Many studies have highlighted the importance of investigating all major hormones, and correcting deficiencies and imbalances if present.[1-8] Given the known mechanisms of testosterone and GH/IGF-1 in building muscle (and possibly also DHEA in elderly) it is reasonable that age-related low levels of anabolic hormones contribute over time to sarcopenia and frailty.[1, 2, 4, 7, 9, 10]

Thus, multiple small effects in aggregate can lead to adverse loss of muscle and disability. In this scenario, if replacement was to occur, it would require lower doses of multiple anabolic hormones. An added benefit to this approach would be fewer side effects from the use of lower hormone doses [11]. In addition, multiple anabolic hormone replacement might also have beneficial additive and/or synergistic effects.[11-13]

A notable study investigated whether supplementation with testosterone and GH together, in physiological doses, results in greater improvements in body composition and muscle performance in older men, compared to testosterone supplementation alone…[11]

STUDY DESIGN AND PARTICIPANTS
sarcopenia-prevention-treatment

122 healthy overweight men (BMI 27) aged 66 to 74 years with baseline testosterone of 550 ng/dl or less, and IGF-I in lower adult range, 167 ng/dl or below, were randomized to receive transdermal testosterone 1% gel (5 g/day or 10 g/day, providing 5 mg or 10 mg testosterone/day) plus GH in doses of 0, 3, or 5 mcg/kg (per 2.2 lb) per day, for 16 wk.
MAIN OUTCOME MEASURES
Body composition by DEXA (dual-energy x-ray absorptiometry), muscle performance, and safety tests.

RESULTS

As indicated in the table, changes in body composition were dose-dependent across the six treatment groups (click the table for full display):

testosterone-GH-combined-supplementation-Sattler2009
Reference: Sattler 2009                       Note: 1 kg = 2.2 lb
As seen in the table, total lean body mass increased by 1 – 3 kg (2.2 – 6.6 lb) and leg/arm (appendicular) lean body mass increased  by 0.4 – 1.5 kg (0.9 – 3.3 kg).

Total fat mass decreased by 0.4 – 2.3 kg (0.9 – 5 lb), and trunk (abdominal) fat decreased by 0.5 – 1.5 kg (1.1 – 3.3 lb).

It should be noted that only testosterone 5g/day + GH 5 mcg/kg/day, and testosterone 10g/day + GH 3 mcg/kg/day and testosterone 10g/day + GH 5 mcg/kg/day (groups C, E and F) resulted in statistically significant results in all body composition variables.

These body composition changes are illustrated graphically in the figure below:

testosterone-GH-combined-supplementation-graph-650-Sattler2009
Reference: Sattler 2009

As can be seen in the table and figure, the changes were clearly dose-dependent.

Maximum voluntary strength of upper and lower body muscles increased by 14 to 35 % (statistically significant only in the three highest dose groups), and correlated with changes in lag/arm lean mass. Aerobic endurance increased in all six groups.

In terms of metabolic effects, fasting blood sugar increased by 3 mg/dl across the entire study population but did not reach significance in any of the six groups. Indices of insulin resistance (HOMA-IR and QUICKI) were likewise unchanged in each of the six groups. Total and low-density lipoprotein (LDL) cholesterol didn’t change in any of the six groups. High-density lipoprotein (HDL) cholesterol increased in most participants, but the increase was only significantly in group E by 4 mg/dl. Fasting triglycerides (blood fats) decreased on average by – 18 mg/dl, but the decrease was only significantly in group F by  – 40 mg/dl.

SAFETY PARAMETERS

The testosterone + GH supplementation resulted in some predictable adverse events; however, they were modest and reversible.
Systolic and diastolic blood pressure increased similarly in each group with mean increases of 12 and 8 mm Hg, respectively. At follow-up over the ensuing 12 weeks after discontinuation of study therapies, the average increases in systolic and blood pressure were lower but still elevated by 9 and 6 mmHg, respectively.

Hematocrit increased significantly in four of the six groups; eight subjects had increases to 50–52%, one to 53%, but none to 54% or greater. After discontinuation of study interventions, hematocrit returned to less than 50% in all subjects.

Although PSA increased in subjects by 0.2 ng/ml, it increased significantly only in group F from 1.1 to 1.8 ng/ml); no subject had a PSA increment greater than 1.4 ng/ml and values returned to baseline on repeated testing.

CONCLUSION and COMMENT

Supplemental testosterone produces significant gains in total and leg/arm lean mass, muscle strength, and aerobic endurance with significant reductions in whole-body and trunk fat. Results were further enhanced with GH supplementation, i.e. GH augments the beneficial effects of testosterone. The greater beneficial effect of combined testosterone + GH therapy, as opposed to testosterone only therapy, was also demonstrated in a follow up study.[12] It is impressive that these beneficial body composition results were achieved without any resistance training. One can imagine the further improvement of body composition by combining testosterone +GH therapy with resistance training.

The important take home message from these studies is that combined testosterone + GH therapy results in a larger magnitude of beneficial effects while keeping side effects at a minimum. Thus, testosterone combined with GH is a more effective muscle anabolic / fat loss treatment regime than either alone, and thus confers a better risk/benefit ratio. It should be underscored that by combining testosterone and GH, a given anabolic and fat loss effect is achieved with a smaller dose of each compared with when testosterone and GH are given alone, and thus the risk for side effects is minimized. There may also be an extra effect that may not be achievable with either alone, which is likely because testosterone  and GH/IGF-1 act on different metabolic pathways in an additive and possibly even synergistic manner.[11]

References:
1.         Bross, R., M. Javanbakht, and S. Bhasin, Anabolic interventions for aging-associated sarcopenia. J Clin Endocrinol Metab, 1999. 84(10): p. 3420-30.
2.         Morley, J.E., Anabolic steroids and frailty. J Am Med Dir Assoc, 2010. 11(8): p. 533-6.
3.         Villareal, D.T. and J.O. Holloszy, DHEA enhances effects of weight training on muscle mass and strength in elderly women and men. Am J Physiol Endocrinol Metab, 2006. 291(5): p. E1003-8.
4.         McIntire, K.L. and A.R. Hoffman, The endocrine system and sarcopenia: potential therapeutic benefits. Curr Aging Sci, 2011. 4(3): p. 298-305.
5.         Kovacheva, E.L., et al., Testosterone supplementation reverses sarcopenia in aging through regulation of myostatin, c-Jun NH2-terminal kinase, Notch, and Akt signaling pathways. Endocrinology, 2010. 151(2): p. 628-38.
6.         Sayer, A.A., et al., New horizons in the pathogenesis, diagnosis and management of sarcopenia. Age Ageing, 2013. 42(2): p. 145-50.
7.         Burks, T.N. and R.D. Cohn, One size may not fit all: anti-aging therapies and sarcopenia. Aging (Albany NY), 2011. 3(12): p. 1142-53.
8.         Pasquali, R., et al., Sex-dependent role of glucocorticoids and androgens in the pathophysiology of human obesity. Int J Obes (Lond), 2008. 32(12): p. 1764-79.
9.         Maggio, M., et al., The hormonal pathway to frailty in older men. J Endocrinol Invest, 2005. 28(11 Suppl Proceedings): p. 15-9.
10.       Morley, J.E., M.J. Kim, and M.T. Haren, Frailty and hormones. Rev Endocr Metab Disord, 2005. 6(2): p. 101-8.
11.       Giannoulis, M.G., et al., Hormone replacement therapy and physical function in healthy older men. Time to talk hormones? Endocr Rev, 2012. 33(3): p. 314-77.
12.       Sattler, F., et al., Testosterone threshold levels and lean tissue mass targets needed to enhance skeletal muscle strength and function: the HORMA trial. J Gerontol A Biol Sci Med Sci, 2011. 66(1): p. 122-9.
13.       Sattler, F.R., et al., Testosterone and growth hormone improve body composition and muscle performance in older men. J Clin Endocrinol Metab, 2009. 94(6): p. 1991-2001.
 
 

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35 Comments
  1. Mischa 6 years ago

    I question the current practice and (miss)use of test and GH in elderly population. For me it shows the misconception and mentality of our population in relation to our aging. In the mindset of a large group of people, getting old almost correlates with disease.
    This reminds me on two videos from Will Brink about programming design and hormones (“Why Your Workouts Suck” and “Understanding Your Hormones”). He mention that bodybuilders often use drugs to overcome a plateau instead of use a proper (non linear) program design that allows them to grow again without drugs. Same as for hormones. First check what could be the reason for a lack of testosterone before use of “magic testosterone subs” or even medication. These statements can be applied very well to the current shortcut thinking of using test and GH on hormone correcting of elderly people.
    Yes, test and GH certainly have their place in therapy for out of balance hormones. But these days doctors rarely ever check if there are other reasons for out of balance hormones of patients. And do you really need to correct hormone levels if they are just 10% out of range of an average 70 year old dude? For me it seem to be a mainstream phenomenon and well accepted practice to prescribe test on men over 50 even if there test levels correlates perfectly with their age. Just watch all the adds on TV and on the web – Just call us and we give you what you want. We are not interested what may cause out of balance hormones and we don’t ask any questions. We are interested to sell our products and make you happy as a customer…
    Well, everyone can do whatever he wants. But I am not happy with the direction we go. We should focus more on being self-actualise, accepting our genetic limits, put more emphasis on disease prevention and get away from disease management. It is sad to see, that most people think, that the only way to treat disease are pills and prescription drugs.
    For me, there is nothing wrong with the post from Monica per se. As always it is very well researched and contains a complete list of references. And I like to thank her for the time she puts in to write many interesting articles on the brink zone. But with my post like to put this article in a bigger context.
    Regards, Mischa

    • Jim 6 years ago

      Mischa, do you wear glasses, have contact lenses or have you had corrective surgery to restore eyesight? I’m assuming not. If you had type 2 diabetes I am also assuming that you would not be taking meds? How about elevated cholesterol? No statins? I doubt it.
      You’re conflating cosmetic therapies with evidence based corrective hormone therapies that not only have a significant impact on quality of life as we age but decrease degenerative disease and mortality.
      I get it if you choose to avoid all medical therapies based on an unusual ideology. My bet is that you are like most of and you try and to take care of yourself, rationalizing away your practices and being critical of others.

      • RICH 6 years ago

        Great reply!! I think you should do what ever it takes to get to were you want to be. It is personal your choice. RICH

        • Matt 6 years ago

          Haha! I am WAY outta everybody’s league here, but I THINK what Mischa is trying to say, is whether it is really necessary in the long run, or are we just all afraid to get old and die!! At least we’ll be able to stand over the casket and say how great he looked!!! Ya know, basically, it’s all part of the plan, as it were… young, healthy males and females are to repopulate, and bring in new genetics… I say, work out, take your vitamins, and maintain as healthy a body as you possibly can… I am more concerned about the long term effects of the meds than anything else. Keep up the good diatribe folks… it stimulates the thought process.

    • Will Brink 6 years ago

      Here’s some of my thoughts on your comments Mischa:
      “I question the current practice and (miss)use of test and GH in elderly population. For me it shows the misconception and mentality of our population in relation to our aging. In the mindset of a large group of people, getting old almost correlates with disease.”
      Any drug can be misused and many are. There are docs not properly using these hormones to the most benefit of people using them, and some doing an outstanding job. Par for the course. Two. aging DOES correlate with increased rates of diseases, and some of those diseases related to sub optimal hormone levels. Read my and Monica’s other material on that on this page.
      ” First check what could be the reason for a lack of testosterone before use of “magic testosterone subs” or even medication. These statements can be applied very well to the current shortcut thinking of using test and GH on hormone correcting of elderly people.”
      I have covered common reasons for reduced/imbalanced hormones and what people can do to improve that. But, in some cases, the drop/imbalances are age/genetics related.
      “Yes, test and GH certainly have their place in therapy for out of balance hormones. But these days doctors rarely ever check if there are other reasons for out of balance hormones of patients.”
      That’s poor medicine, and not recommended by me. I do not condone at any time use of hormones without lab work. You’ll also see consistently Monica stressing lab work and evidence based treatment approaches also in all her articles.
      “And do you really need to correct hormone levels if they are just 10% out of range of an average 70 year old dude? For me it seem to be a mainstream phenomenon and well accepted practice to prescribe test on men over 50 even if there test levels correlates perfectly with their age. ”
      That is may correlate has no bearing on what’s optimal for health, mood, libido, etc. and studies continue to support higher levels (closer to what would correlate to a healthy young man) is best. If you want to “grow old gracefully” and be weak and tired and no libido (how old are you BTW?), then I support your right to that. But, for those who have no interest in that, and prefer to have the hormone levels and balances of a younger healthy person, be in via external sources or other, then the should have access to that.
      “Just watch all the adds on TV and on the web – Just call us and we give you what you want. We are not interested what may cause out of balance hormones and we don’t ask any questions. We are interested to sell our products and make you happy as a customer…”
      For sure. I agree. As expected, there’s now a rush to fill that desire and less hormone clinics (some good some terrible) are popping up left and right. See my vid “Is Low T Legit?” which also discusses some of that.
      “Well, everyone can do whatever he wants. But I am not happy with the direction we go. We should focus more on being self-actualise, accepting our genetic limits, put more emphasis on disease prevention and get away from disease management. It is sad to see, that most people think, that the only way to treat disease are pills and prescription drugs.”
      Again, true points, but why can’t we do both? Disease prevention is very lacking in the US, and yes, cure by pill/med vs prevention is common, but that’s also a different topic than making aging populations healthier and feel better by the *proper* use and application of some hormones.
      “For me, there is nothing wrong with the post from Monica per se. As always it is very well researched and contains a complete list of references. And I like to thank her for the time she puts in to write many interesting articles on the brink zone. But with my post like to put this article in a bigger context.”
      But, in the larger context of her other articles as well as mine, and the overall focus of this site (health, wellness, nutrition, science based info, etc) I think this info is useful. Taken out of context or viewed in isolation, is another matter…. 🙂

      • Monica Mollica 6 years ago

        Mischa, I want to bring several important facts to your attention:
        * It is currently NOT a “mainstream phenomenon and well accepted practice to prescribe testosterone for men over 50 even if there test levels correlates perfectly with their age.” And more importantly, due to interindividual variability in androgen sensitivity (due to, among other things, androgen receptor polymorphism) two people can have the same total and free testosterone levels, yet one of them can suffer badly from symptoms and signs of hypogonadism, while the other one is perfectly healthy. Few biological distributions are normally distributed and this is especially true for testosterone levels (and its different fractions, total, bioavaliable and free, which don’t always correlate with each other). Also, there are no universal age-specific reference ranges for testosterone. And there is no data to suggest an altered testosterone requirement in older males.
        * You say “put more emphasis on disease prevention and get away from disease management.” This is exactly what testosterone/GH replacement is all about, as hormonal deficiencies and imbalances great can greatly accelerate manifestation of aging related/induced physical deterioration and precipitate disease development and unnecessary suffering.
        * You say “It is sad to see, that most people think, that the only way to treat disease are pills and prescription drugs”. By correcting hormonal deficiencies/imbalances in time before they do physiological damage, disease can be prevented and in some cases treated. Testosterone and GH are not synthetic foreign substances; they are endogenous to the body and required for optimal physiological and cognitive functioning.
        Like Will pointed out, anything can be abused. Even essential things like food!

        • Jim 6 years ago

          Keith,
          Of course. I suggest suggest testosterone and growth hormone. Both are bio-identical, all natural and work very well. Keep in mind that cyanide and hurricanes are all natural, but generally not considered healthy.
          You have a couple of good options to raise gh if you don’t want to seek eval and treatment from a physician.
          1. Charles Poliquin’s German Body Comp Routine. Essentially you are engaging in weight training that keeps you in lactic acid zone with very short breaks between sets. The short rest period and high volume stimulate gh release.
          2. Add 2 grams glutamine just before bed plus 0.1-0.5 mg (low dose compared with what you typically see) of sublingual melatonin.
          The glutamine works well for those that are producing growth hormone. The problem is that you may not be making/storing sufficient levels of growth hormone. If this is the case, then glutamine may not work.
          It is critical to monitor cortisol when treating a growth hormone deficiency. Both melatonin and growth hormone are primarily released during our first few hours of sleep (men). Both of these hormones suppress cortisol. If cortisol is mildly deficient and then suppressed by gH and or melatonin, the conversion of bound thyroid (T4) to free (T3) increases (sometimes dramatically). This can result in signs of hyperthyroidism (with concurrent thyroid treatment) or more commonly hypothyroidism if you can’t keep up with the increased demand for thyroid.

      • Marko 6 years ago

        “I have covered common reasons for reduced/imbalanced hormones and what people can do to improve that. But, in some cases, the drop/imbalances are age/genetics related. ”
        Will, could you please post a link to that article ? I can’t find it :/

      • boomerangg 6 years ago

        Great job on shooting down Mischa’s points Will (not). You systematically picked apart every one of her points. Your points were valid from a bodybuilding mentality. Although I exercise and eat healthfully I think viewing life from a muscle building perspective and encouraging older adults (i’m 58) to desire the hormonal profiles and body compositions of younger adults is an unhealthy goal to promote from a mental health perspective. It is more beneficial to focus on our acceptance of who we are rather than expending a disproportionate amount of energy focused on who we are not. I’m confident that most of your readers applauded from their inclined benches, but I think Mischa made some valid points around physical and mental health, one’s own self image, and acceptance of the aging process in ourselves.

        • Monica Mollica 6 years ago

          boomerangg, I want to bring to your attention, and everybody else’s, that my article is about the HEALTH impact of T/GH, NOT about ego/appearance. These are two completely separate issues.

        • Jon DeVaul 6 years ago

          boomerang, I’m going to be 64 in 3 weeks. I’d like to know just what the heck is wrong with me wanting to feel and look like I did 30 years ago? I’m in a creative field(advertising/commercial photography) where 30 year old art directors think that anyone over 40 has somehow lost their creative ability. I have to compete with that. I’m very secure with who I am, I certainly don’t plan on dying my white hair, but if I can trim my body fat, increase my energy, firm up the muscle that I gained over the last 40 years of lifting, and also take advantage of the psychological benefits that TRT can give me, what’s wrong with that? Oh yeah, I’m writing this from my computer, not my incline bench, and certainly not from my rocking chair. Gotta run now, I have to go show some art director why my work is better than any 30 something out there!

          • Jon DeVaul 6 years ago

            One more thing…thank God for the impartial information we get from Will and Monica!

          • Monica Mollica 6 years ago

            Keep it up Jon! 🙂

        • Will Brink 6 years ago

          I addressed every one of her points and all responses were from a health perspective and has no discussion of visual/bbing application. You either didn’t understand what I wrote, or you didn’t fully read it. The discussion is on HRT – and the associated health benefits – period and impact on health/well being. That you “feel” having hormones in line with a younger person is an “un healthy” goal is not supported by the research that exists (physically or mentally BTW), per my writings here and Monica’s.
          If you are of the opinion that people should simply accept the reduced hormone levels as a “natural” part of aging and all the negatives that come with it, that’s perfectly OK, but passing a negative opinion on those who don’t agree, and want to be healthier due to optimal hormone levels is short sighted and small minded.
          You’re welcome to your opinion, and I don’t agree with it, and neither does the stack of studies sitting on my desk.

  2. Philip 6 years ago

    Great article Monica, Thanks. I’ll just wait til you write the article that says what I need to buy to alter my DNA to heal instantly, remember everything, hear an angel fart, and lift a tank. When can we see those drugs? Because goddammit……….WANT!!! 🙂
    Ok seriously, I’d love to be able to go to my doctor to get a combination of this – if it would certainly help, then I agree with Will; Why the hell not…

    • Matt 6 years ago

      Hahaha! Brother, you, me, and twenty-million other guys!!!

  3. isaac olurankinse 6 years ago

    Wow that’s amazing. I have been training for over 27yrs . Until around 18months ago. I’m an ectomorph. Who put on lean muscle but now I’m 47 can’t seem to find the energy to work out. Feel stiff all the time. And have started to gain body fat around my normally trim waist and abs. I have thought of over the last few years to try very small amounts of Gh. Or testosterone. But didn’t want to use steroids to build muscle. I have tried natural supplements so called to stimulate testosterone or Gh. Like tribulus . Hi dossages of Zinc etc. I noticed in the above test in the recent article testosterone and Gh gel was used where could this obtained from in the Uk. What’s amounts were used and when ?.I’m sure I read an article a while ago on the net regarding celebs in the USA using small amount ts to help reduce body fat. Firm the skin. Reduce grey hair. By just administrating a few i u still a day.
    Have you thought of reviewing herbal or natural so called Gh or testosterone stimulants. Do they work? With my own experience no. Evesham combined with the so called Gh releasing exercises like dead lift and squats. Any advice on turning the clock back body wise and feeling energetic.refreashed and a quicker recovery time in between workouts . .Thanks in advance and keep the advice email coming.

    • Will Brink 6 years ago

      “Have you thought of reviewing herbal or natural so called Gh or testosterone stimulants. Do they work?”
      Short answer: no they don’t work as advertised.
      Long answer, I cover “testosterone booster” supplements here (you’ll find on a search) and cover GH booster type supplements in my Body Building Revealed Program and Sports Supplement Bible book.

    • Jim 6 years ago

      Have your hormone levels evaluated. Also include cortisol. 1/3 to 1/2 of aging adults are deficient in cortisol. When properly balanced it is very safe, non-catabolic and dramatically increases quality of life (particularly those that are very thin and/or have low blood pressure, fatigue, sluggish immune system etc.).

  4. keith22fine 6 years ago

    Great article, are there any natural supplements that you recommend to raise GH & Test levels ?

    • Jim 6 years ago

      Keith,
      Of course. I suggest suggest testosterone and growth hormone. Both are bio-identical, all natural and work very well. Keep in mind that cyanide and hurricanes are all natural.
      You have a couple of good options to raise gh if you don’t want to seek eval and treatment from a physician.
      1. Charles Poliquin’s German Body Comp Routine. Essentially you are engaging in weight training that keeps you in lactic acid zone with very short breaks between sets. The short rest period and high volume.

    • Will Brink 6 years ago

      I answer that question above Keith.

  5. Jon DeVaul 6 years ago

    Back in 2010 I was tested by my endocrinologist. My total test levels were 179. I can’t remember what my free test was, but it was quite low also. I was 60 at the time, and after working out hard for decades, I found it almost impossible to lose the fat and build any kind of muscle. I had the classic Metabolic Syndrome belly. My doctor put me on Androgel and eventually my test was around 670(again, I can’t remember my free test number, but it went up dramatically too). I was able to get into pretty good shape, not high-end bodybuilding shape, but I was looking really good. My triglycerides, dropped a lot, my sugar dropped, and my cholesterol improved. What no one has mentioned here, is the psychological improvements I felt. I went from a scared, depressed guy to someone who felt great! Unfortunately, we lost our health coverage(became unemployed), and I couldn’t afford the blood work. We now have new coverage, and I’m meeting with my endo in a couple of weeks to start up again…can’t wait.
    One quick question…does it make any sense to do Androgel and also a DHEA supplement?

    • Monica Mollica 6 years ago

      Jon, thanks for sharing your experience.
      To answer your question if it makes sense to take both Androgel and also a DHEA: if you DHEA(S) level is low, yes.
      DHEA has non-hormone related health promoting effects (which not many people are aware of, and which I will cover in an upcoming article). Therefore, I recommend supplementing (keeping an eye on your estradiol) with DHEA to get your level to mid-high range.

      • Jon DeVaul 6 years ago

        Monica, thanks…looking forward to any info on TRT, DHEA, etc.

      • Matt 6 years ago

        I know Will had spoken of DHEA and Estradiol previously, but it would be good to hear it again. Thanks for all the great info…

  6. Kenroy Grant 6 years ago

    Hi Monica, thanks for the research, it’s excellent as always, the only thing that concerns me about testosterone and GH treatment is enlargement of the prostate. As men age you know our prostates tend to get larger (BPH), my question is will the testosterone administered convert to dihydrotestosterone? What are the statistics for someone already predisposed (through hereditary) to prostate cancer successfully using GH?

    • Monica Mollica 6 years ago

      Thank you.
      I have not seen any studies specifically investigating GH and prostate cancer risk.
      Yes, testosterone does dose-dependently convert to DHT, which is why a 5-alpha-reductase inhibitor should be used in conjunction with TRT (especially by men with prostate issues).
      These are points you need to talk over with your doctor.
      Close monitoring on TRT and TRT/GH is essential for anybody with predispositions for adverse outcomes.

      • Kenroy Grant 6 years ago

        Yes, then there’s the ADRs associated with the 5-alpha-reductase inhibitor such as impotence, decreased labido, anxiety, and depression. It seems just a bit of a gamble to me, but I’m not in my sixties, or diagnosed with severely low testosterone. I did do a series of testosterone shots at a clinic for low testosterone, it was great for a time. I felt great, my strength was increased, muscle mass increased, unfortunately I was given more HCG in conjunction to the testosterone, which caused an adverse effect. My plasma leveled increased, I felt lethargic, so I discontinued the series, it was one shot of test and two shots of HCG a week . That was my first and last experience with testosterone.

    • Jim 6 years ago

      Kenroy,
      Monica and i are going to disagree on the 5 alpha reductase inhibitors.
      BPH can be caused by several mechanisms. Elevated DHT or Estradiol.
      In very simple terms the prostate consists of the outer muscular capsule containing both the gland and stroma cells. The capsule is maintained by free testosterone and the gland by dht.
      Most men that experience bph are older and have untreated testosterone deficiency. Their clinician may prescribe a reductase inhibitor forcing testosterone (what little they have) toward estrogen. As dht drops so does the size and integrity of the internal gland, initially shrinking the prostate. Unfortunately estrogen rises and without the inhibiting effects of dht, the stroma cells can quickly grow offsetting the initial improvements seen by shrinking the gland. The stroma cells when growing uncontrolled can become very hard exacerbating the problem and making the situation more difficult to resolve.
      It much simpler to aggressively manage estrogen in men that experience bph. To do this, they must also receive testosterone therapy. In some cases it may be necessary to use a low dose reductase inhibitor, however it should never be given without testosterone or significant side effects can occur.
      Here is where Monica and I disagree. The use of a reductase inhibitor is an adjunct and only used when absolutely necessary. Most problems can be resolved by aggressively managing estrogen and ensuring that the testosterone/dht ratio is correct.
      As an unrelated comment:
      Baldness is typically caused by either excessive reductase activity and or testosterone deficiency. Either one leads to an improper t/dht ratio…you’d think with his testosterone levels Will would have hair like Donald Trump. What’s going on there Will?
      One more comment on gh therapy.
      Igf-1 levels are negatively correlated with prostate cancer. Some low information researchers (not Monica) have been confused by seeing elevated igf-1 levels in prostate cancer patients and then labeling this as a risk factor. It’s turning out that some prostate cancer lines generate igf-1. So, the conditions prior to the cancer were such that igf-1 was low, not high.
      There is also some evidence that the low levels of binding protein igf-1 BP3 could be linked to cancer. As this protein decreases in concentration, it allows for more free igf-1 to circulate and act.

      • Kenroy Grant 6 years ago

        Thats interesting Jim, what you stated about the stroma cells is exactly what I’ve read. It’s also states that for men who already have enlarged prostates the use of 5 alpha reductase inhibitors increased their risk of developing prostate cancer. Although from what you’re stating is that the introduction of testosterone therapy will curtail this effect?

        • jim 6 years ago

          There is significant controversy over this issue. We know from autopsy reports that between 14-46% of men over 40 have prostate cancel cells. The mainstream opinion is that testosterone therapy should not be given to men with prostrate cancer. There have been two studies where men with prostate cancer have been given androgen supplementation and survived longer and maintained a higher quality of life than the group that did not take male hormones.
          There is also some data to support the the view that the decline of dht and testosterone allow for the precancerous transformation of prostate glandular cells, especially when estrogen is high. Adding a 5AR inhibitor will only reduce dht and push the reaction toward estradiol. If testosterone is deficient, then you are in a situation where estradiol is unopposed.
          The data is pretty clear that if you don’t have prostate cancer, then you will lower your risk of prostate cancer by restoring hormones to youthful levels and ensuring that estrogen is aggressively managed.
          If you have prostate cancer, then the proper course of action becomes much more uncertain. I wouldn’t even try to suggest a course of action here.
          In terms of hormone replacement therapy, the most important decision you will make is selecting the correct physician. What appears to have occurred is that the docs that choose to inform themselves in this area realize that their colleagues are ignorant and have chosen to move into private pay where they can be properly compensated and can get away from dealing with the annoyance of insurance companies.

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