Can Deca Replace Testosterone in HRT?
A hormone that does most of what testosterone does but is 10 times more powerful and doesn’t affect your prostate or your hair – why aren’t we using it?
I started thinking about the anabolic steroid nandrolone (deca-durabolin) because of my dog. He was diagnosed with degenerative spinal disease a couple of years ago and it wasn’t too long after the bad news that I had him fitted for one of those doggy wheelchairs that looks like a truncated version of the sulky that horses pull in harness races.
I remember getting teary eyed looking at that wheelchair but rather than wallowing in pity – pity for him and pity for me – I got mad. I redoubled my efforts to help him walk again. I put him on a highly structured physical rehab program and pumped him up with any supplement I knew of that might help.
I also put him on a mild dose of prednisone to quell the inflammation that was no doubt leading to further compression of his spinal cord. Lastly, I upped his dosage of testosterone cypionate to build up his atrophied hind legs and to negate any additional muscle-wasting effects from the prednisone. (I’d started giving him low doses of testosterone a couple of years earlier for general health purposes. More info here: How to Make Your Dog Live Longer.)
Twelve months have passed and the wheelchair is in a closet somewhere. While his walk is more of a lumber, he gets around just fine. We go for short walks and he even chases the ball every day. Most importantly, he doesn’t seem to be in pain.
It sounds like a success story and it is, but not a day goes by that I don’t think what progress he could make if I could get my hands on nandrolone, the fabled steroid from the “golden age” of bodybuilding. (It was discontinued in the U.S. back in the early 2000s, allegedly because of supply problems.)
Here’s Why I Covet Nandrolone
While the testosterone helped my dog a great deal, it has a couple of significant drawbacks. For one, it has a low myotrophic/androgenic ratio – about 1 to 1 – meaning it affects muscle growth just about as well as it causes the development of secondary male characteristics. In practical terms, that means it causes muscles to get bigger while also possibly causing prostate growth.
As such, I was limited to how much testosterone I could give my dog. Any amount that might cause truly helpful improvements in muscle size and strength would likely cause his prostate to grow and make it difficult for him to urinate and possibly lead to further complications like urinary tract infections, which isn’t an acceptable trade off.
But nandrolone has a myotrophic/androgenic ratio of about 11 to 1. That means it causes phenomenal muscle growth with negligible or non-existent effects on the prostate. Not only that, but nandrolone is reputed to have a downright marvelous effect on the joints.
My point is this: Veterinarians should routinely prescribe Nandrolone to help animals stave off the effects of degenerative diseases that ultimately cripple them.
And yes, I said U.S. pharmaceutical companies no longer make nandrolone, but it can still be produced in any number of U.S. compounding pharmacies. (It’s also still available in a number of other countries.) All that’s needed are some enlightened veterinarians who are ready to pull out the prescription pad.
So that’s why I’ve been thinking about nandrolone lately. It also occurred to me that it should be routinely used in human patients to stave off the muscle wasting associated with a lot diseases or degenerative conditions. Furthermore, I think it could be used as a replacement for testosterone in male hormone replacement therapy, or at least as an adjunct to testosterone.
That’s the real subject of this article.
I even found a review article in Translational Andrology and Urology by researchers Pan and Kovac that supports the latter viewpoint: “Beyond testosterone cypionate: evidence behind the use of nandrolone in male health and wellness.”
What’s the Problem with Traditional T Replacement Therapy?
Traditional TRT usually involves the exogenous supplementation of some testosterone ester by itself or in conjunction with other drugs like human chorionic gonadotropin (hCG), clompihene citrate (Clomid), and anastrozole (Arimidex).
However, as mentioned, testosterone has a low myotrophic/androgenic ratio. A relatively weak ability to build muscle isn’t generally considered to be a problem in true TRT (for the purposes of reversing hypogonadism), but it’s the other side of that ratio that often poses a problem: Testosterone’s androgenic, or virilizing effects.
Testosterone is prone to the attentions of the 5-alpha reductase enzyme, meaning that a portion of it is chemically transformed to dihydrotestosterone, or DHT. Unfortunately, DHT is what causes the prostate to grow. DHT is also what may cause scalp hair to fall out.
Men undergoing TRT often take 5-alpha reductase inhbitors like Finasteride to counter these prostate-expanding and hair-shrinking effects, but these drugs may have sexual side effects and possibly cause anxiety or depression.
5-alpha reductase also romances nandrolone, but the end product isn’t DHT, but 5-alpha-dihydro-19-nortestosterone. Unlike DHT, 5-alpha-dihydro-19-nortestosterone has virtually no interest in binding with the androgen receptors on the prostate or on hair follicles.
That means no hair loss and no prostate growth. Instead, you get significant muscle growth without the need for 5-alpha reductase inhibitors.
Another Potential Advantage of Nandrolone
Bodybuilders who use nandrolone are often enthusiastic about how great their joints feel when they’re on the steroid. While I’m not aware of any human studies on this aspect of nandrolone usage, there’s at least one animal study that gives nandrolone’s joint-happy rep some credence.
Pan and Kovacs, in their paper, reported on a study of white rabbits where nandrolone administration resulted in reduced functional impairment of the rabbits’ rotator cuffs after release of their supraspinatus tendons. In other words, the researchers gimped up the rabbits’ rotator cuffs. Nandrolone made them heal faster and better.
There’s a Fly With Erectile Dysfunction in the Ointment
Remember how I said that nandrolone doesn’t reduce to DHT? Well, when it comes to potential prostate growth or hair loss, that’s a good thing. The only problem is that men need at least a little DHT to maintain normal sexual function. DHT is the active androgen involved in the production of nitric oxide, the vasodilating gas that makes erections possible.
And while there are no consistent reports in the scientific literature about the use of nandrolone and erectile dysfunction, bodybuilders have long bandied about the term, “deca dick,” meaning a penis that, because of nandrolone usage, won’t rise to the occasion.
Whether these reports are true or merely apocryphal, I don’t know, but the chemistry indicates it’s a distinct possibility.
(As far as my dog and his spinal problems, I considered this potential aspect of nandrolone to be irrelevant: His mating days are long over. Besides, walking takes precedence over erections, regardless of species.)
There’s also evidence that nandrolone, like all anabolic/androgenic steroids, negatively affects the hypothalamic pituitary axis (HPG), which further decreases testosterone and DHT levels, thus making erectile dysfunction even more of a possibility.
Of course, all anabolic steroids do that.
But there’s one other thing to consider: A percentage of nandrolone, like testosterone, “aromatizes” to estradiol, thus upsetting the balance between “male” hormone and “female” hormone, which can further negatively affect sexual function.
Increased levels of estrogen are also associated with gynecomastia, additional body fat, and undesirable blood values
So Why Are You Even Pushing Nandrolone?
Nandrolone has the following things going for it:
- It’s extremely anabolic.
- It doesn’t convert to DHT, thus making prostate growth or hair loss non-issues.
- It has a potential role in healing joints, particularly the rotator cuff.
- It has a long half-life.
On the downside, nandrolone brings with it some baggage:
- It potentially suppresses the HPG axis (but so does conventional TRT).
- Since it doesn’t convert to DHT, nandrolone usage may lead to some degree of erectile dysfunction.
- It aromatizes to estradiol (as does testosterone).
When you weigh the plusses and minuses, the only unique strike against nandrolone is the fact that it doesn’t reduce to DHT at all, thus possibly causing the dreaded “deca dick.”
There is, however, another route by which DHT is formed and it doesn’t involve a testosterone intermediate. It’s called the “backdoor pathway” and it involves the reduction of 17-alpha-Hydroxyprogesterone to a couple of intermediate compounds, ultimately resulting in the production of DHT.
Regardless, we can’t count on that to give us 100% confidence that an erection will be there when we need it.
I still think, though, as do Pan and Kovac, that there’s room for nandrolone in male hormone replacement therapy. Nandrolone could be used in conjunction with low doses of testosterone.
That way, you get the benefits of both – nandrolone’s profound muscle building and joint healing without fear of prostate growth or hair loss and just enough testosterone to assure adequate production of DHT to keep erections chugging along.
Alternately, small doses of nandrolone could entirely take the place of testosterone in hormone replacement therapy. Sufficiently small doses would still build muscle without prostate growth or hair loss without affecting the HPG axis. That means that your natural production of testosterone wouldn’t be affected and enough DHT might still be produced to drive erections.
It would take a little individual experimentation, but it wouldn’t be difficult to figure out each patient’s ideal balance or dosage.
Just How Much Stigma Do We Need to Overcome?
Whether anyone can find doctors progressive enough and courageous enough to prescribe nandrolone to patients – animal or otherwise – is questionable.
Doctors in general don’t like steroids. As Pan and Kovac point out, a recent study surveyed healthcare provider attitudes towards users of anabolic steroids and found that they’re viewed less favorably than cocaine abusers. So it goes.
I, for one, will continue to crusade for nandrolone and her anabolic-steroid cousins. These valuable medicines have been stigmatized for too long because of ignorance, misinformation, and fear.
Reference
Reference
- Pan MM et al. Beyond testosterone cypionate: evidence behind the use of nandrolone in male health and wellness. Transl Androl Urol. 2016 Apr;5(2):213-9. PubMed.