A dam good post by Dr. nco at MESO.

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This is a must read here is a cut & paste.

Phil

Quote:

Originally Posted by Zek

That is my biggest concern. I want to have children one day and I

don't want TRT to cause a problem with that.

Testosterone replacement therapy (TRT) entails increasing DEFICIENT

levels of testosterone to normal or optimal physiologic levels per

that particular person. A person should be deficient in testosterone

in the first place to receive TRT.

Some adverse effects and associated conditions:

1. If only testosterone is used in replacement therapy, a person

does run the risk of causing atrophy of the testes and reduction in

sperm production. This is because with the higher testosterone

levels, the brain does not need to produce luteinizing hormone (LH)

and follicle stimulating hormone (FSH) to increase testosterone

production. The lower follicle stimulating hormone levels also

reduce sperm production. If a person wants to have optimum

fertility, while on testosterone replacement therapy, then it is

important to supplement testosterone treatment with human chorionic

gonadotropin (HCG) treatment. HCG behaves in the human body like LH

and FSH. It will keep the testes from atrophy, and maintain sperm

production. SWALE has a great protocol to use as a starting point.

2. It is important to monitor for prostate cancer. Testosterone

itself does not cause prostate cancer - Estrogen is much more of a

risk for prostate cancer. However, testosterone, like estrogen,

promotes tissue growth. Thus, testosterone needs to be blocked or

withdrawn if prostate cancer exists. Some recommend twice a year

prostate exams and more frequent prostate specific antigen tests

when on testosterone replacement therapy to monitor for prostate

cancer.

3. If dihydrotestosterone (DHT) levels become too high (from

conversion from testosterone via the alpha-reductase enzyme), then

hair loss may accellerate. Excessively high DHT levels may also

increase visceral (belly) fat - which then increases the risk of

high cholesterol, blood pressure, stroke and heart attacks, cancer,

etc. DHT levels are easily monitored via blood tests. An easy way to

monitor DHT levels informally is to see if one gets acne - a symptom

of perhaps excessively DHT levels. When DHT is increased, one may

also notice more body hair or faster hair growth in the DHT-

resistant hair follicles (the ones that one does not easily lose

when going bald). I, myself, try to aim for testosterone levels

between the age of 24-30, not teenage male levels.

4. If estrogen levels become too high (from conversion from

testosterone via the aromatase enzyme), then you have a higher risk

for weight gain, heart attack, stroke, cancer, etc. A sign of excess

estrogens is gynecomastia (breast growth) in men. Estrogen levels

are easily monitored and can be treated.

5. If, a person has been deficient in testosterone for a long time,

eventually, adrenal fatigue can set in. This means the adrenal

glands cannot make enough Cortisol and other hormones when needed to

help the mind and body withstand stress. An initial problem with

elevating testosterone is that one of testosterone's functions is to

suppress the spike in cortisol and other hormones from the adrenal

glands. This helps limit the stress response - preventing damage to

the body from excessive cortisol and other hormone levels (this

includes diabetes, obesity, muscle wasting, etc.). The initial

testosterone elevation suppresses cortisol temporarily (until the

adrenals can recover from their fatigue from the calming/stress-

reducing effects of testosterone). This temporary suppression of

cortisol may make a person more susceptible to viral illnesses such

as colds. This is not often seen as a problem in people, but is

possible, and should be expected to be transient. It is an example

of secondary problems that can occur from deficient testosterone

levels.

6. Prostatic enlargement (and urinary retention and urinary

frequency) from higher DHT and higher Estrogen levels is a

possibility with testosterone replacement. Treatment may include

taking saw palmetto (which seems to be highly specific for blocking

prostate alpha-reductase rather than systemic alpha-reductase - and

is thus safer to use than finesteride and other commercial alpha-

reductase inhibitors with TRT), and taking arimidex (or other

aromatase inhibitor), or taking DIM (to reduce estrogen activity).

Testosterone, itself (rather than DHT), over time may reduce

prostatic enlargement.

When increasing the testosterone levels, it is important to be aware

of other neurotransmitter/hormones that are effected and to be aware

if adverse effects can occur, then to take steps to counter those

adverse effects.

Most of these adverse effect occur from secondary imbalances in

other neurotransmitters and hormones. The watchword is

maintaining " balance " - maintaining physiologic levels of all the

neurotransmitters and hormones - which minimizes risk and optimizes

function. In general, I think when physiologic levels of

testosterone and other neurotransmitters and hormones are

maintained, the risk of adverse effects is very low with

testosterone replacement therapy. Of course, if a person

accomplishes testosterone replacement therapy using drugs such as

aromatase inhibitors (e.g. arimidex), then the person runs the risk

of adverse effects of each individual drug itself.

For each person, it is important to weigh the risks and benefits of

treatment. However, the risks of continuing deficient testosterone

levels are clear. They include:

1. Heart attacks.

2. Strokes.

3. Prostate cancer, possibly other cancers (from unbalanced

estrogens actions).

4. Chronic fatigue and difficulty coping with stress (accompanying

adrenal fatigue/insufficiency that secondarily occurs with low

testosterone levels)

5. Excessive anxiety, stress, irritability, anger outbursts (the

irritable male syndrome)

6. Severe depression.

7. Impaired memory and attention, difficulty learning new material

(some to the extent of a dementia-like syndrome).

8. Impaired fertility - if low FSH/LH levels or FSH/LH resistance

are the cause of low testosterone levels.

9. Lack of libido, erectile dysfunction - often bandaged with

Viagra, but with undiagnosed testosterone deficiency as a direct

cause.

10. Obesity - which is difficult to treat with diet alone - which

can lead to arthritic conditions.

11. Diabetes

12. Loss of muscle mass.

13. Impaired immune system.

14. Reduced reaction time, quickness of reaction, mental quickness

(from reduced dopamine levels, insulin-resistance associated with

testosterone deficiency - among other associated changes)

There is a general progresson of other heretofore " age-associated "

changes in one's health and ability to function - which would have

been prevented by maintaining optimum testosterone levels.

Ultimately, maintaining testosterone deficiency may significantly

reduce the quality of one's life.

__________________

Any statement I make on this site is for educational purposes only

and is subject to change. It does not constitute medical advice,

does not substitute for proper medical evaluation from physician,

does not create a doctor/patient relationship or liability. If you

want medical advice, you will have to pay for it. Thank you.

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Last edited by marianco : 8 Hours Ago at 02:08 AM.