T Nation

Harvard Study: More Test is Better, Healthier

The typical doctor loves to get you just above minimum. That way they get a little CYA and that’s about it. I posted these studies for all of us to have ammo if needed. Now to find a doc who’ll not just pooh-pooh the studies.

“”"
Rises in the levels of the gonadotropins, follicle stimulating hormone (FSH) and luteinizing hormone (LH), have been associated with Alzheimer’s disease [AD], but the clinical effects of reducing their levels remain to be determined.

We hypothesize that androgens, gonadotropin modulators, or perhaps selective androgen receptor modulators may be useful components of therapy aimed at preventing the onset or delaying the progression of AD in male patients.
“”"

Gonadotropins increase in response to lost testosterone levels [in cases of primary hypogonadism]. The key factor is the loss of testosterone levels, not the gonadotropins increasing in response.

So there is less AD in secondary hypogonadism where there the gonadotropin levels are low or nil?

Do the high levels of hCG in pregnacy cause AD? Do childless women have less AD than mothers?

I offer that the association should not have been stated any more than to offer an association of AD with lost libido.

To suggest reducing gonadotropin levels is insane. However, one method of doing that effectively is TRT.

This thread is great, and very relevant to my current situation. I had to stop my HRT due to an elevated PSA of 7, which came back to 2.5 after a month of Cipro. Still not as low as pre-HRT, but with a normal digital rectal exam I had the feeling it was prostatis. My first HRT doc had freaked out and made me stop the HRT and the look on her face said cancer.

I went to two urologists, both want me to have biopsies, even though the second one saw the 2.5 and said it probably was just prostatis. I read about biopsies of the prostate, this is not a benign test anymore as they put you under general anesthesis and biopsy 18 sites since it is so hard to find prostate CA. The test itself can lead to erectile dysfunction.

 My current "holistic" doctor was the first one to have really read the literature, and knew about studies such as the harvard one in this thread. He convinced me the downside of not using HRT right now in me was far greater than the risk of prostate cancer, and I resumed the HRT. He also put me on pregnenelone which I believe has helped.

I also have wondered about the proper target level of total test...my ED disappears when the levels get above 900 whereas most HRT docs like it a little lower, even this smart one I have now. However ED is also related to many other factors...that's another thread.        Doc

[quote]Dr.PowerClean wrote:
This thread is great, and very relevant to my current situation. I had to stop my HRT due to an elevated PSA of 7, which came back to 2.5 after a month of Cipro. Still not as low as pre-HRT, but with a normal digital rectal exam I had the feeling it was prostatis. My first HRT doc had freaked out and made me stop the HRT and the look on her face said cancer.

I went to two urologists, both want me to have biopsies, even though the second one saw the 2.5 and said it probably was just prostatis. I read about biopsies of the prostate, this is not a benign test anymore as they put you under general anesthesis and biopsy 18 sites since it is so hard to find prostate CA. The test itself can lead to erectile dysfunction.

 My current "holistic" doctor was the first one to have really read the literature, and knew about studies such as the harvard one in this thread. He convinced me the downside of not using HRT right now in me was far greater than the risk of prostate cancer, and I resumed the HRT. He also put me on pregnenelone which I believe has helped.

I also have wondered about the proper target level of total test...my ED disappears when the levels get above 900 whereas most HRT docs like it a little lower, even this smart one I have now. However ED is also related to many other factors...that's another thread.        Doc[/quote]

Clean, make sure you are getting an ultra sensitive estradiol analysis.

It is likely your estradiol was elevated when you were on HRT, thus leading to an inflamed prostate

[quote]Wise Guy wrote:
Dr.PowerClean wrote:
This thread is great, and very relevant to my current situation. I had to stop my HRT due to an elevated PSA of 7, which came back to 2.5 after a month of Cipro. Still not as low as pre-HRT, but with a normal digital rectal exam I had the feeling it was prostatis. My first HRT doc had freaked out and made me stop the HRT and the look on her face said cancer.

I went to two urologists, both want me to have biopsies, even though the second one saw the 2.5 and said it probably was just prostatis. I read about biopsies of the prostate, this is not a benign test anymore as they put you under general anesthesis and biopsy 18 sites since it is so hard to find prostate CA. The test itself can lead to erectile dysfunction.

 My current "holistic" doctor was the first one to have really read the literature, and knew about studies such as the harvard one in this thread. He convinced me the downside of not using HRT right now in me was far greater than the risk of prostate cancer, and I resumed the HRT. He also put me on pregnenelone which I believe has helped.

I also have wondered about the proper target level of total test...my ED disappears when the levels get above 900 whereas most HRT docs like it a little lower, even this smart one I have now. However ED is also related to many other factors...that's another thread.        Doc

Clean, make sure you are getting an ultra sensitive estradiol analysis.

It is likely your estradiol was elevated when you were on HRT, thus leading to an inflamed prostate
[/quote]

Wise guy, good call. I did have very high E2 a few months prior to that PSA test, partly due to bad test I was getting in Costa Rica (Mexican Sustanon) and partly due to ignorance and inability to get adex. 

I did not know there was a clear link from high E2 to prostatits. Is it that well known? None of my doctors suggested it...but that's nothing new, I find more useful info here on T-Nation than in doctors offices.   Doc

[quote]Dr.PowerClean wrote:

I did not know there was a clear link from high E2 to prostatitis. Is it that well known? None of my doctors suggested it...but that's nothing new, I find more useful info here on T-Nation than in doctors offices.   Doc

[/quote]

If you do some WWW research, you can find a lot of research studies, but not much that Doctors would see unless they were searching. Some doctors know about this.

This hits a few:
http://www.google.com/search?hl=en&q=enlarged+prostate+estrogen&btnG=Google+Search&aq=f&oq=

Part of the prostate incorporates a cell cluster that also develops into the female uterus.

Typical young men have high T and low estrogen. With age, many men have elevated estrogen and low T. While I have never seen this stated, I would expect T to block some of the effects of estrogen just as progesterone does in women. For men with low T and high[er] estrogen, they will have unopposed estrogen and get enlarged prostates, just as women become estrogen dominant when progesterone levels decline; leading to an enlarged uterus - perhaps with fibroid and a high risk of cancer.

Decreasing my E2 two years ago improved my urine flow. Today I got a DRE from my age management doc. He said I had the prostate of a 20 year old. [Almost 60 years old.

Many consider E2 to be the big problem, not T and not DHT.

Prostatitis can include infections and other problems. Perhaps E2 driven BPH could make such things worse.

This is what wiki says:

I really know very little about Prostatitis.

Also recieved my Life Extension Foundation magazine today. It has a huge amount of material concerning estrogen and men. Also a lot of material about estrogen and the prostate.

[quote]Dr.PowerClean wrote:

I also have wondered about the proper target level of total test...my ED disappears when the levels get above 900 whereas most HRT docs like it a little lower, even this smart one I have now. However ED is also related to many other factors...that's another thread.        Doc[/quote]

As one ages, the T receptors can be fewer and the cell walls less permeable. And the needs vary by guy to guy just as their levels are different in youth. Dose should be driven by symptoms otherwise only the lab work is getting treated.

FT or bio-t should be the therapeutic target. If one has more SHBG, then there will be more SHBG bound T and that pushes up TT. Some docs do not even test for TT and only look at FT.

If E2 is high, SHBG and TT will increase at the expense of FT.

My TT is 1000 and I just got my dose of T cyp increased by 25% by my symptoms and FT that has gone down.

Remember that many drugs will reduce E2 clearance rates.

[quote]KSman wrote:
Dr.PowerClean wrote:

I did not know there was a clear link from high E2 to prostatitis. Is it that well known? None of my doctors suggested it...but that's nothing new, I find more useful info here on T-Nation than in doctors offices.   Doc

If you do some WWW research, you can find a lot of research studies, but not much that Doctors would see unless they were searching. Some doctors know about this.

This hits a few:
http://www.google.com/search?hl=en&q=enlarged+prostate+estrogen&btnG=Google+Search&aq=f&oq=

Part of the prostate incorporates a cell cluster that also develops into the female uterus.

Typical young men have high T and low estrogen. With age, many men have elevated estrogen and low T. While I have never seen this stated, I would expect T to block some of the effects of estrogen just as progesterone does in women. For men with low T and high[er] estrogen, they will have unopposed estrogen and get enlarged prostates, just as women become estrogen dominant when progesterone levels decline; leading to an enlarged uterus - perhaps with fibroid and a high risk of cancer.

Decreasing my E2 two years ago improved my urine flow. Today I got a DRE from my age management doc. He said I had the prostate of a 20 year old. [Almost 60 years old.

Many consider E2 to be the big problem, not T and not DHT.

Prostatitis can include infections and other problems. Perhaps E2 driven BPH could make such things worse.

This is what wiki says:

I really know very little about Prostatitis.[/quote]

Absolutely Ksman.

Its great to see that someone else is on my page about these issues.

You are duely informed and a wealth of knowledge, and I enjoy your posts immensely.

Quite often I simply don’t have the time to go into things in a lengthy manner, but you explained the E2 - Inflammed prostate thing for everyone nicely, in a much more detailed manner.

Let us also in another fact - Elevated estradiol(E2) causes a specific form of estrogen known as 4 and 16 hydroxy estrogen to elevate. These particular estrogens are a nasty brew, as they increase the breakdown of testosterone into DHT within the prostate. DHT can be of a particular problem in this area, also causing inflammation.

Remember it is NOT circulating levels of DHT, but actually DHT specific in the prostate.

One action by which saw palmetto is effective is by reducing the 5 alpha enzyme responsible for the T - DHT conversion. It is also important to get a good brand of Saw Palmetto - LEF is good for this. Saw Palmetto from LEF is really cheap as well, during annual sales it can be picked up for as little as 5.50 for a month supply.

Keeping estradiol in check as a youngster with a diet high in vegetables, ZMA use and exercise is prudent. As one ages, keeping T high and E2 in check my require supplemental T and arimidex. Adding in Saw Palmetto will further boost this defense, giving one solid protection.

All of this is useful information, but it is still unclear to me exactly the relationship between estrogen and a normal sized prostate with bacterial prostatitis. The BPH relationship I knew about, and it is not so hard to see how non-bacterial prostatitis could occur.

But even that condition is poorly understood. I believe it is entirely possible I have had chronic nonbacterial prostatitis with two discrete bouts of bacterial prostatitis on top of that, because the symptoms of the latter I think are more profound and obvious when they occur (ie burning when urinating) and it also responds well to antibiotics.

This weird condition called non-bacterial prostatits could certainly explain my longstanding symptoms reminiscent of BPH even though my prostate is NOT enlarged (several DRE’s).

I have been using a saw palmetto formula for some time, it seems to have lost its initial outstanding effectiveness. It is a high quality formulation (Prostatrol Forte).

 Any ideas?                   Doc

You could try Silymarin with Isosilybin B. I would stop taking
the saw palmetto if it’s no longer helping.

Life Extension, Mega Silymarin with Isosilybin B:

http://www.iherb.com/ProductDetails.aspx?c=1&pid=4731960672189557324&at=0

[quote]bugs wrote:
You could try Silymarin with Isosilybin B. I would stop taking
the saw palmetto if it’s no longer helping.

Life Extension, Mega Silymarin with Isosilybin B:

http://www.iherb.com/ProductDetails.aspx?c=1&pid=4731960672189557324&at=0
[/quote]

Thanks, great idea. Doc

I recently, as in yesterday, resumed injections. Using 250 mg/week in 2 divided doses, HCG SC 250 IU 3 times per week, and Ana 3 or 4 times per week in very low doses. I also have high hematocrit, so gotta give blood. Love those needles!! Yeah baby!!!

Everyone should keep an eye on hema/hemoglobin. Steroids DO increase your blood volume. Resign yourself to getting drained every couple of months. At least its for a good cause!

This post was flagged by the community and is temporarily hidden.

[quote]Chushin wrote:
Headhunter wrote:
I recently, as in yesterday, resumed injections. Using 250 mg/week in 2 divided doses, HCG SC 250 IU 3 times per week, and Ana 3 or 4 times per week in very low doses. I also have high hematocrit, so gotta give blood. Love those needles!! Yeah baby!!!

Everyone should keep an eye on hema/hemoglobin. Steroids DO increase your blood volume. Resign yourself to getting drained every couple of months. At least its for a good cause!

HH,

Isn’t that a lot of T for HRT?[/quote]

For most guys, yes.

[quote]KNB wrote:
I wish I still had the link to the study that discusses the lowered incidence of Alzheimers’ and higher Testosterone levels in older men.

The gist was that higher Testosterone levels in older men (60+)had a lower rate of developing the “plaque” that causes the loss of brain function known as Alzheimers.
Just think, a better QOL, a stronger heart, more flexible (and less potentially plugged) arteries, better brain funtion, and oh yeah, sexual function w/o the little blue pill too!

I’m glad i’m on TRT now, so I have the potential to age gracefully and stay as strong as possible in every way as I age.

I remember life before TRT, and life was barely an existence, where now even though I have some physical issues, I still have the desires of a 17 year old and the ability to carry it out, where before I just wasn’t interested…

[/quote]

interesting stuff as had alzheimers have an effect on loved ones is devastating , really hard hard thing
heartbreaking

[quote]AynRandLuvr wrote:
"A retrospective analysis by researchers at Beth Israel Deaconess Medical Center (BIDMC) published in The New England Journal of Medicine found no causal relationship between testosterone replacement and prostate cancer or heart disease risk

“We reviewed decades of research and found no compelling evidence that testosterone replacement therapy increases the incidence of prostate cancer or cardiovascular disease,” said Abraham Morgentaler, a urologist at BIDMC and associate clinical professor at Harvard Medical School.

“Although it would be helpful to have data from long-term, large-scale studies, it must also be recognized that there already exists a substantial body of research on the effects of testosterone in men.”

http://www.hno.harvard.edu/gazette/2004/02.05/10-testosterone.html[/quote]

makes sense. cardio disease is the number one killer of americans and prostate cancer is pretty high on the list. i doubt many people in these cases have had trt. thanks for the info.

I apologize if I’m putting this in the wrong forum, but this seems to be the most relevant one for this question.

I recently sent off for a saliva testosterone / estradiol test.

My estradiol came back at 2.2 pg/ml (acceptable range of 0.8-1.5)
My testosterone was 102.1 pg/ml (75-95)

I’ve never done a cycle of AAS and I’m 34 years old. Health is good and by body fat is around 14%.

My first question is: Are my estradiol levels high enough to reduce my gains from lifting?

Second, how can I get my estradiol levels down into the normal range?

Most here have no idea what to make of saliva based results.

If this were a serum test, I would like to see E2=22pg/ml. That is around 40% of the upper range 0-54. 40% of 1.5 pg/ml would be 0.6 pg/ml. But that is a leap and I do not know how the upper range limits compare.

Now that you are motivated, you will have to find others who understand that data or get a serum E2 test.

If E2 is too high you will not get morning wood.

Elevated E2 blocks testosterone receptors and limits the action of the T that you have and also reduces T production and %FT. Yes, your lifting gains can be affected.

Hmm, just got my test results back, they tossed these tests in with the rest of the bloodwork:

Tests: (5) TESTOSTERONE (2830)
Order Note:
TESTOSTERONE 253 NG/DL SEE BELOW *29

****** EXPECTED VALUES FOR TESTOSTERONE ******
MALE . . . . . . . . . . . . . . . . . . NG/DL 241 - 827
FEMALE . . . . . . . . . . . . . . . . . NG/DL 14 - 76

Tests: (6) TSH REFLEX TO FREE T4 (2834)
Order Note:
TSH 1.2 UIU/ML 0.3-5.1 *30

Basically told me that being below 300 was too low and started me on androgel.

I’m due back in for follow-up tests in about a week and a half, which will then let them make adjustments.

Should be interesting, I’ve never done this sort of thing before.