In a perfect world shouldn’t TOT and TRT be same same?
I would disagree but I’m not “in it” to convince you specifically. I think you are smart enough to know your own risk / reward profile. I also find our conversations run in circles and as stated on other threads we will continue to agree to disagree.
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I think I can be too literal sometimes, but here’s my take. As I said before, TRT, or Testosterone REPLACEMENT Therapy is a misnomer. Since I don’t know what my T levels were when I was making a healthy amount of T, then I have no idea what I’m supposed to replace. Not to mention the fact that a healthy person who has a total T level of say 600, is not the equivalent of someone on exogenous T who has a total T level of 600.
TOT means taking close to the least amount of testosterone that makes me feel optimal. In other words, the least amount that relieves my low T symptoms.
https://statmodeling.stat.columbia.edu/2019/01/28/bullshit-asymmetry-principle/
Two questions then arise:
1. Is this principle true? Or, more specifically, when is it true and when is it not?
- To the extent that the principle is true, where is it coming from? I can think of a couple theories:
a. Asymmetry in standards of evidence: it’s much easier to suggest that something might be true than to demonstrate conclusively that it’s not the case. For example, consider “cold fusion”: A single experiment with anomalous results got lots of attention, but it took a lot of effort to figure out what went wrong.
b. Ethical asymmetry: The kinds of people who bullshit are more likely to be the kinds of people who misrepresent evidence, avoid correcting their errors , and intimidate dissenters, so at some point the people who could shoot down the bullshit might decide it’s not worth the trouble: Why bother fight bullshit if the bullshitters are going to turn around and personally attack you? From this standpoint, once bullshit becomes “too big to fail,” it can stay around forever.
Congrats. How many times has then been covered now?
Here’s the analogy again, and why it’s a bad analogy.
I’m only posting this because you continued with the topic.
“If you have pain in your foot and you take ibuprofen everyday, you’ll likely get a stomach ulcer, a certain percentage of those people that do so, die. But I guess it’s a good thing to take them every day, as there is short-term symptom-relief. The long-term effects, who really cares about that? Oh wait let’s treat the stomach problems with pantoprazole. Alright, stomach has no problems anymore. Now you have a higher risk of dementia and infections. Lucky you, that’s probably even further away in the future.
You could have fixed the foot instead of eating ibuprofen like gummy bears. But you went for more ibuprofen instead.”
Taking ibuprofen for foot pain, instead of fixing the issue causing the pain, is not the same as taking Testosterone to fix the issue of my body not being able to produce a healthy amount of testosterone.
I’ll go to the extreme end to try your point. We had someone a year ago in the pharna section. He did doctor prescribed TRT with 500 mg per week for years. He asked if this is healthy. He explicitly said that all of his symptoms have gone away but come back if he goes to 400 mg. Would your advise be to stay on a “TRT” of 500 mg/week?
Hmmm, someone has a video for that kind of scenario as well.
Given only that information, no. But I have heard of a few people here that only get symptom relief with high doses.
I don’t discount the possibility of the rare person that actually needs 500 mg per week for symptom relief. Does that seem impossible to you?
Maybe you need a picture.
Many times, when your gut is telling you that you’re being taken advantage of, played for a fool, or simply being mistreated, and you confront a disordered character about it, they’ll act like they have no idea what you’re talking about. They’ll pretend to be totally unaware and in the dark. Sometimes, when you have received information from a reliable source about something you suspect they’ve been doing, they’ll pretend they have no earthly idea where anyone could have come up with such an idea about them. Feigning ignorance is an effective tactic that manipulates the person confronting the behavior into having doubts about the legitimacy of the issue they’re trying to bring to the other person’s attention. It invites them to see themselves as a false accuser and victimizer, instead of being the victim of the disordered character’s malicious behavior.
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On the other hand**, if Charles continues to believe that the test was unfair after seeing the grade distribution, he is either severely challenged in his capacity for rational calculation or he is the perpetrator of willful ignorance.** Willful ignorance occurs when individuals realize at some level of consciousness that their beliefs are probably false, or when they refuse to attend to information that would establish their falsity.
People engage in willful ignorance because it is useful. Growing up, my best friend’s parents always had classical music playing in their house. My friend’s father, who was a bit unyielding in his pronouncements and views, would say something about the music such as “that’s Mozart at his best.” His mother, who had a much better musical ear, would wait until he left the room and giggle: “It’s Brahms.” If you asked her, she would claim that her husband knew more about music than her. Deep down, though, I suspect that she knew this wasn’t true, but convincing herself to believe it served to maintain marital harmony as well as her desire to see her husband as a connoisseur of music, wine, poetry, the Yankees—you name it.
Where have i have i seen this behavior? 
Yes it is impossible that he NEEDS this amount. He can get “symptom relief” by taking 500, but as I said many times now, only because something gives you symptom relief does not equate to the missing of this substance being the cause for your symptoms.
Someone having a broken foot and taking ibuprofen does not have a ibuprofen deficiency, only because ibuprofen provides symptom relief.
If you have 170 ng/dl T level and you get it up to 600-1000 trough to peak and you still have symptoms, then okhams razor says it’s not only the testosterone level that’s wrong. Taking 1000 mg and then saying that’s a correct therapy for whatever symptom like “not enough muscle mass” is not a therapy.
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So in your world, absolutely nobody has an issue that would require 500mg of test per week to relieve symptoms? Congrats. You now know everything.
I never said otherwise.
Dude, what the hell are you talking about? Again, I’m happy that you can now say that you know for a fact that there’s nobody that needs more testosterone than you think. You have reached the peak of knowledge. You are my inspiration.
And when have I ever defended someone wanting to take 1000mg of testosterone to build muscle mass, as the same thing as having low t symptom relief.
Apparently analogies and straight up definitions are both not understandable to you, as evidenced by your post.
Clearly there are medical conditions which need more than physiologic levels of AAS. TRT is not one of them, in no case at all, ever.
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You do say exactly that. You say that when you have vague symptoms of low T (which by the way without measuring T levels, could really be nearly any other disease), the preferred method of treatment would be to titrate up testosterone until symptom relief is achieved. It does not matter to you if the symptoms stem from low T, it only matters if they are treatable with any dose of testosterone. That is exactly the same as saying:
I have pain, ibuprofen at some dose kills the pain, problem solved.
If you do not see this, I don’t think you are actually up for an intellectual discussion. It’s an easy point. Please provide a counter argument or frame in which one could work out the dose, without symptom resolution being the only objective. As it clearly is not sufficient as evidenced by this and 10s of other posts at this point. I start to see bad intentions in your posts as you don’t respond to the point made at all. Is it normal that one has to make one point 10 times to you until it elicits a thought through response?
Here for example. What is this? Are you not understanding the point or why do you feel the need for this completely ridiculous sentence? Please post something that would provide a different frame work than the one I laid out. Show me in which one you operate. Instead of making intellectually dishonest and fallacious utterings.
This is the last chance. If you can’t provide anything intelligent this time, I’m out.
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500mg/wk of testosterone? Where exactly might this fellow lie?
About 28 sigma from the mean? Amongst… nobody else.
Advice: In a discussion when different points of view clash, set the foul lines. That is a range of reasonableness. It would seem reasonable to me that 500mg/wk of testosterone is in foul territory. About half of that could be argued as the left field foul line (though that is high in my opinion.) It would seem clear that zero testosterone would be the right field foul line.
Or, you could continue to talk past others here.
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“28 sigma from the mean…gee Dad, that’s big.”
take a look.
This is just bullshit that I never claimed. Again I grow tired of defending a position that I don’t take. This is my last explanation of how this is not my position on this.
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I never said not to check t levels to determine if someone has low t. That’s asinine.
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I never said that the preferred method is to titrate UP. I’ve advocated for finding the correct dose, whether that’s up or down, or staying with the current protocol.
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I’m specifically talking about low t symptoms. I’ve made that clear multiple times on This forum.
You are another @equel who instead of having a rational conversation with me about the things I actually say, you create ridiculous bullshit and claim that I believe it, only to call me out on shit I never said, to make it sound like I’m unreasonable.
It’s a shitty way to try to have honest dialogue.
Good.
Again, did not say what you are saying I’m saying. Is my point still too difficult? I’m glad you at least made a point that I can contend with now.
I did not say that that is what you do. I said that symptoms with or without T levels in range are a lackluster indicator. With low T measured, you bring it in range, if they persist, then you have to look somewhere else and not further increase the T.
This is also medically completely illiterate. You would never titration down. You would start with a low to moderate dose and go up until the physiological range is maxed out. If no improvement then, then more T is not the answer.
You did not specify which. Which is why I made the point that low T symptoms are a medically diverse set of symptoms that could stem from low T or from something else. If T is brought in range or even high physiological range and there are symptoms, they are come thing from that something else.
More testosterone than you would ever produce naturally might resolve some symptoms which could stem from low T or not but it is then not the correct treatment. Please contend with this point. Contend with it specifically. Why would more T be the answer to a problem not caused by low T? Don’t say you are not saying that as you have no proof and can’t ever have proof that it stems from a deficiency in testosterone.
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