Guys with Issues - These Videos Cover Estrogen, TRT, and DHT

You have an opinion on the use of AIs, and I think everyone in this forum knows it. My opinion is not all that different, but is a little more flexible for quys who are way out of range for E2 as the one you hypothetically described.

My opinion on dosing also differs from yours. I believe in a more cautions approach rather than jumping straight to big doses with infrequent weekly injections… However, I don’t beat people over the head with it. I simply offer it as a different approach that has worked well for me for over 8 years and was prescribed by one of the leading authorities in TRT.

Can we agree to have differing opinions and bring this conversation to a close?

I’d certainly be interested in hearing what he has to say. I’d be more interested in hearing from medical professionals with varying opinions on the subject and make a rounded informed decision for myself. I’ll start with the review article posted previously and if i feel the need research the topic further for other review articles and meta-analyses in the literature. This drug has been around for a long time, I’m sure these high level reviews on safety an performance have to exist.

AGAIN. Am I just talking to a wall or are you doing this on purpose?

This isn’t an OPINION. This is FACT backed up by EVIDENCE.

YOU have an opinion. Your opinion is demonstrably FALSE.

Estrogen is a PARACRINE HORMONE. It is aromatized from testosterone in the tissue. You are only measuring what little bit leaks into the serum which doesn’t demonstrate the varying levels in tissue, skeleton, or brain which makes serum level a moot point. FACT demonstrated by EVIDENCE.

If you say OPINION again, you’re demonstrating to be a moron.

Here is the EVIDENCE one last time:

https://drive.google.com/drive/folders/1Ml3jnxdxpBTc3kKIIpW3KT5CqrwIdjuG

Your opinion is irrelevant.

This means crap in my book.

I’ve seen Drs with better credentials and in particular with endos (most know very little about trt or they make you think they know) . It is very difficult finding a Dr this knows trt and I live near a very populous City.

Besides, any idea how much we’ve learned on the subject since 1993 or 2006 or whatever other year? 19/20 doctors who I speak to about this (I’ve been getting a lot of phone calls lately) are CLUELESS about this stuff. It’s almost comedic when I start explaining it to them.

Anyone still in doubt:

All hail the king of the forum! He has spoken. Let there be no further dissenting opinion or discussion. I bow to your superior intelligence.

2 Likes

We’re talking about statins in this side conversation. Which has taken a decisively negative turn by a certain individual.

My wife has atherosclerosis. Dr switched her from zocor to crestor. Crestor and lipotor are the only 2 statins from my research that MAY reverse plaque.

So while someone is trying to fix their diet and fitness, the statin can be useful. Of course the goal is to hopefully take the statin short term and fix with diet and exercise.

At least one good thing about this thread is that I am now motivated to review the literature a bit closer on the use of statins. One more topic to research in depth. As I previously posted, I’ve had absolutely no perceivable adverse effects with over 2 years of use of low dose (10mg) atrovastin (Liptor).

Plan to start with the review article link previously posted and then move on to see if there are any Cochrane reviews on the subject. They typically provided the highest quality meta-analyses in the medical industry with both easy to read summaries and in depth analysis across multiple data sources.

Short synopsis of my story: I started TRT over 8 years ago and my cholesterol and lipids, which had never been above the normal range, suddenly jumped upward and out of range within a few months. I resisted the use of statins due to fear mongering on the internet and in forums like this for many years (bad decision).

After discussing this with my trusted doctor in an annual exam where my lipids had gotten particularly high, we decided to do a trial of the lowest dose of atrovastin available. Since then, my cholesterol and lipids have both been in range and with good HDL/LDL ratios.

Interestingly, I took a statin vacation for a couple of months last year under the advice of another physician who was treating me for some unrelated medical issues. His advice was to limit the number of potential causes. Turns out that the issue was completely unrelated to statins. The most interesting outcome was that my cholesterol and lipids jumped up again and out of range. I’ve since restarted statin treatment at the same 10mg dose (again with no perceivable side-effects). Got the results today and all cholesterol and lipid measures are back to being in the excelling range.

1 Like

Hi John,

Unfortunately, the article is not available OPEN ACCESS, so I cannot review the full text. However, your post motivated me to do a little searching of PubMed and the Cochrane Library. Three OPEN ACCESS articles and one Cochrane Meta-Analysis looked like good candidates for review. I’ll dive into them perhaps tomorrow:

Collins, R., Reith, C., Emberson, J., Armitage, J., Baigent, C., Blackwell, L., Blumenthal, R., Danesh, J., Smith, G.D., DeMets, D., et al. (2016). Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet 388, 2532-2561. Interpretation of the evidence for the efficacy and safety of statin therapy - PubMed

Dimmitt, S.B., Stampfer, H.G., and Warren, J.B. (2018). The pharmacodynamic and clinical trial evidence for statin dose. Br J Clin Pharmacol 84, 1128-1135. The pharmacodynamic and clinical trial evidence for statin dose - PubMed

Adams, S.P., Tsang, M., and Wright, J.M. (2015). Atorvastatin for lowering lipids. Cochrane Database of Systematic Reviews. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008226.pub3/epdf/full

I skimmed through the high level review articles on statins. I say skimmed because the Cochrane Systematic Review is 402 pages, which is typical of their in depth reviews. Below is my take aways on each of the papers.

Overall, they did get me to rethink my dose, particularly the Dimmit 2018 review which puts doses in perspective with their ED50 (Effective Dose for 50% of the population taking them). The ED50 for Atorvastain is only 2mg, but I am taking 10mg (5X the ED50) because that is the lowest dose available in the USA. This discussion has excellent timing because my doctor recently gave me an open lab order for lipids every 4 weeks for as long as I feel the need to do the labs to monitor my return to using the drug after a 2 month vacation (and my lipids going out of range again). So, I think for my next lab, I’ll try a dose of 5mg by cutting the tablet in half. Should be an interesting experiment, as my goal is simply to undo the lipid alterations caused by TRT.

Collins, R., Reith, C., Emberson, J., Armitage, J., Baigent, C., Blackwell, L., Blumenthal, R., Danesh, J., Smith, G.D., DeMets, D., et al. (2016). Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet 388, 2532-2561. Interpretation of the evidence for the efficacy and safety of statin therapy - PubMed

They were certainly in the pro-statin camp. They concluded: It is, therefore, of concern that exaggerated claims about side-eff ect rates with statin therapy may be responsible for its under-use among individuals at increased risk of cardiovascular events. For, whereas the rare cases of myopathy and any muscle-related symptoms that are attributed to statin therapy generally resolve rapidly when treatment is stopped, the heart attacks or strokes that may occur if statin therapy is stopped unnecessarily can be devastating.

Dimmitt, S.B., Stampfer, H.G., and Warren, J.B. (2018). The pharmacodynamic and clinical trial evidence for statin dose. Br J Clin Pharmacol 84, 1128-1135. The pharmacodynamic and clinical trial evidence for statin dose - PubMed

An interesting read. This is the review paper that discusses statins in terms of the ED50. not being an expert on this subject, I’m a bit confused with their conclusions. They lead off with a conclusion that Statin doses around estimated effective dose 50 (ED50) can reduce myocardial infarction by over 25% and mortality by around 10%. Then go on to conclude that for 10 mg of atorvastatin, there is no randomized controlled clinical trial evidence that coronary mortality is lowered, or that survival is increased. But that is 5X the established ED50 for the drug. They do discuss in depth the potential adverse effects in the body of the text and conclude that AEs increase in number and severity with increasing dose. They provide additional discussion of liver function in Table 3 and show a very low effect of 10mg on ALT (increase of 0.2%) compared to a significantly higher (p<0.001) effect of 80mg (increase of 1.2%). I have monitored liver enzymes closely and there appears to be no effect for me. OTC ibuprofen and naproxen have a MUCH greater effect.

Adams, S.P., Tsang, M., and Wright, J.M. (2015). Atorvastatin for lowering lipids. Cochrane Database of Systematic Reviews. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008226.pub3/epdf/full

They reviewed 296 trials of atorvastain which included 38,817 participants. The data shows that there is a linear dose-related effect on blood total cholesterol, LDL-cholesterol, HDL-cholesterol
and triglycerides. But provide no long-term survival data because most of the studies were shot-term ‘efficacy’ studies. They did point out regarding safety that withdrawals due to adverse effects were not statistically significantly different between atorvastatin and placebo
groups in these short-term trials. They also point out the same limitation on safety conclusions that the review does not provide a good estimate of the incidence of harms associated with atorvastatin because included trials were of short duration and adverse effects were not reported in 37% of placebo-controlled trials.

So… what’s the strategy? People need straight-forward info laid out plainly, not teasers and videos that are longer than some workouts.

Also worth noting that the forum had gotten away from stickies because, basically, the stats showed that people simply weren’t using them despite being directed towards them. There also got to be a silly number of “stickied” threads which cluttered the pages and diluted the relative importance of the sticky.

It’s something we might get back to for the site if it can be worked out properly with succinct, accurate, and (trickiest of all) indisputable advice that applies to the overwhelming majority, if not all, readers.

1 Like

I’m a big believer in the approach: “If you can’t explain a concept so a 12-year old would understand, you either lack a deep understanding yourself or your presentation needs work.”

You’re saying there’s no way to bullet point the key takeaways? No way to summarize into practical steps?

Not really. It’s fairly common sense that getting a medication’s dosing correct is essential for results. That description simply isn’t informative and is absolutely not sticky material. It’s pretty much just a restated teaser/YT video description one would use post without giving anything away.

To get dialed in, how often should bloodwork be monitored? Are higher frequency injections a panacea or do they bring more problems? What are the signs when you’re finally dialed in optimally? This is the stuff I’d expect to learn after finding out “how to dial in your protocol using the best strategy possible”.

I get that some people are better suited to delivering information via different mediums. Some folks can get their thoughts out better when writing and they’ll freeze or stammer on camera, some people get their points across more clearly with longer videos or podcasts, etc. But at the end of the day, the forum here is written and it’s a monumental ask to expect people to invest a big chunk of time listening to a monologue, regardless of how useful the info might possibly end up being.

It follows a mafia family across several decades. In particular, it focuses on why and how one of the Don’s sons reluctantly evolves from uninvolved in The Family to eventually leading the whole operation. It had some of the best acting Pacino, De Niro, Brando, and Duvall have ever done, paired with a great story and great dialogue.

Did the summary miss some nuance and not address some layers? For sure. Does it get the point across so you actually know what it’s about? For sure.

Pfft, that was Part 3. It gets a lot of hate, but I rewatched it a little while ago and (potential Flame-Free Confession thread entry) it’s not as bad as I remember.

6 Likes

Kinda like how every Youtuber wants to make a video and never wants to give out info without directing traffic to their channel.

I get where you’re coming from, but, c’mon.

6 Likes

He’s given out quite a bit more info than most here in addition to videos of interviews with docs. Most YouTubers wouldn’t take the time he has if their only agenda was to recruit followers.

I understand that. I just don’t believe that it’s absolutely impossible to summarize/bullet point the most important takeaways from the video.

1 Like

I agree with Chris. You should be able to bullet point this.

Like starting dose and frequency and how you move from there.

It’s like listening to a 1 hour podcast to find the 1 minute they talk about an ideal metformin dose for non diabetics.

It’s become clear he came here to promote his channel. Not saying his material is useless.

2 Likes

Ok. Nice try getting your video to be a sticky. If I was you, I would try too.

Maybe start your own website. See if it catches.

I listened to 2 minutes. Using the forward button.

Basically if you doing 1x a week and don’t feel right ALL week keep increasing frequency until you feel good every day.
Didn’t want to hear more so I don’t know what you said about dosages. Would you like to summary that part?