medical issues from steroids

Guys now that we have a good dialogue going on qa few different topics let make individual threads for them and please leave a link here in this thread.

Thanks
 
I'm in my mid 40s. I've been on trt a bit over a year. Done a decent amount of cycles in my time relatively safe. I blast twice a year. I seem to be having a problem in the sexual content. When I have an orgasim if feels like its not coming out like it use to. Almost painful. And the amount of nut def is not the same amount as it use to be. I'm not dehydrated at all. I get bloods done and everything cause back fine. Actually they just took blood today so I will have numbers shortly. I take Cialis a small amount everyday. Sometimes my balls hurt if I don't have sex or rub one out in three days. I thank you in advance for any help you can give me.
 
I'm in my mid 40s. I've been on trt a bit over a year. Done a decent amount of cycles in my time relatively safe. I blast twice a year. I seem to be having a problem in the sexual content. When I have an orgasim if feels like its not coming out like it use to. Almost painful. And the amount of nut def is not the same amount as it use to be. I'm not dehydrated at all. I get bloods done and everything cause back fine. Actually they just took blood today so I will have numbers shortly. I take Cialis a small amount everyday. Sometimes my balls hurt if I don't have sex or rub one out in three days. I thank you in advance for any help you can give me.

Do you include hCG in your TRT protocol?
 
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!


Dr O

Hello - I'm 40 and have been on TRT for about 8 months now. I've never done AAS or any illegal drugs for that matter.

I'm currently not using HCG and at 40 have no interest in having more kids. Do you recommend HCG for general health reasons? As you have mentioned, there is little information on the long term affects of TRT with or without HCG.

Thanks!
 
Do you include hCG in your TRT protocol?

In my clinical practice and after over 10 years of experience, I do use HCG. I use it in several situations:

1. Fertility base treatment. For men on AAS or TRT who desire fertility, there is nothing better than an HCG regimen. I have very close to a 100% success rate.

2. HCG concomitant with TRT for men who desire to "maintain" fertility and avoid testicular atrophy. Although, I do warn that long-term protocols of HCG, with/without TRT/AAS may lead to failure and worsen failing HPTA in addition to fertility potential over time- WE JUST DON'T KNOW! This is something "controversial" and there are no good longitudinal studies on this issue.

3. I have used HCG with and without other ancillary medications as I wean a man off AAS. This is in the medical literature now related to Anabolic Steroid Induced Hypogonadism, ASIH and is ethically correct for an expert physician to consider in a man suffering from AAS use.

I hope this helps,

Dr O
 
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Hello - I'm 40 and have been on TRT for about 8 months now. I've never done AAS or any illegal drugs for that matter.

I'm currently not using HCG and at 40 have no interest in having more kids. Do you recommend HCG for general health reasons? As you have mentioned, there is little information on the long term affects of TRT with or without HCG.

Thanks!

There is no reason for using HCG for "general health". Please see my reply post for how I use HCG in my clinical practice.

Thank you for you post.

Dr O
 
There is no reason for using HCG for "general health". Please see my reply post for how I use HCG in my clinical practice.

Thank you for you post.

Dr O

So I'm 65 yrs old and have been around for years with AAS use. Old school :(
Anyway I'm going to run a Low Test and High Deca cycle with AI. Now these guys suggest I should include HCG. I might just cruse for a time on the Test (low dose) for a long time and not PCT.
So do you suggest I use the HCG for this cycle ?
 
Hey doc how are you going nice to have you here .
My question to you is this ive suffered a fair amount of broken bones and ligament and tendon damage from a motorcycle accident whenever im on cycle wether it be aas peptides or sarms i dont usally have any problems but as soon as my cycle finishes the pain returnees its pretty bad in my right shoulder knees and bad carpeltunnel in my left arm i dont think i spelt that last one correctly sorry about the grammer so i was just wondering what i can do to help with pain its hard enough to stay motivated post cycle let alone adding pain to the whole deal any ideas would be greatly appreciated cheers doc
 
Hey doc how are you going nice to have you here .
My question to you is this ive suffered a fair amount of broken bones and ligament and tendon damage from a motorcycle accident whenever im on cycle wether it be aas peptides or sarms i dont usally have any problems but as soon as my cycle finishes the pain returnees its pretty bad in my right shoulder knees and bad carpeltunnel in my left arm i dont think i spelt that last one correctly sorry about the grammer so i was just wondering what i can do to help with pain its hard enough to stay motivated post cycle let alone adding pain to the whole deal any ideas would be greatly appreciated cheers doc

I WILL PICK SPECIAL QUESTIONS LIKE THIS AND GIVE A FULL DISCUSSION VS ANSWERING ALL QUESTIONS HERE ON THE BOARDS- I JUST DO NOT HAVE TIME, BUT I APPRECIATE ALL OF YOU GUYS AND WANT TO TEACH AS MUCH AS I CAN!!!

Hey Blakey, thank you for your warm welcome! Its great to be back live on the boards! This is s a great question, although a tough one. It seems like you have a some serious injuries from a motorcycle accident-ouch! Over the past year, I've really gotten into heavy duty mountain biking- including bad-ass down hill stuff so I understand what you are suffering from- Crashes are reality!! Apart from understanding the detailed nature of your injuries, I can tell you that, and as you know, as you state that you feel better on AAS, specifically Decca, has been thought to work wonders for painful soft-tissue non-healing injuries. The mechanism-of-action has never been proven, but it is thought to mediate via cortisol-like effect on the damaged soft tissue injury. Unlike cortisol injections, the tissue is not damaged. There is also a good anabolic effect by the drug and because it is an AAS, its thought to have anti-inflammatory properties. The problem is that Deca is an AAS and you cant live on it! It may, like other AAS cause heart disease over time- of course- dose dependent. It also can raise hemoglobin and cause polycythemia- something that can be part of the reason for why it and other AAS cause heart disease. We just don't know. This is why I always watch men on steroids very closely and always encourage them to get off. Ethically I have too.

What can you do: You need to get a good diagnosis on what the detailed nature of your injuries are- #1 thing to do. Consider X-rays, MRI and a real good Ortho Doc!! Next, check for systemic disease like Celiac disease, have your doc think about osteoarthritis and rheumatoid arthritis(very rare, but part of the work-up) also check for systemic inflammation- CRP and SED RATE. You need a good Internist to complete a detailed history and physical exam, including laboratory investigation. You want to exclude any other disease process that may be contributing to your pain! Many physicians simply do not have the time to do this properly, so you have to help them!! Print this and bring it in to your Doc.


I'm giving you the full deal here, because in the end, you feel great on AAS, but cant live on these! I would also ask you to see a good Doc and consider if you have anabolic steroid induced hypogonadism ASIH, you say you feel very poorly after being off AAS, maybe it is because your endogenous testosterone levels are low ? This would cause you to feel poorly overall and has to be addressed. If you do have ASIH and begin treatment, it may just help you with your pain and hopefully provide you balance and health overall.

I hope this helps !!

Dr O
 
Thank you doctor o for replying and so quickly i understand you are a busy man. Goodluck with the downhill mountain biking fun stuff great getting out into nature and flying down the side of a mountain on a pushbike . I i have had my rheumatoid factor checked and it wasnt high enough for me to have that and im not a Celica im pretty sure im just stuck with the pain i have unfortunately it was a fairly decent accident and im lucky to be lifting again at all i will get this printed because you have touched on some very good subjects and take it into my doctor next time i go in .
As for what i said about not it being as easy to lift being off cycle its more of a motivation thing as its alot easier to get motivated when using gear and like i said it helps greatly with the pain
. As for the asih i haven't had bloods done to get my levels checked for a while but i will get that sorted asap and see what all my levels are doing i always take great precautions and always have a pct oct sorted out but i am aware that a pct isnt always effective. The only thing that is a bit of a worry is that im over here in Australia and i think its a great deal harder to get trt over here my farther in law was diagnosed with lower test he was depressed gaining weight and overall not in a good place and he had to fly over 5 hours away just to find a doctor that would help him ...
Thanks again for replying so fast and for replying at all i said it before but ill say it again great to have you her doctor o im sure you will be able to help alot of people here and thanks for helping me cheers mate be safe on the bike
 
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Dr O thx for your generosity and knowledge here. Quick clarification on long term HcG use in TRT. Is it your opinion that men not concerned with fertility (I have kids and had a vasectomy) have no real basis for using HcG as a part of their protocol? I currently do Test C, HcG, and Anastrozole. Curious on your perspective as I hear "backfilling other hormone pathways and testiculr atrophy" etc as a reason otherwise for the inclusion. The med is $30 per month though. I've been on this dr rx protocol for 4 years.
 
Hi Doc,

Firstly would just like to say how grateful I am to have you here! I feel that I can learn a lot from this thread.

So I am 24 and have done a few cycles, very light to moderate, since the age of 20. I have always recovered fine and in good time. My last stint, however, I was getting ready for my first show, so I bulked for 6 weeks on tren but had to stop there due to high blood pressure (180/95 - My GP knows of my steroid use and manages my health). I stayed on a trt dose for about 10 weeks just slowly bulking, then figured I'd try something a little milder than tren to bulk up some more, so I used deca. Bloods were good, but around week 8 I did my blood pressure again, which was again elevated (158/75). I stopped the deca but continued running test at trt dose so that the deca may clear my system in order for me to just do pct.

I did my pct for 4 weeks. Probably should have gone longer considering the amount of time I was "on", but in my country it's hard to source the drugs needed. I was only able to use the pct I had on hand. After pct I went for bloods and my LH and FSH came back low as I thought it would be, but my testosterone came back at 55ng/dl. My gp admitted that this was outside of his field, so I have an appointment with an endo in just over two weeks. These bloods were done 2 weeks ago and I can confirm that my sex drive was pretty much zero, I had impaired memory (however I played rugby that weekend and got hit in the jaw during a tackle, so could be concussion) and also severely low energy levels. Since then these have improved, I can manage a work day and I can also make my partner happy almost every night (sometimes it's a bit of a struggle as I lack sex drive and energy, but I can get it up). I have also noticed my testicles slowly getting bigger but have no bloods to show improvements.

So I guess my question to you would be, what are my chances of making a decent recovery? Also, would I be able to cycle in the future? I have dreams of being a pro bodybuilder (more classic physique, so would keep dosages on the lower side), but also have to think about having kids in the next few years as things with my partner are getting pretty serious. She is aware of my steroid use, but said that she definitely wants kids. Also note that I have never used hcg.

Out of all of this, the thing that baffles me the most, is that even on such low testosterone levels, I have no problem getting it up and have even in the last few days had a bit of a sex drive.

This question is only for when you have the time to answer it. I will be seeing an endo so can ask him all these questions and more, hopefully learn a few things too, if you do not have the time to answer this. Also I apologize if this post is a bit all over the place, my mind is still a bit foggy. It's hard to concentrate.

Cheers doc, it's great to have you on the team!

OTG
 
Dr O thx for your generosity and knowledge here. Quick clarification on long term HcG use in TRT. Is it your opinion that men not concerned with fertility (I have kids and had a vasectomy) have no real basis for using HcG as a part of their protocol? I currently do Test C, HcG, and Anastrozole. Curious on your perspective as I hear "backfilling other hormone pathways and testiculr atrophy" etc as a reason otherwise for the inclusion. The med is $30 per month though. I've been on this dr rx protocol for 4 years.

Hey Gbrad, thank you for your welcome. OK, I do have to say that everything I do as a board certified Doc should be supported by as much sound peer-reviewed literature as possible. Unfortunately, we do not have enough evidenced based literature on anabolic steroid use, not too mention the utility of ancillary agents like HCG, with and without TRT. Sometimes in medicine, what "we" do is anecdotal. This is very important and there are thousands of "man years" worth of experience regarding topics like HCG use with TRT.

I would say that most men on TRT- especially long-term, that are not interested in maintaining fertility will not use or need HCG. This is the main reason why I use HCG with TRT. I will say, and to Dreaded's point, some men on TRT enjoy the addition of HCG for sexual optimization. If this mediates via prolactin or other mechanism(s) of action is not known. The truth is that most men, in my opinion will do well on TRT only. We also know that HCG can increase the testicular size on AAS and TRT and I have seen men say that they have better sex with a greater ejaculate load and more sensation on TRT with HCG. I do agree with men that like to use HCG intermittently for sexual optimization. There appears to be no danger with medical regimens like this- except for the potential that such regimens may further down-regulate a mans ability to produce endogenous testicular testosterone over time. Another great topic to discuss!!

As a a medical expert, I strive to use evidenced-based-protocols for our patients and always consider patient-to-patient individual regimens.

I hope this helps!!

DR O
 
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