TRT - Let’s stop jacking around.
Real talk for a second here, guys. So many men out there looking for testosterone “replacement” therapy. TONS of websites and clinics offering prescription and “natural” boosters for testosterone. Not to spit in the face of anyone out there monetizing the TRT space, but I think there are some misguided ideas out there on this topic that deserve better clarity. This may be hard to hear, but you guys deserve truth about the world of taking hormones.
Bioidentical Hormone Replacement - The implication of this phrase is that everything you’re taking is just exactly like your body’s own hormones, right? Wrong. There is no way, at least not yet, that we can suck testosterone or any other hormone, out of your neighbor and put it in you. We can synthesize the hormones chemically, just like any other medication, but there’s nothing really “bioidentical” about that process now is there? Doesn’t matter if its in the form of injection, pellets, creams, gels, troches or capsules. Its ALL synthetically produced in a lab. What the term “bioidentical” actually means is to give you synthetically manufactured hormones at a low enough dose to achieve blood hormone levels somewhere in the range similar to what the body produces naturally.
Now that we have that cleared up, think about how the body works for a second. The endocrine (hormone) system works on negative feedback. Meaning, when enough of a hormone or its metabolite exists, the body slows down the hormone’s production. So, if I give you a hormone exogenously (meaning from outside the body), what happens to your natural production? Correct, sir, the natural production slows down.
That’s right, when you take “bioidentical” testosterone it is 1) synthetic, and 2) slows or even stops your natural production of testosterone. So how’s that “bioidentical”?? Great question. Ask the punks using the term. Bottom line, “bioidentical” is 100% a marketing scam targeting people who want to believe the hormones they are taking are all safe and not synthetically manufactured or replacing their own body’s natural processes. It might feel more warm and fuzzy but it usually also means such low doses the user never sees much in terms of results. But at least they can feel better knowing their not like all those meat-heads on the juice!
Low Testosterone - I hear guys in the gym and see them on social media talking about their T level. My T level was 150 before I started TRT! Oh yea, well mine was 75 before I started! Dudes wear this low T thing like a badge of honor. Especially when they come back with “Now my T level is 850!”. Congratulations, sir, you now have normal T, but did anyone stop and ask WHY does a 40 year old man have a testosterone level of 150? Probably not. They just took his $ and gave him the prescription per protocol. Does he feel better? Sure he does! Is it normal for a guy at 40 to have a T level so low? NO!
The marketers would lead you to believe low T is all part of aging, right?
“Not feeling like the guy you once were?”
“Wish you had the energy you had when you were 20?”
You’ve seen all the pitches I’m sure. Truly, low T is NOT normal for any man, regardless of age. T levels do decrease as we get older but not at the rate we have seen in the last 20-30 years. We could postulate on the reasons we are now seeing such low T levels, even in very young men: toxin exposures, inadvertent hormone exposure in the diet (dairy, xenoestrogens, etc), climate change (hahaha-couldn’t resist). These and many other factors are likely contributing to the trend. However, very low T levels can indicate a more serious problem. If your testosterone levels are less than 200 and your under the age of dead, someone needs to be asking why and do a little more digging.
Post TRT Testosterone levels - Another topic where guys on TRT love to share their private health information with the world. “I just got my labs done and my T level was 1200!” So that total serum testosterone level is not bad, but how much of that is actually working for you in the body? Turns out, about 98% of your total testosterone is protein bound, meaning it is unavailable to act on target cells and do all the magical things T does for you. If most of a man’s testosterone is bound to transport proteins like albumin and sex hormone binding globulin, it ain’t really doing him much good, right? Stop looking at total T levels, guys. Its ok to check it, but it should not be the end-all, be-all marker for measuring effectiveness of testosterone treatment and optimization. SHBG, estradiol, DHT, and several other markers are vital to consider along with testosterone levels. If your treatment plan is not following these types of markers, I would suggest finding another “expert” to monitor your treatment.
Testosterone Dosing - This subject really cracks me up. For most men’s health clinics, dosing is all a scripted protocol but very silly in its design. I see guys taking hormone pellets every 6 months and other guys taking an injection of T-cyp every 2-4 weeks. Again, not picking on anyone in particular, but if you’re doing TRT of any kind, you need to ask hard questions about dosing. Look, when you’re taking testosterone injections (T-cypionate, enanthate or whatever) you are essentially dosing the foundation of an anabolic steroid cycle. Make no mistake, testosterone is an anabolic steroid, even at low doses. Its really just semantics but it should change the perspective of some who might be quick to judge guys they think are “running gear”. If you’re on TRT, you’re running gear, bro. If you’re only dosing it every 2 weeks, you’re running a very dumb cycle of gear. The cypionate and enanthate esters of testosterone only have about a 4 day half life at best. If you’re not dosing these esters twice weekly, your peak and trough hormone and metabolite levels will be all over the place which will make you feel even worse! There’s certainly nothing “bioidentical” about that now is there? Again…couldn’t help myself.
Pellet TRT is a less desirable delivery system for men. Now, this is 100% opinion but one based on years of experience with pellet HRT so hear me out. The average guy will get 1800-2400mg of testosterone pellets inserted every 6 months or so. Now, that first round of pellets will have you feeling like Zeus around week 3 but by week 12, most guys are back where they started or can at least feel the effects slipping. The follow up labs after pellet insertions are, by protocol, conveniently staged around week 4-6 when levels are at peak so guys think they are good to go. Beyond that point, it is a steady decline at a rate no one really knows for sure. Here’s the truth: there’s just no good way of maintaining a sustained release of testosterone by any mechanism, other than your body’s own, for months on end. Now, results always vary and a few guys out there on pellets may not agree with me, but much of the result hinges on the skill of the inserter, the anatomy of the recipient but mostly on their physiology. Men can do pellet insertions on a shorter frequency, like every 3 months, but most providers will significantly dial back the dosing. If not, you will eventually run out of real estate in your butt from scar tissue and have to put the pellets elsewhere, like in the abdomen or around the lumbar/”love handles”. Also, getting 2000mg of synthetically manufactured testosterone pressed into a pellet labeled “bioidentical” and think your going the natural route (laugh, cough)…um…you’re not.
What about dosing topicals?? LOL…don’t, just don’t. Maybe I’ll write that up later when I stop laughing. Seriously, guys don’t waste your time and money.
As I close this out, I want to make one thing undeniably clear. I DO NOT advocate the use or abuse of illegal anabolic steroids. I DO NOT support the abuse or misuse of legal anabolic steroids, including our beloved testosterone!
If you’re offended at this point, you shouldn’t be. My hope is that if something in here rang true, it will prompt the asking of questions and some research into what you’re doing with testosterone treatment. What I hope you will do is find a knowledgeable professional you can work with that understands what your labs mean and what to look for. One who has the experience to help you select the correct testosterone delivery and dosing to meet your goals and needs. Most importantly, someone who will keep you safe through the process. You deserve better than some stupid protocol driven approach to testosterone treatment.
No apologies.
Alpha Male