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TOPIC: TRT Basics

TRT Basics 31 Mar 2020 09:39 #221737

  • ibanez
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I can't be the only person on TRT wondering if there is a trade off between testosterone vs your immune system?

One perspective suggests:

Everything has a trade off.

Males who are sick or injured have to allocate their finite caloric resources in immune function and tissue repair, so that energy can’t be invested in muscular development and aggression. As a result, testosterone is decreased so that energy stays focused on immune activation and survival. In this way, testosterone is a bit like a switch. When times are good, invest in bigger muscles or fighting for a larger territory to increase reproductive success. When times are tough, prioritize survival.

The body is calibrating testosterone to a level that is appropriate for current circumstances and condition. Circumventing this and adding extra testosterone when the endocrine system is actively trying to downregulate testosterone may be fighting against a body’s own physiology.

Standford study, 2013:

Nor does testosterone appear to directly chill immune response; rather, it seems to interact with a set of genes in a way that damps that response.
This is the first study to show an explicit correlation between testosterone levels, gene expression and immune responsiveness in humans.
They found that, in the high-testosterone men, high-activation levels of Module 52 genes correlated with reduced post-vaccination antibody levels.
Additional analyses showed that testosterone reduces levels of certain transcription factors (regulatory proteins) that ordinarily prevent Module 52 genes from “turning on.” In other words, higher testosterone levels result in more Module 52 expression. Several Module 52 genes have known immune-system connections; activation of one of these genes, for example, results in the accelerated differentiation of cells whose job it is to suppress, rather than foster, immune response.
While it’s good to have a decent immune response to pathogens, an overreaction to them — as occurs in highly virulent influenza strains, SARS, dengue and many other diseases — can be more damaging than the pathogen itself.

This 2016 study suggests:

Endogenous testosterone appears to be immunomodulatory rather than immunosuppressive.
Immune function is enhanced when exogenous testosterone is paired with food supplementation, but without food supplementation exogenous testosterone results in decreased innate immune function.
There is still ambiguity depending on which aspects of immune function are studied, and whether the impacts of testosterone on immune function are direct or indirect.
While there may be trade-offs between testosterone and some more energetically costly aspects of immune function, one would not expect that testosterone would down-regulate all aspects of immune function equally.

Very interesting. One way wuhan flu is fatal is by triggering a cytokine storm. Testosterone seems to suppress this.

I'm in two minds, should I stop my TRT cold turkey for a few weeks in support of my immune system and resume once this is over?

Appreciate substantiated input.
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TRT Basics 31 Mar 2020 11:39 #221745

  • vladtheimpaler
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Get Doctari.
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TRT Basics 01 Apr 2020 10:44 #221751

  • LesDoctor
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ibanez wrote:
I can't be the only person on TRT wondering if there is a trade off between testosterone vs your immune system?

One perspective suggests:

Everything has a trade off.

Males who are sick or injured have to allocate their finite caloric resources in immune function and tissue repair, so that energy can’t be invested in muscular development and aggression. As a result, testosterone is decreased so that energy stays focused on immune activation and survival. In this way, testosterone is a bit like a switch. When times are good, invest in bigger muscles or fighting for a larger territory to increase reproductive success. When times are tough, prioritize survival.

The body is calibrating testosterone to a level that is appropriate for current circumstances and condition. Circumventing this and adding extra testosterone when the endocrine system is actively trying to downregulate testosterone may be fighting against a body’s own physiology.

Standford study, 2013:

Nor does testosterone appear to directly chill immune response; rather, it seems to interact with a set of genes in a way that damps that response.
This is the first study to show an explicit correlation between testosterone levels, gene expression and immune responsiveness in humans.
They found that, in the high-testosterone men, high-activation levels of Module 52 genes correlated with reduced post-vaccination antibody levels.
Additional analyses showed that testosterone reduces levels of certain transcription factors (regulatory proteins) that ordinarily prevent Module 52 genes from “turning on.” In other words, higher testosterone levels result in more Module 52 expression. Several Module 52 genes have known immune-system connections; activation of one of these genes, for example, results in the accelerated differentiation of cells whose job it is to suppress, rather than foster, immune response.
While it’s good to have a decent immune response to pathogens, an overreaction to them — as occurs in highly virulent influenza strains, SARS, dengue and many other diseases — can be more damaging than the pathogen itself.

This 2016 study suggests:

Endogenous testosterone appears to be immunomodulatory rather than immunosuppressive.
Immune function is enhanced when exogenous testosterone is paired with food supplementation, but without food supplementation exogenous testosterone results in decreased innate immune function.
There is still ambiguity depending on which aspects of immune function are studied, and whether the impacts of testosterone on immune function are direct or indirect.
While there may be trade-offs between testosterone and some more energetically costly aspects of immune function, one would not expect that testosterone would down-regulate all aspects of immune function equally.

Very interesting. One way wuhan flu is fatal is by triggering a cytokine storm. Testosterone seems to suppress this.

I'm in two minds, should I stop my TRT cold turkey for a few weeks in support of my immune system and resume once this is over?

Appreciate substantiated input.

I’ll try my best to respond to every pertinent point you have raised using medical knowledge I have acquired thus far (doctor in first year of internship with an interest in endocrinology). It is a known fact that testosterone is immunosuppressive but a better term would be immunomodulatory.

So I’ll start by just stating that the way that Corona Virus Kills is through what is known as ARDS. The syndrome is influenced by our immune system. According to one article (www.ncbi.nlm.nih.gov/pubmed/21986736) ARDS was more likely to develop in women however mortality from it was the same. This is not surprising as women tend to have a larger immune response than men. However, as you may have seen, a lot more men have died. The cause for this gender disparity is not really known. If I were to postulate, I’d suggest this was more linked to lifestyle than sex hormones. Men tend to age a lot poorer than females mainly due to lifestyle factors such as smoking being higher in males, higher red meat consumption, lower vegetable and fruit intake etc. But not much is known yet....

In response to the first point you made, exogenous androgens have actually been shown to be of benefit to patients in catabolic states (look at the research surrounding Burns and ICU patients being given testosterone or oxandrolone - anavar). It blunts the catabolic response to cytokines (the big one is TNF-alpha which is a hormone that is responsible for the cachexic states seen in cancer and TB).

I’ll just lump my response to all your points on the immunosuppressive effects of testosterone here. Yes, testosterone is immunosuppressive. This is seen in a lot of rodent models that suggest that androgens have negative feedback with the immune system. However, when looking at this data it seems doses of testosterone were at 1.1mg/kg ED which is extremely high. When looking at data with more therapeutic doses of testosterone, yes, you will see a decrease in immune system markers but it is not statistically significant in a lot of cases (which a lot of these news articles etc fail to mention). However when used at supraphysiological doses testosterone can actually be cytotoxic (kill cells) especially to lymphocytes and neutrophils. In addition, the cytokine and CD4 reduction is massive and you’d be technically classified as having secondary immunosuppression.

Males are not classified as immunosuppressed because although certain immune system markers are lower than females, they are not out of range. Furthermore, in terms of susceptibility to infections, no data shows statistical significance. As mentioned in the opening paragraph testosterone is not immunosuppressive since it does not cause deficiencies in any markers however it is immunomodulatory which means it simply regulates the response to infections by blunting over-reaction to antigens (such as viruses). This is the reason more women have auto-immune conditions.

Sorry, my response was a bit all over the place and lacks the links to support claims I have made but feel free to message me and when I have time I will send the link to the articles I am referencing.

Overall: Stay at THERAPEUTIC trt doses. You can stop trt and since you will be chemically castrated until your HPTA recovers you’ll have an immune system like a female (this was actually shown in rats) but the choice is yours :)
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TRT Basics 01 Apr 2020 15:53 #221760

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WOW. Best read ive had in a long time on explaining multiple ideas. Wouldn't say it was all over the place @LesDoctor. +1 from me btw. So to put it in short just to see if i understand -

Test isnt SIGNIFICANTLY (stats wise) immunosuppressive however it is immunomodulatory. Meaning it changes the way how your body responds to a virus through homeostasis ?

High dosages of test is cytotoxic meaning it kills other cells basically. So if i have "googled" correct its like puffadder venom - instead of flesh it goes after the specific white blood cells that respond towards a virus.

What is interesting though is the mentioning of auto-immune conditions that more females tend to have compared to men. Makes me think of the Spanish flu. Only weird thing is that back then mostly the people that died were the young males.

"In response to the first point you made, exogenous androgens have actually been shown to be of benefit to patients in catabolic states (look at the research surrounding Burns and ICU patients being given testosterone or oxandrolone - anavar). It blunts the catabolic response to cytokines (the big one is TNF-alpha which is a hormone that is responsible for the cachexic states seen in cancer and TB)."

clearly better to stay on trt for the gains tho ! ;)
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TRT Basics 01 Apr 2020 22:39 #221763

  • LesDoctor
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Thanks for the support @vladtheimpaler.

If testosterone was significantly immunosuppressive most males (those not on hormone replacement) would technically have to be classified as have immune suppression which is not the case. It is also difficult to find research to support males having weaker immune systems. In addition, no one marker is sufficient to define immunodeficiency. There are varying types such as IgA deficiency etc. Back on topic, immunomodulation is essentially a homeostatic mechanism as you mentioned. It just ensures the immune reaction to whatever issue the body is facing, whether it be Trauma or a virus is adequate. If there weren’t these mechanisms you’d essentially go into systemic shock every time you faced a viral infection which is far from ideal.

Nandrolone (Deca) and Winstrol have been shown to be cytotoxic to lymphocytes. It is like the venom. It produces free radicle which damage the lymphocytes and their precursors. Supraphysiological dosages of testosterone do the same.

Spanish flu in 1918 is an interesting one that confuses most doctors (especially the epidemiologists). From what I know there were two big factors that influenced the death rate. Firstly, younger populations were more effected because influenza strains that had circulated before 1889 had similar receptors to the Spanish Flu and thus those Who were born before 1889 had this predisposing immunity to the Spanish flu. That explains why young people were more affected but what about the males? More research has found that latent TB in the lungs of young soldiers had an interaction with the Spanish flu making it a lot easier to complicate. Most soldiers at the time were male and had just returned from the trenches where TB was rampant.

Overall, when we are faced with conditions that tend to affect one sex more than the other its fun to postulate whether its due to our sex hormones but in most cases it isn’t.
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TRT Basics 04 Apr 2020 09:19 #221779

  • crawler
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I have been running TRT dosage of 150mg every 7 days / weekly. PGW enan

Starting to get gyno symptoms, skin also starting to slightly break out

I am use to getting these on 500mg a week

Only have letro on hand, what dosage would you guys recommend? 2 drops eod?


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TRT Basics 04 Apr 2020 09:37 #221780

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Hi, I'm assuming you're using LP Letrozole if it is in a dropper bottle? I'm unfamilier with the dose that comes with each drop. 0.15mg to 0.25mg EOD for a 500-1000mg/wk aromatisable AAS is generally what I see being used.

I'm not a fan however of tanking your estrogen levels. Generally, on trt doses an AI is rarely required. Estrogen has many protective purposes such as being neuro-protective and cardio-protective. The best thing to do is get a blood test, although this is a bit difficult at the moment.

The main cause of gyno isn't necessarily just the estrogen it is the ratio of testosterone to estrogen (hence why young pubescent males and old men undergoing senescence are most at risk). If you've just come of a blast and going to cruise then you might need to use an AI for a while to let the ratio balance itself.

For now if you are adamant on taking an AI, the best pharmacological concept is starting as low as possible and gradually increasing the dose.

Hope this helps. Sorry for the unnecessary info just like to emphasize the importance of estrogen and want to get rid of this notion that it is the enemy.
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Re:TRT Basics 04 Apr 2020 10:14 #221781

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Thanks appreciate the feedback

Did bloods before I started and test were low, results available in my thread

www.anabolicsteroids.co.za/forum/3-pepti...abol-in-stead-of-hgh

Will test igf and testosterone again as soon as I can go to lancet safely

Will start with low as possible dose

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TRT Basics 07 Jun 2020 07:47 #222510

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Thank you for sharing your informative account. I have found this very useful in my own journey and will be sharing of my experiences.
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TRT Basics 05 Aug 2020 10:23 #223241

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Hey, been a WHILE (years) since I posted on this forum.

I am looking at starting TRT for about a year. Getting ready to compete next year. I am looking for a doc who is clued up and can monitor me and my bloods?

Dunno if I posted this in the correct place?

Any help would be appreciated. I am in Cape Town.
"There is no reason to have a plan B because it distracts from plan A" - Phil heath
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