Having an honest conversation with a doctor is hard in Taiwan. They got 200 patients a day to see.
In the US, this would be the case. All kinds of options to give you to boost your T ranging from gel, pellets to shots. . I know when my T was down in the low 100âs, I felt like absolute shit. Now Iâm at a whopping low 300, which is now classified as ânormalâ depending on who you ask, I feel much better.
@Taiwan_Luthiers It may be worth finding out what your T level is. Just need to do a blood test. Of course as Finely already stated, first thing people will say if your T is low is to eat better and exercise and lose weight. If you are already doing that, then may need additional help to boost your T back up.
Can you expand on this? Iâm curious. And maybe it would be good for people who are viewing (will be viewing) this thread.
I didnât want to do anything. I was highly irritable. Extremely moody. Everything and everyone annoyed me. Zero libido. Didnât see the point of living. Felt like I was just going through the same motions every day waiting for the day to end just to rinse and repeat. Everything was doom and gloom.
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Indeed. And yet the US population remains one of the sickest on the planet.
People are always looking for a quick fix, and if the doctor offers one theyâll often be tempted to take it - particularly if they donât know any better. I canât comment on your particular case, and I donât doubt at all that the testosterone has made you feel better. Itâs almost guaranteed to have that effect. However, knowing what I know about the nature of testosterone supplementation, I would never go near this solution personally, unless I had some demonstrable organic cause underlying the problem. The risks are far too high.
It is therefore up to the doctor to not hand out these things too readily. Itâs the reason doctors are empowered to prescribe, instead of just making these things available OTC.
The cause of my low T was because I was exercising too much and dieting for too long. Body fat was probably too low. And the stress of wanting to continue to diet and exercise didnât help. So, in my particular case, I started to eat junk food, got some more body fat and exercise less and 1 year later it was back in ânormalâ range and has been for last 2 years.
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I can imagine this happens a lot (to women as well as to men). Under those circumstances I donât see anything wrong with a short course of testosterone replacement - with, as I said earlier, a specific therapeutic goal in mind. The problem comes when old men are âput onâ hormone replacement therapy for the rest of their lives.
I donât know what my T level is, I think years ago they tested for it after I came back to Taiwan and they said it was ok. But when I was in the states it was very low, like 300 something which is very low for men. The doctor prescribed clomid which thankfully is cheap in the states. I stopped taking them since I ended up in jail. I got no idea what it is now and I donât have extra money to be paying copay to figure out because doctors here want you to see a different specialist for different problems. GP here isnât going to care about T level, theyâll tell you to see an endocrinologist.
And if you need Viagra or sildenifil citrate (theyâre the same thing) theyâll tell you to see a urologist. Nhi wonât pay for those kind of things and pharmacies here almost never sell the generic version which is extremely cheap.
Yes I think so. Iâm on it and itâs great. I feel so much better. I was on the lower end of normal which is not good as I suspect the lower end normal testosterone isnât good if you see the average person walking around these days.
Studies show that having low testosterone is bad for your longevity from heart health to muscle mass. Too high is bad too for your heart health. But for example as you get older thereâs a correlation between muscle mass, strength, and your longevity.
Itâs also a quality of life thing, why not if you can. Helps mentally and maybe they also want to have the urge to have sex again.
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Does nhi pay for T related treatment, or is it deemed as unnecessary like ED?
Hereâs some more info on the subject:
Iâm sure it is great. I can still remember what Nandrolone feels like, and itâs not even particularly androgenic. One downside of this sort of thing is that it works.
Cocaine probably feels great. That doesnât mean that everyone is suffering from a chronic lack of cocaine, and that it should be prescribed freely as a nerve tonic.
A testosterone assay simply tells you how much circulating testosterone you have (at any given moment - it varies). It doesnât tell you anything about how your bodyâs cells are responding to that testosterone, and unless you have some more tests done (GnRH, LH, FSH) it doesnât tell you if your body is âstrugglingâ in some way. Without further information - including signs and symptoms - a testosterone assay doesnât tell you much.
One thing that frustrates me about doctors is that they do not understand how adaptive closed-loop dynamic systems work, and donât feel that they need to. Even endocrinologists seem to have only a sketchy outline of the subject. Yet itâs fundamental to understanding a whole range of biological systems. If you observe a certain setpoint for testosterone, the physician should assume - in the absence of evidence to the contrary - this this is âcorrectâ for that individual, even if it is âlowâ or âhighâ relative to someone else, or to some average for the population.
The answer to âwhy not?â is that you are forever dependent on the drug for your happiness, and if you take it for many years, it will cause irreversible damage that will make you completely dependent upon it.
Again, Iâm not saying TRT should never be prescribed. In some cases it may be useful short term. In other cases there may be an actual disease process that requires it for the patientâs wellbeing. Iâm merely advising caution, and when it is used, the patient should be fully informed of the effects, positive and negative, and that he should attempt to explore all other options for mitigating whatever the immediate issue is.
You may have come across the observation that older criminals eventually calm down and stop being criminals, and one theory is that falling testosterone is the cause. In that instance, their lives are actually improved. If we went around handing out testosterone to every middle-aged man, would we start seeing an epidemic of tattooed 60-year-olds starting fights in bars and harassing 50-year-old women on HRT?
I can tell you that a good TRT doc does take in a lot more than testosterone and free testosterone. LH and FSH along with kidneys health markers, liver, haematology profile, cholesterol, and even more as you need.
I find this a weak argument. If your testosterone is low, assuming itâs from aging and not factors you can control like being overweight or bad diet. Itâs not going to recover and improve. If itâs already low and youâre a healthy individuals the benefits I see outweigh any risk.
In fact the long term studies are now more readily available in that when done right, itâs not harmful. Men improved in longevity and their own perception of quality of life.
I for one am glad that the medical community is now viewing aging differently now. For example you could tear your ACL at 50 before and some doctors will literally tell you whatâs the point of surgery, youâre old. You donât need an healthy ALC anymore. Just let it heal poorly.
I believe a lot of the negative effects of aging on the body can be mitigated with not only medication but lifestyle choices and diet.
But in most cases itâs only âlowâ relative to some arbitrary ideal. Unless, as mentioned, there is some actual malfunction in the HPG axis - which can happen of course - testosterone is not âlowâ in many cases. It is where it is supposed to be, for the personâs age.
I honestly donât see how you could prove this one way or the other, because you donât know, in any individual case, what their longevity or QoL is going to look like without the intervention. All you can do is look at population averages, which can be deceptive. Iâm also doubtful that these studies have been done properly, given the complexity of the task and the relatively recent popularity of TRT. Longitudinal studies would be incredibly expensive and time-consuming.
Similar arguments can be made with (for example) cholesterol. Circulating cholesterol tends to rise as we age. Nobody knows why this happens (although I suspect itâs related to loss of muscle mass, which leads to a greater reliance on circulating triglycerides to buffer dietary carbohydrates). So the doctor says, aha, your cholesterol is too high. Hereâs some statins. Thereâs no reason for the cholesterol-lowering medication aside from the fact that the doctor has compared the cholesterol panel to his little chart and found that the numbers are higher than the population average. No therapeutic value is being claimed, and none has been demonstrated experimentally. But the gubmint says weâve got to lower everyoneâs cholesterol, so dammit thatâs what weâre going to do.
The underlying issue here is the doctorâs assumption that our bodies are perpetually âmaking mistakesâ, ergo we need to fiddle around - with pharmacological interventions - with whatever itâs doing. I think this is fundamentally wrongheaded.
But thatâs an entirely different scenario. Here youâve got a very obvious problem that needs fixing, and where the outcome of fixing it is pretty much guaranteed to be positive. TRT is far less clear-cut.
There may well be safe ways to introduce TRT into someoneâs life. But the nature of the intervention inevitably results in H-P-G adaptations to at least some extent, and ultimately to irreversible physiological changes, which in turn leads to serious problems down the road ⌠which need to be managed with more drugs. Has your doctor advised you - for example - to take breaks from TRT therapy?
Nope, itâs for life. Theyâre very clear on that. You can try to go off and try to recover but itâs difficult if you already were low to get to where you were at even the low point.
The only exception is when fertility is involved. Testosterone is basically a male contraceptive. You do need to go off or very low and use HCG and clomid to regain fertility. Works in most cases unless you already had fertility issues prior. They also do advice you to freeze some sperm just in case before you go one.
At the very least, we donât see detrimental health issues. Itâs more popular now but itâs been studied for a while now. There used to be concerns of health problems but recent studies show the opposite for example.
I see no reason not to take it if you have symptoms from low testosterone and you are benefiting from it. Do you?
But you really donât feel much symptoms of low or high cholesterol. You absolutely do with testosterone. So it is a QOL issue. If someone in their 20s has low testosterone and has no sex drive, have trouble sleeping, etc. Why would he not take testosterone to improve his symptoms. Same as a 60 year old man. What exactly is the harm as I canât see it.
How much can I expect a testosterone therapy to cost in Taiwan? Will NHI pay for it?
Based on being ignored asking this question twice, I guess nobody knows.
This strikes me as ⌠well, I canât think of any word other than reckless. Iâm not aware of any good longitudinal studies for that sort of thing, but the underlying biology is such that you will suffer negative consequences from uninterrupted TRT. Guaranteed. Precisely what will happen as you head into your 70s and 80s - because, unless you know differently, nobody has really checked - but thatâs what you can expect from first principles (and from a large body of anecdotal evidence from the bodybuilding world - you can take that for whatever its worth).
There is no free ride, no unmitigated upside. Technological interventions almost always involve some sort of tradeoff. The question boils down to a philosophical one: in exchange for short-term gains, are you prepared to accept some long-term losses (some of which may be poorly-characterized, or even unknown)?
When I was a kid there was a lot of hysteria about anabolic steroids (including testosterone). Much of it was unfounded, but there was a core of truth in it - which was the observation that your body will adapt to long-term usage of exogenous androgens in ways that can be distressing at best. Why ârecent studies show the oppositeâ seems mysterious, but I suspect the answer involves money.
Well, as I said, itâs a tradeoff. If youâre content to take those short-term gains in exchange for the absolute necessity of exogenous testosterone for the rest of your life (and who knows what else) thatâs very much a personal decision. Me, Iâd hate being dependent on some manufactured technology for my continued wellbeing - not least because it may become unavailable in a crisis scenario.
Well, this brings up another issue. How far down the slippery slope do you want to go? What do you consider to be âsymptomsâ? Should we hand this out to 29-year-olds who feel their youth is slipping away? How about 20-year-olds who just want a boost? And at what point do we just throw all the cards up in the air and delete the line between ârecreationalâ use and therapy? Is there any reason we canât just put every male on TRT when they get to 50? Or 40? Or 30?
Thatâs exactly the argument people use when they get into recreational drugs. It feels good. Itâs not doing me any harm. I can quit it anytime they like.
The harm is that your bollocks will end up the size of raisins within a few years, and about as useful. There also a strong psychological component to this, precisely because (as you know) it improves your sense of wellbeing. But youâre not replacing anything; youâre adding something on top of what is already there in the correct amount. Thatâs why it feels so good. Itâs adjacent to taking amphetamines to get you through the day, and the psychological risks are similar.
Iâve read a lot of the literature on this subject from way back when, and it was pretty unequivocal: the harm takes a few years to manifest, and although itâs dose-dependent, if your doctor hasnât been honest with you about that, he may have conflicts of interest. I really recommend reading some of the older literature on the subject, because it sounds like modern publications may be polluted by Big Pharma bias. Testosterone is dirt-cheap to manufacture, but testosterone-delivery systems sell for quite a lot. Every person âhookedâ for life is a ka-ching! moment for a pharma company, and the earlier you get them, the better it gets.
You are talking about super physiological dosages of anabolic androgenic hormones compared to replacement of baseline. 2 completely different things. As Iâve mentioned. We know there are health consequences of too high and too low testosterone with many studies.
A good TRT doctor will monitor everything every 3 month like mine for longevity and QOL. I recently lowered my dosages for example as I was getting too high on my free testosterone levels and it was also causing my estrogen to be higher. So itâs about monitoring from an entire health perspective not just letâs get this guy some testosterone to feel good.
Because
Thatâs a weird thing to say. I feel like youâre not that well versed on the studies of this topic. In fact my grandfather in Taiwan or all places was given testosterone in his 70s. This is nothing new. Itâs more of the nuances of earlier use for QOL thatâs more common now. But itâs been studied for treatment for a long time now.
This is not true. You would use HCG with it to prevent this if you cared about it.
I feel like your information is outdated or not accurate. Just like that statement above is simply not true. We know a lot more on how to improve male QOL with TRT now than ever before.
There is absolutely money to be made on this. That doesnât mean thereâs no benefit. Iâm a big skeptic on big pharma but that doesnât mean I donât believe that they also produce life saving and changing medicines. Do you find me as someone who would go into this blindly? A doctor didnât sell me on it. I chose it after looking into a lot of research and doing a cost benefit analysis.
One concern is yes, Iâm dependent on having testosterone available. But itâs a relatively cheap and easy drug to synthesize so I doubt thereâs every a real issue with supply.
Iâve seen the long term studies and I feel great. I sleep better. I have great sex drive. I maintain muscle mass and strength and keep off body fat easier while I watch my friends waste away in their 30s with their bodies looking sick. But Tbf, Iâve always had good genetics when it came to that. But Iâve definitely not lost a step from my 20s in terms of metabolic health.
Can you define âcheapâ? How much should such treatments cost?
I canât tell you in Taiwan. The drug is cheap but itâs about having a doctor work with you and monitor you thatâs the cost.