FAQ About HRT / TRT
Testosterone is actually a steroid, but the term steroid is just a chemical classification of certain fat-soluble organic compounds, many of which are found naturally in the human body. They’re responsible for having a whole slew of physiological effects ranging from tissue growth, reproductive development, inflammation, immune response, and even salt and water balance. Examples include estrogen and, of course, testosterone. Testosterone is responsible for the development of secondary sex characteristics like broader shoulders, a deeper voice, development of sexual organs, facial hair, and most of the physical characteristics that distinguish men from women. When men get older and their testosterone levels drop, testosterone replacement therapy is often prescribed to reverse many of the effects of aging and to restore confidence, libido, and a more youthful, energetic feeling. Of course, when most non-medical people refer to steroids, they’re referring to anabolicsteroids, which are typically used for cosmetic performance or physical performance reasons (like building muscle, burning fat, or enhancing athletic ability). It’s true that all anabolic steroids are synthetic variations of naturally occurring testosterone, but as mentioned, they’re used for non-health reasons and aren’t suitable for testosterone replacement therapy. Many have unpredictable side effects and they’re almost always used in extremely large, potentially dangerous doses. So yes, testosterone is a steroid, but it‘s a naturally occurring one that’s vital to a healthy functioning body.
1. Appearance • Testosterone replacement therapy can have dramatic effects on your appearance, especially if you do it in conjunction with an exercise program and a healthy diet. • Body Fat — Body fat levels begin to decrease in 1 or 2 months, but this loss may take 2 to 3 years to plateau. • Waist Size — Just as with body fat in general, you should expect your waist size to start to decrease in 1 or 2 months. Expect to lose approximately 3.5 inches in the first year after starting therapy. • Muscularity — The amount of muscle you gain is dependent on genetics, exercise, age, and diet, but you should start to see more muscle in as little as a month. 2. Sexual Benefits • Testosterone replacement therapy does a lot more than just increase your sex drive. TRT patients generally report stronger and more frequent erections and ejaculations, in addition to a more satisfying sex life in general. • Sexual Desire, Thoughts, and Fantasies — You could feel an increase in libido in as little as a week, but generally, it takes about three weeks for things to really start to percolate, generally plateauing at about the 9th week. 3. Psychological Effects • A lot of people don’t realize it, but psychological problems like depression and anxiety might have their roots in low testosterone levels. Also, positive psychological traits like sociability and “appropriate aggressiveness” might be associated with higher testosterone levels. (“Appropriate aggressiveness” refers to asserting yourself or acting confidently, such as mustering up the courage to ask the boss for a raise or asking a woman out to dinner.) • Anxiety Levels, Appropriate Aggressiveness, Sociability, Mental Wakefulness, and Creativity should start to improve • Depression –– Depression, or even increased levels of sadness, should start to decrease by about week 6, but maximum effects take longer and vary widely from individual to individual. 4. Health Benefits • Insulin Sensitivity — Without good insulin sensitivity, a good portion of the food you eat gets transported to fat storage instead of being used to build muscle. The more insulin sensitive you are, the better, and TRT starts to increase insulin sensitivity in just a few days, but often continues for several years. • Bone Density — While osteoporosis is more often a problem with aging women, men with low testosterone levels can also have signs of diminishing bone density. However, restoring testosterone levels to normal or high normal can show positive effects on bone density in about 6 months and continue for at least 3 years. • Inflammation — Inflammation plays a big role in just about every human disease, especially heart disease, and TRT generally starts to calm inflammation in 3 to 12 weeks. • Blood Chemistry — Total cholesterol and LDL (but not HDL, i.e., “good” cholesterol) generally start to decrease by about week 4 and continue to improve for 6 to 12 months.
• Fatigue • Unexplainable weight gain • Depression • Diabetes • Sleep apnea • Low sex drive • Erectile dysfunction • The inability to maintain or gain lean muscle
False. A meta-study published in the Journal of the American Heart Association [November 13th, 2013] looked at over 100 testosterone studies and they determined that it’s actually low testosterone levels that are associated with heart health. In fact, the journal reported that low testosterone was associated with a host of possible conditions: • Higher risk of cardiovascular disease • Narrowing of carotid arteries • Abnormal EKG • More frequent congestive heart failure • Increased incidence of angina • Increased body mass index • Type II diabetes • Metabolic syndrome • Insulin resistance • More belly fat Higher death rate from all causes, including cardiac mortality. Clearly, the suggestion that testosterone therapy can cause heart problems is a complete myth.
• False. • Amazingly, this myth is largely based on a report from 1941 — a report based on a single patient! • Let’s consider a recent study that involved a larger group of men instead of an ancient one that involved only one. Researchers in the United Kingdom looked at 1400 men who had received testosterone replacement therapy for up to 20 years and they found only 14 cases of prostate cancer over the course of the study. • This prompted the co-author of the study, Dr. Malcolm Carruthers, medical director at the Center for Men’s Health in London, to state, “This myth about testosterone replacement therapy being linked to prostate cancer has been rooted deep in medical consciousness for over 60 years,” “But this paper says no,” added Carruthers, “testosterone treatment is actually good for the prostate, not bad.” The study was published online June 6, 2012, in the Journal of Sexual Medicine.
• False. • Paradoxically, it’s often men with low testosterone levels that are moody, depressed, and even angry, while men with normal or high testosterone levels are generally sociable and gregarious. • That being said, improper usage (very high doses) of testosterone could elicit aggressive tendencies in men that might be predisposed to such behavior. • As such, it’s important to work with a physician experienced in testosterone replacement therapy to ensure proper dosages.
• False. • Generally, the only hormone people associate with women is estrogen, but the testosterone level of a healthy woman is about ten times greater than her estrogen levels. • Testosterone actually plays a huge role in women’s health, psyche, and libido, just as it does in men. • And, just as in men, low testosterone levels in females can lead to problems, including a decrease in bone and muscle mass, a gain in body fat, and decreases in sexual desire and energy. • However, it’s imperative for women to work with a physician skilled in testosterone replacement. Over time, higher-than-desired doses could lead to unwanted side effects such as the growth of body hair or growth of the clitoris.
• False. Or probably false. • The fact is, most doctors don’t routinely check testosterone levels, regardless of the patient’s age. For one thing, it’s generally not covered by insurance, and secondly, doctors generally don’t know that much about the hormone. • Ask almost any doctor and he’ll tell you that medical schools devote a total of about 15 minutes to discussing testosterone; hardly enough to give the average physician comprehensive knowledge of the hormone. • Lastly, even if your doctor was savvy enough to test your levels, the “normal” range for testosterone is extremely broad — around 200 to 1100 nanograms per deciliter — depending on the laboratory used. • Your test might indicate a level of 350, which, while “normal,” is quite low. You might have poor energy, depression, and a non-existent libido, but because your test indicated a “normal” level, your traditional doctor wouldn’t even bother to bring it up.
• When doctors order blood work to determine testosterone levels in your body (which is something they rarely do in the first place), they generally ask the lab to test for “total testosterone.” The results will generally reveal a number somewhere between 300 nanograms per deciliter (ng/dl) and 1100 ng/dl. • If the number is somewhere above 400 ng/dl, the physician will probably tell you your testosterone levels are fine. Unfortunately, despite getting a “normal” reading, your true testosterone level might be anything but normal. • Here’s the problem. Testosterone pretty much exists in three different states. First, you have free testosterone. This is the testosterone that’s unencumbered and free to do all the good things that testosterone is supposed to do. However, the vast majority of the remaining testosterone is non-free, or bound to other chemicals, making it pretty much unavailable to the body. • About two-thirds of this bound or non-free testosterone has formed a tight, chemical bond to something called Sex Hormone Binding Globulin (SHBG). For all intents and purposes, it’s locked up and put away. The other third of this bound testosterone is loosely bonded to a protein called albumin. While bound, this albumin-bonded testosterone can still work to improve your brain, muscles, blood, heart, sex life, and all the other things we count on testosterone to do. • That brings us to another term: bioavailable testosterone. As the name implies, it refers to the total amount of testosterone that’s available to the body to work on tissues. Here’s a formula that should make it clearer: Bioavailable Testosterone = Albumin-Bonded Testosterone + Free Testosterone • This is why, when testing your blood, we focus on your free testosterone and your bioavailable testosterone. That’s the only way to get a realistic and effective idea of what testosterone is doing in your body.
• Absolutely. While women are considered to be purely estrogenic creatures, the testosterone levels of healthy women are 10 times greater than their estrogen levels. • Testosterone deficiencies, however, are quite common in females, causing women to suffer some of the same symptoms as men, including low energy, loss of muscle, loss of bone mass, loss of energy, weight gain, and sexual dysfunction. In fact, a few studies report that the percentage of women between the ages of 18 and 59 that suffer from “sexual dysfunction” is somewhere around 50%. • Oftentimes, this dysfunction is commonly misdiagnosed as underlying depression with referrals to psychotherapy or counseling, but many doctors are starting to suspect testosterone deficiency because the hormone plays as big a part in female sexuality as it does male sexuality. • Clearly, testosterone is very important to the health of women and it’s quite common for women to receive carefully monitored testosterone replacement therapy at Renewus.