Got Testosterone?

[WillBrink]

Interesting paper on the relationship of T and SAT to low T and obesity.



Determinants of testosterone levels in human male obesity

EndocrineInternational Journal of Basic and Clinical Endocrinology


Abstract

Testosterone (T) levels are decreased in obese men, but the underlying causes are incompletely understood. Our objective was to explore the relation between low (free) T levels and male obesity, by evaluating metabolic parameters, subcutaneous adipose tissue (SAT) aromatase expression, and parameters of the hypothalamic–pituitary–gonadal axis. We recruited 57 morbidly obese men [33 had type 2 diabetes (DM2)] and 25 normal-weight men undergoing abdominal surgery. Fourteen obese men also attended a follow-up, 2 years after gastric bypass surgery (GBS). Circulating T levels were quantified by LC–MS/MS, whereas free T levels were measured using serum equilibrium dialysis and sex hormone-binding globulin, luteinizing hormone, and follicle-stimulating hormone by immunoassay. SAT biopsies were used to determine adipocyte cell size and aromatase expression by real-time PCR.

Total and free T levels were decreased in obese males versus controls, with a further decrease in obese men with DM2 versus obese men without DM2. There were no differences in aromatase expression among the study groups, and sex steroids did not correlate with aromatase expression. Pearson analysis revealed an inverse association between (free) T and SAT cell size, triglycerides, and HOMA-IR. Multivariate analysis confirmed the inverse association between (free) T and SAT cell size (β = −0.321, P = 0.037 and β = −0.441, P = 0.011, respectively), independent of age, triglycerides, HOMA-IR, obesity, or diabetes. T levels were normalized 2 years after GBS. These data suggest that SAT cell size rather than SAT aromatase expression or parameters of the hypothalamic–pituitary–gonadal axis is related to low T in male obesity, which points to adipose cell size-related metabolic changes as a major trigger in decreased T levels.

Full Paper:

http://link.springer.com/article/10..../fulltext.html

[Irish]

The entire thing can be summed up as: more research is needed. Taking the (essentially) worthless mouse studies, and combined with the US study done in humans, combined with some possible wrinkles added by what you posted, would at best, lead one to conclude more research is needed. I will say, lab work I have seen from users "in the wild" found nadda, and interest by users dropped sharply after that study and general lack of "real world" results by users. I'd also have to go back and look at the materials and methods of the study to see if they tested the product for purity and dose, which they often do.

Cool. Just trying to further the discussion.

[WillBrink]

Cool. Just trying to further the discussion.

"T booster" supplements are like new AR manufacturers claiming to be better than Colt, gets a big yawn from me as a rule.

[Skar]

I have been on self T injections for the last two years .6 on the syringe every 10 days .
My work switched insurances first of the year and they rejected my prescription. Doc says I need to go off
The testosterone for awhile and give blood work showing I need it .(stupid) then resubmit to insurance company and they should buy it then. Wtf
Anyway how long until my levels drop once I'm off? I have an appointment for blood work 21 days after my last injection.
Is this enough time. Normally I'm on a 10 day cycle given in the thigh.

[WillBrink]

I have been on self T injections for the last two years .6 on the syringe every 10 days .
My work switched insurances first of the year and they rejected my prescription. Doc says I need to go off
The testosterone for awhile and give blood work showing I need it .(stupid) then resubmit to insurance company and they should buy it then. Wtf
Anyway how long until my levels drop once I'm off? I have an appointment for blood work 21 days after my last injection.
Is this enough time. Normally I'm on a 10 day cycle given in the thigh.

21 days should be long enough depending on which ester of T you were using and the ranges of the lab being used. How going off the T and testing within a month some how "proves" you need it is idiotic, but logic and science is not a strong point of insurance companies. If you have been on T long enough, any mans T will be low in that window of time due to suppression of natural production which takes a long time to rebound, if it ever does.

The doc should be able to tell them in his medical opinion it's indicated and that's that. But, there's still debate as to who is is medically indicated which leaves wiggle room for insurance companies etc.

[Skar]

21 days should be long enough depending on which ester of T you were using and the ranges of the lab being used. How going off the T and testing within a month some how "proves" you need it is idiotic, but logic and science is not a strong point of insurance companies. If you have been on T long enough, any mans T will be low in that window of time due to suppression of natural production which takes a long time to rebound, if it ever does.

The doc should be able to tell them in his medical opinion it's indicated and that's that. But, there's still debate as to who is is medically indicated which leaves wiggle room for insurance companies etc.

Cypionate injection .6 every 10 days so after 21 days of being off my blood work should show low ?
Yes the Insurance company is being ridiculous.

[WillBrink]

Cypionate injection .6 every 10 days so after 21 days of being off my blood work should show low ?
Yes the Insurance company is being ridiculous.

.6 does not really tell me anything. How many mg of T is that? That will depend on the mg/ml of the T you're using. That sounds like a very low dose BTW. What does that dose bring your total T to? You could wait an even 30 days if you wanted to make sure it was low.

[WillBrink]

Good article from one of my authors via BrinkZone:

Testosterone and Fat Loss – The Evidence

It is well documented that obesity may cause hypogonadism, and that hypogonadism may cause obesity [1-4] This has generated debate about what condition comes first; obesity or hypogonadism? And what should be the first point of intervention?

In this article I will summarize data from several reviews on the associations of hypogonadism and obesity [1-4], and make the case that these conditions create a self-perpetuating vicious circle. Once a vicious circle has been established, it doesn’t matter where one intervenes; one can either treat the obese condition or treat hypogonadism first. The critical issue is to break the vicious circle as soon as possible before irreversible health damage arises.

Nevertheless, as I will explain here, treating hypogonadism first with testosterone replacement therapy may prove to be a more effective strategy because it to a large extent “automatically” takes care of the excess body fat and metabolic derangements. In addition, treating hypogonadism first also confers psychological benefits that will help obese men become and stay more physically active.

Key Points:

• Traditional obesity treatments with diet and exercise programs are notorious for failing in long-term maintenance of weight loss due to lack of adherence. Anti-obesity drugs have limited efficacy and may not be without adverse effects.

• In the prospective Massachusetts Male Aging Study (MMAS), non-obese men who became obese had a decline of testosterone levels comparable to that of 10 years of aging.

• Testosterone deficiency and obesity each contribute independently to a self-perpetuating vicious cycle.

• Long-term testosterone therapy in men with hypogonadism improves body composition, metabolic syndrome components and quality of life, and thereby can help break the vicious cycle.

• Treatment of hypogonadism with long-term testosterone therapy, with or without lifestyle modifications, effectively treats obesity by correcting testosterone deficiency; one physiological root cause of obesity.

• In contrast to the U-shaped curve for weight loss seen with traditional obesity treatments, which are characterized by weight loss and weight regain, treatment with testosterone therapy results in a continuous reduction in obesity parameters (waist circumference, weight and BMI) for >5 years, or until metabolic abnormalities return to healthy ranges.

• The significant effectiveness of testosterone therapy in combating obesity in hypogonadal men remains largely unknown to doctors. Educational efforts are therefore critical to bring research findings into clinical practice in order to improve patient care and health outcomes.

Cont:

http://www.brinkzone.com/anti-aging-...-the-evidence/

[Six Feet Under]

I'd been feeling like crap for years, even though I'm only 25. Continual weight gain, lack of energy, almost no libido, HORRIBLE mood swings, anxiety, impatience, etc. I chalked most of the mental stuff up to residual effects of a shooting I was involved in five years ago (receiving end) and being told I'd never go back to the police academy, be able to lift weights, get full use of my arm back, etc. I had three years of daily struggle between therapy sessions, workouts, and just dealing with the situation and the loss from it before I was able to go back to school and complete it to get hired as a cop. I had gone to see a therapist for a few months afterwards and like everything else I've ever had happen to me, talking it out with the therapist, my family, and my friends helped me get over it. The mood swings and lack of energy had only gotten worse over the last two years.

Long story short:

Finally went and asked my GP for a blood test because I thought I had low T and he agreed with me. Blood test came back, total test was 234. He told me he was basically uncomfortable prescribing injections vs. the gels because he didn't know as much about it as a specialist would, so he referred me to a urologist. Couple visits at the urologist, got my blood tested again, test was 160. He refers me to an endocrinologist about an hour away from my house, he prescribes another blood test, this time it was 135. No changes in diet or activity during this six month time period. Starts me on 1mL of 200mg/mL test-cypionate every two weeks.

After approximately ten to twelve weeks, I got bloodwork done again and my level was 597. The biggest change I've noticed has been the mental change, I feel much more at peace and generally am in better spirits on a regular basis than I have been in a long, long time. I've also noticed a moderate increase in my energy levels, but the libido and weight gain are still about the same that they were pre-test.

Going to start working out again daily here soon, not that it's an excuse but I was working a lot of over time (normally only work 14 days a month and I had three days off in January, not much better in Feb, and I've been working or out of town most of the days this month) and when I had free time I was busy trying to take care of stuff around the house or relaxing. Hopefully with regular weight lifting and bicycling, my last two issues will start improving.

On my recent visit, the endo put me on the same dose, but increased the frequency to every 10-12 days as I told him I've noticed that the last 2-4 days of each two week injection cycle, I notice myself start sliding back toward being lethargic, moody, etc.

[Irish]

On my recent visit, the endo put me on the same dose, but increased the frequency to every 10-12 days as I told him I've noticed that the last 2-4 days of each two week injection cycle, I notice myself start sliding back toward being lethargic, moody, etc.

I'm not an expert by any means, but everything I've read points to the greater the frequency of injections, the better the results. You might try switching to a once weekly protocol or even possibly 2X a week to really try to smooth things out. Personally, more than once a week sounds like a lot, but there are many people in the know who promote it and subscribe to it. Definitely worth checking out the once a week shot in my opinion.