Long Term dangers of TRT and How to mitigate them?

[petemitchell30]

I have several doctor friends that will only prescribe TRT in severe cases citing the dearth of long term studies on the subject. I'm 34, in very good health, and like many others am using TRT as a way to optimize my energy and quality of life. Of course, were this optimization of quality to come at the expense of quantity, I would be significantly less likely to elect for TRT therapy.

So, my questions are
1) What are the long term risks of maintaining the test level of a healthy 22 yr old
2) What are the long term risks of low dosage HCG (for ex 500iu 2X a week)
3) What are long term risks of low dosage anastrozole?
4) What, if any, are the best ways to mitigate these dangers?
5) If one were to make the decision to terminate their TRT protocol after a period of 5, 10, or 20 yrs, would the body return to its pre TRT state or would their be negative consequences?

Obviously I've done some research and spoken to a few docs about this, but am interested to read the different opinions/experiences of the members of this board.

[Mr.BB]

Several studies show there is more risk of maintaining low levels of testosterone. Low T is linked to cardiovascular and metabolic diseases.

Of course, if you have normal testosterone levels, but want to increase it to get more muscles and/or libido , etc the abovr sentence doesnt apply. The risks of maintaining T levels above range are well described all across internet, most immediate is policythemia IMO.

[Simon1972]

You won't return to your pre trt levels. Even without getting on trt you would drop by 1% per year naturally.
I'd expect your levels would drop more so considering endogenous test would all but shutdown.
Agreed, long-term damage is nothing if anything, I've seen lots of old men with heart dieseae, cardio issues and osteoporosis, not to mention diabetes and arthritis....and guess what they all have in common??n
That's right, they weren't on trt!

[petemitchell30]

You won't return to your pre trt levels. Even without getting on trt you would drop by 1% per year naturally.

Just for arguments sake, say you were to never get on TRT and your natural level at age 35 would be 400. If you get on at age 30, when your natural level is 450, if you try to get off at age 35 would your level return to 400?

I've heard both that it would and that it would not. Interested to read your take.

[Simon1972]

Just for arguments sake, say you were to never get on TRT and your natural level at age 35 would be 400. If you get on at age 30, when your natural level is 450, if you try to get off at age 35 would your level return to 400?

I've heard both that it would and that it would not. Interested to read your take.

I reckon, no. When you shut down your testes you very rarely return to pre trt levels, even using hcg, it keeps them primed, but general consensus is you will lose more than you would than if you never got on trt to begin with.how much is anyone's guess

[bullshark99]

And that's the million dollar question because there is no "right" answer to it..... Everyone responds differently, take the poor fella that shot Herion and died of an overdose his very first time. then you have people that have been hardcore addicts for 20 years... you just never know how the body will truly respond.
One thing is certain, when you discontinue TRT even if your levels return they will be no higher than they originally were. point is if you are truly suffering from symptoms, the same symptoms if not worse will resurface when you discontinue TRT.

[kelkel]

Most (if any) adverse effects of TRT are due to poor medical care (protocols by uneducated doc's) and/or pre-existing conditions. TRT is no panacea but it's benefits far outweigh any associated risks.

Adverse effects of testosterone replacement therapy: an update on the evidence and controversy

[macmathews]

Any direct medical benifits aside..
I can see how it would get the sedentary guy or somebody who may be trying to be more active the ability to get physically active wether it be in the gym or sport..
And from that start , felling better about themselvs , eating better and the like

[IncreaseMyT]

It is possible to take testosterone and then recover natural levels and get them higher than they were before, I will admit its not very likely. In the following study I believe 10% returned to normal and above, this was without HCG. This tends to been seen in those with delayed pubertal maturity.

Our results indicate that reversal of hypogonadotropic hypogonadism occurs across a broad spectrum of GnRH deficiency and its related phenotypes. Consistent with the few case reports published to date, the present cohort of men with sustained reversal of idiopathic hypogonadotropic hypogonadism includes patients with the Kallmann syndrome and patients with normosmic idiopathic hypogonadotropic hypogonadism.13-18 It is notable that reversal occurred in Patient 3, who had a “fertile eunuch” variant of idiopathic hypogonadotropic hypogonadism characterized by lack of virilization and hypogonadal serum testosterone levels but active spermatogenesis.27 Furthermore, reversals occurred both in men with absent puberty and in men with partial puberty, suggesting that evidence of previous endogenous GnRH secretion is not predictive of future reversal of idiopathic hypogonadotropic hypogonadism. However, testicular growth, a biomarker of gonadotropin secretion over time, represents a subtle yet key factor pointing to reversal of idiopathic hypogonadotropic hypogonadism, as evidenced by testicular growth during androgen therapy in four patients with reversal of idiopathic hypogonadotropic hypogonadism.

MMS: Error

[Simon1972]

To be fair, delayed pubertal means guys that haven't sexually matured yet. Not something the typical male on this forum hasn't achieved.

[IncreaseMyT]

To be fair, delayed pubertal means guys that haven't sexually matured yet. Not something the typical male on this forum hasn't achieved.

I understand. But that doesn't mean it doesn't work for others. If you notice out of 27 recoveries some were absent puberty and some merely "partial" maturation.

The problem here is not that it may not work for other categories, it is merely that there is no research on it.

Like I said the probability is low, but have seen it myself.

PS you would be surprised how many people here fit that category. People forget and do not realize how many thousands of people see these threads and never post here.

Most of the guys in this category are going to be younger. Self selection probably drew them here, look at steroids because they offset the symptoms there are having.

For instance can't grow muscle and have wasting. Low sex drive even though really young. Trouble recovering from exercise.

They read these threads and see these guys taking "steroids" and how they have great sex drive and what not. How they recover really fast and grow muscle fast. So they do steroids and we never know if they had a problem to begin with.

Most people, even the doctors, need someone to explain the difference between using steroids and doing TRT. Many of those guys don't realize TRT would work great for them.

[hammerheart]

I always wondered whether I have hit full maturity.

Personally, I never developed a full beard. If you look at my body shape, the hips are kind of unproportionate for a man's body, together with the narrower waist they go form a pear shape, I hate that. Luckily, the shoulders compensate. Sex drive has always been somewhat latent.

[InternalFire]

I always wondered whether I have hit full maturity.

Personally, I never developed a full beard. If you look at my body shape, the hips are kind of unproportionate for a man's body, together with the narrower waist they go form a pear shape, I hate that. Luckily, the shoulders compensate. Sex drive has always been somewhat latent.

Makes sense, I feel the exact same about myself.

Trial and error I guess, for curiosity I may try and see 1-2 year later trying to go off TRT for a while and observe if body bounces back to mid/higher T range naturally, and if it does that would prove something to be more than just speculation

[2Sox]

I have several doctor friends that will only prescribe TRT in severe cases citing the dearth of long term studies on the subject. I'm 34, in very good health, and like many others am using TRT as a way to optimize my energy and quality of life. Of course, were this optimization of quality to come at the expense of quantity, I would be significantly less likely to elect for TRT therapy.

So, my questions are
1) What are the long term risks of maintaining the test level of a healthy 22 yr old

IMO, none - except being very horny a good deal of the time. Risky business, sometimes.

2) What are the long term risks of low dosage HCG (for ex 500iu 2X a week)

This really isn't a low dosage at all. IMO, low would be somewhere around 250iu/week. And some men do just fine on that.

3) What are long term risks of low dosage anastrozole?

Dosage would depend on your T dose and blood test results, so you'd have to be more specific about your question. You probably don't need a primer on out of control estradiol.

4) What, if any, are the best ways to mitigate these dangers?

No dangers here yet that I can see - unless I'm missing something about the questions you are asking.

5) If one were to make the decision to terminate their TRT protocol after a period of 5, 10, or 20 yrs, would the body return to its pre TRT state or would their be negative consequences?

Pretty good answers above already.

Obviously I've done some research and spoken to a few docs about this, but am interested to read the different opinions/experiences of the members of this board.

Comments in bold above. I'd be curious to know how you came to need TRT at your age.

[petemitchell30]

I don't NEED TRT per se, it is really more of a WANT. I felt as if my energy levels had really fallen off, so I got tested and my levels came back at 390. I told my doc I wanted to be toward the top end of "normal" and he wrote me some scripts.

[kelkel]

Odds are if you are a 390 TT level then your FT (which is what works for you) is low as well. Unless there's something else suppressing your endogenous T then imho you would do well to start a solid protocol.

[FakeLove]

So, my questions are
1) What are the long term risks of maintaining the test level of a healthy 22 yr old
2) What are the long term risks of low dosage HCG (for ex 500iu 2X a week)
3) What are long term risks of low dosage anastrozole?
4) What, if any, are the best ways to mitigate these dangers?
5) If one were to make the decision to terminate their TRT protocol after a period of 5, 10, or 20 yrs, would the body return to its pre TRT state or would their be negative consequences?

1) Some develop polycythaemia on trt, meaning too high haemoglobin (which can be dose dependable). There's two ways to control it: donating blood regularly or decreasing the T dose. Sometimes even a small decrease like 15% in free testosterone might stop the red blood cell count increase. Not much studies about controlling it though, but that's my personal experience as well as my doc's who has 1000 trt patients, and deals with this regularly.
2) When balanced - none. It might excess the estrogen production that could result in need of more anastrozole. Like said above by 2Sox, even lower doses than 500IU 2 x a week many times work. As low as 125IU eod can keep the fertility in shape for many.
3) There's no long term study data available, but if the dosage is right and estrogen is in check probably there's very little if none. I personally checked my cholesterol and triglycerides after two years of continuous use and they were perfectly in check. Even better than before starting. Those many times are the ones of what people are worried about.
4) The best way is to stay regularly on top of the blood tests and making sure all is balanced.
5) Probably some fraction of people would recover moderately, but I really wouldn't count on that. Really.