to lower your cholesterol via statins, force you to eat plants, and age gracefully. I think I told the tale of my doc back in 2013...a super vetted cardiologist...wanting me to lose weight. I was 175 and single digit bodyfat...but according to the BMI charts...

    Go find a doctor that knows his stuff. If he looks like Woodhouse, or like Andrew Zimmer....run away. Look for a guy that does what he preaches. Ask him and listen to him. The medical establishment is so full of shit that I don't take their word for anything. Do your own studies.


    - the short to medium term benefits of TRT are well documented - increased strength, vitality, and sexual performance
    - TRT is not a fountain of youth (though the way some people talk about it you'd think it is)

    Well...maybe not, but it sure is better than cardigan sweaters, checkers and shuffleboard. Whatever you are, more T will make you better. JMHO after a year. Will it turn you into Capt. America? No. But theraputic T is like a very low level of steroid cycling. And if you remove the holier-than-though puritanism seen in sports...who else uses steroids and most likely T supplements? SOCOM, NSW, GSG9, etc. Just sayin.

    But the long term effects are not clear. It appears that there were two studies done that correlated TRT and increased chance of prostate cancer and cardiovascular disease, but that those studies were far from conclusive:

    I read those. So IF YOU ALREADY HAVE prostate issues, some serious introspection is in order. If you do not, don't worry. Same for cardio issues. The cardio arises from the POSSIBILITY of hematocrit...which is also not a given. So what to do? Get your PSA checked and your blood checked regularly. TRT is not a DIY matter.

    So as far as I can tell the jury is still out on TRT long term effects. Does anyone have any information to the contrary?

    Asking a forum of laymen is not a good policy. There may be a few docs here but the chances of them responding timely is unlikely. Go find a capable, super fit, older doc that has been doing TRT for years. Ask him. Have him test you. And then proceed.

    Right now my opinion is leaning towards the following:

    "the short and medium term known benefits of TRT outweigh the unknown long term effects of TRT. Furthermore, any potential negative long term effect of TRT will likely be of smaller magnitude than the negative long term effects of life without it, or at least will have a smaller magnitude than other morbidity factors in my life"
    Gabriel Suarez

    Turning Lambs into Lions Since 1995

    Suarez International USA Headquarters

  3. #3
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    I just had my annual physical and decided to broach this topic with my doctor. Everything Gabe said came true. Stroke, heart attack, shorter life is all that would happen to me. No mention of any possible upside. Remember what happened to Lyle Alzado? That would happen to me. Claimed should only be used for "real cases" of low T - not just getting old normally lower T.

  4. #4
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    Quote Originally Posted by Catalina View Post
    I just had my annual physical and decided to broach this topic with my doctor. Everything Gabe said came true. Stroke, heart attack, shorter life is all that would happen to me. No mention of any possible upside. Remember what happened to Lyle Alzado? That would happen to me. Claimed should only be used for "real cases" of low T - not just getting old normally lower T.
    Your doc is an idiot. Fire him and get a new one.

    1). Lyle was using hard steroids. Not the same. I actually had a run in with him once.

    2). Real cases? Not for aging? BULLSHIT. If you are fifty you have what...another 30 years realistically? That is the perfect time. What do you want to be when you are seventyfive? A dude that looks like Georges St. Pierre, or a dude that looks like Woodhouse?
    Gabriel Suarez

    Turning Lambs into Lions Since 1995

    Suarez International USA Headquarters

  5. #5
    Steroids are supposidly "super deadly" yet how many former Mr Olympia guys do you hear about dropping dead or having massive health issues? If you look it up almost all of them are pretty healthy and these guys took massive amounts of roids and other stuff.

    Almost all top BJJ guys, tons of spec ops guys, and at least a few guys at every gym are on steroids. If they were really that deadly we would see the "bad" effects of them more often.

    Now consider that TRT is safer than most steroids and you will probably realize that you dont have much to worry about.

  6. #6
    Any time someone wants to tell you about all the downside stuff, and none of the benefits, you aren't really having an honest discussion (see also "gun control debate").

    Are there side-effects to TRT? Sure. There is no such thing as a medicine with no side effects. Never has been, never will be.

    Here's the thing, though -- people die from low testosterone all the time. They lose muscle mass. Then they fall and break a hip. Then they get pneumonia because they're lying in bed all day. Then they get an MI or a stroke or whatever the hell and that's it. The death certificate doesn't say "low T" but if their testosterone hadn't been low in the first place they wouldn't be dead.

    I don't actually, at this point, anyway, have a dog in this fight. But anyone who goes on a tirade like Catalina's doc is not giving you the real deal.

    I really wonder why there isn't a lot more interest in educating people about age-related loss of muscle mass.

  7. #7
    Join Date
    Sep 2016
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    292
    90%+ of doctors are the last people on earth I'd go to for health advice. I'd literally sooner ask someone's grandmother with no medical training. There are some good doctors out there, but in my experience the ration of bad to good is about 100 to 1. When I used to have a side job at a health food store, I helped countless people heal themselves even when their doctors told them their issues couldn't be fixed. We had one woman who was supposedly in her death bed with cancer end up getting out of the bed in a month or so and going on to live for years. Her doctors could not understand how she survived. And she would have lived much longer had some members of the family and her idiot doctors not convinced her to take some drug to fight off the little bit of tumor that was left that they were so afraid of. She lost her appetite because of the damned drug and nothing we did could get it back (and we tried EVERYTHING!). She started losing weight and died. Can't lose weight when you have cancer.

    So yes, I'd debate these doctors and I'd tell them about studies and when they called me an idiot I'd whip out the reference from the medical journal and show them that my info came from peer-reviewed, double blind controlled studies published in their own medical journals. That usually resulted in a big grin on my face and the doctor storming out re-faced from rage, embarrassment, or both. My favorite line (that I used): "Your doctor is an idiot!".

    If you're doing regular blood work, there's no issue. You'll see any problems coming and be able to manage them and eliminate the risk. That's the problem. So many doctors are like so many other people - they accept mediocrity and dying in a hospital bed after 20 years of being semi-living as "normal". Not for me!
    "Let him cut your skin, and you cut his flesh. Let him cut your flesh, and you cut his bones. Let him cut your bones, and you cut off his life."
    - Toshitsugo Takamatsu

  8. #8
    Join Date
    Nov 2008
    Location
    Texas
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    31
    Long term studies are scarce in all areas of medicine because the expense and feasibility. Longitudinal epidemiologic studies are wrought with issues.

    Regarding testosterone research there plenty of adequate studies showing benefit. Most are smaller studies but with enough power to be significant.

    Unfortunately, the FDA pressured the American Academy of Clinical Endocrinologists (AACE) to issue the current ridiculous guidelines for hypogonadism based upon NO research but at the request of the FDA.

    Treat people not numbers. Think functional not clinical hypogonadism. The benefits are many and if monitored properly the adverse effects are minimal.

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