What is TRT and What is NOT TRT

[tareload]

how many guys are dropping dead from test only cycles.? I’m genuinely asking

Gotcha and my response would be dropping dead would not be my primary concern. Heart enlargement, diastolic dysfunction (HFpEF), autonomic dysfunction and quality of life would be my concern for me. Make sure you don't have preexisting arrythmia before you go down that road.

There are some things worse than death. Like living but not able to do what you want. Hopefully most get some feedback as wake up call before too late. I F'ed around and found out with the recipe I had previously. Took me years to recover mentally from it. I hope to save someone from this or at least prep them for it.

Best analogy I can come up with for blasting Test is smoking cigarettes (maybe a little harsh). Again, are you (1) cycling or (2) blasting and then crusing at 200-300 mg/week Test ester?

So many variables. But let's not pretend 2000 ng/dl TT/30+ ng/dl FT is legimate TRT. I am running this right now and it ain't for hypogonadism. Buyer beware.

 

[Charliebizz]

Gotcha and my response would be dropping dead would not be my primary concern. Heart enlargement, diastolic dysfunction (HFpEF), autonomic dysfunction and quality of life would be my concern for me. Make sure you don't have preexisting arrythmia before you go down that road.

There are some things worse than death. Like living but not able to do what you want. Hopefully most get some feedback as wake up call before too late. I F'ed around and found out with the recipe I had previously. Took me years to recover mentally from it. I hope to save someone from this or at least prep them for it.

Best analogy I can come up with for blasting Test is smoking cigarettes (maybe a little harsh). Again, are you (1) cycling or blasting and then crusing at 200-300 mg/week Test ester.

So many variables. But let's not pretend 2000 ng/dl TT/30+ ng/dl FT is legimate TRT. I am running this right now and it ain't for hypogonadism. Buyer beware.

I wasn’t solely focusing on death lol. But really where is the definitive studies that show test only in supraphysiological levels with no a.I is causing any long term health consequences? I’m sorry I haven’t had time to read all the old t nation threads you’ve had on this topic. ive Read some and really enjoy the debate Though

 

[Charliebizz]

Gotcha and my response would be dropping dead would not be my primary concern. Heart enlargement, diastolic dysfunction (HFpEF), autonomic dysfunction and quality of life would be my concern for me. Make sure you don't have preexisting arrythmia before you go down that road.

There are some things worse than death. Like living but not able to do what you want. Hopefully most get some feedback as wake up call before too late. I F'ed around and found out with the recipe I had previously. Took me years to recover mentally from it. I hope to save someone from this or at least prep them for it.

Best analogy I can come up with for blasting Test is smoking cigarettes (maybe a little harsh). Again, are you (1) cycling or (2) blasting and then crusing at 200-300 mg/week Test ester.

So many variables. But let's not pretend 2000 ng/dl TT/30+ ng/dl FT is legimate TRT. I am running this right now and it ain't for hypogonadism. Buyer beware.

And more to that point, even in my case. No way applying 200mg of test cream daily split up 2x a day is even close to physiological. Are my numbers out of this world no. But is it causing harm that my numbers are probably 700-1100 24 hours a day 365 days a year?

 

[tareload]

But is it causing harm that my numbers are probably 700-1100 24 hours a day 365 days a year?

For you? In your particular case? I have no idea.

What was your pre treatment levels. 700-1100 ng/dl TT 24 hrs a day would not be outside the realm of physiologic for some. For you? Don't know. I have shared good studies from the 1970s showing some of this variability.

Find a solution that works for you and you are comfortable with. My only point is be aware of the uncertainty in all this. I don't claim to have definitive answers. But I do understand best practice when you don't have all the answers. Hence, the discussion we are having seems reasonable to provide informed consent and education to those interested.

EDIT: here you go

Hourly Intraday testosterone profiles in young eugonadal (healthy functional) men (1973-1983)

https://forums.t-nation.com/t/24-hour-tt-profiles-in-young-eugondal-healthy-functional-men-1970s-1980s/277585 Enjoy. There's no way I am copying these graphs again so sorry you have to view this on another site. I reached way back for you guys. 1970s-1980s back when we had "REAL" men...

www.excelmale.com

 

[tareload]

But really where is the definitive studies that show test only in supraphysiological levels with no a.I is causing any long term health consequences?

They don't exist.

But there is information you can piece together.

See all my posts in this thread:

Nandrolone for Mood | Feeling much Better..

Also, I haven't read the mouse study, but it occurs to me that in the early days of Low Carb, there was an attempt to show that (I think) olive oil was toxic using FMD as a measure. However I believe Volek subsequently showed that it was a short-term affect which disappeared after several weeks...

www.excelmale.com

Or if you have a lot of your time you can skim through my 2500 posts LOL here. I can't view my TNation stuff either now.

....

 

[Charliebizz]

They don't exist.

But there is information you can piece together.

See all my posts in this thread:

Nandrolone for Mood | Feeling much Better..

Also, I haven't read the mouse study, but it occurs to me that in the early days of Low Carb, there was an attempt to show that (I think) olive oil was toxic using FMD as a measure. However I believe Volek subsequently showed that it was a short-term affect which disappeared after several weeks...

www.excelmale.com

View attachment 34573


Or if you have a lot of your time you can skim through my 2500 posts LOL here. I can't view my TNation stuff either now.

....

They don't exist.

But there is information you can piece together.

See all my posts in this thread:

Nandrolone for Mood | Feeling much Better..

Also, I haven't read the mouse study, but it occurs to me that in the early days of Low Carb, there was an attempt to show that (I think) olive oil was toxic using FMD as a measure. However I believe Volek subsequently showed that it was a short-term affect which disappeared after several weeks...

www.excelmale.com

View attachment 34573


Or if you have a lot of your time you can skim through my 2500 posts LOL here. I can't view my TNation stuff either now.

....

Well the fact of the matter is we do not know that there isn’t a risk for “anyone“ for that matter. So if dr saya has his patients in a range of say 700-1100 24hours a day and it is harmful for one out of 10 patients. Is he any better then @RobRoy who keeps his patients at 1200-1500 and it’s harmful for 1 out of 10 patients.

also many of these trt drs and clinics are blasting guys out of the gate with a.I while jacking t levels up. I think that’s more harmful then what @RobRoy ”might be doing “.

 

[tareload]

Well the fact of the matter is we do not know that there isn’t a risk for “anyone“ for that matter. So if dr saya has his patients in a range of say 700-1100 24hours a day and it is harmful for one out of 10 patients. Is he any better then @RobRoy who keeps his patients at 1200-1500 and it’s harmful for 1 out of 10 patients.

also many of these trt drs and clinics are blasting guys out of the gate with a.I while jacking t levels up. I think that’s more harmful then what @RobRoy ”might be doing “.

fair enough. I also give Doctors points for not acting as if they have the definitive answer when no one does yet. Dr. Saya is pretty humble about it and that counts in my book. Informed consent is big for me.

I have also covered what the estimated range is for Defy Patients based on data shared. The conclusion is to your point...there are lots of guys running pretty high compared to liberal ref range of 300 - 1200 ng/dl. I won't get into FT ranges as few understand them and how to measure them properly. But again to your point lots of dudes now running 30+ ng/dl FT.

 

[Charliebizz]

fair enough. I also give Doctors points for not acting as if they have the definitive answer when no one does yet. Dr. Saya is pretty humble about it an that counts in my book. Informed consent is big for me.

I have also covered what the estimated range is for Defy Patients based on data shared. The conclusion is to your point...there are alots of guys running pretty high compared to liberal ref range of 300 - 1200 ng/dl. I won't get into FT ranges as few understand them and how to measure them properly. But again to your point lots of dudes now running 30+ ng/dl FT.

And honestly. (Just and observation) seems as most the guys doing well are on that higher side. It seems the ones that micromanage every little detail and want to stay in this magic little “natural” range are the ones who suffer. Trust me I was that guy for years. granted I’m still within the alleged “healthy“ range On trt. And I agree with @Cataceous miet of us probably have never seen the levels that we are at on trt “naturally”. But that brings in the debate about the serum not reflecting what’s going on in the cells and the whole “symptom relie” debate that gets everyone wound up.

so really the big hang up for you and @RobRoy is that rob speaks as if we have no chance of doing harm with higher levels and you just want him to a knowledge a possibility of some harm ? Other then that seems to me you guys aren’t far off on how you view trt

 

[tareload]

so really the big hang up for you and @RobRoy is that rob speaks as if we have no chance of doing harm with higher levels and you just want him to a knowledge a possibility of some harm ? Other then that seems to me you guys aren’t far off on how you view trt

I appreciate your trying to help us find common ground.

Yes that is a decent way to put it. Plus the wide gulf we have when it comes to Hct. Very dangerous overconfidence in my opinion and I have laid out why in excrutiating detail. His mentor's video has really confused and sent many folks in the wrong direction. Kinda unforgivable with someone with that experience.

Misinformation...

No serious person confuses PCV with erythrocytosis.

Increasing Hct increases whole blood viscosity. Fact.

This thread has been up now for almost 4 years. Not one substantive counter argument or rebuttal:

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

Hi ExcelMale folks, I wanted to start off by expressing my gratitude for this site, all of the amazing work that has been put in to make this place such a great source of information. I would expect no less from a chemical engineer :). I've been following this "debate" about how to properly...

www.excelmale.com

Erythrocytosis is harmless (blanket statement). Horrible.

 

[Charliebizz]

I appreciate your trying to help us find common ground.

Yes that is a decent way to put it. Plus the wide gulf we have when it comes to Hct. Very dangerous overconfidence in my opinion and I have laid out why in excrutiating detail. His mentor's video has really confused and sent many folks in the wrong direction. Kinda unforgivable with someone with that experience.

Pure trash...

I’m still hung up on one of the podcasts when the host asked “why do men with high hct feel better when they donate they feel better“ and he just skimmed right past the question.

look’ing at this logically I would say if your getting tons of side effects from your hct being high and then you lower it and feel better, it was causing problems!! but that’s just me!!

 

[tareload]

I’m still hung up on one of the podcasts when the host asked “why do men with high hct feel better when they donate they feel better“ and he just skimmed right past the question.

look’ing at this logically I would say if your getting tons of side effects from your hct being high and then you lower it and feel better, it was causing problems!! but that’s just me!!

Nandrolone for Mood | Feeling much Better..

I think they all contribute some really good things to the field overall, but u unfortunately have to take certain things they all say with a grain of salt, @readalot, lets go with @Gman86 here. Let's critically listen to everything these guys say, and use what's good (if any), discard what's...

www.excelmale.com

Don't look here.

And therein is the issue. I could spend the rest of whatever life I have left arguing with someone who is purposely obstinate and I would add duplicitous. Lack of good faith. That is what really bugs me. But he is not just responsible for himself. He is also caring for others and they trust him.

I have been "debating" @RobRoy for at least 4 years now / Danny / all of their followers. Not one substantive counter / rebuttal to my comment about plasma viscosity + Hct = WBV. Hence, Hct is a relative indicator of WBV and you better understand the individual patient you are referring to before making insane statements like erythrocytosis is harmless.

 

[FunkOdyssey]

I’m still hung up on one of the podcasts when the host asked “why do men with high hct feel better when they donate they feel better“ and he just skimmed right past the question.

look’ing at this logically I would say if your getting tons of side effects from your hct being high and then you lower it and feel better, it was causing problems!! but that’s just me!!

From the paper readalot just linked to, they actually have a name for the constellation of symptoms that sometimes appears in association with high hematocrit: hyperviscosity syndrome.

 

[tareload]

From the paper readalot just linked to, they actually have a name for the constellation of symptoms that sometimes appears in association with high hematocrit: hyperviscosity syndrome.

Here's a funny story. The TOT crowd also points to secondary erythrocytosis due to altitude. Although not quite the same as secondary erythrocytosis from TRT.

Here's another cause of secondary erythrocytosis: CCHD at sea level.

Hyperviscosity syndrome revisited - PMC

Secondary erythrocytosis occurs in cyanotic heart disease as a physiological response to chronic hypoxia, and this leads to hyperviscosity and various complications of the same. Microvascular stasis due to hyperviscosity results in symptoms ...

www.ncbi.nlm.nih.gov

And BTW there are a subset of populations at elevation that run into serious problems. Already covered that too in the other thread. Have a look for those interested.

Global REACH 2018: High Blood Viscosity and Hemoglobin Concentration Contribute to Reduced Flow-Mediated Dilation in High-Altitude Excessive Erythrocytosis - PubMed

Excessive erythrocytosis (EE; hemoglobin concentration [Hb] ≥21 g/dL in adult males) is associated with increased cardiovascular risk in highlander Andeans. We sought to quantify shear stress and assess endothelial function via flow-mediated dilation (FMD) in male Andeans with and without EE. We...

pubmed.ncbi.nlm.nih.gov

https://journals.physiology.org/doi/full/10.1152/physiol.00029.2021

https://physoc.onlinelibrary.wiley.com/doi/abs/10.1113/JP279694

https://physoc.onlinelibrary.wiley.com/doi/abs/10.1113/JP282972

https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.119.316053

https://physoc.onlinelibrary.wiley.com/doi/full/10.1113/JP283362

Nothing to see here, especially anything that can be spoken about systematically on an entertaining podcast. How can you guys ignore this stuff and not review it? Or have you? Since you all are the "experts" get together and do some journal clubs like the rest of us do.

Here's you a whole 'nother podcast of material @RobRoy. Tell Jay to pick it up some. Your listeners deserve the whole truth. How is this information applicable to your patients and listeners?

 

[tareload]

And of course we have the emerging trans medicine literature to reflect on.

Erythrocytosis and thromboembolic events in transgender individuals receiving gender-affirming testosterone - PubMed

Erythrocytosis is a well-recognized consequence of exogenous testosterone, however its prevalence and contributions to thrombosis remain unknown in the context of gender-affirming hormonal therapy. We undertook a retrospective study of transgender and non-binary (TGNB) adults receiving exogenous...

pubmed.ncbi.nlm.nih.gov

 

[tareload]

@RobRoy...


@RobRoy .....

?????

Nothing?

And again if you ever come across this Joseph Hearnshaw....I have never claimed to have anything to do with you and have never met or spoken/interacted with you. Not sure where @RobRoy is getting any of this.

My only thought is you have put together some PK profiles here:

Microdosing TRT – The Future of Testosterone Replacement Therapy - The Men’s Health Clinic

Microdosing is the most effective way to mimic natural Testosterone levels and minimise side effects. We explain why in this article.

themenshealthclinic.co.uk

So @RobRoy must have thought we are same person. But they don't include first order absorption plus elimination. Hence not quite as realistic as some I have done. The ones you did will overestimate peak to trough ratio.

Peace out Brethren. There is really nothing more humanly possible I could do within reason to engage any more substantively in this "debate". Just a hobby for me that has taken up too much time.

Best wishes as you sort through all this for yourself.

 

[Deleted member 43589]

WOW! See what I get for having to sit in the hospital all day? It will take me the rest of the week to read this. No it wasn't the result of high HCT, I sat on my toilet and the porcelain literally exploded leaving me on the floor of the rest room bleeding profusely. I have 10 stitches in the lower leg and 6 stitches in the top of the hand. Thought I would bleed out before I could get to the hospital. Damn Eliquis. So since I can't do any physical exercise for 10 days let me start reading all of this. At least RobRoy showed up. Had no idea this has been going on for 4 years.

 

[aneuman]

Find a solution that works for you and you are comfortable with. My only point is be aware of the uncertainty in all this. I don't claim to have definitive answers. But I do understand best practice when you don't have all the answers. Hence, the discussion we are having seems reasonable to provide informed consent and education to those interested.

Lack of good faith. That is what really bugs me. But he is not just responsible for himself. He is also caring for others and they trust him.

I hear you brother.

 

[tareload]

WOW! See what I get for having to sit in the hospital all day? It will take me the rest of the week to read this. No it wasn't the result of high HCT, I sat on my toilet and the porcelain literally exploded leaving me on the floor of the rest room bleeding profusely. I have 10 stitches in the lower leg and 6 stitches in the top of the hand. Thought I would bleed out before I could get to the hospital. Damn Eliquis. So since I can't do any physical exercise for 10 days let me start reading all of this. At least RobRoy showed up. Had no idea this has been going on for 4 years.

Holy shit Brother. Get well soon. I always wondered if this had ever happened to someone I just wish it had not happened to you.

You are just too fuc*ing powerful for the toilet. Jesus.

I have had so many lacerations that were life threatening. I feel your pain seriously. Glad you made it.

 

[tareload]

Had no idea this has been going on for 4 years.

Started here...with Danny Bossa and "yeti308"..the smartest man Danny knew at the time.

The Health Optimization Doctors RoundTable: High Hematocrit Not Important?

It seems like the evidence cited for the safety of "non woke" TRT is studies of men on "woke trt".

www.excelmale.com

Links embedded in this thread. I wasted many hours trying to educate this dude. But hopefully it is not a waste if other folks read it and it made them think.

And the funny part is I can't look at this stuff anymore so my bad if the link is not matched to the correct posts. The thread was a doozy.

 

[tareload]

Timely thread going over all over again @RobRoy...

EPO vs high HCT

Why do some guys report getting out of breath easier when their HCT is high, yet athletes use EPO to increase their RBC’s, which would obv increase their HCT as well. Why are these athletes getting improved cardio, while guys on TRT report decreased cardio when their HCT levels get too high?

www.excelmale.com

Surely a timely 60 min podcast for you guys over in TOT world.