Re: Male HRT

[Guest guest]

I am a masters discus thrower (9 time US champion and former world champion

in the discus). I am 59 years old and would benefit from HRT. However, I

compete around the world and do not want to risk a positive test, so I don't

take

hormones. I train 12 months a year but am finding it increasingly difficult to

attain top performances. I have thrown reasonably far during the past two years

(178-4) but my average marks have decreased. My testosterone is 300 ng/100

ml, which is on the low side of normal. I am losing strength and speed rapidly

and have only been able to maintain my performance level by improving my

technique.

We can infer from the literature that HRT is beneficial for many older

adults. Shalander Bhasin's groups from Drew Medical College and UCLA— in more

than

15 studies— has shown that middle age men benefit from HRT and have few side

effects (at doses below 300 mg of testosterone per week). There work shows that

the ability to hypertrophy muscle is directly proportional to blood

testosterone levels. I think the data on growth hormone and IGF-1 is also very

promising. HRT is big business in the US. Even young people are taking GH to

lose body

fat.

It seems odd to me that older athletes are barred from these therapies. Most

of us have genetic advantages over other people our age. However, we also

expect a lot out of our aging bodies. Doping is so politicized right now that it

is difficult to have a rational dialog about the medical use of hormones in

older adults. I think that athletes should be allowed to have normal levels of

testosterone, growth hormone, and IGF-1— even if they require supplementation.

That would level the playing field. As my hormone levels deteriorate, I may

someday reach the point where feeling good becomes more important than throwing,

so I will retire. That would be a shame. I think many older athletes are

reaching that point.

I think the level playing field argument is nonsense. Recent studies by

people like C. Bouchard from Canada and from Puerto Rico showed

that

top athletes in many sports have gene variants that make them successful. We

have separate competitions for men and women and weight classifications in

wrestling, weight lifting, and bodybuilding— why not have competitions for

slugs

and the genetically gifted (equally funded). Genetic variance is just as

significant for success as gender or body weight. We should either bar people

with

abnormaly good genes from competition or put an asterick next to their names in

the record book.

Dr. Fahey

Exercise Physiology Lab, Dept of Kinesiology

Track and Field Team

California State University, Chico

Chico, CA 95929-0330

[Guest guest]

Did anyone ever assess why your Testosterone levels were below normal?

Cowell

Raleigh, NC

Bob Tomlinson wrote:

<<<I am male and 47 yrs. old. I have been injecting 300 mg./week of

testosterone cypionate for roughly 18 months. I am hypogonadal

(abnormally low testosterone levels). Without medication my T

levels were approximatley 250 ng/dl. Normal levels for men of my

age range from 300-875 ng/dl according to my primary care physician.

The administration of 300 mg/week elevates my levels into the 550

range. Right in the middle of the normal parameters.>>>

[Guest guest]

Hi,

Curious. How did you go about getting your " T " levels

tested? Regular physician? Will (most) insurance cover

the procedure?

The reason I ask is because I may be exhibiting some

of the same symptoms you are. Either that or I'm just

plain overtrained. Currently I'm not sure but this is

something I may want to look into.

Thanx,

McInnes

Wilmington, DE

--- portagelakemichigan

wrote:

> I am male and 47 yrs. old. I have been injecting

> 300 mg./week of

> testosterone cypionate for roughly 18 months. I am

> hypogonadal

> (abnormally low testosterone levels). Without

> medication my T

> levels were approximatley 250 ng/dl. Normal levels

> for men of my

> age range from 300-875 ng/dl according to my primary

> care physician.

> The administration of 300 mg/week elevates my levels

> into the 550

> range. Right in the middle of the normal

> parameters.

>

> I suspected my testosereone levels were low as I

> began to experience

> an inordinate amount of aches and pains. I was

> storing more fat in

> the abdominal area without a commensurate increase

> in calories.

> Although I might have chalked this up to ageing the

> level of

> increase seemed extreme. My ability to recover in

> between workouts

> was also unexplainably poor. I did experience some

> degree of

> emotional depression as well.

>

> Has my strength increased dramatically? Not really.

> My primary

> goal in training is to improve relative strength.

> At a bodyweight

> of 195 lbs. and a body fat % of 9.88%, my one rep

> max in the

> traditional deadlift is 533 lbs. (as if July 15,

> 2006) and my one

> rep max in the " just below parallel " squat is 420

> lbs. Prior to

> commencement of the testosterone regimen my

> bodyweight was roughly

> 210 lbs. with a body fat % of roughly 14%. My one

> rep max lifts

> were in the same neighborhood as they are now.

>

> I can say that normalizing my T levels has made

> training fun again.

> I can play on the floor with my young children

> without agonizing

> when its' time to stand up. I recover much more

> quickly, have very

> little joint or connective tissue soreness and

> maintain a more

> positive outlook on life. If anyone has any

> additional questions,

> please feel free to ask.

>

> Bob Tomlinson

> [Mod: Please sign all letters with full name and

> city of residence, thanks]

>

>

>

> >

> > I think that argument for male HRT is more

> complicated than female

> HRT. Men

> > suffering from really low T levels are compromised

> in their

> performance,

> > they also typically suffer from muscle waisting

> and the like. If a

> master

> > PL in his 50's or 60's were to suffer from

> abnormally low T levels

> his

> > ability to compete would rapidly diminish.

> Supplementation of T in

> those

> > sort of medical conditions may be arguably

> allowable as the lifter

> would

> > then be on level footing again. However as T is

> also a performance

> enhancer

> > it could be abused, how would you differentiate? I

> guess as an

> individual

> > it would be a health choice over a competition.

> Anyway just

> supposition, I

> > would like to hear from those who really

> understand androgens, I'm

> just an

> > active reader on the topic.

> >

> >

> > ***

> > As I recall, 225 ng/dl is the bottom end of

> acceptible test

> levels; below that, some physicians recommend HRT.

> Standard

> treatment among those I know receiving it is 100-200

> mg/cc of depo

> testosterone cypionate every two weeks to bring test

> up to a max of

> 825-850 ng/dl, that number being deemed average.

> >

> > Many " boomers " have become unwitting candidates

> for HRT due to

> detrimental reliance on the then current medical

> advise of the 60s

> and 70s, perhaps even 80s. At that time it was held

> that vasectomies

> were the safest of all forms of birth control, in

> part due to

> absolutely no consequences. In fact, I've read

> numerous reports

> holding that a minimum of 35% of males experiencing

> premature

> andropause had the procedure done; moreover, other

> reports hold that

> more than 50% of cases of clinically treated

> impotence occur among

> the vasectomy population. Of course, other factors

> pertain to

> andropause onset.

> >

> > Most of the arguments we see journalists parroting

> against steroid

> use turn out to be false, while HRT supplementation

> is now held to

> contribute to longevity, protecting against insulin

> insensivity,

> heart disease, etc.

> >

> > My real point about HRT is that banning those

> undergoing such

> preventative medical treatment are discriminated

> against for both

> gender and medical reasons. Of course, when the

> rules were

> formulated some decades ago, knowledge of andropause

> was scant. The

> condition of the world at that time differentiated

> between those

> abusing steroids in large quantities versus those

> drug- free. The

> distinction was clear, the world black and white.

> Subsequent growth

> of medical science has shown that view to be limited

> and limiting,

> certainly omitting a gray area now known.

> >

> > It seems to me the clearest model for

> distinquishing between

> treatment and abuse is that standard already used in

> medicine - it

> certainly accounts for an even playing field.

> Perhaps some

> individuals who are drug free exceed 850 ng/dl. So

> what. Limiting

> those undergoing life-saving HRT to a max of 825/850

> simply says

> their test has been normalized, not exceded for

> performance

> enhancement. Without it they are obviously

> performance deficient.

> That seems isomorphic to those who are insulin

> dependent.

> >

> > Ken ONeill

> > Long Life Fitness

> > kayoneill@...

[Guest guest]

Bob Tomlinson responds-

I had my primary care physician order the blood test. Insurance

paid for the blood test and initially paid for a portion of the

medication but has since changed their policy (Blue Cross Blue

Shield). The new policy of BCBS is to not cover any of the

medication cost. A 10 ml. vial costs roughly $125.00 and 25

syringes are priced about half that. Not inexpensive but the only

viable alternative in my mine.

Bob Tomlinson

St. , IL

primalfitnessclinic.com

> > >

> > > I think that argument for male HRT is more

> > complicated than female

> > HRT. Men

> > > suffering from really low T levels are compromised

> > in their

> > performance,

> > > they also typically suffer from muscle waisting

> > and the like. If a

> > master

> > > PL in his 50's or 60's were to suffer from

> > abnormally low T levels

> > his

> > > ability to compete would rapidly diminish.

> > Supplementation of T in

> > those

> > > sort of medical conditions may be arguably

> > allowable as the lifter

> > would

> > > then be on level footing again. However as T is

> > also a performance

> > enhancer

> > > it could be abused, how would you differentiate? I

> > guess as an

> > individual

> > > it would be a health choice over a competition.

> > Anyway just

> > supposition, I

> > > would like to hear from those who really

> > understand androgens, I'm

> > just an

> > > active reader on the topic.

> > >

> > >

> > > ***

> > > As I recall, 225 ng/dl is the bottom end of

> > acceptible test

> > levels; below that, some physicians recommend HRT.

> > Standard

> > treatment among those I know receiving it is 100-200

> > mg/cc of depo

> > testosterone cypionate every two weeks to bring test

> > up to a max of

> > 825-850 ng/dl, that number being deemed average.

> > >

> > > Many " boomers " have become unwitting candidates

> > for HRT due to

> > detrimental reliance on the then current medical

> > advise of the 60s

> > and 70s, perhaps even 80s. At that time it was held

> > that vasectomies

> > were the safest of all forms of birth control, in

> > part due to

> > absolutely no consequences. In fact, I've read

> > numerous reports

> > holding that a minimum of 35% of males experiencing

> > premature

> > andropause had the procedure done; moreover, other

> > reports hold that

> > more than 50% of cases of clinically treated

> > impotence occur among

> > the vasectomy population. Of course, other factors

> > pertain to

> > andropause onset.

> > >

> > > Most of the arguments we see journalists parroting

> > against steroid

> > use turn out to be false, while HRT supplementation

> > is now held to

> > contribute to longevity, protecting against insulin

> > insensivity,

> > heart disease, etc.

> > >

> > > My real point about HRT is that banning those

> > undergoing such

> > preventative medical treatment are discriminated

> > against for both

> > gender and medical reasons. Of course, when the

> > rules were

> > formulated some decades ago, knowledge of andropause

> > was scant. The

> > condition of the world at that time differentiated

> > between those

> > abusing steroids in large quantities versus those

> > drug- free. The

> > distinction was clear, the world black and white.

> > Subsequent growth

> > of medical science has shown that view to be limited

> > and limiting,

> > certainly omitting a gray area now known.

> > >

> > > It seems to me the clearest model for

> > distinquishing between

> > treatment and abuse is that standard already used in

> > medicine - it

> > certainly accounts for an even playing field.

> > Perhaps some

> > individuals who are drug free exceed 850 ng/dl. So

> > what. Limiting

> > those undergoing life-saving HRT to a max of 825/850

> > simply says

> > their test has been normalized, not exceded for

> > performance

> > enhancement. Without it they are obviously

> > performance deficient.

> > That seems isomorphic to those who are insulin

> > dependent.

> > >

> > > Ken ONeill

> > > Long Life Fitness

> > > kayoneill@

>

[Guest guest]

>I had my primary care physician order the blood test. Insurance

>paid for the blood test and initially paid for a portion of the

>medication but has since changed their policy (Blue Cross Blue

>Shield). The new policy of BCBS is to not cover any of the

>medication cost. A 10 ml. vial costs roughly $125.00 and 25

>syringes are priced about half that. Not inexpensive but the only

>viable alternative in my mine.

****

I use androgel. I tried the testosterone cypionate injections,

but had some unpleasant side effects and it wasn't nice getting

a thick, oily liquid injected into your buttocks every couple of

weeks. Androgel is very easy and fairly convenient to use (

e.g. no injections - you just rub it into your skin). I get

it through my insurance (United Healthcare) and have to make

a copayment of $90 for a 3-month supply. This is not as good

as the situation I had in the UK, when I lived there. I was

prescribed restandol - testosterone that can be taken orally.

This was even more convenient that androgel. Also, in the UK,

requiring HRT meant that the prescription cost was covered by

the NHS, and thus cost nothing out of pocket. I would certainly

pick the restandol if it were offered here in the US. Another

product I tried here were the testosterone patches, but they

terrible - they caused irritation and inflammation and dropped

off whenever I got even slightly sweaty (not good when you like

working out!).

Neal R. Harvey

Los Alamos, NM, USA

[Guest guest]

Bob Tomlinson responds-

With all due respect, why go the indirect route of an Adrenal Stress

Index which may indicate a penchant for low testosterone when you

can simply have your T levels checked directly and find out

definitively?

Bob Tomlinson

St. , Illinois

primalfitness@...

primalfitnessclinic.com

>

> > <<Curious. How did you go about getting your " T " levels

> > tested? Regular physician? Will (most) insurance cover

> > the procedure?

> >

> > The reason I ask is because I may be exhibiting some

> > of the same symptoms you are. Either that or I'm just

> > plain overtrained. Currently I'm not sure but this is

> > something I may want to look into.>>

>

> ***

> The first thing I would recommend is getting an Adrenal Stress

Index

> Test. THis is what Poliquin does with all of his

athletes

> (to my knowledge). This will show your 24hr Cortisol:DHEA ratio.

If

> your cortisol is elevated (or depressed) at any point in the day

> outside of the norms, you are likely in one stage or another of

> Adrenal Fatigue. This assessment is carried out by many

laboratories

> (Great Smokies Lab is a good one) and is minimally invasive (you

spit

> into a vial every 6 hrs). Here's a good link for a more in-depth

> article: http://www.medical-library.net/sites/

> _adrenal_fatigue.html. Adrenal fatigue is certainly a precursor

to

> depressed Testosterone Levels because when the adrenals are

> exhausted, they cannot assist in the production of testosterone

> (among other hormones).

>

> Cowell

> Raleigh, NC

>

[Guest guest]

Why get the Adrenal Stress Test? Wouldn't it be nice to know the

aetiology of one's depressed testosterone levels? I'm not claiming

that this individual is in some stage of Adrenal fatigue at all. I'm

simply suggesting to get it checked out. If he doesn't get it

checked out and it turns out that his testosterone levels are in fact

depressed because of overtraining, then what good has he done to his

body by undergoing HRT? In my opinion, all he's done is applied a

giant band-aid, metaphorically speaking. Undergoing HRT because of

depressed testosterone isn't necessarily dealing with the cause. It

is dealing with a symptom. It's similar to the claim that my

headaches are due to a Tylenol deficiency in my body so therefore I

need Tylenol to make my headaches go away. I always feel like it's

best to avoid messing with mother nature if at all possible. The

testosterone levels are depressed for a reason, why not try to figure

out the reason and then address that so that hopefully the

testosterone levels can restore naturally? Again, just my opinion.

Cowell

Raleigh, NC

[Guest guest]

What kind of syringes do you require?

W.G.

Ubermensch Sports

San Diego, Ca.

>

> >I had my primary care physician order the blood test. Insurance

> >paid for the blood test and initially paid for a portion of the

> >medication but has since changed their policy (Blue Cross Blue

> >Shield). The new policy of BCBS is to not cover any of the

> >medication cost. A 10 ml. vial costs roughly $125.00 and 25

> >syringes are priced about half that. Not inexpensive but the only

> >viable alternative in my mine.

>

> ****

>

> I use androgel. I tried the testosterone cypionate injections,

> but had some unpleasant side effects and it wasn't nice getting

> a thick, oily liquid injected into your buttocks every couple of

> weeks. Androgel is very easy and fairly convenient to use (

> e.g. no injections - you just rub it into your skin). I get

> it through my insurance (United Healthcare) and have to make

> a copayment of $90 for a 3-month supply. This is not as good

> as the situation I had in the UK, when I lived there. I was

> prescribed restandol - testosterone that can be taken orally.

> This was even more convenient that androgel. Also, in the UK,

> requiring HRT meant that the prescription cost was covered by

> the NHS, and thus cost nothing out of pocket. I would certainly

> pick the restandol if it were offered here in the US. Another

> product I tried here were the testosterone patches, but they

> terrible - they caused irritation and inflammation and dropped

> off whenever I got even slightly sweaty (not good when you like

> working out!).

>

> Neal R. Harvey

> Los Alamos, NM, USA

>

[Guest guest]

HI All:

I'm answering several questions posed in different posts in this single entry.

My first determination of low test levels occured in Tucson, Arizona. My

attending physician/health consultant at that time was just beginning to work

with a compounding pharmacist. After two years my PSAs shot up to 4.6, so the

physician was set to stop administration of test. A little research on my part

followed by a talk with the compounding pharmacist resulted in administering the

test with a small quantity of progesterone, within two weeks bringing PSAs down

to 2.3 - where they've staid for more than two years. My current health

insurance is Blue Cross/Blue Shield which covers blood testing. Compounding

pharmaceuticals are not covered. My dosage of test was running $42 monthly.

Recent revision of that compounding, including avodart and femura in small

quantities has tipped the price upwards slightly. No syringes, no injections.

Instead the BIO-IDENTICAL NATURAL test molecule. He also places more emphasis

on estradiol levels than PSAs.

Upon moving to Wimberely, then Austin, I have been with Dr Lane Sebring. He's on

the board of examiners for the American Association of Anti-Aging Medicine, in

my opinion a remarkable physician.

Having learned of my test deficiency, no doubt connected to having had a

vasectomy thirty one years ago, I make it my business to become aligned with

physicians whose scope of practice includes hrt and other protocols - including

vitamin supplementation. My physician also advocates versions of the anabolic

diet, especially use of free range fed meat sources. It should be born in mind

for those that are not familiar with the anti-aging movement that a considerable

portion of it is an outcome of sports medicine.

I'll post notice when my upcoming article on sarcopenia appears online.

Ken ONeill

Long Life Fitness

Austin, Texas

kayoneill@...

[Guest guest]

>

> Why get the Adrenal Stress Test? Wouldn't it be nice to know the

> aetiology of one's depressed testosterone levels? I'm not

claiming

> that this individual is in some stage of Adrenal fatigue at all.

I'm

> simply suggesting to get it checked out. If he doesn't get it

> checked out and it turns out that his testosterone levels are in

fact

> depressed because of overtraining, then what good has he done to

his

> body by undergoing HRT? In my opinion, all he's done is applied

a

> giant band-aid, metaphorically speaking. Undergoing HRT because

of

> depressed testosterone isn't necessarily dealing with the cause.

It

> is dealing with a symptom. It's similar to the claim that my

> headaches are due to a Tylenol deficiency in my body so therefore

I

> need Tylenol to make my headaches go away. I always feel like

it's

> best to avoid messing with mother nature if at all possible. The

> testosterone levels are depressed for a reason, why not try to

figure

> out the reason and then address that so that hopefully the

> testosterone levels can restore naturally? Again, just my opinion.

***

Bob Tomlinson responds-

I hate to be one but the adrenal cortex and medulla are responsible

for the production of cortisol, aldosterone, DHEA (cortex) and

epinephrine, norepinephrine and dopamine (medulla). Testosterone

production is generated from the complex interaction of the

hypothalamus, pituitary and Testes. Notwithstanding DHEA being a

precursor of T, the likelihood of adrenal fatigue being the culprate

in a situation of low plasma testosterone levels is highly remote.

I agree there is a reason for everything that is why I had a CAT

scan of my pituitary gland. The fact of the matter is, and this

should go without saying, Testosterone levels naturally decline as

we get older. My contention is low plasma T levels are probably

highly common in middle aged men. The assertion that overtraining

is responsible for substantially and chronically low T levels is not

very likely. If someone were overtrained to that degree more than

likely there would be a myriad of other symptoms relating to

depressed immunity, poor sleep patterns, etc. Just my opinion.

Bob Tomlinson

St. , IL

primalfitnessclinic.com