Adjusting my dose down for longterm health reasons, will it lead to muscle loss?

[Bubbs]

For years I've been on 200mg test and 100md ND a week, split into multiple shots. The deca is because I have moderate osteoarthritis and have had multiple surgeries on my shoulders, hips and knees over the years and prefer not to ever take NSAIDS if possible

As I'm turning 46 next year I feel this is a bit of a high total dose for long term health reasons, my HCT is always low 50s and even through my Cystatin C egfr is at 115 consistently, my creatinine is always terrible. I'm also concerned about long term cardiac damage from deca so a lower dose makes me happier

I've cleaned up my diet and gone keto/paleo and added in hard 30 min cardio sessions 4-5 times a week after my weight training, as well as 1500mg niacin, coq10 and fish oil daily. I take lisinopril 10mg and HCTZ at 12.5mg ed along with with trt

I've dropped to 150mg test a week and 75mg deca, I guess my question would be is this enough to hang onto the muscle I spent years building? At one point while abusing AAS I was 230lbs and 10% but these days I'm a soft 225lbs. Ideally I'd like to get down to a ripped 200ish if that's maintainable on a lower dose. I understand it's still 225mg total AAS a week but from what I understand the deca in low doses isn't especially anabolic

Any thoughts appreciated

 

[HealthMan]

More than enough

 

[Nelson Vergel]

Your "lower" dose is more than enough (total of 225 mg per week of androgens). I assume that your hematocrit is under 53 and your blood pressure is equal or below 185/35. Have you donated blood ever? Have you measured your ferritin? How is your HDL?

You may want to review this thread

What is the testosterone dose for muscle gain?

Some of the guys I work out with know that i inject T. It has come up why then do I not put on more gains, I do heavy rssitance training and little cardio. I explained that I am on a theraputic dose. Shoot I take a paltry 30 mg twice a week to keep red blood cells in line, so i could never...

www.excelmale.com

 

[shroud778]

For years I've been on 200mg test and 100md ND a week, split into multiple shots. The deca is because I have moderate osteoarthritis and have had multiple surgeries on my shoulders, hips and knees over the years and prefer not to ever take NSAIDS if possible

As I'm turning 46 next year I feel this is a bit of a high total dose for long term health reasons, my HCT is always low 50s and even through my Cystatin C egfr is at 115 consistently, my creatinine is always terrible. I'm also concerned about long term cardiac damage from deca so a lower dose makes me happier

I've cleaned up my diet and gone keto/paleo and added in hard 30 min cardio sessions 4-5 times a week after my weight training, as well as 1500mg niacin, coq10 and fish oil daily. I take lisinopril 10mg and HCTZ at 12.5mg ed along with with trt

I've dropped to 150mg test a week and 75mg deca, I guess my question would be is this enough to hang onto the muscle I spent years building? At one point while abusing AAS I was 230lbs and 10% but these days I'm a soft 225lbs. Ideally I'd like to get down to a ripped 200ish if that's maintainable on a lower dose. I understand it's still 225mg total AAS a week but from what I understand the deca in low doses isn't especially anabolic

Any thoughts appreciated

I think it’s possible to drop to 200lb and get body fat down to low teens on a much lower dose than your new one. Curiously before I started TRT and my T was in the lower range of normal I was in my best shape ever. It’s now 3 years of TRT and whilst I’ve still got the same overall mass (maybe a bit more) I’m less ripped. Point is diet, training intensity coupled with adequate rest is equally if not more critical than your free or total T levels IMHO

 

[Bubbs]

Your "lower" dose is more than enough (total of 225 mg per week of androgens). I assume that your hematocrit is under 53 and your blood pressure is equal or below 185/35. Have you donated blood ever? Have you measured your ferritin? How is your HDL?

You may want to review this thread

What is the testosterone dose for muscle gain?

Some of the guys I work out with know that i inject T. It has come up why then do I not put on more gains, I do heavy rssitance training and little cardio. I explained that I am on a theraputic dose. Shoot I take a paltry 30 mg twice a week to keep red blood cells in line, so i could never...

www.excelmale.com

Thanks for the link Nelson! Yes, my BP is usually 115/70

I've not donated blood for 3 months and my HCT was 47 this morning so I had to tell the hematologist PA to go away and stop trying to get me to donate every 2 weeks to get to the "magic" 45 lol. She is a complete idiot and doesn't care about ferritin and always tells me I will die from 48-51 HCT because she claims testosterone induced erythrocytosis is the exact same as PV and refuses to discuss it with me (I'm looking for a new dr)

 

[madman]

For years I've been on 200mg test and 100md ND a week, split into multiple shots. The deca is because I have moderate osteoarthritis and have had multiple surgeries on my shoulders, hips and knees over the years and prefer not to ever take NSAIDS if possible

As I'm turning 46 next year I feel this is a bit of a high total dose for long term health reasons, my HCT is always low 50s and even through my Cystatin C egfr is at 115 consistently, my creatinine is always terrible. I'm also concerned about long term cardiac damage from deca so a lower dose makes me happier

I've cleaned up my diet and gone keto/paleo and added in hard 30 min cardio sessions 4-5 times a week after my weight training, as well as 1500mg niacin, coq10 and fish oil daily. I take lisinopril 10mg and HCTZ at 12.5mg ed along with with trt

I've dropped to 150mg test a week and 75mg deca, I guess my question would be is this enough to hang onto the muscle I spent years building? At one point while abusing AAS I was 230lbs and 10% but these days I'm a soft 225lbs. Ideally I'd like to get down to a ripped 200ish if that's maintainable on a lower dose. I understand it's still 225mg total AAS a week but from what I understand the deca in low doses isn't especially anabolic

Any thoughts appreciated

Even if you were achieving a healthy FT on 100 mg T/week without ND and diet/training was on point you will still maintain muscle.

Hanging on to every pound is highly doubtful especially when dieting as you are always going to sacrifice some muscle when losing adipose.

You can definitely look great on 150 mg T/week + 75 mg ND.

Packing on mass.....not so much.

 

[Bubbs]

Even if you were achieving a healthy FT on 100 mg T/week without ND and diet/training was on point you will still maintain muscle.

Hanging on to every pound is highly doubtful especially when dieting as you are always going to sacrifice some muscle when losing adipose.

You can definitely look great on 150 mg T/week + 75 mg ND.

Packing on mass.....not so much.

This is true, as I get older I seem to lose more muscle every time I cut even though I try to maximize volume and keep the weights as heavy as possible.

My DB bench for example only dropped from 120 x 15 to 110 x 15 after losing 30lbs a couple months back but my arms, chest and shoulders all lost visible size. I used to cut on 200mg test but then added 600mg anabolics and hgh to that, which is absolutely not something I'm willing to do anymore

 

[Wilson7]

I've asked several docs that have been using ND in practice for everything from HIV to HRT and not one has had concerns about cardio toxicity or has seen it in practice in therapeutic dosing. Sure there are animal studies, where are the human studies to support them? We have data from cross-sectional analysis of wannabe genetically altered farm animal look alikes taking high doses of multiple drugs, that doesn't tell us anything about therapeutic dosing esp for HRT ND/TC that is long term. 150TC/75ND is more than enough for HRT, top end borderline supraphysiological, sure don't need more than that. If you are truly concerned about cardiotoxicity, get an echo and a CT angiogram, and/or LGE cardiac MRI to assess fibrosis. See where you stand, you'd be the perfect N of 1 given your history esp if you have no family history. IMO, either an ARB or ACEi should be taken by anyone either abusing AAS or even on TRT (old guys), always prescribed as there is the risk of angioedema in some populations. ANGII and ALD are the players in LVH and fibrosis, and HTN.

 

[FDV70]

She is a complete idiot and doesn't care about ferritin and always tells me I will die from 48-51 HCT because she claims testosterone induced erythrocytosis is the exact same as PV and refuses to discuss it with me (I'm looking for a new dr)

I have a hematologist who insists I do the same -- maintain HCT at 45. He's a nice guy but just doesn't get it, because he's in his 60s and only knows studies from decades ago. I went to a much younger doc and he and I got discussing crashed ferritin. I created a protocol that he was skeptical of but when it worked, he changed his tune. I created a thread for it.

Raising ferritin FAST (a how-to, not a question)

Hi all, I started TRT in 2001 and have been giving blood over the years and have always had issues with recovering my ferritin. Long story short, I got tired of waiting for others to do the research, so I did it myself, created a protocol, hired a hematologist in May 2021 who thought it could...

www.excelmale.com

The nice thing is that I can now donate double red and put my ferritin exactly where it was before donating in a mere 4 days. I can go higher if I choose. The method takes a lot of explaining so that's on my own site and not in the thread, but the method itself is posted. And it works. I have other guys who tried it -- it leaves hemoglobin alone and raises ferritin. Then you get where you want your ferritin and stop. Worth looking at if you feel you want to continue donating. Of course, some guys are okay with things like grapefruit products, losartan, or letting it go, etc. but I personally feel better getting phlebotomy.

 

[Bubbs]

Thanks for the insight guys, raising ferritin to pre donation levels that quickly would be great, what brand do you use for the Ferrous bisglycinate chelate?

I feel like just doing a double red twice a year vs wasting any more time with the hematologist to be honest, its nice to get the bloodwork done for free at the Dr's office but it's exhausting dealing with someone who gets triggered to the point of facial tics when I ask her to explain how Hepcidin works and how TRT affects it, potential risks of crashed ferritin etc. Draining and filling up senior citizens seems to be all she's happy with doing.


I have a treadmill stress test and echo booked for next week so I'll get a better idea how my heart is then. I do know of one kid on getbig who had a heart attack running 1.2g of deca for months but no one running 50-100mg a week who has had any issues (not that posts about it online at least)

 

[Wilson7]

My hematologist likes my HCT below 50%, urologist who treats a number of patients and transgender sets the threshold at 55%, my comfort level is 52 - 53% when I get a phlebo. Ferritin runs at the very bottom of normal but blood iron is fine. No way to know if the 1.2 g/wk of ND caused the MI, but nothing good has ever come from trying to look like a genetically altered farm animal. Please update on the echo, it would be great if we could have a forum for that data alone so we could have some idea of what TC/ND taken in dosing totally < 300 mg/wk long term really has on LVH, function, etc. That is the one question I think all of us would like answered.

 

[xcpatr922]

What's ND ? I have been 6 months on TRT and measuring my body fat loss thru DEXA. I'm also pretty active with HIIT and other sports. 46 years old. The rate of percentage body loss that I've experience is about 0.8-1.0 percent every 5 weeks. This is with 140-150 per week Cypionate (twice a week) and HCG of 500 IU/week (twice a week).Hematocrit is sitting at 43 with this combination after last reset of blood donation, the first 6 weeks I'm on 160mg/week and the loss of body fat is quite dramatic, about 3%.

It's actually amazing that most of what Nigel advises in this forum really happened to me.

 

[xcpatr922]

Thanks for the insight guys, raising ferritin to pre donation levels that quickly would be great, what brand do you use for the Ferrous bisglycinate chelate?

I feel like just doing a double red twice a year vs wasting any more time with the hematologist to be honest, its nice to get the bloodwork done for free at the Dr's office but it's exhausting dealing with someone who gets triggered to the point of facial tics when I ask her to explain how Hepcidin works and how TRT affects it, potential risks of crashed ferritin etc. Draining and filling up senior citizens seems to be all she's happy with doing.


I have a treadmill stress test and echo booked for next week so I'll get a better idea how my heart is then. I do know of one kid on getbig who had a heart attack running 1.2g of deca for months but no one running 50-100mg a week who has had any issues (not that posts about it online at least)

Just another tip, most MI frequently occurred in the morning hours especially in fall/winter sessions when the temperature drops. So one might want to reduce activity during this combination. The reason is simple actually, the platelet is aggregate and sticky more in the morning. For this very reason, I'm taking the med before sleep or in the morning.

 

[Wilson7]

What's ND ? I have been 6 months on TRT and measuring my body fat loss thru DEXA. I'm also pretty active with HIIT and other sports. 46 years old. The rate of percentage body loss that I've experience is about 0.8-1.0 percent every 5 weeks. This is with 140-150 per week Cypionate (twice a week) and HCG of 500 IU/week (twice a week).Hematocrit is sitting at 43 with this combination after last reset of blood donation, the first 6 weeks I'm on 160mg/week and the loss of body fat is quite dramatic, about 3%.

It's actually amazing that most of what Nigel advises in this forum really happened to me.

ND = nandrolone decanoate

 

[tareload]

I've asked several docs that have been using ND in practice for everything from HIV to HRT and not one has had concerns about cardio toxicity or has seen it in practice in therapeutic dosing. Sure there are animal studies, where are the human studies to support them? We have data from cross-sectional analysis of wannabe genetically altered farm animal look alikes taking high doses of multiple drugs, that doesn't tell us anything about therapeutic dosing esp for HRT ND/TC that is long term. 150TC/75ND is more than enough for HRT, top end borderline supraphysiological, sure don't need more than that. If you are truly concerned about cardiotoxicity, get an echo and a CT angiogram, and/or LGE cardiac MRI to assess fibrosis. See where you stand, you'd be the perfect N of 1 given your history esp if you have no family history. IMO, either an ARB or ACEi should be taken by anyone either abusing AAS or even on TRT (old guys), always prescribed as there is the risk of angioedema in some populations. ANGII and ALD are the players in LVH and fibrosis, and HTN.

Related comments:

What is TRT and What is NOT TRT

Anyone able to answer my question about the change in FSH ref range?

forums.t-nation.com

I've done two 19-week stints of ND with TRT (100 mg/week of TC; 80-120 mg/week of ND) in the last 3 years. Haven't touched the ND since very early 2020 so its metabolites should be pretty much cleared by now ;-).

 

[FDV70]

Thanks for the insight guys, raising ferritin to pre donation levels that quickly would be great, what brand do you use for the Ferrous bisglycinate chelate?

I feel like just doing a double red twice a year vs wasting any more time with the hematologist to be honest, its nice to get the bloodwork done for free at the Dr's office but it's exhausting dealing with someone who gets triggered to the point of facial tics when I ask her to explain how Hepcidin works and how TRT affects it, potential risks of crashed ferritin etc. Draining and filling up senior citizens seems to be all she's happy with doing.

I use Kirkman brand 25mg, and I also buy 5mg too so I can hit 60mg. I could buy 30's from some other brand but I know the Kirkman works so I stick with it.

And yeah the hepcidin -- I sought out a hematologist who is a molecular biologist and when I asked him about iron homeostasis and hepcidin he started to explain until I interrupted. I knew I'd hit gold.

When I first told him my plan he was pretty nonplussed. Like FDV, people have been trying to figure this out forever (he has other TRT patients). When my ferritin values came back higher after mere days, he was very enthused and told me to go nuts -- 7 days next time, plus 30mg daily. I didn't do the daily. I know what he was going for though.

 

[xcpatr922]

I'll follow your protocol, so basically 60mg (about 3 pills of 25mg) 3x a day in 3 days.
What next after that ?

 

[FDV70]

I'll follow your protocol, so basically 60mg (about 3 pills of 25mg) 3x a day in 3 days.
What next after that ?

That's pretty much it -- then, retest your ferritin to confirm that it's back to pre-donation level.

The times of taking are crucial, as is avoiding Vitamins C and D (while you're doing this). No dose skipping either!

For people just jumping in:
the explanation is here.

Fixing High Hemoglobin or Hematocrit and Low Ferritin While on TRT

 

[xcpatr922]

Yes I've read your explanation yesterday. It's quite impressive and straight to the point.

One thing that you're very right is the CPAP part. The CPAP reduces hypoxia chance during sleep hence the HT is staying lower. Also for people in reduced EF due to HF, the CPAP can increase the EF functions.

 

[tareload]

That's pretty much it -- then, retest your ferritin to confirm that it's back to pre-donation level.

The times of taking are crucial, as is avoiding Vitamins C and D (while you're doing this). No dose skipping either!

For people just jumping in:
the explanation is here.

Fixing High Hemoglobin or Hematocrit and Low Ferritin While on TRT

Thanks for sharing your detailed writeup. Fascinating and looks very similar to all the posts I've done here and at T-Nation regarding Hct and erythrocytosis from TRT. Very nice!

One part you mention:
=====
Aspirin and Nattokinase are taken to avoid cerebrovascular events. They don't play a role in managing hemoglobin or hematocrit, they are for prevention.

=====


There is some evidence in the rodent literature regarding effect of ASA on erythropoiesis rate in the bone marrow:

DHEA improves thyroid function in men with autoimmune hypothyroidism- Hashimoto's

Impact of dehydroepiandrosterone on thyroid autoimmunity and function in men with autoimmune hypothyroidism Robert Krysiak · Witold Szkróbka · Bogusław Okopień Abstract Background Testosterone administration was found to have a protective effect on thyroid autoimmunity in men with autoimmune...

www.excelmale.com

Does High Hematocrit Lead to Complications for Men on TRT?

I did a trial of 325 mg/day of aspirin for the last 3 maybe 4 months for a number of reasons. I had also concurrently been slowly ratcheting up my TRT dose from 70 mg/week to 100 mg/week over the same time frame. Pulled blood work last week for a 6 month appt and was expecting to be back...

forums.t-nation.com

Hematocrit drives Blood Viscosity- Does that Matter in Men on TRT? Effect of Altitude?

https://forums.t-nation.com/t/does-high-hematocrit-lead-to-complications-for-men-on-trt/268171/65 Update on my experiment with 325 mg/day of aspirin. Potent reduction in Hct while on TRT. One of the few supplements I've tried that really had a significant effect on Hct. Please consider the...

www.excelmale.com

My cardiologist thought I was insane when I mentioned this to him. My anecdotal experience (controlling for hydration) gives some credence to this effect in humans. I'm not advocating persons take 325 mg/day of aspirin (my own experiment) but FYI. And great work on the Hct writeup.