5 ms·

> That's not how it works. LH and FSH are suppressed when you're on TRT, but they stabilize after cessation. The testes atrophy over time when LH and FSH are s

> That's not how it works. LH and FSH are suppressed when you're on TRT, but they stabilize after cessation. The testes atrophy over time when LH and FSH are suppressed. Even if LH and FSH return (which isn’t guaranteed) the testes need to be able to respond to those hormonal signals, but atrophied testes do not respond the same. For someone with true intractable hypogonadism this hardly matters because they weren’t capable anyway. Many people prescribed TRT today don’t actually have intractable hypogonadism, though. Body builders have some tricks to try to reverse this, but it’s not perfectly effective and even body builders know to cycle their steroids to avoid having prolonged periods of suppressed HPG axis activity. I was involved with weightlifting in my younger years but never dabbled with steroids or TRT. Everyone I know who did try testosterone or steroids thought they were doing it the safe way (HCG, PCT, limited cycle length) but became unable to produce enough endogenous testosterone by their 40s even with SERMs. Men on TRT for years will have considerable testicular atrophy that is not totally reversible. > The question is, why would someone with clinical hypogonadism cease TRT? TRT is no longer limited to men with clinical hypogonadism. Men’s health clinics that advertise on social media, TV, and radio will prescribe to anyone who contacts them (and pays cash for the prescription and gear). In some surveys of patients on TRT, 1/4 of patients didn’t even have testosterone levels measured prior to initiation of TRT.

mise_en_place 1y ago
> TRT is no longer limited to men with clinical hypogonadism. Men’s health clinics that advertise on social media, TV, and radio will prescribe to anyone who contacts them (and pays cash for the prescription and gear). In some surveys of patients on TRT, 1/4 of patients didn’t even have testosterone levels measured prior to initiation of TRT. That's hugely problematic if true. They should be investigated and if found of wrongdoing, have their medical licenses revoked.
- SpicyLemonZest 1y ago
  I dunno. It seems straightforwardly analogous to the fake medical marijuana clinics you see in places where recreational use isn't legal, or the countless online pharmacies with doctors on retainer to prescribe Ozempic and Viagra. It's not how I would design the medical system if I were in charge, but these aren't addictive substances like opioids.
  - Aurornis 1y ago
    Testosterone induces physical dependency which can be irreversible when taken for prolonged periods. I don’t think it’s analogous at all to medical marijuana.
    - SpicyLemonZest 1y ago
      Interesting. I'm surprised I didn't know that and have to agree that makes the analogy inapplicable.
- Aurornis 1y ago
  It’s true. You can even go on Reddit and find anecdotes and guides about which clinics to call and what to say to get prescribed with minimal hassle. Some of the clinics were even prescribing anabolic steroids intended for terminal cancer patients. If you want to read about something even crazier, look up the services that were started during COVID to be prescription mills for Adderall or Xanax. The relaxed COVID prescribing rules allowed telehealth providers to give schedule II prescriptions to new patients remotely, so services were created to advertise on TikTok and give prescriptions for a monthly fee. The FDA cracked down on these, though. There’s even a famous story of a whistleblower who worked at one of these clinics and got reprimanded for not prescribing Adderall enough. There was a leaked memo where they pushed providers to prescribe Adderall over other options because their data showed the highest customer retention rate that way.
  - jstummbillig 1y ago
    Did you use a LLM to write these comments?
    - Aurornis 1y ago
      I do not. I’m typing on my phone from a waiting room. I’d probably have fewer incorrect words and awkward sentences if I did.
      - jstummbillig 1y ago
        I see. I got curious because of the correct usage of ’ (instead of the common ')
        K0balt 1y ago
        Argh. It’s so strange to be ridiculed and have your ideas devalued just because you know how to use punctuation marks. I have 20 year old blog posts with hundreds of comments accusing me of using AI. I understand people being suspicious, but it’s beyond annoying when it becomes an entire personality online, as it has for many persons. How about we go back to valuing ideas, regardless of their origins, if they deliver insight, value, or joy? I don’t care if someone writes something good or if the idea was stolen from something they read, or if a machine made it for them, unless the value proposition is their personal capacity for original prose. AI gotchaism is becoming as least as tiring as the droll, tone deaf creations of LLMs.
financltravsty 1y ago
Curious on your thought to my reply: https://news.ycombinator.com/item?id=46059074 https://news.ycombinator.com/item?id=46059074 Can you share your longitudinal anecdata? I am considering going back on AAS for the QoL benefits, but would like to create a better mental model of long-term ramifications for testicular health. It's my understanding that 40, it simply is expected that your hormones levels will be much lower (and that is not necessarily a bad thing). However my mind is failing to grasp what long-term damage TRT can do to the HPTA when not using an obscene amount of gear and on HCG. Trying to figure out the mechanism. Perhaps receptor desensitization and epigenetic compensatory changes?
lossolo 1y ago
> Everyone I know who did try testosterone or steroids thought they were doing it the safe way (HCG, PCT, limited cycle length) but became unable to produce enough endogenous testosterone by their 40s even with SERMs. Then your sample is either very limited or very weird, because I test my testosterone, and my friends who did multiple cycles in the past (10–15+ years ago, and not huge competition level doses) are also within the normal range.

mise_en_place 1y ago

> TRT is no longer limited to men with clinical hypogonadism. Men’s health clinics that advertise on social media, TV, and radio will prescribe to anyone who contacts them (and pays cash for the prescription and gear). In some surveys of patients on TRT, 1/4 of patients didn’t even have testosterone levels measured prior to initiation of TRT. That's hugely problematic if true. They should be investigated and if found of wrongdoing, have their medical licenses revoked.

SpicyLemonZest 1y ago
I dunno. It seems straightforwardly analogous to the fake medical marijuana clinics you see in places where recreational use isn't legal, or the countless online pharmacies with doctors on retainer to prescribe Ozempic and Viagra. It's not how I would design the medical system if I were in charge, but these aren't addictive substances like opioids.
- Aurornis 1y ago
  Testosterone induces physical dependency which can be irreversible when taken for prolonged periods. I don’t think it’s analogous at all to medical marijuana.
  - SpicyLemonZest 1y ago
    Interesting. I'm surprised I didn't know that and have to agree that makes the analogy inapplicable.
Aurornis 1y ago
It’s true. You can even go on Reddit and find anecdotes and guides about which clinics to call and what to say to get prescribed with minimal hassle. Some of the clinics were even prescribing anabolic steroids intended for terminal cancer patients. If you want to read about something even crazier, look up the services that were started during COVID to be prescription mills for Adderall or Xanax. The relaxed COVID prescribing rules allowed telehealth providers to give schedule II prescriptions to new patients remotely, so services were created to advertise on TikTok and give prescriptions for a monthly fee. The FDA cracked down on these, though. There’s even a famous story of a whistleblower who worked at one of these clinics and got reprimanded for not prescribing Adderall enough. There was a leaked memo where they pushed providers to prescribe Adderall over other options because their data showed the highest customer retention rate that way.
- jstummbillig 1y ago
  Did you use a LLM to write these comments?
  - Aurornis 1y ago
    I do not. I’m typing on my phone from a waiting room. I’d probably have fewer incorrect words and awkward sentences if I did.
    - jstummbillig 1y ago
      I see. I got curious because of the correct usage of ’ (instead of the common ')
      - K0balt 1y ago
        Argh. It’s so strange to be ridiculed and have your ideas devalued just because you know how to use punctuation marks. I have 20 year old blog posts with hundreds of comments accusing me of using AI. I understand people being suspicious, but it’s beyond annoying when it becomes an entire personality online, as it has for many persons. How about we go back to valuing ideas, regardless of their origins, if they deliver insight, value, or joy? I don’t care if someone writes something good or if the idea was stolen from something they read, or if a machine made it for them, unless the value proposition is their personal capacity for original prose. AI gotchaism is becoming as least as tiring as the droll, tone deaf creations of LLMs.

financltravsty 1y ago

Curious on your thought to my reply: https://news.ycombinator.com/item?id=46059074 https://news.ycombinator.com/item?id=46059074 Can you share your longitudinal anecdata? I am considering going back on AAS for the QoL benefits, but would like to create a better mental model of long-term ramifications for testicular health. It's my understanding that 40, it simply is expected that your hormones levels will be much lower (and that is not necessarily a bad thing). However my mind is failing to grasp what long-term damage TRT can do to the HPTA when not using an obscene amount of gear and on HCG. Trying to figure out the mechanism. Perhaps receptor desensitization and epigenetic compensatory changes?

lossolo 1y ago

> Everyone I know who did try testosterone or steroids thought they were doing it the safe way (HCG, PCT, limited cycle length) but became unable to produce enough endogenous testosterone by their 40s even with SERMs. Then your sample is either very limited or very weird, because I test my testosterone, and my friends who did multiple cycles in the past (10–15+ years ago, and not huge competition level doses) are also within the normal range.