Problem is that muscle mass and fitness in older age are like wealth in older age: much easier to maintain or even grow if you’ve been investing in it all along. Vital to manage even starting late, but if someone is north of 60 and they are just now realizing they haven’t got much? Get rich quick plans probably aren’t the way to go. Still much much better starting late than never. Even more important if you have little in your funds to withdraw from.
I have little expertise on the benefits and risks of testosterone supplementation but my understanding gained from those I do consider expert is that some non-zero but not majority of men with documented significantly low testosterone will experience clinical benefit.
A blanket recommendation of use for normal aging seems snake oil to me. I understand a baseline prostate exam and following PSA regularly is part of guidelines for the real stuff.
A number of chronic conditions decrease muscle mass, and there are many conditions which make exercise more difficult to do. I am not an expert in hormone replacement, but one wants to be sure a treatment is likely to improve desirable outcomes while considering the drawbacks.
They are the right solution for men with specific symptoms where that has been shown to be the likely cause. This is not the majority of aging men. Exercise is a better solution, and would benefit many more people - but, as mentioned, is better if introduced early, and can be difficult to do following certain circumstances.
I understand they were referenced “to show they work” at producing muscle mass in the presence of strenuous weight bearing exercise. But exercise does this without exogenous steroids - more safely, but less dramatically. Many of the reasons elderly men replace hormones are actually quite different. Though winning the Tour de France may help elderly people with their depression, an extremely common symptom in the elderly, though underdiagnosed and undertreated.
I feel like I’ve reached an age where “if i don’t use it, i lose it” to a much greater extent than when i was young. I’m working with a personal trainer in an attempt to hang on to muscle mass and general strength. I suspect a pinch of testosterone would help a lot of men hang onto what they’ve got, in addition to exercise. (I wonder if it would help me, too, honestly. But i don’t have any compelling reason to seek it.)
I noticed they didn’t show his friends ditching him because of his personality changes, or the restraining order filed by his SO, or the job losses, etc.
Is this an old man? No one is arguing supraphysiologic doses of anabolic steroid can put on muscle with strenuous weight bearing exercise (which also does this without exogenous steroid). Whether this is wise, sustainable, healthy or typical are different questions separate from occasional legal concerns. The goal of hormone replacement when indicated are for mid-range values.
Armstrong juiced so much that even he thinks it might be what caused his cancer.
agreed
This isn’t quite true. They won’t make the average athlete world class but they can & will improve performance. Within the past couple of days there was a discussion on one of the triathlon forums & how many of the age groupers are doping. This video claims that 20% of the triathletes in these German surveys admitted to doping. If 20% admitted it, even anonymously, how many more are doing it & didn’t admit to it?
Granted anyone training for & racing Iron-distance triathlons are much more in shape & much more driven than the average Joe but if person A doping & person B is not, that might be the difference between being on the podium or getting a KQ (Kona Qualifier - the Ironman championships in HI) for those who are no where near world/national/state champions but just good enough.
Fair enough. But the improvement is usually modest and I meant more along the lines of making an average weekend warrior a professional. There is no doubt they give an edge to those in certain sports where size is beneficial and already at an elite level - but not without risk.
The biggest damage they do is publicize a false sense of what is healthy and attainable. This is a separate issue from hormone replacement which is more reasonable, especially when done with the proper indications (see the AAFP article above). Most men, even if elderly, do not require them. It should not be seen as a first line treatment for depression though may have a role. Exercise helps with mood considerably.
Testosterone supplementation has a place in those whose levels are low. In these cases, replacing testosterone has been shown to be beneficial in reducing many of the side effects of low testosterone, most of which have been noted above. I would also like to add that low testosterone also causes anemia, which contributes to fatigue.
What has not been shown to be beneficial is the use of testosterone or other anabolic steroids in men with normal testosterone levels. Much like in the case of women and post-menopausal hormone supplementation, you need to make a risk benefit assessment because as noted there is a higher risk of cardiac disease.
It should also be mentioned that testosterone supplements are not as easy as popping a pill. There are topical forms but you need to avoid contact with people who could be adversely affected by absorption. The most commonly used is the axillary form and I always wonder about having to keep a partner from accidentally touching your armpits. Injections can be painful and implants require implantation and the dose is harder to regulate. JMHO but I find a lot of men who are started on testosterone supplements eventually find the hassle not worth the benefits and eventually give it up.