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

  1. #21
    Ray Gillenwater's Avatar
    Ray Gillenwater is offline Administrator, Starting Strength Gyms
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    • starting strength seminar april 2024
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    Here's a House subcommittee hearing summary on the topic of endocrine-disrupting chemicals in drinking water:

    - ENDOCRINE-DISRUPTING CHEMICALS IN DRINKING WATER: RISKS TO HUMAN HEALTH AND THE ENVIRONMENT

    Dr. Nichols asked me to share it with you.

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    Quote Originally Posted by J. Keith Nichols MD View Post
    Send me your email and I will send you some studies
    Dr. Thank you for your time in addressing these issues on the podcast. Your experience, training and wisdom is greatly appreciated. One question I had that was touched upon but not really answered was when does testosterone usage become abusive, and in what respect? I do agree with Rip's assessment that regularly using over 500mgs of test is probably for physique/performance enhancement purposes, not for general health and longevity purposes. But in what respect is it BAD? You did a great job of addressing and dispelling a number of myths about testosterone usage (reference range, estradiol, H&H, clotting, prostate cancer, etc). so thank you for that. But what about someone who WANTS to take testosterone to obtain supra-physiological levels to obtain supra-physiological results in either performance or physique?

    At what point with testosterone usage for performance enhancing/physique enhancing purposes DO problems manifest and what are they likely to be they be?

    Thank you for your time and patience.

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    That is a very good question and one that is debated constantly. First, from a medical standpoint, you cannot overdose on a hormone. You get symptoms of too much or too little when it comes to hormones. If someone abuses testosterone, they may be more likely to experience side effects such as acne and fluid retention, which are the most common but not dangerous and easily treated.

    The real problem regarding testosterone is that most men do not get enough to attain both symptomatic relief and the maximum benefits of testosterone. There is a dose response relationship with regard to testosterone -- increasing levels will result in an increased response with regard to increasing muscle mass and decreasing body fat both visceral and subcutaneous etc. My goal as a physician is to resolve symptoms first and foremost as well as maximize the beneficial effects in each patient.

    The dose to improve symptoms is typically going to be less than the dose that will resolve symptoms and also provide the maximum benefits of testosterone. So I am for optimal levels, and in my world that is a free testosterone typically in the 30 to 50 ng/dL range. Some men run a little lower and some men may run a little higher. Some will argue that those levels are abusive and unnecessary, but from a clinical standpoint every man that I see that has those levels not only has symptomatic improvement but he also obtains the maximum benefits of testosterone regard to his health. In other words every parameter of health that I can measure improves at those levels. Their hemoglobin A-1 C improves, their inflammatory cytokines go down, their bone mineral density goes up, their visceral body fat goes down and with that their insulin resistance improves or resolves, their lean muscle mass increases etc.…

    When you get levels where you’re pushing your free testosterone above 100, for instance, it will no longer have an affect on how you feel but it will provide you with an increase in lean muscle mass, and that’s why bodybuilders abuse it. So it becomes abusing testosterone when a person makes it that way. When a person raises levels purely for the performance enhancement characteristics -- most specifically to increase lean muscle mass only -- then they are abusing it. It’s not just the levels but it’s the mindset. So I find from a clinical standpoint the total levels between 1000 and 2000 and a free between 30 and 50 or so ng/dl is where you’ll find a balance of symptomatic improvement and maximum benefits of testosterone with regard to health. You could continue to increase your levels and you would continue to get an increase in lean muscle mass but no further improvement in health.

    So the question becomes: do high doses of testosterone in isolation cause harm? I cannot provide you with any medical evidence that testosterone in isolation by those that abuse it has proven to be harmful long-term. The problem is that men that abuse testosterone also abuse multiple other anabolic substances and also use aromatase inhibitors, and all of those definitely will cause harm. So simply in summary, are you trying to find the middle ground between not getting enough and not abusing it, and that middle ground -- which is what I have defined above -- is that range where I don’t see any significant side effects and every parameter of health improves. I hope that answers your question, if not let me know

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    I’m a bit late to this party but I found Anthony Jay’s Estrogeneration pretty useful on EDCs.

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    starting strength coach development program
    Dr. Jay will be with me on the podcast Friday.

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