androgel side effects

[Paul J Molinaro MDJD]

Haha. He's had this planed a long time I tell ya.

I'm getting slower with age... maybe I need my T checked? My personality indicates my levels would be high, but my physique would indicate low... though my In 'n Out burger levels are well maintained.

- Paul

[Metalject]

Paul, thanks for responding. A lot of people post things, make claims and promote products or services without every responding again. So again, thanks again for responding.

In my opinion, the the majority of problems that surround testosterone medications do not rest in the manufacturers product itself. Exogenous testosterone hasn't really changed in the last 75yrs other than new methods of delivery, some better than others. The problem, in my opinion, is two fold.

1. Big pharma, I think we can all agree it often handles itself in an unethically and yields far more power than it should. However, this is largely the fault of the consumer/voter/individual. The heads of the FDA, notice the names of these men are those that formerly sat at the head of many of the same big pharmaceutical companies. Eventually they are replaced by others in the same position and they go back to the private sector working for big pharmaceutical companies. It's a never ending game of musical chairs that you would think would be deemed a conflict of interest in any legal proceeding. Somehow this practice has gotten a free pass.

2. The physicians - many physicians are not educated on TRT. I'm sure you're aware that it's not something that's taught with any level of extreme detail in medical school. Even endocrinologist are often lacking - they understand thyroids, diabetes, etc. but if you ask them about the conversion of testosterone to estradiol they look at you as if you've asked them to explain time travel. So what happens next? You have the countless pharmaceutical sales reps pushing AndroGel - many of the same uneducated physicians (uneducated on TRT, they may very well be fantastic physicians in other areas) learn about TRT from their AndroGel sales rep.

Another issue that has been a problem for years. The view of testosterone has, I think we call hopefully agree, been placed in an emotional category rather than logical since the late 1980's early 1990's due to the steroid hearings leading the steroid control act of 1990, later reignited due to MLB and the steroid control act of 2004. The arguments were based on the morality of steroid use in sports. If a sporting body says PED use is against the rules, then it is certainly against the rules just a a corked bat is against the rules. Somehow, that same line of thought transcended beyond sports and into the every day man's life. Look at the leading physicians who have been fighting the steroid war since the start, my favorite being that of Dr. Gary Wadler, chairman of the WADA. He once famously quoted that we cannot justify more study on the topic of testosterone because it would be unethical. When asked for the basis of this claim he had nothing to back it with. When asked a similar question at a symposium at Hofstra a few years ago, similar replies were given. The point - if testosterone use truly can be safe, if TRT is a viable option for many men that can improve the quality of their lives, there are many physicians like Dr. Wadler that fight this every step of the way ensuring that no studies, unbiased studies that follow standard guidelines are never performed. How is this ethical? Sure, some studies are done, some without promoting an already desired outcome, but for the last 20+yrs they are few and far between.

My comment about the car - you're right, not the best comparison when dealing with the human body. It was simply the first thing that popped in my head. Perhaps a better one: If a doctor performs open heart surgery, closes the patient up and the patient dies - when examining the Dr's. protocol, steps and procedures and it's found that he did not follow any of the proper steps, would we then say open heart surgery is bad? This is exactly what happened in the two testosterone studies from the fall of 2013, but because testosterone is such an emotional topic for many, these factors are largely ignored.

Lastly, I agree men should not be lied to. Further, I believe TRT is very simple medicine yet, unfortunately, many physicians simply do not know what they're doing. Does it require an endocrinologist or urologist for proper treatment? I would have to say no, and here's why. There are a few medical issues that can occur due to TRT but can also be avoided with proper care and easily so:

1. Thickening of the blood: This can occur due to increases in RBC count and hematocrit. The vast majority of men do not experience this, but with regular monitoring, if it does occur, in most all situations donating a pint or two of blood per year remedies the situation. Is that a pain to deal with? Maybe, but if taking this simple step dramatically improves your quality of life, it's worth it to most men.

2. High estradiol: Testosterone converts to E2, if levels go to high this can cause problems. If regular blood work is done, E2 can easily be lowered. Problem solved.

3. Prostate: For decades the fear of testosterone induced prostate cancer was at the forefront. This theory was later obliterated by Dr. Abraham Morgentaler out of Boston. What we know: testosterone can aggravate existing prostate cancer but it cannot cause prostate cancer. It can also, in some men, induce benign prostatic hyperplasia (BPH) although not the majority of men. If occurs, it is easily treated, often in recent years by the now FDA approved use of daily Cialis (low dose).

4. Cardiovascular: Control blood thickness and this is normally not an issue. If blood testing shows extreme problems in lipids or other related areas, the simple solution is to forgo treatment until this problem is resolved. Interestingly enough, there are several studies that have shown low testosterone (prolonged) can cause unhealthy lipid profiles. This leads to a fairly agreeable conclusion, in my opinion, there are balances in life within the human body, proper balances. Too much or too little of anything can prove problematic and often in the same areas.

[The_Crawfish]

Awesome post metal!

[Paul J Molinaro MDJD]

Metalject,

EVERYONE taking testosterone or considering taking it should read your posts here (I have not read the rest of your posts, but I will assume they are written in a similar fashion), post questions here, and use the information you provide... it is clear that you have studied the topic and not only learned it well but are quite capable of explaining in easy to understand language... a lot of the information on the "Net" promoting or criticizing Rx (or other topics for that matter, gun control, politics, whatever) is uninformed inflammatory blather by people who intentionally ignore facts they don't like... so, thanks from me and the others reading!

RE: “1. Big pharma, I think we can all agree…”

No one should make the mistake of thinking the FDA is not in the pockets of the Rx makers. NPR did an incredible radio story on the new Rx Zoe-high-dro… an incredibly potent opiate that will be hitting the pharmacies soon and raking in billions for the manufacturer… many other articles from reputable news agencies will tell the story of how the advisory panel to the FDA voted 11–2, with one abstention, to recommend that the agency refuse to approve Zoe-high-dro citing to its risk of misuse and abuse as the reason… what did the FDA do? Approved the Rx! Did they do so because there is a dearth of good pain medicine already on the market? Come on, now… many generics and name brands are over-dispensed like candy already… this is just a new brand name Rx that is relatively cheap to make and will be the new thing. Some states have even tried to ban the sale or distribution of the Rx… and the courts are hearing these cases now. Indeed, Big Pharma controls either directly (by having, like you said, previous big wigs from Rx companies on their panels or in positions of authority) or indirectly by feeding the FDA false information.

RE: “2. The physicians - many physicians are not educated on…”

In medical school in the late eighties (yup, that was when I went), all they said was testosterone is great for cancer patients who need muscle buildup or for specific diseases that cause low testosterone … a couple hours on the topic at best… unless you went into endocrinology, oncology, or some other specialty, that was all we got. That said, there have to be treating clinician physicians out there who really know this topic and know how to safely prescribe, when appropriate. I bet, though, that one would have to do some research to find such a physician… but be careful of the ones unabashedly promoting testosterone… especially when they are selling it direct or doing labs to skew the numbers (some argue that there are unscrupulous clinics that will draw T levels at certain times of the day when they are known to be lower to show the patient how bad it is). Not sure if the people on this form would want to post publicly, but private messages about which physicians in which areas are experts and which are jabronies would be of benefit.

RE: “morality of steroid use in sports”

This is sort of what I was hinting at in my example of the Rx that had a 90% chance of extending one’s life to 100 years but a 10% chance of causing death… the rock star question from philosophy 101… would you risk a long life to live it up like a rock star now? Professional athletes have a different risk benefit analysis when looking at what to do to their bodies in the short term.


RE: “we cannot justify more study on the topic of testosterone because it would be unethical”

Interestingly, when lawsuits are brought against Rx makers, they are often done in special courts… multidistrict litigation where a committee/panel heads the plaintiff side and spends literally millions of dollars to carry out not only depositions and document review (of millions of pages), but to reproduce studies and even conduct new ones. Ethical and accurate research is important… as we all know… four out of five statistics are utterly false.

RE: “Thickening of the blood” and the other medical concerns.

That’s where the educated prescribing physician comes into play. I agree! Regular checks and exams and labs… an ounce of prevention is worth a pound of cure… applies to noticing a problem early… much easier to treat a little of something.

And now… for some Sunday chores around the house.

- Paul

I have to misspell Rx as I have less than 25 posts and the auto spaminator gets me.

[Metalject]

Metalject,

EVERYONE taking testosterone or considering taking it should read your posts here (I have not read the rest of your posts, but I will assume they are written in a similar fashion), post questions here, and use the information you provide... it is clear that you have studied the topic and not only learned it well but are quite capable of explaining in easy to understand language... a lot of the information on the "Net" promoting or criticizing Rx (or other topics for that matter, gun control, politics, whatever) is uninformed inflammatory blather by people who intentionally ignore facts they don't like... so, thanks from me and the others reading!

I wouldn't say I'm light years ahead of the pack, but I have spent the last 15+ years studying hormones. I started using steroids at the age of 19 for competitive bodybuilding purposes, I'm 35 now. I have not competed in several years but I am on TRT and have been for several years. Very low dose testosterone use, regular blood work and a doctors visit every 6 months. Even when I was bodybuilding I kept up with how my health was doing, regular blood work just to make sure everything wasn't falling apart. Anyway...I went to school with the idea of being an attorney, took the LSAT, got into law school but never went. I had already begun making money other ways and my career path took a different turn. It's taken many turns and evolved since but I spent several years writing about hormones, research, etc. it's how I made my living. If you've ever googled the word "testosterone" or any other steroidal hormone, growth hormone , etc. you've more than likely read something I've written. It would be impossible not to. Anyway, just a little background on myself, nothing more.

RE: “1. Big pharma, I think we can all agree…”

No one should make the mistake of thinking the FDA is not in the pockets of the Rx makers. NPR did an incredible radio story on the new Rx Zoe-high-dro… an incredibly potent opiate that will be hitting the pharmacies soon and raking in billions for the manufacturer… many other articles from reputable news agencies will tell the story of how the advisory panel to the FDA voted 11–2, with one abstention, to recommend that the agency refuse to approve Zoe-high-dro citing to its risk of misuse and abuse as the reason… what did the FDA do? Approved the Rx! Did they do so because there is a dearth of good pain medicine already on the market? Come on, now… many generics and name brands are over-dispensed like candy already… this is just a new brand name Rx that is relatively cheap to make and will be the new thing. Some states have even tried to ban the sale or distribution of the Rx… and the courts are hearing these cases now. Indeed, Big Pharma controls either directly (by having, like you said, previous big wigs from Rx companies on their panels or in positions of authority) or indirectly by feeding the FDA false information.

The manner in which the FDA has gotten out of control is largely the fault of the voter, IMO. As someone who's largely libertarian minded, we've let the government do as it pleases, and as a result, the FDA. I've seen good doctors fall under the wrath of the FDA over the years because they weren't connected, and it's honestly a crying shame.

RE: “2. The physicians - many physicians are not educated on…”

In medical school in the late eighties (yup, that was when I went), all they said was testosterone is great for cancer patients who need muscle buildup or for specific diseases that cause low testosterone… a couple hours on the topic at best… unless you went into endocrinology, oncology, or some other specialty, that was all we got. That said, there have to be treating clinician physicians out there who really know this topic and know how to safely prescribe, when appropriate. I bet, though, that one would have to do some research to find such a physician… but be careful of the ones unabashedly promoting testosterone… especially when they are selling it direct or doing labs to skew the numbers (some argue that there are unscrupulous clinics that will draw T levels at certain times of the day when they are known to be lower to show the patient how bad it is). Not sure if the people on this form would want to post publicly, but private messages about which physicians in which areas are experts and which are jabronies would be of benefit.

In my opinion, endocrinologist more often than not fall into the category of inadequate when it comes to TRT. They are not taught much more than what you probably were. The example I used above about aromatizing testosterone, most endos are not aware that this happens, and it's one of the simplest core facts surrounding testosterone. The problem, just a theory but I think a good one; many endos and other hormone specialist are threatened by physicians who practice TRT. Endos are supposed to be the experts, so when TRT is bashed, the bashers turn to endos; after all, they carry the hormone title. We've become obsessed with titles as a society; we expect a title to mean the individual is an expert in the field and without such a title he must lack the capacity. I'm sure you would agree there are plenty of men with the acronym "J.D." beside their name that are not fit to represent any client, but the title itself has become far more valuable in many cases than the man.

RE: “morality of steroid use in sports”

This is sort of what I was hinting at in my example of the Rx that had a 90% chance of extending one’s life to 100 years but a 10% chance of causing death… the rock star question from philosophy 101… would you risk a long life to live it up like a rock star now? Professional athletes have a different risk benefit analysis when looking at what to do to their bodies in the short term.

Yes, big difference in athletes and the every day man, but the laws that surround hormones should not be based in a way that affects the every day man due to the actions of the athlete. How the government has the right to interfere with sports, independent bodies in the first place is beyond me, but that's a separate argument.

Of course, the other big smoking gun the government has used to attempt to destroy TRT is the "save the children" mantra. The horror stories of adolescent steroid use are always forefront. But when we look at the data, such as that of the NIDA study in 2010, adolescent steroid use is and has been virtually non-existent. I cannot recall off the top of my head but the number was around less than 2% have ever used an anabolic steroid compared to the double digit percentages, well over 20%, sometimes as much as 50% for nearly every other drug known to man.

RE: “we cannot justify more study on the topic of testosterone because it would be unethical”

Interestingly, when lawsuits are brought against Rx makers, they are often done in special courts… multidistrict litigation where a committee/panel heads the plaintiff side and spends literally millions of dollars to carry out not only depositions and document review (of millions of pages), but to reproduce studies and even conduct new ones. Ethical and accurate research is important… as we all know… four out of five statistics are utterly false.

Brings up the point again of the old prostate study that said testosterone can cause prostate cancer. This study was based off of one patient and it was held as gospel truth in the medical community for nearly 50yrs. While the current studies from this fall count numerous men, they are still flawed. If in court either study were used to prosecute a case, I would hope the judge would recognize that neither study followed set guidelines and throw the studies out. But because it's testosterone, such an emotional topic for many people, I doubt that would be the case. After all, the same attorney could find an expert endo to support the claims, and because he carries the title of endocrinologist, the studies would remain.

And now… for some Sunday chores around the house.

- Paul

I have to misspell Rx as I have less than 25 posts and the auto spaminator gets me.

Hope you enjoyed your Sunday. I made the mistake of eating Chinese food tonight so I am head to my bed to enjoy my belly full of MSG, lol!

[Paul J Molinaro MDJD]

RE: “I made the mistake of eating Chinese food tonight so I am head to my bed to enjoy my belly full of MSG”

Did the restaurant properly and adequately warn you that said Chines food had substantial amounts of this powerful depressant? Did you lose valuable income producing time as a result of having to sleep excessively? Did you get any kinks in your neck or back as a direct result of sleeping unnaturally soundly as a result of this chemical induced comatose state? This may need to be further examined.

Thank you for taking the time to post back and forth with me and give me a different perspective and an education. I always appreciate that. Whether or not there are viable lawsuits against the maker of Anne Dro Gel is still up very much up in the air… I got an email today citing to comments made by another M.D., J.D. who opines that properly dosed testosterone actually strengthens heart as much of the heart is made of muscle and can prevent heart attack… I have not seen any such study, and my initial impression would be that such would be a study that only looked at the effect of testosterone on heart muscle growth/size and does not even look at blood cells.

My take on these Rx lawsuits (pretty much all of the ones in which I get involved) is from the failure to adequately warn of harm(s) angle… another angle would be a defectively made product, but that is quite tough when it comes to Rx… that angle is useful for implantable devices such as artificial knee joints and mesh.

- Paul

[2Sox]

The guy's an attorney and this is as good of a place as any to advertise. Think about it, this site gets more views than any other related to testosterone, and most of the views are not from registered members of the site, they're passerby's. Anyway, I do not expect my post to be responded to as I suspect his OP was just that, advertisement, as well as a copy paste post, but it would be nice to hear someone defend those points rather than listening to myself talk, lol!

I would tend agree with Metal here and I find the poorly veiled purpose of the OP's posts to be objectionable. The bullshit meter is well in the red zone.

Metal, I respect your replies - and the work that went into them - a great deal.


But let's give the OP a chance to dispel our suspicions:
If your post was NOT to advertise, please clarify what exactly WAS the purpose of your post?

[61er]

Great discussion!

[Metalject]

RE: “I made the mistake of eating Chinese food tonight so I am head to my bed to enjoy my belly full of MSG”

Did the restaurant properly and adequately warn you that said Chines food had substantial amounts of this powerful depressant? Did you lose valuable income producing time as a result of having to sleep excessively? Did you get any kinks in your neck or back as a direct result of sleeping unnaturally soundly as a result of this chemical induced comatose state? This may need to be further examined.

Thank you for taking the time to post back and forth with me and give me a different perspective and an education. I always appreciate that. Whether or not there are viable lawsuits against the maker of Anne Dro Gel is still up very much up in the air… I got an email today citing to comments made by another M.D., J.D. who opines that properly dosed testosterone actually strengthens heart as much of the heart is made of muscle and can prevent heart attack… I have not seen any such study, and my initial impression would be that such would be a study that only looked at the effect of testosterone on heart muscle growth/size and does not even look at blood cells.

My take on these Rx lawsuits (pretty much all of the ones in which I get involved) is from the failure to adequately warn of harm(s) angle… another angle would be a defectively made product, but that is quite tough when it comes to Rx… that angle is useful for implantable devices such as artificial knee joints and mesh.

- Paul

The idea of suing the Chinese restaurant, while I did enjoy a laugh it also made me wonder if we're not that far from that. Maybe the next time I go to Florida I'll sue the state for not warning me with a big sign when I entered "Welcome to Florida, it's VERY Hot Here!" LOL! Hey, why not? That guy that spilled coffee on his pants back in the 90's won

Back on topic, I found this interesting and a little surprising: The FDA's comments on the two testosterone studies from last fall - I was surprised that the statement acknowledged the risk were largely held by those with preexisting cardiovascular conditions. I was even more surprised to see them say you should not stop taking your prescribed testosterone at this time. I say "surprised" because the FDA has always instituted a witch hunt against testosterone.

Statement seen here:
FDA evaluating risk of stroke, heart attack and death with FDA-approved testosterone products

Also of interesting note, I noticed AbbVie put this line on the homepage of the AndroGel website: "You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: The FDA Safety Information and Adverse Event Reporting Program or call 1-800-FDA-1088." Just curious to know if that's always been there or if that was recently added due to all the hoopala

[lovbyts]

This should all be moved to it's own post starting at #13.

I'm sure I'm not alone with skipping over post that are 2 years old thinking they are probably just bumped by newbies.

[Metalject]

This should all be moved to it's own post starting at #13.

I'm sure I'm not alone with skipping over post that are 2 years old thinking they are probably just bumped by newbies.

Agree. Hopefully someone will do that.

[Paul J Molinaro MDJD]

RE: "Also of interesting note, I noticed AbbVie put this line on the homepage of the AndroGel website: "You are encouraged to report negative side effects of prescription [Rx] to the FDA. Visit MedWatch: The FDA Safety Information and Adverse Event Reporting Program or call 1-800-FDA-1088." Just curious to know if that's always been there or if that was recently added due to all the hoopala."

Looking at the "Way Back Machine" (great archive site for the Internet for many purposes), it appears that said such a recommendation appeared in 2008... so, it's been there for a while.

As for the idea of posting only to troll for clients... of course, I am always looking for clients, but... my two professions (law and medicine) never have a shortage of paying customers (patients or clients)... For example, I tell every smoking patient to quit, and I encourage such... knowing that if they did, they would get less disease and not see me as often... that's just fine with me... I try to talk patients into healthy choices about diet, exercise, taking Rx, and not falling for the holistic cure scams out there instead of getting real medical treatment when needed (you want to see me rant, get me started on holistic "natural" cures). As for clients, I really do try to only accept clients with real cases based on real wrongs... sometimes, the truth does not come out until after a case is filed, though... a pessimistic lawyer once told me that the first person to lie to a lawyer in most cases is the lawyer's own client. Thus, a lot of learning should be done before a case is taken.

With regard to Androgel... while I enjoy the discussion here (and on a few other websites) that my somewhat unwelcome initial posts start, one thing that has not happened is anyone here saying he has suffered some kind of blood thickening harm or even knows someone who has... which indirectly leads me to believe that maybe it's not as common as it seems... and this leads to a few assumptions... one being that the readers and posters on this site do not have problems because... either, problems are really rare or people here are educated enough to watch for side effects and monitor health and labs appropriately.

- Paul

[Metalject]

Paul, here's something you might find interesting.
The Androgen Study Group | For Accurate Reporting of Studies on Testosterone Replacement Therapy (TRT)

[Paul J Molinaro MDJD]

I did. Thanks!

Wow... the summary of the letter, and the letter to, the FDA makes a pretty compelling argument. This letter does not stop at asserting T does not cause increased risk of cardiovascular disease but goes on to argue that it DECREASES risk... "On the contrary, the weight of evidence accumulated by researchers around the world over several decades clearly indicates that higher levels of testosterone are associated with amelioration of CV risk factors, and reduced risk of mortality."

As more and more men start using testosterone which I bet will be the case, we will see statistics based on huge patient populations and not just these contradictory studies we now have. Interesting, indeed.

- Paul