Should aging men consider steroids?

In My Humble Opinion
21

Most aging men are not high level athletes nor ever were. Steroids have many side effects. Taking them affects many other things, including downgrading natural hormones, and should not be done without a valid medical reason. They won’t make you big unless you train hard and will not give you the results you seek in small doses. If you are not used to training hard, having big muscles with weak tendons and ligaments is a recipe for chronic musculoskeletal problems. And what happens when you stop taking them?

There are certainly a few valid medical reasons for taking them, but they will not turn an average athlete into a better one and they are less important than exercising wisely, eating well and getting restful sleep. The mythology is largely wrong. The superhuman performance is a slight edge to people already competing at a superhuman level, and is still not likely worth it in the long run. It is true some celebrities and influencers take them - that hardly makes it wise. It is sad and unfortunate that unhealthy behaviours are associated with a false image of health.

Aging men should consider taking them if they are symptomatic, have proper testing done to show a marked deficiency, do so under a doctor’s supervision and have medical symptoms improve due to their use. Women occasionally have medical cause to take them too, not least for birth control.

22

And there are also legitimate reasons for women to take hormone replacement therapy (and those drugs are steroids too), although their use has fallen off massively in recent years.

This is something that men need to discuss with their doctors, and do what’s best for them.

23

But that’s the question: are the symptoms of aging themselves a valid medical reason. We know with a high degree of certainty that with age men’s bones will become more brittle, their muscles will atrophy, and they will become less active. Steroids can counter those developments. Isn’t that a medically valid reason?

I’m not talking about turning middle aged men into super athletes or huge bodybuilders. I’m asking if it makes sense for men who are approaching 50 and up to take hormones that will combat the markers of aging and offer them a recipe for the vitality of their own particular youth.

Moreover, I’m wondering if the side effects can be offset by a healthy lifestyle, which steroids assist with leading.

24

I am 74 now and seriously thinking of testosterone therapy if it would help. Muscles are shrinking and libido is waning.

25

I find it interesting that it is considered acceptable to alter a woman’s natural hormone cycle to improve the quality of her life, but it’s given far more skepticism when considered for males.

26

I had to push my endocrinologist for a slightly higher dose of testosterone. My numbers were coming in at the lowest end of the range. The product monograph indicates a starting dose of 5g up to 10g, but he felt 5g was sufficient. I listed my physical symptoms and he finally agreed to modify the script. Lo and behold, I’m now in the middle of the range and no symptoms of low T.

27

My primary care doc thought being at or below the lowest end of the range was fine. The naturopath was like, you need to be at the upper end and does bloodwork to make sure I’m in the right range.

28

Testosterone replacement isn’t something that I have researched, specifically. But I would say that there are two components of getting older:

  1. Degradation of the body and its systems, due to aging.
  2. Adaptations meant to prolong our life, despite that degradation.

For example, our bodies reduce growth hormones, presumably because the likelihood of DNA damage that could lead to cancer is higher. Slowing down growth and focusing on stasis helps to prevent the body from developing malignant growths. If nothing is growing then bad stuff can’t grow.

So, in general, I would want to make sure that low testosterone is part of trait 1 of aging and not trait 2, before choosing to ramp it up above the average for men of my age. Feeling real good and strong isn’t of so much value if you’re just going to make yourself fall over. The safe guess would be that the average level for men of your age is the healthiest level. It’s the one that evolution found to be optimal for someone in your condition.

That said, it may be incorrect to compare yourself to men of your age. It seems likely that aging is the outward manifestation of a semi-controlled breakdown of DNA and its chromatin shielding. Like, if you took two 2002 Corvettes, fresh out of the factory, stuck one in a nitrogen filled chamber at a constant 45 degrees, and drove the other daily for 20 years, put them together side-by-side, then they’d both be the same “age” but one is still basically brand new and the other one is ready to be scrapped. The model year is a reasonable indication of wear, on average, but somewhat meaningless at the individual level.

On average, we age at the average rate but, per person, we can age faster or slower depending on nutrition, lifestyle choices, environment, G load, relativity effects, etc. Thanks to the drop-off in smoking, we’re all mostly younger than our grandparents were at the same age. We haven’t all spent decades trying to damage our DNA to the max.

So, if you wanted to micro-optimize then, in theory, you could measure your level of DNA damage and compare that to others to determine your functional age and then use numbers from others at that functional age to figure out whether you’re at a normal level of testosterone and what level to target.

29

Mood disturbances are a known side effect of catabolic steroids. Prednisone is known for it, as just one example.. In some people the drug causes full blown psychotic episodes. Fortunately that extreme is rare, but change in mood not.

30

The point about women being offered steroids for birth control and to combat menopausal symptoms such as hot flashes or vaginal dryness - but more skepticism when discussed for men, is a fair point. It should be noted that doses to do this are very low, kept as low as possible, that these treatments exacerbate certain common cancers, and that they are prescribed somewhat more cautiously than they once were. Treatment generally is considered after a complaint of specific symptoms.

Modest, physiologic doses of steroids will not make men look like The Rock or The Liver King - and wanting this unnatural appearance is not a specific symptom (excusing dysmorphia). Is this a reasonable goal for most, achievable in healthy ways, regardless of age? There is a difference between improving real medical symptoms and wish fulfillment. This is a not to belittle male concerns. But there are many people who illicitly take steroids. Their reasons for doing so are not always wise, nor the best ways of doing things, nor end in the desired result, nor are always applicable to aging men.

The point about aging and its symptoms being considered a treatable disease to improve lifespan, healthspan and longevity is a separate discussion. There has been some hesitant progress that offers real hope, but this field is still subject to quackery and grandiose claims. I would recommend the books Elderhood and Lifespan for a good discussion of these and other issues, keeping a healthy sense of skepticism in the latter work.

Good doctors first stress non-pharmacological solutions. A mixture of regular weight-bearing and cardio exercise, every week, goes a long way towards stronger bodies and bones, maintaining metabolism and mobility, avoiding diabetes and other chronic issues, better mood and healthier hearts without the side effects. People prefer easy solutions to better ones which require persistence and effort. But the benefits accrue at any age, and even elderly people can gain significant muscle and mobility especially if they have never done so. No steroids required. Just knowledge and persistence. And realistic expectations.

31

anabolic steroids are just one form of medical intervention to help prevent sarcopenia (the loss of muscle that occurs with aging). Other therapies like HGH therapy or (soon) myostatin inhibitors will also be available to prevent the muscle degradation that occurs with age. I do not know the safety profiles of them, but there are other options aside from just TRT.

32

Including exercise. There is nothing prima facie inevitable about large decreases in metabolism and muscle with age. Recent studies have shown the cause is less activity, the amount of decrease has been exaggerated and starts much later than many believe, and that the effects can be largely reversed naturally. The things you mention may have their uses among people with specific medical problems.

33

That’s all true. But i did a ton of research about estrogen replacement therapy, and the all-cause mortality for women who start to take estrogen around menopause and continue for a decade or so is less than that if women who don’t. (And there aren’t a lot of studies that run longer than that.) Basically, there’s a slightly higher risk of cancer offset by a lower risk of broken bones. And broken bones (especially broken hips) kill and cripple a lot of elderly people.

I had symptoms from low estrogen. But I’d also prefer to be a breast cancer survivor as compared to a broken-hip survivor. I decided this before my mom broke her hip, but that reinforced my impression. Narrowly, just looking at the hip, she recovered quite well. But her health, vitality, and cognition all took a huge hit from that incident.

Dunno how that plays out for men. I think testosterone is more dangerous than estrogen, but maybe that’s related to the doses people take.

34

A careful balance of risks and rewards is important. Hormones are not the only drugs which strengthen bones (calcitonins, bisphisphonates, possibly early calcium and D), the only means of doing so (weight bearing exercise; tissue strength is related to forces applied) or the only means of preventing falls (proper lighting, handgrips in areas like tubs and showers, rails, appropriate modalities for balance as needed, avoiding wet, snowy and icy surfaces etc.). Replacement works well for many and improves some things (including certain cancers) while worsening others (including certain cancers).

As soon as you take an active drug it is converted to a bunch of other stuff. Note that a some treatments given for replacement act more locally (e.g. ointments not tablets), but it depends what one is treating.

The OP references Armstrong and the mythology which drives why too many younger men take steroids. They may have their place for older men with certain specific symptoms and proven low values.

35

Yes, it’s because of the complexity that i like to look at all-cause mortality.

(The other drugs that improve bone density often don’t work very well, too. And these things are not exclusive. One can engage in weight bearing exercise and avoid ice on any or no drug regimen.)

And yes, i have a little bit of resentment that when i was seriously depressed a few years back, and told the doctor it felt like PMS, he insisted on putting me on Prozac, because it was safer than hormones. It worked well enough, but i had to go off it due to all sorts of unpleasant side effects. I’m now on estrogen which is much less unpleasant to take, and is at least as effective for the depression.

36

All that being said, i think it would be very unwise to play with testosterone without a doctor’s recommendation, and without a doctor monitoring the impact.

37

I would consider TRT but as of now I’m in my 40s, my libido is too high if anything, I’m physically active 60+ hours per week, my energy is good, and my body composition doesn’t indicate lack of T. I have to admit in my personal life I’ve missed out on many of the experiences younger men take for granted so that and my ego leave me not wanting to age if I don’t have to.

38

My uneducated opinion is that it is the same (except replace breast cancer risk with prostate cancer risk, and replace estrogen with testosterone).

As the OP, I only referenced it to underscore the fact that steroids work - no, they can’t make a typical man into a championship athlete, but they can revive the professional athletic career of a cancer patient.

This is similar to what led me to my query. I’ve been on antidepressants for years, and due to some issues was wondering if I needed to adjust my dosage.

But maybe it’s a different hormone issue altogether. Lower testosterone levels are associated with depression.

If you ever see wellness clinics geared towards men, or references to TRT (testosterone replacement therapy), or more generally hormone replacement therapy, it’s referring to doctors who are providing monitored prescriptions.

Most of these places advertise themselves as “a blend of eastern and western medicine”, and usually also do things like acupuncture or vitamin infusions.

39

All true.

But just like the MDs who run (or ran) oxycontin “pain clinic” pill mills, I’d take the advice of somebody running a “Men’s Vitality Clinic” with a man-sized bag of salt.

He (likely a he) is (probably) exploiting his license in pursuit of profit first, last and only, with patient benefit not real high on the list of concerns.

Admittedly, when the financial rewards are large, there are real immediate benefits to most patients, and the downsides come only later and only to some, well, that’s a pretty easy rationalization to make.

But don’t mistake “I think this is right for you” as carefully considered personally customized advice with due regard for long term consequences. Think of it more as a used car salesman selling you whatever’s on his lot.

These clinics and their billboards are everywhere here. They got common just about as the pill mills got dried up by the Feds. Perhaps a coincidence.

40

They’ve been around. It’s ironic - 50 years ago, my comic books had those muscle-bound Charles Atlas ads telling me I’d get the girl if only I’d buy their product. Now, my classic/exotic car mags have pictures of muscle-bound balding/graying guys telling me I’ll get all the girls if only I’d buy their product. (Which is kind of sad - you’re rich with a Ferrari and you still have to work out? Damn, bro.)

The difference with the latter is they’ve upped their ad budgets to a bit more mainstream now that some high-profile figures have clearly bought in.