Is HRT Dangerous?

[Sam]

Peak check out this article,  I know it's another blog, but this is really more of a patient resource for ZRT labs.   Some really good info here if you read through the articles. 

http://www.zrtlab.com/professionals/zrt-blogs/entry/testosterone-elixir-or-dangerous-drug

[PeakT]

Okay, thx Samson.  Another great post.

This is interesting.  The study cited I have seen before, but now they are actually looking for details behind it: 

Guys,

Here is the key statement give in my mind and the issue seems to be with just the topicals, although I think they need to see if there is an issue indeed:

"In contrast to what we see with endogenously produced hormones, when testosterone, or any other steroid hormone, is applied topically as a cream, gel, or spray, levels in capillary blood (finger) are remarkably higher, by 10-20 fold, than venous blood levels.  Moreover, salivary hormones are often >100% of venous serum levels, which ordinarily are only 2-3%.   This remarkable increase in capillary blood and salivary testosterone is NOT seen when it, or other hormones, are delivered orally, or as im-injections or sc-pellet implants.  With these delivery systems capillary blood and venous serum levels are about the same."

....

"Of further relevance to the NEJM study, we find that men using the higher pharmacological topical testosterone gel have capillary blood levels of estradiol that usually exceed 100 pg/ml, which is very high for males.  While physiological levels of estrogens are beneficial to the male cardiovascular system, higher levels can be harmful (.   Unfortunately, estrogens were not monitored in the NEJM study so it is not possible to know if levels, even in venous serum, were higher than physiological range.  It is very possible that some of the cardiovascular events observed in the older high risk men participating in the NEJM study were precipitated by excess estrogens derived from excess testosterone."

[henngiss]

I am glad you posted this.  I have been trying to figure out why my T levels per my blood test were low while I have other symptoms of increased T levels.  Primarily my muscle mass is greater using the topicals, even though the T in my blood decreases.  Apparently the topicals can send T some places but not others?  Is it possible to get increased T in your muscles but not in your blood?

[PeakT]

I am glad you posted this.  I have been trying to figure out why my T levels per my blood test were low while I have other symptoms of increased T levels.  Primarily my muscle mass is greater using the topicals, even though the T in my blood decreases.  Apparently the topicals can send T some places but not others?  Is it possible to get increased T in your muscles but not in your blood?

I don't think they know the answer to these questions yet.  They should begin researching it, though, because the topicals are BIG business now.  The whole assertion doesn't really make a lot of sense to me, so I'm curious what will come out of it all.

One comment: 

On this board, the guys who have had no or even declining testosterone levels after Androgel or Testim still have their low T symptoms.  So I think it's got to be absorption issue primarily. 

[henngiss]

To be clear, my bad symptoms such as fatigue and brain fog get better when I first start the topicals.  My muscle mass gets better too.  Later, when my T tests low in my blood, my fatigue and brain fog gets bad again.  Only my muscle mass stays better.  Maybe it takes more time to lose the muscle?  Anyhow, I am starting injections this week hopefully.

[PeakT]

To be clear, my bad symptoms such as fatigue and brain fog get better when I first start the topicals.  My muscle mass gets better too.  Later, when my T tests low in my blood, my fatigue and brain fog gets bad again.  Only my muscle mass stays better.  Maybe it takes more time to lose the muscle?  Anyhow, I am starting injections this week hopefully.

Hmmm.  Doesn't totally make sense, but I believe you of course.

[Sam]

Henn,  Fatigue and Brain Fog are by far my two biggest issues.  Both of which seemed to respond to DHEA and Pregnenolone supplementation.  Fatigue didn't go away 100% but Brain Fog seemed to.  I didn't even realize I had ED issues until I experience what I assume is a normal Erectile Function after my Varicocele repair.  Libido was definitely off, but with 2 kids and a 3rd on the way my wife and I barely have time for each other lately. (we are working on that)

I am not telling you to take DHEA or Preg, but I have seen some people on this board were DHEA is prescribed in conjunction with Testosterone therapy.   Since I have a had a host of tests and different doctors pointing at Adrenal and Thyroid as possibly low functioning I think the million dollar questions is what do you fix first, and is it possible one faulty system can effect others.   In my recent posts on my Kaisers Endo's responses he said no, but I don't believe him.  It just seems like common sense to me that if you are living with a chronic condition that is causing one system to not function it stresses you and subsequently all of the other endocrine functions in your body.  Determining what can be fixed with a little bit of support via diet, exercise and lifestyle vs. medical intervention is a process that needs to be done thoughtfully. 

I honestly think the answer to this is different for each person and why it is so important to make sure you are working with a doctor who is willing to test and interpret all of these things.  The other consideration for us as patients is finding doctors who aren't snake oil salesmen, but generally want to help you live the fullest life possible.

Just my 2 cents, and a journey we are all on.

Good luck.

[PeakT]

I couldn't disagree with your doctor more.  I think the opposite is largely true:

"Everything affects everything". 

That's a slight exaggeration, but the more I ready about health, the more it all seems intimately interconnected.  Neurocardiology is a classic example of this...

[henngiss]

I have now read the article and have another question.  Is it possible that the topicals could increase your saliva T level while your blood T level goes down?  At the same time, could your saliva E2 go up while your blood E2 remains normal?  If so, could this provide an explanation for my reaction to the topicals?  If my saliva T is high, then might my muscle mass be benefiting from this increase?  Meanwhile, could the high saliva E2 be causing my fatigue and brain fog to go up in spite of the increased T?  This is all very interesting to me.

[PeakT]

I have now read the article and have another question.  Is it possible that the topicals could increase your saliva T level while your blood T level goes down?  At the same time, could your saliva E2 go up while your blood E2 remains normal?  If so, could this provide an explanation for my reaction to the topicals?  If my saliva T is high, then might my muscle mass be benefiting from this increase?  Meanwhile, could the high saliva E2 be causing my fatigue and brain fog to go up in spite of the increased T?  This is all very interesting to me.

This is very possible.  Unfortunately, we're going to have to wait and see.  I just don't understand why the topicals would diffuse differently in the first place.  I know that whether you inject into muscle or fat makes some differences and scrotal patches can do the same.  But we should have some good research coming out in the next few years:  it's really a great place for a researcher to make a name for him or her self since there are so many big dollars riding on it.