I just re-listened to a podcast I did with Rick Cohen MD about Low T. He makes the point that Low T is a signal of health problems. He recommends making every effort to solve the health issues which would improve T, before resorting to TRT as a last resort. This is probably most people’s approach, but I wonder how many other “supplements/meds” could be rendered unnecessary by solving the underlying root cause(s)? Plus, I’ll bet there would there be additional benefits to health and longevity resulting from solving the root causes vs. short-cutting the solution with exogenous chemicals. The extreme example is putting moisturizer on my skin to make it less dry also makes my skin look healthier without actually making my skin healthier…I have to put on the moisturizer every day.
I’m doing another podcast with Dr Cohen today about my expanding list of drugs and supplements for health and longevity, and how I can be aggressive AND smart (not stupid) in my efforts.
I saw this clip today which is related to this debate of addressing root causes vs. short-cutting the solution but related to ADHD medication. There’s always the risk someone doesn’t do anything and end up just overweight with a bunch of health problems because they didn’t take ozempic, for example.
Yes, it is an important consideration. I try to stay away from the topic of how to get people to do good for themselves even when they can’t or won’t do it voluntarily. Someone needs to think about that, but not me. I just want to know what is true or the best thinking at the moment; I’ll take responsibility for getting it done for myself.
Possibly DHEA.
My T is in the low normal range, but my doctor thinks it is okay for my age.
301 ng/dL.
I am going to take 100 mg of DHEA daily for 3 months and then get tested again.
This is a meta-analysis, but I am not paying to see the whole paper:
DHEA supplementation is effective for increasing testosterone levels, although the magnitude varies among different subgroups
Dr Cohen mentioned several ways to boost T: “exercise to failure” (lifting weight), good sleep, reducing stress (cortisol competes with T). He mentioned others as well.
I would probably not want to go on something that “I would have to be on permanently” i.e as I understand TRT and shutting down testosterone production. Is it the same for DHEA?
(Although I would take cholesterol medications, multivitamins, etc permanently…)
Couldn’t agree more with this one. I know there is guys that do it, and I was one of them even though i was in normal range I gave it a try for couple years, and took me another year or so to get my body to produce it by itself. I was mid 400’s pre TRT, went to high 700’s on it, and then the number was in toilet for about 1-12 months after stopping TRT, and went back naturally to low 500’s now after that, but with plenty of strength training and supplements, now being a little higher than when i had started TRT.
Needless to say, my 300 tablets of 50mg of Enclomiphene $ 108 USD are slowly making their way to USA. Want to give that sucker a try as I would like my Total T to march toward a nice 700-800 level. Will see if it works.
I have found no literature suggesting that DHEA shuts down T production after discontinuing. It is a precursor rather than the sex hormone itself. Since it is banned by all anti-doping agencies, it probably works to some extent.
"Dehydroepiandrosterone (DHEA), also called Prasterone and 3β-hydroxyandrost-5-en-17-one, is a steroid hormone primarily produced by the adrenal gland, but also made in small quantities in the gonads and brain. DHEA is a precursor molecule for the creation of other sex hormones, including testosterone and estrogen. Natural levels of DHEA in the body peak in early adulthood and then decline with age.
This study if I am reading it correctly shows that 12.5 mg is as effective or more effective than the 25 mg dose. If so, you might consider cutting your pills in half and then have a test taken 3 months later. Smaller doses = fewer side effects.
If the DHEA doesn’t work for me I will give Androxal (enclomiphene citrate) a try.
Enclomiphene apparently works as good if not better than the T gel and has far fewer side effects.
bought high dose on purpose to save dough, as I intend to break it in four and do 12.5 every other day and see how it goes. 300 pills should cover about 2 years’ worth, $108 way cheaper than $200/MO = $4,800 TRT lol
edit… 300 divided in four and taken every other day should be good for over five years, and five years of TRT would be well over $10K
Exactly the price difference between doses is minimal. If you buy high doses and divide its way cheaper, assuming most what we are buying are ok to divide.
I’m away at the moment so can’t give any exact numbers but FWIW n=1 etc my T was at the bottom of the range for my age and I started supplementing with Tongkat Ali. Retested after about 4 months and saw an increase of about 20%. Still below mid range but a movement in the right direction.
Taking blood glucose lowering medication. Carbohydrates, the only non essential macronutrient and the only macronutrient that will literally make your teeth rot out of your mouth. I just can’t believe it’s good for our general health to consume large (non ancestral) amounts of them unless you need them for exercise
Lipid lowering medication, probably a band aid for eating way too much food we weren’t meant to eat (and really I believe most medication given in preventive medicine is a bandaid for a crap high carb, high seed oil, low animal fat and protein diet)
Antacids, most people probably don’t need this either. I was taught in med school I had a defective lower esophageal sphincter which needed surgical repair or I should live on antacids but the night I started the carnivore diet was the first night in decades I didn’t wake in agony from reflux (since then I experimented a bit further and found it’s especially certain plant foods, like tomatoes and ginger but not hot pepper nor coffee nor wine in combination with carbs )
I do still take it 5 days a week I.e coinciding with exercise days.
Will measure T again with next lot of blood tests to make sure it is still improving the level.
Based on my talk with Dr cohen I am planning to minimize my stack by focusing on resolving the root causes vs continuously taking exogenous chemicals, wherever possible.
For solving low T root causes, dr cohen mentioned: reduce elevated cortisol, improve deep sleep, get regular “maximum” physical efforts (lift to failure, maximum short effort on a bike). I am working on these myself.
I wholeheartedly agree, but what I don’t know is if an underlying root cause might be due to lacking a particular nutrient in the diet that is contributed by a supplement.
