TRT opinions, low test due to IBD, but young

[itisjack]

Hi all.

I'm looking into TRT as a serious option. I've got internal bowel diseas (IBD; colitis ulcerosa to be specific) since 21 years old, and I'm 24 years old right now. I've never touched steriods before.

Why am I looking into TRT, while I'm still young?
a) My test is low (250-300ng/dL);
b) low testosterone is correlated with IBD;
c) a physiological level of testosterone administration significantly improves the clinical course of the disease. Test + thiopurines works better than any other IBD drug in achieving remission and staying in remission. (Testosterone therapy in men with Crohn's disease improves the clinical course of the disease: data from long-term observational registry study, 2015)

I want to be able to reproduce so I'm looking to commercially freeze sperm, and I'm still researching the use of HCG while on TRT.

I'm also a fitness enthusiast/bodybuilder. I'm 6"4, when I was 21 I was 190lbs 11% bf, which dropped to 165 lbs bc of malabsorption, being unable to train and excreting blood when the disease kicked in. Right now I'm weighing 182lbs ~14-16% bf.

However.. I've read a lot of studies about the cardiac effects of test and it got me concerned about impaired heart functioning and irreversible cardiac hypertrophy as a result of using AAS (most studies dated 2012-2017). These cardiac effects correlate with supraphysiological levels of testosterone (and other AAS) administration. Studies differ in their definition of 'supraphysiological'. One study calls 200mg test-e/week supraphysiological. I guess 100-150mg test-e/week as means of TRT will be fine to avoid adverse cardiac effects?

I've decided that when I do TRT, I might as well add in some cycles every once in a while.

But first I did more research on possibilities to avoid serious cardiac effects. In this 2016 study on rats it is shown that cardiac hypertrophy is more dependent on time than on dosage; Supra-physiological dose of testosterone induces pathological cardiac hypertrophy. Rats were divided in four groups; 5/10/15/20 mg/kg BW, test prop injections three times/week. In 4-week-treated rats, physiological cardiac hypertrophy was apparent with an upregulation of α-MHC without any change in myofilament contractile activation. In contrast, pathological cardiac hypertrophy was observed in 8- and 12-week testosterone-treated groups, as indicated by suppression of myofilament activation and myocardial collagen deposition without transition of MHC isoforms. Only in 12-week testosterone-treated group, eccentric cardiac hypertrophy was demonstrated with unaltered myocardial stiffness, but significant reductions in the phosphorylation signals of ERK1/2 and mTOR. Conclusion: Results of our study suggest that the outcome of testosterone-induced cardiac hypertrophy is not dose dependent but is rather relied on the factor of exposure to duration in inducing maladaptive responses of the heart.

This got me into thinking that short cycles, like 2 weeks on 4 off, 2 on 3 off, are the way to go; I hypothesize, based on these findings, that cardiac hypertrophy and adverse cardiac effects of AAS will be kept at minimal when using AAS like this.

What do you think?

[TRA]

At the lowest dose of the research that would be 500mg/test 3 x a wk for me, which is 1500mg/wk. Never going to happen. And it isn't okay scientifically to assume that the same could happen in lower doses. They say it isn't dose dependent but those are massive doses for the duration, nothing in the range of what TRT or periodic use would be so in my mind the study is not worth much for predicting outcomes in cyclic/TRT uses.

If they were concerned with the dose vs duration why did they use such massive doses?

I would expect a lot of cardiac hypertrophy seen in humans with a history of AAS use would be from uncontrolled blood pressure and would be ventricular and eccentric.

Also, since men have physiologic levels for life, and do not develop concentric cardiac myopathy why would keeping someone in a physiologic range cause it? I personally cannot comment on the collagen deposition or anything because I haven't researched it, but I don't think the study can be applied because of the rat model and the dosing mg/kg body weight factor. Just my .02.

[kelkel]

IBD and low T seem linked but I'm not quite clear on the pathway other than possible treatment (med's) related.
When it comes to testosterone replacement with physiological levels it is far healthier than having low T levels. Watch this video as it will answer most if not all of your questions. It's long but eye opening. Dr. Morgantaler has been researching Testosterone for about 40 years and is recognized as the best in the business:

https://www.youtube.com/watch?v=NPx2dRG1zRQ

Freezing sperm is fine but why not look into clomid therapy first?

[hammerheart]

I don't know what your treatment regime consists of (if it's corticosteroids that alone can be a reason for low T) but IBD is associated with several nutrient/vitamin deficiencies especially D and B12 so I'd advise a supplement regime including D3, methyl-B12, Zinc and a good dose of anti-inflammatory Fish oil to aid with your condition, good luck.

I agree with kel give clomid a try before straight jumping to TRT, as for CV sides recent studies do reveal low T being far more deleterious for cardiac health than AAS use.