medical issues from steroids

The Anabolic Doc

Official Sponsor
As many of you know, I'm an expert physician dealing with anabolic steroid related medical issues, eg., low testosterone from steroids, sexual issues, heart disease, kidney disease, ect....I'd like to hear about your medical issues.

Dr O
 
Hi nice to meet you. So I'm 65 yrs old and have osteoarthritis and I get shots in my hands and my hip for bursitis. I now have a shoulder issue from when I dislocated it back 35 yrs ago. I haven't had problems before but now it bothers me a lot.

I will be seeing my doctor to get some injections next week and was wondering (I'll ask him) if the same anti-inflammation shot can be injected in my shoulder even though it is not related to osteoarthritis. Just was thinking to ask you first since you posted here.
 
TRT and increased resting heart rate .
my HR was always in the 60s-70s for years . After 4 years of being on TRT my resting heart rate is now consistently 80 or more (90+ if I blast). my BP is ok , right now 125/70 . I do donate blood as well.

is being on TRT and increased resting heart rate something to be concerned with long term ?



note: I detoxed awhile back and went on a keto diet and dropped all AAS and TRT for 6 straight months . Resting heart rate went down to the 70s at this time, and my BP dropped to 110/65.
 
nice to have you on board doc.. the rest of the staff and i are really excited about this!!

ok... here i go with my question

been on trt for about 2 years..

ranging between 160-180m test a week (60-80mg twice a week)
adex .5mg twice a week
hcg 200iu twice a week (up until november of last year)

my wife dropped the baby bomb on me summer of last year.. up until then she didn't want to have kids and she decides to change her mind..

in november of last year i increased my hcg to 350iu eod... the limit of my script

mid january i did a semen analysis.. numbers came back at 5.5 million... knowing that i needed to get to 20 million to conceive i have bumped it up to 500iu eod in the last few weeks..

further knowing it takes 3 months for spermatogenesis to occur, i know i need to now go in for another semen analysis...

my question to you is simple..what hcg dosage would you put a trt patient on who is actually supplementing with tesotsterone cyp injections? im a bit concerned with going over 500iu eod because i have read a study that suggests anything over that will desensitize leydig cells... but is that just for the production of testosterone alone or will that also affect sperm count??

i have read a few different studies on the matter and talk to a fertility specialist or two.. one suggested 1500iu twice a week.. another suggested 5000iu once a week..

one study said 3000iu 3 times a week..

there are alot of numbers being tossed around here...

i am the boards head sports nutritionist and know how to eat to benefit sperm count, but im a little lost with this whole hcg thing.. for the time being i have stuck to 500iu eod.. though i now have a script for about 26000iu for the month..


thanks in advanced!
 
If I can pick up on 3J's question, would you ever recommend introducing hMG as well? And if so, when would you go to hMG?
 
Hi nice to meet you. So I'm 65 yrs old and have osteoarthritis and I get shots in my hands and my hip for bursitis. I now have a shoulder issue from when I dislocated it back 35 yrs ago. I haven't had problems before but now it bothers me a lot.

I will be seeing my doctor to get some injections next week and was wondering (I'll ask him) if the same anti-inflammation shot can be injected in my shoulder even though it is not related to osteoarthritis. Just was thinking to ask you first since you posted here.

Hi, thank you. This is not related to Anabolic Steroids, butvstill a great question. Yes, your Doc is going to inject corticosteroid into your shoulder(s). General medical advise states that you are safe to receive injections like this several times ba year. Ask your Doc, about side affects and that it can weaken the damaged tissue.

Let us know

Dr O
 
Any advice on how to deal with cystic acne while on trt or a cycle. Even if I have my estrogen in range I seem to get acne.

Cystic acne is tough. Most men I have seen with this have a history of serious acne- regardless of steroid use. Steroid and TRT use worsen acne for men with a history for sure. I try to keep Testosterone doses down ( as I say,"lets try to use the lowest possible dose to get the job done" Sustainability is everything! Yes, estrogen levels are important, but only part of the picture. Most men with severe acne can get estrogen under control and still suffer. Androgen worsens acne vulgaris in a multifactoral manner. I have found that changing the testosterone ester, e.g, test Enanthate vs Cypionate can help and I Rx topical combinations of Benzoyl peroxide and either erythromycin or clindamycin - works great for most mild/moderate cases!!! This is my first line treatment. If this fails, I refer to Dermatology. One word of caution is Accutaune!! I have seen men get this Rx while they have elevated LFTS secondary to oral steroids!! This can be a huge medical mistake!!

Hope this helps!!

DR O
 
nice to have you on board doc.. the rest of the staff and i are really excited about this!!

ok... here i go with my question

been on trt for about 2 years..

ranging between 160-180m test a week (60-80mg twice a week)
adex .5mg twice a week
hcg 200iu twice a week (up until november of last year)

my wife dropped the baby bomb on me summer of last year.. up until then she didn't want to have kids and she decides to change her mind..

in november of last year i increased my hcg to 350iu eod... the limit of my script

mid january i did a semen analysis.. numbers came back at 5.5 million... knowing that i needed to get to 20 million to conceive i have bumped it up to 500iu eod in the last few weeks..

further knowing it takes 3 months for spermatogenesis to occur, i know i need to now go in for another semen analysis...

my question to you is simple..what hcg dosage would you put a trt patient on who is actually supplementing with tesotsterone cyp injections? im a bit concerned with going over 500iu eod because i have read a study that suggests anything over that will desensitize leydig cells... but is that just for the production of testosterone alone or will that also affect sperm count??

i have read a few different studies on the matter and talk to a fertility specialist or two.. one suggested 1500iu twice a week.. another suggested 5000iu once a week..

one study said 3000iu 3 times a week..

there are alot of numbers being tossed around here...

i am the boards head sports nutritionist and know how to eat to benefit sperm count, but im a little lost with this whole hcg thing.. for the time being i have stuck to 500iu eod.. though i now have a script for about 26000iu for the month..


thanks in advanced!

THIS IS A GREAT QUESTION!! I deal with this issue regularly and have been involved with men on AAS and TRT desiring fertility since 2005. Let's see if I can answer you question!

First thing is as you know, the basic physiology: the testes have 2 basic cells - Leydig cells for the production of testosterone in the presence of LH. Sertoli cells for the production of sperm and are activated by FSH

When men are on TRT, over time they become "infertile", not too mention can experience down regulation and even apoptosis of the basic germ cell lines of both cells aforementioned. This is beyond the scope of this reply, but I want everyone to know that these are not "simple" biologic process- nor are they understood!

I am aware of these "studies" you mention and they are limited in methodology, not to mention duration. There are NO good long-term studies looking at TRT and maintaining fertility, but boy are they needed!

The bottom line I can tell you is that most men on TRT have to come off testosterone and utilize either Clomid or HCG. Of course, I have seen a decent number of men "living" on TRT with regular small dose of HCG, eg, 250 to 500 iu SQ twice a week maintain fertility. I would say that this type of "dual" therapy is successful only in men younger than 35 years of age and certainly not with prior heavy steroid users.


As you know, a normal sperm count is over 15 million sperm per ML. You are obviously low at 5.5 million. I can not recommend what to do, but if this was one of my patients, I would discontinue testosterone and try HCG 2,500 iu IM QOD or Monday- Wednesday- Friday regimen. This, for most of my patients has worked great and in 3 to 6 months we have success.

I continue the patient on HCG, till the woman is in her second trimester ( spontaneous abortions are a reality) and then after a good report from the OB, we restore TRT.

As you said, there are a lot of "numbers" being tossed around and I would have to recommend that you see a fertility Urologist or a Doc like me that has years of clinical experience dealing with this medical issue.

On a cool note, when I "fail" at getting a man fertile with my "means" I have used various fertility experts all over the US, Canada and abroad. HCG works about 90 % of the time, next these Doc's go for HMG and when the BIG GUNS are needed, I see them use: Bravelle and Ovidrel- These are really cool new formulations for fertility and work like a charm! yet are very expensive!!

I hope this helps!!

Dr O
 
I think this is the makings a possible study. I would like to know the mythology with desensitizing to HCG is greatly over stated. If you read the litriture that comes with HCG you will see the 10,000 iu a day is a normal dose for teenage boys suffering from hypogonadism.
 
I think this is the makings a possible study. I would like to know the mythology with desensitizing to HCG is greatly over stated. If you read the litriture that comes with HCG you will see the 10,000 iu a day is a normal dose for teenage boys suffering from hypogonadism.

Hey Dreaded, yes! Someone has to do a true study regarding PCT with HCG! 10,000 iu qd in a kid !! WHAT!!! This is really crazy! I do have several patients, ages 23 to 28 who did AAS from 15 to 19 years ago and told me they did "their PCT" which included HCG 10,000 iu per week and after 6 months to over 1 full year off gear and PCT their HPTA never came back and presented to me with total testosterone levels less than 200 ng/dL. They were depressed and had low to no libido.

Yes, the question is? Should HCG be part of PCT? Does it cause down regulation and apoptosis and at what dose? What characteristic patient should receive HCG and what other agents, eg, Clomid, Nolvadex, ect should be part of a recovery regimen. Its crazy that we treat these patients with anecdotal data.

Clearly, the medical community has to study this!! I may have to be the Doc to do it! Once I settle down- should be in the next 6 months, I'm going to present such a study!


Dr O
 
THIS IS A GREAT QUESTION!! I deal with this issue regularly and have been involved with men on AAS and TRT desiring fertility since 2005. Let's see if I can answer you question!

First thing is as you know, the basic physiology: the testes have 2 basic cells - Leydig cells for the production of testosterone in the presence of LH. Sertoli cells for the production of sperm and are activated by FSH

When men are on TRT, over time they become "infertile", not too mention can experience down regulation and even apoptosis of the basic germ cell lines of both cells aforementioned. This is beyond the scope of this reply, but I want everyone to know that these are not "simple" biologic process- nor are they understood!

I am aware of these "studies" you mention and they are limited in methodology, not to mention duration. There are NO good long-term studies looking at TRT and maintaining fertility, but boy are they needed!

The bottom line I can tell you is that most men on TRT have to come off testosterone and utilize either Clomid or HCG. Of course, I have seen a decent number of men "living" on TRT with regular small dose of HCG, eg, 250 to 500 iu SQ twice a week maintain fertility. I would say that this type of "dual" therapy is successful only in men younger than 35 years of age and certainly not with prior heavy steroid users.


As you know, a normal sperm count is over 15 million sperm per ML. You are obviously low at 5.5 million. I can not recommend what to do, but if this was one of my patients, I would discontinue testosterone and try HCG 2,500 iu IM QOD or Monday- Wednesday- Friday regimen. This, for most of my patients has worked great and in 3 to 6 months we have success.

I continue the patient on HCG, till the woman is in her second trimester ( spontaneous abortions are a reality) and then after a good report from the OB, we restore TRT.

As you said, there are a lot of "numbers" being tossed around and I would have to recommend that you see a fertility Urologist or a Doc like me that has years of clinical experience dealing with this medical issue.

On a cool note, when I "fail" at getting a man fertile with my "means" I have used various fertility experts all over the US, Canada and abroad. HCG works about 90 % of the time, next these Doc's go for HMG and when the BIG GUNS are needed, I see them use: Bravelle and Ovidrel- These are really cool new formulations for fertility and work like a charm! yet are very expensive!!

I hope this helps!!

Dr O

excellent reply sir!! i figured monotherapy was the route to go.. just been hesitant about coming off the trt....

ill do another semen analysis and give you an update...
 
Hi, thank you. This is not related to Anabolic Steroids, butvstill a great question. Yes, your Doc is going to inject corticosteroid into your shoulder(s). General medical advise states that you are safe to receive injections like this several times ba year. Ask your Doc, about side affects and that it can weaken the damaged tissue.

Let us know

Dr O

Thanks doc. I know it wasn't a Q's concerning steroids, but I'm going to see my doc end of next week and I just wanted an idea before I ask him. :dunno:

But thanks and I shouldn't have asked on this forum. I should know better I've been around.
 
Back
Top