Trt options in men with BPH

[Steve78]

I’m only 45 but have BPH, no symptoms. Did mri scan of body and found my prostate to be 38 ml, normal is less than 30 ml.

My TT is around 900-1000, I was thinking of dropping it to 6-700 and maybe add low dose nandrolone as a semi replacement or addition as nandrolone doesn’t convert to DHT. Any other thoughts on this?

@Nelson Vergel ?

 

[Systemlord]

Daily Cialis is FDA approved for the treatment of BPH.

 

[Steve78]

Daily Cialis is FDA approved for the treatment of BPH.

Right, I think it just treats symptoms which I don’t have any. Was thinking of ways to have lean athletic build while minimizing progression of BPH. Luckily my PSA stays around .4
I really think lowering my DHT levels is the best approach and maybe do that by lowering my test dose and supplementing with nandrolone…. Just wanted others thoughts etc

 

[Systemlord]

I would just leave it alone. Stop trying to fix problems that don’t exist.

 

[Steve78]

I would just leave it alone. Stop trying to fix problems that don’t exist.

What do you mean? Don’t change my trt and keep levels around 900-1000 TT? I was thinking more towards risk reduction, ie lower the DHT to prevent progression (which is what dutasteride does)

 

[Systemlord]

I was thinking more towards risk reduction, ie lower the DHT to prevent progression

Your brain needs DHT to function. I wouldn’t want to risk lowering a necessary hormone.

 

[Steve78]

Your brain needs DHT to function. I wouldn’t want to risk lowering a necessary hormone.

I ment really lowering my TT from 1000 to 6-700, still within normal ranges.

 

[Systemlord]

I ment really lowering my TT from 1000 to 6-700, still within normal ranges.

A few years ago that would’ve been in the normal range. When the lab companies lower the normal ranges again, indicating the new normal, you can lower your TT for risk reduction, lol.

 

[Belekas]

I’m only 45 but have BPH, no symptoms. Did mri scan of body and found my prostate to be 38 ml, normal is less than 30 ml.

My TT is around 900-1000, I was thinking of dropping it to 6-700 and maybe add low dose nandrolone as a semi replacement or addition as nandrolone doesn’t convert to DHT. Any other thoughts on this?

@Nelson Vergel ?

I'm sure I listened to some podcast with an uro doc and iirc he said that usually its the ones that are considered the "normal" size that are more problematic from what he and his team has seen. I know it sounds crazy and I can't remember which podcast it was but I'm pretty sure I've heard that. Also I'm interested why did you do full body MRI scan?

 

[Steve78]

I'm sure I listened to some podcast with an uro doc and iirc he said that usually its the ones that are considered the "normal" size that are more problematic from what he and his team has seen. I know it sounds crazy and I can't remember which podcast it was but I'm pretty sure I've heard that. Also I'm interested why did you do full body MRI scan?

I'm sure I listened to some podcast with an uro doc and iirc he said that usually its the ones that are considered the "normal" size that are more problematic from what he and his team has seen. I know it sounds crazy and I can't remember which podcast it was but I'm pretty sure I've heard that. Also I'm interested why did you do full body MRI scan?

I did it to detect a problem early… so many I know with cancer found it on an incidental scan. Is if u catch pancreatic cancer early, much higher cure rate

 

[Belekas]

I did it to detect a problem early… so many I know with cancer found it on an incidental scan. Is if u catch pancreatic cancer early, much higher cure rate

I agree and fair play to ya. You can try talking to the AnabolicDoc via his Zoom meetings as he has a lot of patients on TRT/androgens from around the world and is quite good. I believe that is only $20/month and those meetings are done at least twice a week.

 

[Cataceous]

A few years ago that would’ve been in the normal range. When the lab companies lower the normal ranges again, indicating the new normal, you can lower your TT then too for risk reduction, lol.

TT of 1,000 ng/dL is high-end even by historical standards, and it was most likely reflecting individuals with above-average SHBG. Additionally, their trough and average levels would have been lower. Do not discourage him from aiming for more reasonable levels. There's no evidence that having TT 50% over a healthy average is a good idea. On the contrary, we know that side effects make it problematic for a significant fraction.

 

[Systemlord]

Do not discourage him from aiming for more reasonable levels.

Who determines what reasonable levels are, by what measure, given the state of declining testosterone over the last several decades?

Maybe we should focus on optimal levels, and everyone should find out what is optimal for them instead of focusing on everyone else.

On the contrary, we know that side effects make it problematic for a significant fraction.

@Steve78 doesn’t have any side effects. He’s trying to fix what isn’t broke.

 

[Cataceous]

...
@Steve78 doesn’t have any side effects. He’s trying to fix what isn’t broke.

He said he has BPH. It's possible that supra-physiological levels of testosterone — for the individual — are a contributing factor. I'm aware that normal levels of testosterone appear protective versus hypogonadism, but excess is less explored.

Who determines what reasonable levels are, by what measure, given the state of declining testosterone over the last several decades?

Maybe we should focus on optimal levels, and everyone should find out what is optimal for them instead of focusing on everyone else.
...

In the absence of other information we use statistics to determine what's likely to be best. That's what reference ranges are for. If we know that healthy young men typically make 6-7 mg of testosterone daily then that is a reasonable starting point. But no, everyone wants to start with 10 mg and go up from there because more is better, right? Testosterone gets this special dispensation that doesn't apply to any other hormone or drug. You may not intend it that way, but "optimal" has become more of a code word for excessive dosing — the TOT idiocy.

 

[FunkOdyssey]

I’m only 45 but have BPH, no symptoms. Did mri scan of body and found my prostate to be 38 ml, normal is less than 30 ml.

My TT is around 900-1000, I was thinking of dropping it to 6-700 and maybe add low dose nandrolone as a semi replacement or addition as nandrolone doesn’t convert to DHT. Any other thoughts on this?

@Nelson Vergel ?

There's a great paper on this topic which argues there is no evidence that TRT increases prostate size. In fact, even supraphysiologic testosterone levels have not been shown to increase prostate size (multiple studies supporting this). TRT may prevent or reverse lower urinary tract symptoms in men already suffering with them. A 20 year long prospective study found elevated testosterone and DHT levels in midlife were associated with lower risk of LUTS later on.

Please read this paper before you start dialing back your TRT on account of your prostate: Testosterone replacement therapy and voiding dysfunction - Baas - Translational Andrology and Urology

 

[FunkOdyssey]

Here's what you probably should be more worried about IMO: Diet-Induced Hyperinsulinemia as a Key Factor in the Etiology of Both Benign Prostatic Hyperplasia and Essential Hypertension?

 

[madman]

I’m only 45 but have BPH, no symptoms. Did mri scan of body and found my prostate to be 38 ml, normal is less than 30 ml.

My TT is around 900-1000, I was thinking of dropping it to 6-700 and maybe add low dose nandrolone as a semi replacement or addition as nandrolone doesn’t convert to DHT. Any other thoughts on this?

@Nelson Vergel ?

Male Lower urinary tract symptoms (LUTS)

In the final edition of EAUTV at EAU24 our expert panel discusses Male LUTS. Moderator Prof. Jean-Nicolas Cornu and discussants Prof. Marcus Drake and Prof. Thomas Herrmann cover the distinctions between prostate symptoms and LUTS, storing and voiding issues, and more.

www.excelmale.com

Medical management of BPH

ABSTRACT Medical management of benign prostatic hyperplasia(BPH) has progressed gradually in recent years and remains the starting point for most symptomatic patients seeking treatment. Beyond well-known alpha-blockers and 5-alpha reductase inhibitors, there is growing evidence for the use of...

www.excelmale.com

*Benign prostatic hyperplasia (BPH), also known as benign prostate enlargement or obstruction, is a histologic diagnosis that describes the proliferation of glandular epithelial tissue and smooth muscle within the transition zone of the prostate.1,2 The prostate gland has both intrinsic and extrinsic factors that likely play complex roles in its growth. These include the interaction between the stroma and epithelium, hormone and androgen exposure (specifically testosterone and, more importantly, dihydrotestosterone), dietary factors, micro-organisms, and genetic predisposition.1,2

Although the exact mechanism for the development of BPH is unknown, age-related changes causing metabolic disturbances, changes in hormone balance, and chronic inflammation appear to contribute.3 Despite diminishing levels of testosterone as patients grow older, the amount of circulating dihydrotestosterone and prostatic androgen receptors remains high.2

An overview of leading pathophysiologic theories in BPH - Androgens and estrogens

*26:32-35:10 (androgens/estrogens)

www.excelmale.com

Enlarged Prostate (BPH) Vs. Prostate Cancer

Benign Prostatic Hyperplasia (BPH), or simply an enlargement of the prostate gland, is a condition that is common in men as they age and can oftentimes cause confusion when it comes to the diagnosis and staging of prostate cancer. For example, BPH can cause a higher PSA which is often mistaken...

www.excelmale.com

2:42 What causes prostate enlargement?

Updates on androgen replacement therapy and LUTS

Updates on androgen replacement therapy and lower urinary tract symptoms: a narrative review (2022) Raed M. Al-Zoubi, Mustafa Alwani, Omar M. Aboumarzouk, Mai Elaarag, Ahmad R. Al-Qudimat, Laxmi Ojha & Aksam Yassin ABSTRACT Lower urinary tract symptoms (LUTS) are caused by higher tension at...

www.excelmale.com

The Mysteries of BPH: A Deeper Dive into Pathophysiology

www.excelmale.com

Enlarged prostate/Benign Prostate Hyperplasia (BPH)

www.excelmale.com

post #10

Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring

ABSTRACT The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age...

www.excelmale.com

BPH/LUTS

*There is no evidence that TTh either increases the risk of BPH or contributes to the worsening of LUTS

*At present, there is no evidence that TTh either increases the risk of BPH or contributes to the worsening of LUTS

 

[Steve78]

Male Lower urinary tract symptoms (LUTS)

In the final edition of EAUTV at EAU24 our expert panel discusses Male LUTS. Moderator Prof. Jean-Nicolas Cornu and discussants Prof. Marcus Drake and Prof. Thomas Herrmann cover the distinctions between prostate symptoms and LUTS, storing and voiding issues, and more.

www.excelmale.com

Medical management of BPH

ABSTRACT Medical management of benign prostatic hyperplasia(BPH) has progressed gradually in recent years and remains the starting point for most symptomatic patients seeking treatment. Beyond well-known alpha-blockers and 5-alpha reductase inhibitors, there is growing evidence for the use of...

www.excelmale.com

*Benign prostatic hyperplasia (BPH), also known as benign prostate enlargement or obstruction, is a histologic diagnosis that describes the proliferation of glandular epithelial tissue and smooth muscle within the transition zone of the prostate.1,2 The prostate gland has both intrinsic and extrinsic factors that likely play complex roles in its growth. These include the interaction between the stroma and epithelium, hormone and androgen exposure (specifically testosterone and, more importantly, dihydrotestosterone), dietary factors, micro-organisms, and genetic predisposition.1,2

Although the exact mechanism for the development of BPH is unknown, age-related changes causing metabolic disturbances, changes in hormone balance, and chronic inflammation appear to contribute.3 Despite diminishing levels of testosterone as patients grow older, the amount of circulating dihydrotestosterone and prostatic androgen receptors remains high.2

An overview of leading pathophysiologic theories in BPH - Androgens and estrogens

*26:32-35:10 (androgens/estrogens)

www.excelmale.com

View attachment 44766
View attachment 44767
View attachment 44768
View attachment 44769
View attachment 44770

Enlarged Prostate (BPH) Vs. Prostate Cancer

Benign Prostatic Hyperplasia (BPH), or simply an enlargement of the prostate gland, is a condition that is common in men as they age and can oftentimes cause confusion when it comes to the diagnosis and staging of prostate cancer. For example, BPH can cause a higher PSA which is often mistaken...

www.excelmale.com

2:42 What causes prostate enlargement?

Updates on androgen replacement therapy and LUTS

Updates on androgen replacement therapy and lower urinary tract symptoms: a narrative review (2022) Raed M. Al-Zoubi, Mustafa Alwani, Omar M. Aboumarzouk, Mai Elaarag, Ahmad R. Al-Qudimat, Laxmi Ojha & Aksam Yassin ABSTRACT Lower urinary tract symptoms (LUTS) are caused by higher tension at...

www.excelmale.com

The Mysteries of BPH: A Deeper Dive into Pathophysiology

www.excelmale.com

View attachment 44764

Enlarged prostate/Benign Prostate Hyperplasia (BPH)

www.excelmale.com

post #10

Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring

ABSTRACT The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age...

www.excelmale.com

BPH/LUTS

*There is no evidence that TTh either increases the risk of BPH or contributes to the worsening of LUTS

*At present, there is no evidence that TTh either increases the risk of BPH or contributes to the worsening of LUTS

In other words, we just don’t know lol

 

[Systemlord]

That's what reference ranges are for. If we know that healthy young men typically make 6-7 mg of testosterone daily then that is a reasonable starting point.

What was once considered healthy 30 years ago is being redefined today.

There are over 200 chemicals in your body at any given time. These chemicals disrupt the normal function of neurotransmitters, hormones and more. The result is auto immune diseases, weight gain, fatigue, erectile dysfunction, testosterone deficiency, hair loss etc.

 

[Steve78]

maybe for me i may drop my test dose and add in nandrolone as it may be safer for the prostate. do 80-90 mg each a week.