T Nation

What is TRT and What is NOT TRT

Steroid immunoassay for E2 first came out in 1969 which required chromatography first to separate the analyze. Assays for other hormones shortly followed.

Direct RIAs which allowed for widespread adoption and ease of use without chromatography weren’t commercially available until late 1970s…

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My mission is to have a name for you to call it (besides TRT) when this thread is done. I’ll keep you posted. I’ll throw out trestolone rejuvenation therapy for now so maybe it will be known as TRT with a Bill Clinton wink.

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I’d have to find it again, but I’ve read some old studies indicative that SOME men can produce as much as 15mg/day. 100mg/wk appears to restore my TT/FT to physiologic realms (albeit the upper level of physiology)

I’ve posted around 3-5 studies indicating a generational decline in TT/FT to be present. Lab assay variation may be partially at play, though I’d highly doubt assay variation can account for say… a 30-50% swing in androgen status.

Was recently looking at a study comparing bodybuilders (steroid vs steroid free, looking at cardiac geometry, sperm count etc). The steroid free bodybuilders had an average TT of something like 800-900ng/dl, I’d hypothesise lifestyle plays a factor here.

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I think we may be parsing words, but I have agreed with you and often said we’re practicing functional medicine. As for “restoration” vs “replacement” I suppose I’m thinking that when something is replaced it involves something different, like an old car with a new one. Restoration is not different, just better (hopefully). I have a neighbor who just finished “restoring” a '66 Corvette and while it may not look at it on the surface, it is very much at a higher level than originally when it came out of the factory over 50 years ago.

Anyway, function works for me. But, I’m still going to say TRT. It’s like when a stranger would ask if I lifted weights (meaning bench press) and I’d end up trying to explain the Olympic lifts, the snatch and the clean & jerk, to him for 30 minutes. You and I can have the discussion, because you know what your talking about. The guys that ask what I do get, “testosterone replacement therapy, TRT, you’ll gain muscle, lose fat, have more energy and increase libido and sexual function. Any questions?”

Obviously, another excellent point which I think about a lot. I tell patients, there is such a thing as too much of a good thing. I often wonder where that number is and if it is different for everyone (I think so). It’s like using AAS as PEDs back in the day. I found there was a point of diminishing returns (more is not better) and passing that point yields zero return and going further makes you worse. I explain this to patients and they seem to get it, more is not better, so they don’t pressure me to push the envelope. Though, I suppose some here think I do.

You’ll love this then. I know some guys who did but now don’t. They start low and titrate upward to effect. I don’t ever see myself there.

Yes, SOME as in almost none (>99%tile) when you examine the stats. The 15 mg/day would compare well with 1000-1200 ng/dL cutoff in the above posts.

Thank you for sharing the data point. :+1:

Useful to understand the difference between replenishing T levels back to the high end of normal 20 yr physiology vs going higher than this to simulate/restore youthful function with supra dosing.

Man you’re patients are lucky to have you. Very knowledgeable, patient, and open minded provider. Do you do telemedicine :slight_smile: :wink: ?

This back and forth has spurred a thought and better way to remove the ambiguity here between the words replacement vs restoration. TRT should be Testosterone Replenishment Therapy and running higher could be termed *pseudo-Function/Feeling Replacement therapy (*pFRT). The latter may not be addressing root cause but it it’s potentially addressing symptoms and providing improved patient well-being (at least short term). Long term impact of pFRT we don’t know, but I don’t mean to be a purist as we really don’t understand long term impact of all the persistent chemicals that have been released into food/environment/drinking water. So guys can and should be able to choose their path (TRT vs *pFRT) once they’ve given informed consent.

I salute you. Sounds so simple but so important. Some of us (me) have to learn the hard way.

Thanks so much for your time @highpull.

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What did it say about cardiac geometry?

This was in relation to abuse as opposed to therapeutic use. Prolonged use (within this study) induced cardiac enlargement associated with transient, subclinical deteriorations within cardiac function.

Abstinence from use (following abuse) largely reversed cardiac alterations regarding both structure and function.

That being said, alterations on a cellular level (as seen within rodent models and/or in-vitro models) are potentially permenant, and the abuse present within this study pertained to merely (I think) around 150-200 weeks of cumulative use.


You can’t really compare 1000mg to 100mg though. It should been noted circulating androgen concentrations were diminished in former abusers, as were testicular volumes. From what I recall effects on fertility were largely reversible.

This isn’t accurate. Restoration in vehicle language, means returning it to its original condition. It’s a very specific meaning. Outfitting a 1966 Corvette with modern brakes, a modern engine, modern suspension, wheels and tires, is not restoration.

I think the same applies to TRT. The goal shouldn’t be to replace, or restore to what our levels were before, unless that’s all you want. For me, I want to feel optimal. If I’m going to go through a lifetime of injections, why not have all of my symptoms gone?

Just like that 1966 Corvette. Why settle for the shitty technology of 54 years ago, when we can have better?

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“Testosterone resto-mod”. Or TRM for short. I think we’re on to something here boys.

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After finding out I had hypogonadism/was put on testosterone replacement my faulty logic came to the conclusion “after practically a lifetime of pain I deserve a little extra boost” :laughing:

I keep my TT between 5-900ng/dl.

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Whatever, we’re parsing words. I’m not going to argue with him, or you, and he sells his “restored” cars for a lot of profit. I guess the buyers are OK with upgraded brakes.

You’re missing my point. I’m simply saying that Testosterone “Replacement” Therapy, and “Restoring” lost testosterone, are inaccurate.

The pyramids were built by men with 20,000 plus Testosterone running through their bodies. We have declined a lot since 10,000 years ago. Aliens took it all away with their technology. Im good though


Seeking to understand:

Wonder why the aliens lowered the serum levels of these men? Where these men having issues with their lifespan and cardiovascular function? Were these aliens benevolent healers or sinister invaders jealous of the indigenous peoples’ striated mass?

Yes, but for how long?

Answer to your first question lies hidden in an episode of Ancient Aliens. And the answer to the second question is… til I die.

Managing Hct when you are on the fine line between TRT and *pFRT (mild cycle, supra, whatever you want to call it). Go too high it won’t matter. But in the very fine gray zone, perhaps more infrequent injections will help (weekly instead of daily):

Start here and read down.

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Wow, all this and only 5 likes? Hmmm. I wonder how many likes I’ll get if I throw in first order absorption + elimination and more accurately account for Cmax and Tmax (12-24 hrs) in the original plots? SteroidPlotter, eat your heart out.