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Thread: SS Radio #160: Dr. Keith Nichols and TRT: Myths and Confusion

  1. #1
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    Default SS Radio #160: Dr. Keith Nichols and TRT: Myths and Confusion

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    This podcast was phenomenal. Especially the part about secondary erythrocytosis, blood viscosity and shear stress. Dr. Nichols really knocked it out of the park there. Very well explained!

    One myth that wasn’t touched on: trt and malign lvh. It is claimed, especially on TRT forums, that since the heart is a muscle that above average levels of testosterone would thus increase its size, causing malign lvh. I found no evidence of this, except studies in bodybuilders who abused multiple substances in very high doses. I am very interested to hear what Dr. Nichols thinks about this.

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    Testosterone therapy has never been shown in any randomized controlled trial or prospective study to Date to cause any major adverse cardiac events. It has never been shown to cause left ventricular hypertrophy. It has been used in men with congestive heart failure, severe coronary artery disease, angina, and after myocardial infarctions. And it did not show harm but instead benefit. Men need to worry about low testosterone levels and not optimal levels. The trouble with the bodybuilding world is not testosterone but instead the multiple Other anabolic substances used as well as the aromatase inhibition. I’m glad you enjoyed the podcast and I’m very thankful that Mark had me back on

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    Thank you for your insight, doctor! I didn’t know you posted on this forum.

    It is believed that AR’s in the myocardial cells is most likely what causes the size difference between hearts in males and females. However, lvh is found in the same amount in both sexes. If testosterone would be the culprit, this would not be the case. Just like polycythemia vs secondary erythrocytosis, it is another instance of people, including those that are medically trained, conflating issues because they don’t understand the specific context of what they are talking about.

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    I'm recovering from surgery to repair a quad tendon rupture and broken ankle. I am also on TRT. Mark had mentioned people post-surgery receiving some sort of treatment, but I couldn't make out the medication he was referencing. Does TRT offer similar benefits, or is he referring to a specific hormone?

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    I referred to oxandrolone, sold as Anavar in the US. Look it up.

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    Yes TRT will improve healing but not all testosterone therapy is equal. As I explained in the podcast there is a dose response relationship with testosterone. The better the dose and the levels the better the response. Most men don't get adequate enough levels to get the maximum benefits of testosterone. The anabolic steroids or more powerful synthetic derivatives of testosterone or its active metabolite DHT for instance. Oxandrolone is as Mark pointed out can be used for healing for trauma. Here is its package insert for conditions it is FDA approved 'Oxandrolone is indicated as adjunctive therapy to promote weight gain after weight loss following extensive surgery, chronic infections, or severe trauma, and in some patients who without definite pathophysiologic reasons fail to gain or to maintain normal weight, to offset the protein catabolism associated with prolonged administration of corticosteroids, and for the relief of the bone pain frequently accompanying osteoporosis'

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    Quote Originally Posted by Kletsy View Post
    Thank you for your insight, doctor! I didn’t know you posted on this forum.

    It is believed that AR’s in the myocardial cells is most likely what causes the size difference between hearts in males and females. However, lvh is found in the same amount in both sexes. If testosterone would be the culprit, this would not be the case. Just like polycythemia vs secondary erythrocytosis, it is another instance of people, including those that are medically trained, conflating issues because they don’t understand the specific context of what they are talking about.
    It looks like you have thought about this subject a little; what do you think is the most likely cause?

    __________________________________

    Great podcast and I hope we hear more from Dr. Nichols in the future.

    As to the epidemiology of low T, I believe Dr. Nichols is correct, but that his hypothesis that endocrine disruption is the culprit is incomplete:
    -There is substantial evidence testosterone production, androgen receptor regulation and endocrine receptor regulation is a psychosomatic mechanism.
    -We still see declining overall T levels, but where exactly has endocrine disruption increased compared to 2015, 2010, 2000 or 1990? Is it quantifiable and consistent? Could behavioral differences between older and younger men help explain that trend too?
    - Anecdotally, I hear about large numbers of men in their early 20s who now have ED and or low libido, where it rarely existed before. The issue seems to be prevalent specifically in young men who are viewing large amounts of porn (which is much more widespread and easily accessible than at previous times) and resolves itself after a few weeks of abstaining from pornography. It is difficult for me to imagine a scenario where this behavior is not eliciting some level of psychosomatic response related to hormone levels, androgen receptors and endocrine receptors.
    -Antidepressants are also known to affect hormone levels, but not necessarily in predictable ways.

    I also heard Dr. Nichols mention the microwave as a cause of endocrine disruption; I am curious if that is because it causes chemical leaching, alters the nutritional profile of foods or for another reason?

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    Quote Originally Posted by Yngvi View Post
    It looks like you have thought about this subject a little; what do you think is the most likely cause?
    The usual suspects: in most cases high blood pressure or aortic stenosis, which both make the left ventricle work harder. Genetic disorders are less common. If done correctly, testosterone therapy actually lowers blood pressure and has a positive effect on your CAC-score, so one would actually expect a lower risk of lvh. This would need further research in the future, but today we already know that testosterone therapy (without an AI, a DHT blocker and/or throwing any other pharmaceutical wrench in the machine) has a net positive effect on cardiovascular disease, as explained by Dr. Nichols.

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    I have mountains of articles dealing with the subject of endocrine disrupting chemicals and how it affects the endocrine system with a specific interest on the androgen receptor and testosterone production and metabolism. Once I'm able to compile all the data and put it into a complete review article there will be no question what we are dealing with. Sure there are other influences that are going to affect testosterone levels but not to the degree that we have seen with the endocrine disrupting chemicals. With regard to the microwave yes it was referring the plastics and other chemicals that are used in the microwave and it leaching into our food. The point about EDC's is that we could correct all other influences including obesity, smoking, a sedentary lifestyle, porn, and we would still be seen a significant decline in our testosterone levels and sperm counts due to the toxic environment that we all presently live in. It's not a fun topic to read on nor a fun topic to research but once you get involved in it you would be shocked at what you would find.

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