T Nation

TRT is on the Rise


#1

I just finished this article written by @Chris_Colucci.
In the 1st paragraph it states that the number of men prescribed TRT has tripled on the past decade.

Is this from men having generally lower testosterone from diet and environment? What other things in the past decade have caused unnaturally low test readings?

Or is it simply from TRT becoming more acceptable?


#2

I think it is some of both. There are a lot of toxins that we are exposed to in daily life that can lower your T such as drinking out of plastic water bottles, using nonstick cookware, receipt paper etc. Also, research is showing the benefits of elevated t levels.


#3

Marketing has made men aware of TRT issues and options. Doctors have become more prepared to prescribe and drug reps are fueling the fire. I think that Viagra opened the door to these issues.

One can argue that the need for TRT was under served and that the change is dealing with needs that have not been changing.

Injected T is cheap. Profit motives drive T gels and other new products and the cost of T delivery can be 10 times higher. Once a new T delivery product is FDA approved, there is a lot of money been made.

In most other countries, getting decent male hormone care is very difficult and the needs are very under served. With ‘state medical care’, the financial need for cost control does oppose ‘free’ TRT for everyone.


#4

It’s a tough situation, but it appears that the majority of family physicians who give the initial referrals (or more commonly just their opinions) are following procedure and very seldom, if ever, thinking for themselves. And it makes sense because they’re liable. If they have an idea that makes sense in their mind but gives you a heart attack, they spend months in court and likely lose their license. But if someone else had that idea and published it in a medical journal, then the physician followed protocol and you had a heart attack, well now the physician can defer liability to the researchers and conclude it was just a bad study that spread misinformation. There are many lifestyle modifications that could elevate endogenous testosterone production (diet and resistance training being the major ones) over time, but there is absolutely no motivation to eat well and train hard when you have low test levels (I understand I am oversimplifying things, it’s not allll about T). Sitting for 9 hours and then expecting an individual with no training experience to have the motivation to get up and voluntary exert themselves at their physical and financial expense? That’s crazy talk. Things are changing though, I’m still optimistic that 10 years from now a typical lifestyle will be nothing like what we are seeing today.


#5

I have yet to see any evidence of that ever happening.


#6

I had heard about plastic water bottles but I wasn’t aware of non-stick cookware! I am thinking of getting the pyrex containers to heat up lunch in. They are glass with a plastic lid. Surely they would be better than all plastic in the microwave…


#7

Can you elaborate on this? I had no idea Viagra was even remotely linked to TRT.


#8

There is a lot of research out there showing that men’s T levels have significantly decreased in the last few decades, not much research has been done into the reasons though so research only draws conclusions on what is the most likely causes such as poor diet, sedentry inactive lifestyles and even estrogen in foods


#9

I’ve heard (and joked about) how the rise in female equality has turned a lot of blokes into estrogen filled whimps :joy:


#10

Two things are happening… TRT is becoming more acceptable since the testosterone creams have gained popularity and you also you have the largest group of older people (Baby Boomers) in the nations history. So over the next decade your going to see statistics that point to record breaking of everything like all diseases, heart attacks, prostate cancer, coffin and cremations sales, longer lines at the grocery store (old people take forever) more car accidents, ect… lol. More old people more everything associated with that.


#11

I am kinda skeptical myself, as I emphasised could to suggest a weak possibility. I just haven’t totally discarded the possibility that resistance training begets anabolic hormone production. I understand why such a study would be unfeasible given the long duration that would be required. Also I have seen some rumblings about the ketogenic diet increasing endogenous testosterone, but I have yet to find a study that verifies these adaptations. It doesn’t help that the studies usually use a very low calorie ketogenic diet, but in any case, I can’t disagree with you.


#12

It is at a social level and that is what we are discussing. After we got used to ads on TV about ED, taking about low-T was easy. Daddy, what does ED mean? Try explaining that to your little girl and now they are explicit about erections lasting longer than one hour, explain that too. Low T is simple to explain, its a test that your doctor does. Many years ago, taboo was selling bras and girdles on TV, then it was tampons. Every networks news program is about adult diapers and other problems that means that only old people are watching the news.


#13

I had gotten that figure from a 2016 report put out by the JAMA.

Interestingly, even though the eligible men increased, the percentage of TRT prescriptions increased more dramatically. So, more men were coming in with symptoms, but even more were still being diagnosed and treated.

I do think, like lowcountry said, it’s a combination of factors - lifestyle, environmental, and nutritional - there’s no single pinpoint as a trigger. Xenoestrogens like BPA are devastating to T levels, but also, I think there’s been snowballing anecdotal and empirical evidence over the years connecting hormonal health to overall health, so doctors are (slowly and steadily) getting more on board with prescribing TRT.