drtbear1967
Musclechemistry Board Certified Member
Medical Uses of Testosterone and Testosterone Replacement Therapy (TRT)Testosterone and its associated derivatives and analogues hold a plethora of medical application for the treatment of an almost infinite amount of conditions, debilitations, and diseases. There exist so many applications in fact that they cannot all be covered here, and that an entirely separate article focusing solely on the medical use of Testosterone and anabolic steroids would be required.
Testosterone and its analogues have been effectively utilized for the treatment of hypogonadism and andropause, female breast cancer, hereditary angioedema, anemia, muscle wasting diseases such as AIDS/HIV, burn victims, muscular atrophy, male infertility, adolescent growth failure, osteoporosis, female libido problems, Turner and Klinefelter Syndrome, menopause, chronic dysfunctional uterine bleeding (menorrhagia), treatment for endometriosis, and countless other conditions. It is very evident that anabolic steroids are a miracle drug within medicine, and holds the capability to be utilized for the treatment of almost any medical indication as these hormones exhibit systemic effects on the body that can apply to an infinite amount of uses and treatment options.
Anabolic steroids and Testosterone has helped to save hundreds of thousands of lives over the previous 70+ years of application and use in medicine, as well as off-label uses.The primary purpose for Testosterone itself medically, especially in this day and age, is for the purpose of Testosterone replacement therapy (TRT), also known as HRT (Hormone Replacement Therapy), androgen replacement therapy (ART). TRT is normally a therapy administered to individuals who are experiencing lower than normal levels of Testosterone production for a variety of different reasons. The general and proper medical term for this condition is known as hypogonadism, which is a condition in which the testes are manufacturing inadequate Testosterone in individuals and could be due to genetics, physical injury, disease, or any other reason.
The specific medical terminology for individuals suffering from age-related decline in proper Testosterone production is known as andropause. The treatment for hypogonadism and andropause are perhaps the most common purpose for the use of Testosterone within medicine in the entire world. It is a simple treatment method that could be easily defined as the supplementation of Testosterone in order to restore Testosterone levels of a male to that of a normal to high range. The majority of patients being treated with Testosterone for this purpose happen to be adult males above the median age of 30, which is a very strong indication that these are mostly andropause patients (those whose Testosterone levels have declined due to aging).The initial superficial symptoms of low Testosterone are easy to spot signs and symptoms, which include a notable reduction in sexual function and libido (including erectile dysfunction), a notable loss of general daily energy, decline in strength and overall physical performance, depression (to varying degrees), increased bone frailty, decreased motivation, memory loss, and muscle loss[11]. These symptoms occur both in those who experience andropause as well as general hypogonadism. The truth of the matter is that andropause is actually for all intents and purposes, a sub-category of hypogonadism. It is simply a variant of hypogonadism, and could be labeled as age-related hypogonadism. The symptoms listed above are normally very strong indications of lower than normal Testosterone levels, but a general reference range of where Testosterone levels should be are usually given to doctors for ease of reference and determination.
This range varies between which medical professional is monitoring blood levels, and which medical organization in which country is setting the standards, but it must be understood that although reference ranges are given, no range is ever set-in-stone, and that doctors should always be allowed to treat their patients according to their unique assessment and judgment of a situation. With this being said, the average ‘normal’ endogenous Testosterone range is considered between 350ng/dl and 850ng/dl. This range of 350 – 850ng/dl, as previously mentioned, can vary (for example, some medical literature suggests a range of 241 – 827ng/dl in some countries/regions/organizations. In general, the 350 – 850ng/dl range is considered the normal range.Although this 350 – 850ng/dl range is considered the ‘normal’ range, within it there exists a low, mid, and high end within this normal range. For example, if an individual possesses a blood plasma level of 750ng/dl of Testosterone, they are said to be within the high end of the normal range. If an individual possesses a level of 430ng/dl, they are said to be within the low end of normal range. If levels are lower than 350ng/dl, it is regarded as a significant problem (and as mentioned, some medical professionals will lower this minimum level as low as 241ng/dl or lower). As one can see, the threshold for what is considered a ‘normal’ level of Testosterone is actually quite a large one. This is one of the reasons as to why hypogonadism is actually a very much under-diagnosed condition, and many doctors are even still reluctant to prescribe Testosterone for a variety of different reasons (some of which can be regarded as unreasonable).
It is important for any individual who suspects they are hypogonadal to seek a doctor who understands, is reasonable, and willing to work with the patient. Most doctors are highly uninformed and uneducated on the issue of hypogonadism and will instead elect (foolishly) to simply avoid touching upon the subject altogether.It is important after determining the symptoms to then have blood work completed so as to determine with 100% certainty that Testosterone levels might actually be low. No individual can know with absolute certainty whether or not they are hypogonadal until a proper blood test has been done in order to determine Testosterone levels. Because Testosterone replacement therapy will raise Testosterone levels upwards of the normal to high range, it has a high success rate of alleviating all of the aforementioned symptoms. There are various ranges at which different symptoms will become alleviated with TRT. For example, if levels are restored to 350ng/dl or above, the sexual dysfunction and libido is corrected. Testosterone Enanthate administered at 250mg once every 21 days after 6 months demonstrated a 5% increase in bone mineral density[12]. This is a perfect example of how the administration of Testosterone to restore normal physiological levels can help to restore and improve the function of many of the different systems as outlined previously in this article where Testosterone’s effects on the cellular level were explained. This includes increases in red blood cell count, which translates to increased endurance, improvement in energy, well-being, and restoration of muscle mass.There are various studies that have determined where, on average, Testosterone levels should be in males according to various age groups[13]. These studies have determined the following median blood plasma Testosterone levels according to age:It is important to remember that these numbers are not set in stone, and can indeed be very different depending on the individual in question. It is very important to have a doctor that understands and interprets these functions and results properly. For example, total Testosterone is very different from free Testosterone (free Testosterone is the amount of Testosterone in blood plasma that is unbound by SHBG and free to do its job in the body). SHBG, for those that do not know, is a protein that binds to sex hormones (such as Testosterone, Estrogen, etc.) and renders them inactive, essentially ‘handcuffing’ the hormone, which results in the hormone floating around in the bloodstream doing nothing.Low Testosterone levels have been associated not only with the symptoms described earlier, but also with a host of other health complications and risks. One such risk in men who possess low Testosterone levels is an increased risk for cardiovascular disease (CVD).
Studies have demonstrated that Testosterone used for the purpose of TRT exhibits a positive change in blood lipid (cholesterol) profiles involving a reduction in the ‘bad’ LDL cholesterol, total cholesterol, as well as no changes in the ‘good’ HDL cholesterol[14] [15]. It is normally only once Testosterone levels begin to reach supraphysiological dose ranges that cholesterol alterations begin to change in the negative slightly. In addition to this positive change, the restoration of Testosterone levels to normal-higher ranges has also demonstrated to reduce adipose (fat) tissue in the midsection, lower rates of obesity, and improve the body’s sensitivity to insulin as well as the control of blood glucose[16]. The opposite of these improvements often lead to metabolic complications such as diabetes and obesity, which also further contribute to increased risk of CVD. Testosterone supplementation can also reduce inflammation within the body by increasing levels of the anti-inflammatory cytokine IL-10, and reducing the inflammatory cytokines TNFalpha, IL-1beta, and IL-6[17]. This will assist not only in reducing inflammation systemically, but also protect the arterial walls from the same effects of inflammation.
There are of course some risks and potential side effects associated with TRT. Side effects associated with Testosterone supplementation are the same list of side effects as that of any use of Testosterone, but specifically, elder males seem to encounter a greater degree of potential side effects than younger TRT patients. Because Testosterone is an androgen, it has been found that it might in some individuals induce BPH (Benign Prostatic Hyperplasia) and increase PSA (Prostate Specific Antigen) levels[18] [19]. Prostate hypertrophy is not normally a health or life threatening issue, but can become a discomfort for many, and although Testosterone and related androgens (such as DHT) are not the culprit in prostate cancer, it can play a role in its development provided the environment alongside other contributing hormones is in a perfect position for such a risk. Normal and healthy males that do not exhibit prostate issues prior to TRT do not normally exhibit these problems, and so it is normally advised that men who have (or have in the past had) prostate cancer and/or normally high PSA levels avoid the use of Testosterone[20]. The issue of prostate problems with the use of Testosterone or any anabolic steroids seems to be an issue related to age and of course, genetics. This is evidenced by one study in 2001 investigating supraphysiological (bodybuilding doses, not TRT doses) of Testosterone (600mg weekly for 20 weeks) on 61 healthy males aged 18 – 35 demonstrated no significant impact on prostate-specific antigen (PSA)[21].
Testosterone and its analogues have been effectively utilized for the treatment of hypogonadism and andropause, female breast cancer, hereditary angioedema, anemia, muscle wasting diseases such as AIDS/HIV, burn victims, muscular atrophy, male infertility, adolescent growth failure, osteoporosis, female libido problems, Turner and Klinefelter Syndrome, menopause, chronic dysfunctional uterine bleeding (menorrhagia), treatment for endometriosis, and countless other conditions. It is very evident that anabolic steroids are a miracle drug within medicine, and holds the capability to be utilized for the treatment of almost any medical indication as these hormones exhibit systemic effects on the body that can apply to an infinite amount of uses and treatment options.
Anabolic steroids and Testosterone has helped to save hundreds of thousands of lives over the previous 70+ years of application and use in medicine, as well as off-label uses.The primary purpose for Testosterone itself medically, especially in this day and age, is for the purpose of Testosterone replacement therapy (TRT), also known as HRT (Hormone Replacement Therapy), androgen replacement therapy (ART). TRT is normally a therapy administered to individuals who are experiencing lower than normal levels of Testosterone production for a variety of different reasons. The general and proper medical term for this condition is known as hypogonadism, which is a condition in which the testes are manufacturing inadequate Testosterone in individuals and could be due to genetics, physical injury, disease, or any other reason.
The specific medical terminology for individuals suffering from age-related decline in proper Testosterone production is known as andropause. The treatment for hypogonadism and andropause are perhaps the most common purpose for the use of Testosterone within medicine in the entire world. It is a simple treatment method that could be easily defined as the supplementation of Testosterone in order to restore Testosterone levels of a male to that of a normal to high range. The majority of patients being treated with Testosterone for this purpose happen to be adult males above the median age of 30, which is a very strong indication that these are mostly andropause patients (those whose Testosterone levels have declined due to aging).The initial superficial symptoms of low Testosterone are easy to spot signs and symptoms, which include a notable reduction in sexual function and libido (including erectile dysfunction), a notable loss of general daily energy, decline in strength and overall physical performance, depression (to varying degrees), increased bone frailty, decreased motivation, memory loss, and muscle loss[11]. These symptoms occur both in those who experience andropause as well as general hypogonadism. The truth of the matter is that andropause is actually for all intents and purposes, a sub-category of hypogonadism. It is simply a variant of hypogonadism, and could be labeled as age-related hypogonadism. The symptoms listed above are normally very strong indications of lower than normal Testosterone levels, but a general reference range of where Testosterone levels should be are usually given to doctors for ease of reference and determination.
This range varies between which medical professional is monitoring blood levels, and which medical organization in which country is setting the standards, but it must be understood that although reference ranges are given, no range is ever set-in-stone, and that doctors should always be allowed to treat their patients according to their unique assessment and judgment of a situation. With this being said, the average ‘normal’ endogenous Testosterone range is considered between 350ng/dl and 850ng/dl. This range of 350 – 850ng/dl, as previously mentioned, can vary (for example, some medical literature suggests a range of 241 – 827ng/dl in some countries/regions/organizations. In general, the 350 – 850ng/dl range is considered the normal range.Although this 350 – 850ng/dl range is considered the ‘normal’ range, within it there exists a low, mid, and high end within this normal range. For example, if an individual possesses a blood plasma level of 750ng/dl of Testosterone, they are said to be within the high end of the normal range. If an individual possesses a level of 430ng/dl, they are said to be within the low end of normal range. If levels are lower than 350ng/dl, it is regarded as a significant problem (and as mentioned, some medical professionals will lower this minimum level as low as 241ng/dl or lower). As one can see, the threshold for what is considered a ‘normal’ level of Testosterone is actually quite a large one. This is one of the reasons as to why hypogonadism is actually a very much under-diagnosed condition, and many doctors are even still reluctant to prescribe Testosterone for a variety of different reasons (some of which can be regarded as unreasonable).
It is important for any individual who suspects they are hypogonadal to seek a doctor who understands, is reasonable, and willing to work with the patient. Most doctors are highly uninformed and uneducated on the issue of hypogonadism and will instead elect (foolishly) to simply avoid touching upon the subject altogether.It is important after determining the symptoms to then have blood work completed so as to determine with 100% certainty that Testosterone levels might actually be low. No individual can know with absolute certainty whether or not they are hypogonadal until a proper blood test has been done in order to determine Testosterone levels. Because Testosterone replacement therapy will raise Testosterone levels upwards of the normal to high range, it has a high success rate of alleviating all of the aforementioned symptoms. There are various ranges at which different symptoms will become alleviated with TRT. For example, if levels are restored to 350ng/dl or above, the sexual dysfunction and libido is corrected. Testosterone Enanthate administered at 250mg once every 21 days after 6 months demonstrated a 5% increase in bone mineral density[12]. This is a perfect example of how the administration of Testosterone to restore normal physiological levels can help to restore and improve the function of many of the different systems as outlined previously in this article where Testosterone’s effects on the cellular level were explained. This includes increases in red blood cell count, which translates to increased endurance, improvement in energy, well-being, and restoration of muscle mass.There are various studies that have determined where, on average, Testosterone levels should be in males according to various age groups[13]. These studies have determined the following median blood plasma Testosterone levels according to age:It is important to remember that these numbers are not set in stone, and can indeed be very different depending on the individual in question. It is very important to have a doctor that understands and interprets these functions and results properly. For example, total Testosterone is very different from free Testosterone (free Testosterone is the amount of Testosterone in blood plasma that is unbound by SHBG and free to do its job in the body). SHBG, for those that do not know, is a protein that binds to sex hormones (such as Testosterone, Estrogen, etc.) and renders them inactive, essentially ‘handcuffing’ the hormone, which results in the hormone floating around in the bloodstream doing nothing.Low Testosterone levels have been associated not only with the symptoms described earlier, but also with a host of other health complications and risks. One such risk in men who possess low Testosterone levels is an increased risk for cardiovascular disease (CVD).
Studies have demonstrated that Testosterone used for the purpose of TRT exhibits a positive change in blood lipid (cholesterol) profiles involving a reduction in the ‘bad’ LDL cholesterol, total cholesterol, as well as no changes in the ‘good’ HDL cholesterol[14] [15]. It is normally only once Testosterone levels begin to reach supraphysiological dose ranges that cholesterol alterations begin to change in the negative slightly. In addition to this positive change, the restoration of Testosterone levels to normal-higher ranges has also demonstrated to reduce adipose (fat) tissue in the midsection, lower rates of obesity, and improve the body’s sensitivity to insulin as well as the control of blood glucose[16]. The opposite of these improvements often lead to metabolic complications such as diabetes and obesity, which also further contribute to increased risk of CVD. Testosterone supplementation can also reduce inflammation within the body by increasing levels of the anti-inflammatory cytokine IL-10, and reducing the inflammatory cytokines TNFalpha, IL-1beta, and IL-6[17]. This will assist not only in reducing inflammation systemically, but also protect the arterial walls from the same effects of inflammation.
There are of course some risks and potential side effects associated with TRT. Side effects associated with Testosterone supplementation are the same list of side effects as that of any use of Testosterone, but specifically, elder males seem to encounter a greater degree of potential side effects than younger TRT patients. Because Testosterone is an androgen, it has been found that it might in some individuals induce BPH (Benign Prostatic Hyperplasia) and increase PSA (Prostate Specific Antigen) levels[18] [19]. Prostate hypertrophy is not normally a health or life threatening issue, but can become a discomfort for many, and although Testosterone and related androgens (such as DHT) are not the culprit in prostate cancer, it can play a role in its development provided the environment alongside other contributing hormones is in a perfect position for such a risk. Normal and healthy males that do not exhibit prostate issues prior to TRT do not normally exhibit these problems, and so it is normally advised that men who have (or have in the past had) prostate cancer and/or normally high PSA levels avoid the use of Testosterone[20]. The issue of prostate problems with the use of Testosterone or any anabolic steroids seems to be an issue related to age and of course, genetics. This is evidenced by one study in 2001 investigating supraphysiological (bodybuilding doses, not TRT doses) of Testosterone (600mg weekly for 20 weeks) on 61 healthy males aged 18 – 35 demonstrated no significant impact on prostate-specific antigen (PSA)[21].
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