Hormone Replacement Therapy for Men?

[Tricia]

I know we're talking about male hormones, but there is a lot to consider when thinking about this topic.

After my breast cancer surgery last year I went through a ton of research about hormones and the imact on more than reproductive organs.
There is a lot to absorb. One of the reasons I opted to avoid aromatase inhibitors as part of my treatment.
Obviously, I had lab work done as a part of my decision making process.

All in all, I wouldn't mess around with hormones without consulting a doctor and getting labs done.

 

[martyg]

Big fan. About 10 years ago my wife (who was 50ish) raved about her new hormone treatment. About how sharp she felt. About how well she slept. I said, "I need to look into that."

Since then, it has gone more mainstream. With COVID, the FDA has loosened the classification of T. Before you needed a physical visit. Now it can be telemed. In both cases, you needed bloodwork. The more detail oriented the practitioner, the more detailed (and expensive) your blood work will be. Once a year my blood work is about $1,200.

My observations: I sleep super soundly. Dropping bodyfat is effortless (part is my training schedule). Recovery time is reduced. Much sharper mental acuity. This isn't about megadosing. This is about optimizing your hormone levels, and optimizing your quality of life. I think you will find that anyone at the top of their game is optimizing hormone levels.

TrumanRX is an upstart in this domain. Essentially, you pay a hundred or two bucks, they send a stick kit, you stick yourself, the results go to a lab, and the determination is made if you would benefit from replacement therapy. If yes, you have a telemed appointment with a doc, chat about goals, etc. Prescrpt for a topical cream is sent o your home. Probably a folloow-up stick kit in 90 days to check levels. It is easy. It is at home.

My doc is a high performance guy, works with pro athletes, is a competitive bodybuilder. We moved the needle on my T levels post severe knee injury and surgery - total rupture of my quad tendon. I absolutely crushed PT protocols. Without optimizing every aspect of my recovery (diet, sleep, manual therapies, electro-stim, and hormone levels), I would not be hammering hills on the bike, and doing heavy squat workouts.

Enjoy.

 

[martyg]

A topic one will encounter quite frequently if you hang out on the strength training areas of the internet. Sometimes see suggestions that all older guys should do this, but it is probably best to follow the general medical advice of only pursuing treatment if you actually have symptoms. I have teenage sons I am competing with so it is easy to be tempted but I would not pursue it without more justification.

IF you need it, the effects low Testosterone are serious and you should pursue treatment, just as high levels can cause heart issues, so can low levels. Just be aware that the medical community goes through phases on their tolerance to this and right now seem to be discouraging it (there are claims that research has shown it may not help older men, this is not true). Possible you would need to hunt around for a doctor who would treat you properly.

Your justification should be the objective metrics that blood work would provide - in any aspect of health, from diet to hormone levels, to training. Without hard numbers, you are in a place where you are just guessing. With hard numbers, you have accuracy and granularity, and can move forward with confidence.

Of course, with hard numbers, there is the burden of accountability. If you didn't, for example, reach your goal, it is probably because you did not be disciplined enough follow protocols, and check every single box every single day. And then it is all on you instead of some unknown factor.

 

[martyg]

Personally, self proscribing this type of treat is risky, do this medically supervised, otherwise……Any advise even that well meaning is a risk. Medically sound (advice/guidance) is only real honest answer.

Well. You can't self prescribe this treatment. Unless you are making purchases from someone's truck in a parking lot.

 

[martyg]

189.5 lbs. *

Spam16v this is something that I did not know: "It takes longer to build connective tissue than muscle that’s where consistency comes in." But it is something which I have experienced with each tendon I have ruptured.

Maybe this is why I intuitively have stayed away from the gym and have always built or maintained muscled by sport. I always thought it was a moral failure on my part because gym is boring compared to sport, but maybe it was my intuition telling me something about my body.

Para 1: Correct. Para 2: Incorrect. If you want robust connective tissue it is going to be most effiicienty to do it in the gym, with very heavy, slow, controlled eccentric motions. Like after 10 reps, 2 - 3 sets, you should be fried. "Sport" will provide a number of wonderful benefits. Building structually superior connective tissue is not one of them.

 

[Tricia]

Big fan. About 10 years ago my wife (who was 50ish) raved about her new hormone treatment. About how sharp she felt. About how well she slept. I said, "I need to look into that."

Since then, it has gone more mainstream. With COVID, the FDA has loosened the classification of T. Before you needed a physical visit. Now it can be telemed. In both cases, you needed bloodwork. The more detail oriented the practitioner, the more detailed (and expensive) your blood work will be. Once a year my blood work is about $1,200.

My observations: I sleep super soundly. Dropping bodyfat is effortless (part is my training schedule). Recovery time is reduced. Much sharper mental acuity. This isn't about megadosing. This is about optimizing your hormone levels, and optimizing your quality of life. I think you will find that anyone at the top of their game is optimizing hormone levels.

TrumanRX is an upstart in this domain. Essentially, you pay a hundred or two bucks, they send a stick kit, you stick yourself, the results go to a lab, and the determination is made if you would benefit from replacement therapy. If yes, you have a telemed appointment with a doc, chat about goals, etc. Prescrpt for a topical cream is sent o your home. Probably a folloow-up stick kit in 90 days to check levels. It is easy. It is at home.

My doc is a high performance guy, works with pro athletes, is a competitive bodybuilder. We moved the needle on my T levels post severe knee injury and surgery - total rupture of my quad tendon. I absolutely crushed PT protocols. Without optimizing every aspect of my recovery (diet, sleep, manual therapies, electro-stim, and hormone levels), I would not be hammering hills on the bike, and doing heavy squat workouts.

Enjoy.

Soft tissue and bone density was definitely a concern of mine when I considered treatment.
Hormones are vital to both.

 

[Tim Hodgson]

martyg what about tendons? I did a total rupture of the supraspinatus muscle on my right side trying to lift 80 lbs. to my shoulder. True I did not work up to it. I am adult and am responsible for my actions. That is why I am researching this topic. And that is why I am reaching out to this community because we all share the same sport of skiing. So, you and others are not giving medical or PT or other advice.

Given that, there seem to be two different persectives on building tendon strength.

1. high reps low weights;
2. low reps high weights.

Which is right or are both seemingly contradictory approaches both right?

 

[martyg]

martyg what about tendons? I did a total rupture of the supraspinatus muscle on my right side trying to lift 80 lbs. to my shoulder. True I did not work up to it. I am adult and am responsible for my actions. That is why I am researching this topic. And that is why I am reaching out to this community because we all share the same sport of skiing. So, you and others are not giving medical or PT or other advice.

Given that, there seem to be two different persectives on building tendon strength.

1. high reps low weights;
2. low reps high weights.

Which is right or are both seemingly contradictory approaches both right?

If you are truly researching the topic, then you are probably spending hundreds of dollars to access peer reviewed scientific papers, and thousands to access the dozen or so other articles that each primary piece of literature references. That is where the truth lies. It is a lot of reading and scruteny to do it right.

Your research should show that lower weights are used in early treatment phases of catestrophic injury, and is used as a vehicle for collagen orientation. And that both schools of thought essentially get you to the same place. The goal being total muscular fatigue. With higher weights / lower reps however, you are building a more robust structure.

Best to seek out a PhD level PT, or one who has completed their fellowship. Pay them the $500 for an eval and a follow-up or three. Do it once. Do it right.

But we digress from the original topic.

 

[Tim Hodgson]

We are not digressing from the original topic. Because the implied thesis is skiing aggressively while fighting the aging process. Now for my first smilie ever:

 

[Corgski]

Your justification should be the objective metrics that blood work would provide - in any aspect of health, from diet to hormone levels, to training. Without hard numbers, you are in a place where you are just guessing. With hard numbers, you have accuracy and granularity, and can move forward with confidence.

Interesting argument but note that my statement is merely deferring to the establishment view, I have no attachment to it whatsoever. The issue is that most doctors are not even going to authorize testing without significant symptoms. The bigger problem is that if you have enough symptoms to get tested, you will probably need ridiculously low levels to get treatment. Your treatment might be barely enough to bring you back into the bottom of the range. Should you still have symptoms at this point you might well be told that your levels are now normal and that obviously TRT is not the fix for your symptoms.

The main point of my posting on this topic is to warn people that even if they have symptoms, there is a fair chance that their experience getting help may be very different than yours. So how does the average person find the right doctor? And by the right doctor I am not talking about someone who will prescribe without justification.

 

[Rod9301]

martyg what about tendons? I did a total rupture of the supraspinatus muscle on my right side trying to lift 80 lbs. to my shoulder. True I did not work up to it. I am adult and am responsible for my actions. That is why I am researching this topic. And that is why I am reaching out to this community because we all share the same sport of skiing. So, you and others are not giving medical or PT or other advice.

Given that, there seem to be two different persectives on building tendon strength.

1. high reps low weights;
2. low reps high weights.

Which is right or are both seemingly contradictory approaches both right?

They both work, but it will take a year or so to build tendons and 2 months to build more muscles than the tendons can support.

 

[Tim Hodgson]

Corgski understood. I had to go outside of the Kaiser network for stem cell injections into my knees. Which I don't believe helped BTW, but I am happy that I tried that approach. This company is local:

Health Associates Medical Group

Health Associates, the original Nutritional & Functional Medicine practice in Sacramento blending Traditional & Herbal Medicine to create a Holistic Integrative Medical approach.

kwikermedical.com

And I am interested in investigating the company which martyg mentioned:

TrumanRx

www.trumanrx.com

 

[Seldomski]

Maybe this is why I intuitively have stayed away from the gym and have always built or maintained muscled by sport. I always thought it was a moral failure on my part because gym is boring compared to sport, but maybe it was my intuition telling me something about my body.

In the gym, you can isolate and load muscles and tendons safely to higher levels of fatigue than you can do in sport. In the gym, you can use a spotter to protect against fatigue injuries. You can also get to muscle fatigue in far fewer reps using weights. In sport, you should not do this because it is not usually possible to have this kind of spotting and safely.

The sport is for training the complex motion - muscle coordination, proprioception, precision, efficiency, etc. The gym is for building more capacity to do that motion - ie with more force, range of motion, etc. My 2c.

Done improperly, the gym can also injure you very quickly. So get some help there if you are not big into gym workout now.

 

[Tim Hodgson]

TrumanRX is not available in California.

 

[Rod9301]

In the gym, you can isolate and load muscles and tendons safely to higher levels of fatigue than you can do in sport. In the gym, you can use a spotter to protect against fatigue injuries. You can also get to muscle fatigue in far fewer reps using weights. In sport, you should not do this because it is not usually possible to have this kind of spotting and safely.

The sport is for training the complex motion - muscle coordination, proprioception, precision, efficiency, etc. The gym is for building more capacity to do that motion - ie with more force, range of motion, etc. My 2c.

Done improperly, the gym can also injure you very quickly. So get some help there if you are not big into gym workout now.

Very true, build the big muscles in the gym, little ones doing the fun stuff

 

[Tim Hodgson]

I come here to ask for recommendations for me personally based on the experience of the large number of members here.
I am not making recommendations. Don't do anything discussed here without consulting your physician.

Just an update:
I have not started hormone replacement therapy.
I am continuing to take DHEA and Bulgarian Tribulus but I have not had a male blood panel done yet, so I don't know how much if any my hormones are being effected by taking it. DHEA was recommended by my knee stem cell Doctor. Don't take it without physician advice. (BTW, I don't think the stem cell injections helped either knee.)

This morning I weighed 184.5 lbs.
That is from end of June to today.
So 60 days from 206 to 184.5 = 21.5

I have since stumbled on what my "diet" is called. It is called the KETO diet.
By chance I heard a great explanation of it on Bryan Suit's Dark Secret Place to which I subscribe on ConnectPal for $5/mo.
Our bodies metabolize carbs first.
If you have no carbs, your body will metabolize fat.
If you exercise during the day and work your muscles somewhat so that they need to repair and build a little at night,
your body will metabolize fat as the nutrient to use to repair those muscles.

Except for two dinners at which I had two beer and ate meat like a pig and a little carbs, I have had no carbs whatsoever during those two months. Except for Orville Redenbacher's Movie Butter Popcorn which sometimes I eat in the evening. (I ate two bags last night. I felt full like a pig, but it kept me from opening one or two cans of Guinness which sit next to the Orville box in the pantry.)

My diet is meat, chicken, and fish (on Friday - because I am trying to become a better Catholic) and broccoli and cauliflower and baby carrots and apples with cheese and hardboiled eggs in the morning and whatever my wife puts in the smoothies she makes in the morning.

I started white water kayaking when I was 18. @martyg could tell you that any form of kayaking will work your upper body and if done correctly it works your core. But I haven't really kayaked since 2010.

We now live next to river where we stand-up 2-cycle jet ski. It works your upper body and your core, and also works your legs more than ww kayaking.

When I jet ski, the next morning I find I have lost weight.

My knees are bone on bone arthritis. I like having less weight on my knees.

Any suggestions for how to proceed?

 

[Henry]

Adding testosterone to prostate cancer is like putting gasoline on a dumpster fire. Every older man probably has prostate cancer. (I had my cancerous prostate removed at age 56.)
https://pubmed.ncbi.nlm.nih.gov/16006887/

 

[Rod9301]

Para 1: Correct. Para 2: Incorrect. If you want robust connective tissue it is going to be most effiicienty to do it in the gym, with very heavy, slow, controlled eccentric motions. Like after 10 reps, 2 - 3 sets, you should be fried. "Sport" will provide a number of wonderful benefits. Building structually superior connective tissue is not one of them.

Very true