I've got a client who is too stubborn to research but will follow my advice to the T. I don't want the stubborn jackass to get hurt so please help me out. He is 35, 5-11, 220 (been lifting for 10+ years). He was on T-replacement at 150mg/week for a year, then started a test only-cycle at 500mg/week. He has been "on" for going on 8 months now. He reasons that it's a mild dose plus he has kept up with blood work, following very quality nutrition/supplement advice (yours truly) and there are no issue yet. He keeps asking me how long he can be on a mild cycle without adversely affecting his health. I am versed in general steroid use, as I am also on T-replacement, but I would like some scientific and or anecdotal opinions from you guys. I have yet to see any credible evidence in general that appropriate gear use can cause long term adverse health affects.
I realize I'm going to frustrate you with this answer, but your clients shouldn't be coming to you for anything resembling medical advice, and if they are, you shouldn't be giving it.
If his bloodwork checks out and his haematocrit is fine, then its ok to stay on for a long periods of time, especially if he's just using test. Of course its not going to be as healthly as being on a TRT dose, but the risks are pretty small. You don't get overnight atherosclerosis, it takes decades.
I'm not particularly knowledgeable, but I agree with MG, and would have offered the same opinion.
However, he needs to be aware of the law of diminishing returns, so will benefit from returning to his HRT dose for at least a couple of months and increasing the sensitivity of his androgen receptors.
Out of interest can you share with us the nutritional and supplemental advice you have been giving him?
First off, this is not traditional medical advice like I have a sore on my dick, tell me what to do?! This is lifestyle advice and I'm a lifestyle professional (CPT). Plus, 95% of GP's are clueless. Furthermore, illegal steroid use is not "medical" since its ILLEGAL. The only way to do this the right way is network with other lifters who are experienced with it. FYI, I have read much of what Dr. John Crisler D.O. has written, who is a world-renowned testosterone expert. Finally, my client will listen to me but not his doc (as he knows how ignorant they are).
Thanks to MG and buddaboy. I have read about the desensitization of AR's and believe that holds general truth in all endocrinology. Unbound test is then gobbled up by SHBG and removed. But to what degree or when, who really knows. Wound Masteron or other substance (i.e. herb) help to keep that sensitivity?
As far as my nutritional advice, my research/study background is near the doctoral level in anthropology. Works by Cordain and Eaton (two of the more accomplished anthro's out there) have painted a very clear picture that deficiency/toxicity is the root of most common chronic disease. The credible, non-industry funded, research shows abundant evidence that a paleolithic diet plan is the closest to the perfect diet for human genetics. Its futile to argue that a species that not just survived but thrived on the paleo diet for literally hundreds of thousands of years+ (sans grains and milk and obviously processed shit) should be eating anything remotely resembling the typical western diet.
Anyway, he mostly eats veggies, fruit, lean meat (grass-fed red meat), nuts, seeds, and gets plenty of carbs from starchy root veg and a few servings of grain like oatmeal or sprouted bread, and some cheese. Yes I know grains/dairy are not Paleo approved but I have to be pratical with clients plus I believe as long as it's of the best quality grains and dairy can be consumed in limited quants. He also takes the best molecular forms of omega 3 fatty acids, D3, multi-vitamin/mineral, etc. I also have him on a high performance PWO shake which is a custom blend of whey/casein hydrolisates, high-insulin carbs, BCAA's, etc, etc.
As far as the pathology on heart disease (atherosclerosis), its driven by an inflammatory diet/lifestyle, deficiencies, stress and lack of activity. Genetics are WAY down on the list. On the paleo diet, I do not believe moderate steroid (not long-term, such as a year) use will significantly increase this risk. Cancer I believe might be a different story as chronically elevated sex hormones can increase cancer risk.
I have been on Test for 14 years now ED...injectable, transdermal custom compounded blends, etc. What occurs is hypertension due to blood thickening which is a side effect. Routinely giving blood does wonders for his HBP. He needs to have his LH checked monthly along with prostate, etc. Given long term he is so much better off with a transdermal as it is readily adjusted whereas injectables are basically all or nothing. Took injectables for years and it gets old real fast. I use a custom 15% Test blend with pharm grade DHEA, Progesterone, etc in a creme. No residue, no smell. My Test numbers have been as high as 1500ng/dl and I maintain at 700-900ng/dl. Makes for a great product when you come off injectable and need a maintenance until everything gets running.
What is nice about the product I use is the lack of estrogen homeostasis...stays nice and suppressed with a built in blocker. I pull bloods every 2 months..
Do you mean Leutenizing Hormone? What would be the benefits of this, in your opinion?
I'm curious about this product. I assume it is compounded by your pharmacy? Sounds good! Do you know what they are using to prevent E2 aromatization? I wasn't aware of any transdermals that can accomplish this.
Thanks for the info. That's an awesome protocol that keeps you high-normal, but it's specfically made for you... not sure how that concoction might work for everyone. DHEA can convert to many things besides test. Another issue is getting it from a compounding pharm is you would need a prescription... he is all black market; not going through a conventional doc (no doc at all, except to order labs as requested). So, the compounding is out unless you have a source. Also, why check LH so often? Whether running TRT or mass cycles, LH will be depressed due to HPTA feedback loop. Further, I have the same question as the above poster - how do you control for E2? DHEA can be synthesized into any hormone the body needs, which means E2 (extra of course is bad). Plus, the test can aromatize as well. What's up with taking progesterone??? Never heard of anyone taking that except women.
Looking forward to your response,
I forgot to add that yes, donating blood keeps hemoglobin and hematocrit (blood thickeners) at acceptable levels - I have mentioned that to him to consider it every 3-6 months, depending on lab results. He is also on LOTS of fish oil as it natural anti-aggregation, not to mention regular cardio has this effect as well.
Top Sirloin: Not to speak for him as I'll let him justify his own reasons, but progesterone is a step down the chain from pregnenolone on the cortisol production line. Many people that take pregnenolone with the goal of boosting the gluccocorticoids just can't get it to convert down that path (it all goes down stream into the androgens) so progesterone is used as an intermediary and is able to more easily convert to cortisol.
Agreed, but is he treating adrenal fatigue or what? Of course cortisol is a needed steroid but if the body is not making enough there are likely other issues in play that should be addressed... this is the reason I said his concoction is proprietary.