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Medically Reviewed by Dr. George Touliatos
Guys have 101 questions about TRT before they start.
However, there is usually a core of basic questions that are asked over and over.
In this article we answer 10 of your most common questions about testosterone replacement therapy.
When you take exogenous testosterone, your body detects this and stops producing its own testosterone.The production of testosterone is key to sperm production. Therefore, if you want to father children and remain fertile on TRT, you must take HCG.HCG or Human Chorionic Gonadotropin is a hormone that mimics the behaviour of luteinising hormone in the body. This sends a signal to the testes to produce testosterone, stimulating sperm production.
A typical dose of HCG alongside testosterone to maintain fertility would be 1000-1500 iu’s weekly.
The whole concept of ‘cycling’ comes from bodybuilding where individuals typically take supraphysiologic doses of testosterone and other anabolics.Doing this for prolonged periods can be extremely detrimental to health. That’s why bodybuilders tend to cycle these drugs.However, when you come off testosterone, it might take your body weeks to recover and start it’s own natural production of testosterone.
This is not a nice place to be. This is both dangerous and stupid.
TRT is administered with therapeutic doses of testosterone, e.g. 200-250mg weekly. This is beneficial to health and avoids the negative side effects at higher doses.
If you cycle TRT, this means you lose the benefits of it each time you come off it. Therefore, it makes ZERO sense.
The use of an AI (aromatase inhibitor) has become a hot topic in recent times. An AI works by blocking the action of the aromatase enzyme, which is responsible for the conversion of testosterone into estrogen.Increased levels of testosterone through TRT will normally raise estrogen levels. And this is not necessarily a bad thing.
However, too much estrogen can have unwanted side effects such as gynaecomastia, water retention, and nipple swelling.
Some doctors say you need an AI to effectively mitigate negative estrogenic side effects. Some say AIs are the devil incarnate and are detrimental to your health.
Ultimately, if the patient has a clinical need, and aromatase inhibitors are used in a sensible way, they are quite safe.
Most of the hyperbole around testosterone comes from flawed studies and hearsay.The evidence is mounting in favour of testosterone. Studies have been done on large sample populations to show testosterone is safe and beneficial.There are millions of men all around the world who are testament to the efficacy of testosterone therapy.
What’s more, testosterone is a hormone that is readily accepted by the body.
We NEED it to live for heaven’s sake! This is not like some strange drug. Think about that for a moment.
Do your own research and make your own conclusions. Don’t listen to the media hype.
When you are diagnosed with low testosterone, the idea is for you to trial it for several months to see if it relieves your symptoms.If you don’t see success with treatment, then you are under no obligation to continue.However, there are usually a couple of scenarios where this happens:
Either the individual was not patient enough – because sometimes it can take several months to balance your hormones. Or the individual was given an ineffective treatment protocol by a doctor.
Testosterone is rarely if EVER the real issue when treatment doesn’t work.
There are several different ways in which TRT can be delivered, although tablet form is usually not one of them. It is possible to get oral testosterone but there are concerns that it can cause problems with the liver. Therefore, there is a focus on alternative delivery methods which bypass the liver and allow testosterone to get straight into the bloodstream. These include:
As we have already discussed, testosterone is safe and can be highly beneficial. However, like all medication, there can be some risks associated with taking TRT. Depending on the method of delivery, there may be a rash or itching at the site of application, but this is usually temporary and rarely serious.
Testosterone use may also increase the risk of heart attack or stroke, but this is yet to be substantiated by large clinical trials. There are also some conditions which could be exacerbated by testosterone therapy, such as benign prostatic hypertrophy, sleep apnea or congestive heart failure, so men suffering from these conditions should be closely monitored by their physicians while taking testosterone therapy.
The debate as to whether TRT causes prostate cancer is still ongoing, but to date there are no studies which have found a link between the two. There are a number of doctors who suggest that taking TRT can speed up the rate at which prostate cancer tumours grow but so far there is no clear evidence to support this.
In a word, no. The anabolic steroids which are used to enhance performance usually include testosterone or a similar chemical, but at much higher levels than would be found naturally in the body. TRT is designed to replace natural testosterone levels so would never have that kind of dose. It is also common for performance steroid treatments to contain other drugs which increase muscle development.
First and foremost your doctor will establish that your testosterone levels are truly low. This means measurements which show testosterone is either low or absent in your bloodstream. Your doctor will also test for other hormones in order to make sure that your diagnosis is accurate and your treatment is carried out safely. These tests may cover:
This article has been researched and written based on scientific evidence and fact sheets that have then been crossed checked by our team of doctors and subject matter experts.
References, sources and studies used alongside our own in-house research have been cited below, most of which contain external clickable links to reviewed scientific paper that contain date stamped evidence.
Our team of healthcare experts and GMC registered doctors are licensed to UK GMC standards. We strive to provide you with the latest evidence based, researched articles that are unbiased, honest and provide you with accurate insights, statistics and helpful information on the discussed topic to ensure you gain a better understanding of the subject.
We value your feedback on our articles, if you have a well-researched paper you would like to share with us please contact us.
If you know your total testosterone reading from a previous blood test input the results to the left above to see if your testosterone levels are normal.
You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.
The Total Testosterone Level You Entered Is Incorrect. Figure Must be in nmol/L you can use our converter here.
Your testosterone levels appear to be in the normal range.
You must be over 38, have had your ovaries removed or have suffered with premature menopause to warrant further hormone tests.
Please contact us to discuss your hormones, we need your total testosterone levels to validate your hormone deficiency. You can order a blood test here.
You may have low testosterone depending on the symptoms you have, please contact us to find out how we can help.
You appear to have higher than normal testosterone levels, please contact us for further investigation.
You appear to have normal testosterone levels. Contact us if you have any concerns.
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