When it comes to side effects shutdown of the hpta, reduced fertility/testicular atrophy, and an increase in your hemoglobin/hematocrit is a given.
The addition of hCG which mimics LH will help prevent/minimize testicular atrophy and maintain fertility.
RBCs/hemoglobin/hematocrit can be managed by blood donations but it is a slippery slope.
Regarding some of the cosmetic sides such as (acne, increased body hair, male pattern baldness, water retention/bloat, and gyno).
When it comes to acne, male pattern baldness, and gynecomastia genetics will play a big role as some men are more prone to this.
Many can struggle with acne (especially body) or notice accelerated hair loss when using therapeutic doses of T, especially when running too high an FT level, but when it comes to getting gynecomastia it is far from common.
Although excess e2 can play a role in water retention (bloat/puffiness) it is not solely to blame.
Androgens increase the retention of electrolytes.
The use of exogenous androgens will result in the retention of sodium, chloride, water, potassium, calcium, and inorganic phosphates.
Bloating/edema can be common in some and to what degree depends on many factors.
Most of the initial increases in weight gain on trt are water-related whether extra-cellular/intra-cellular.
Many men on trt can gain 5-15 lbs of water weight within the first month.
The majority of gains when first starting trt are due to extra-cellular water (between the muscle and skin) which shows up as bloat/puffiness and intra-cellular water (inside the muscle cell) which will make the muscle look fuller and harder due to increased glycogen stores.
The majority of men that end up struggling with elevated RBCs/hemoglobin/hematocrit let alone some of the cosmetic sides are due to running too high an FT level.
Keep in mind that many of the men on those forums struggling with sides are overmedicated and running very high/absurdly high trough FT levels!
Stuck on that more T is better mentality!
To be honest, when it comes to cardiovascular and prostate health having a healthy TT/FT level is critical.
Low-T is detrimental to your overall health (physical/mental).
The main reason testosterone is used for replacement therapy over nandrolone let alone any other AAS is that testosterone drugs
provide a hormone that is already produced in the body.
T's metabolites estradiol and DHT are needed in healthy amounts to experience the full spectrum of testosterone's beneficial effects on (cardiovascular and prostate, brain, libido, erectile function, bone, tendons, immune system, lipids, and body composition).
*Natural testosterone is viewed as the best androgen for substitution in hypogonadal men. The reason behind the selection is that testosterone can be converted to DHT and E2, thus developing the full spectrum of testosterone activities in long-term substitution
*Preparations of native testosterone or its esters (aromatizable T) should be used for TTh
Regarding cardiovascular/prostate health and TRT some of these threads may help put your mind at ease!
Testosterone replacement therapy and cardiovascular disease (2022) Jeremy M. Auerbach and
Mohit Khera The use of testosterone therapy has a complex history of apprehension and questions regarding its safety. Despite an eventual consensus that testosterone therapy was safe and effective...
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Testosterone Treatment and the Risk of Prostate Adverse Events (2022) Jason A. Levy, DO, MS, Arthur L. Burnett, MD, MBA, Adrian S. Dobs, MD, MHS INTRODUCTION Definition Hypogonadism is a clinical syndrome that results from failure of the testis to produce physiologic concentrations of...
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Management of Erythrocytosis in Men Receiving Testosterone Therapy: Clinical Consultation Guide (2022) Pranjal Agrawal, Sajya M. Singh, Taylor Kohn 1. Introduction Testosterone deficiency, previously known as male hypogonadism, affects approximately 25% of all men, with a prevalence that...
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