I’m no endocrinologist but I think is safe to say that there is a big difference between someone who has been medically assessed, prescribed and monitored by a medical doctor, a low dosing to maintain proper biological functioning and someone who has self administered grams of PEDs for years and now that they’re “shut down” they self administer much less but rationalize it to themselves (and everyone else) as TRT.
S
These guys are endocrinologists, and have written an excellent overview of secondary hypogonadism due to exogenous androgens:
Edit: T-Nation was one of the online forums they examined in preparing the article.
Continuing from my first post here: if I ever experienced just one of these mishaps I wouldn’t continue to pulverize my body. But that’s just me.
I’m getting a login screen.
The hands and fingers cracked me up. How do you break your hands and fingers lifting?
(not a serious question to you, just my thought when I read that)
Try googling “Male Central Hypogonadism Secondary to Exogenous Androgens” and see if that can get you around it.
It did a little. I got the abstract and intro, but no conclusions.
No biggy, but it would be interesting to read at some point.
I did read and agree with a post you made recently on TRT and peoples willingness to jump right on it in another section/thread. I’ve kicked around the idea a bit since I’m no longer 9 feet tall and bullet proof (mid 20’s), but have to really carefully consider its necessity in light of the fact that I’m not suffering any quality of life issues and really would just be supplementing to feel “more better”.
Because sometimes good just isn’t good enough.
[excerpted]
Results
We found that online discussions and advertisements concerning agents that can be used to combat the side effect of hypogonadism are very common. There was a mixture of information available from online communities (forums), AAS user blogs and from websites attempting to sell products such as anabolic steroids and substances directly related to hypogonadal recovery. Roughly one-third of the Internet sites we reviewed also offered to sell these drugs without prescription.
[…]
Information on forums consisted of anecdotal reports and advice from unverifiable sources (some claiming to be medically qualified). [Emphasis mine. Also, sound familiar?] These sources referenced mainstream scientific papers and abstracts on the issues discussed. However, there were clear flaws to this superficially ‘evidence-based approach’. The papers quoted were of only limited generalizability to AAS users, ASIH [anabolic steroid-induced hypogonadism], or to the argument proposed by the ‘expert’. Equally most users were unable or unwilling to progress beyond subscription pay-walls, leaving them to draw conclusions from the abstracts or the ‘expert opinion’ alone.
[…]
The rationale behind the different tactics used was the quick restoration of the hypothalamus–pituitary–testicular axis and return of the endogenous steroid production to normal, whilst minimizing ‘time lost’ to AAS use and/or muscle mass augmentation and avoiding other symptoms of low testosterone in men, namely erectile problems, loss of libido and low mood. Fertility concerns were typically secondary; indeed, plenty of users reported getting their partners pregnant whilst using AASs and most users ignored potentially sustained effects on numbers and quality of sperm. Discussions often lead to misunderstanding the pathophysiology of spermatogenesis and its impairment, leaving users to believe that return to normal serum testosterone levels translated to normal spermatogenesis. In most discussions, men seemed to equate regaining endogenous steroid production to normal fertility, ignoring long-term effects on quality of sperm, such as poor morphology and motility, which might potentially be irreversible.
[…]
Discussion
We analysed 20 websites offering advice on the use or selling ancillary medications to counteract the side effects of ASIH. We are not aware of any other study that has examined these online practices in the past. Our study illustrates the degree of information available on the Internet that extends beyond that covered in the current medical literature. We found that many sites conveyed controversial prodrug messages, often appearing to be based upon personal experience and nonrelevant available scientific literature. The authors of these websites sometimes accused the medical profession of biased motives.
The treatment of ASIH and subsequent subfertility remains inadequately studied, and many clinicians have limited experience with regard to managing men with ASIH. AAS users appear to be well aware of this and may thus tend to give less weighting to clinician recommendations than those of ‘online expert users’.
hCG, SERMs and AIs are amongst the drugs commonly used to counteract the side effects of ASIH. Although some of these are certainly effective in the context of congenital (or pituitary lesion-related) hypogonadotrophic hypogonadism, the extent to which data from medical treatments can be compared and extrapolated to ASIH is uncertain. This is because the pathophysiology of ASIH may be more complex, representing a combination of the endocrine disruption and direct testicular toxicity related to the supraphysiological doses or multiple drug combinations used by users.
We recommend that, based on currently available evidence, if fertility is desired, the logical first-line management is to cease using AAS along with any other potentially ‘culprit’ agents (e.g. marijuana, opioids, methamphetamine, cocaine), with serial semen analysis. Studies of exogenous androgen–progestagen combinations examining their potential role in male contraception have shown that the typical probability of recovery of spermatogenesis to 20 million/ml was 67% within 6 months, 90% within 12 months, 96% within 16 months and 100% within 24 months, so the timelines and outcomes for men with ASIH may not be dissimilar.
[…]
If spontaneous reversal of hypogonadism does not occur with expectant management within a reasonable timeframe as discussed above, then use of hCG ± hMG, SERMs or AIs is potentially effective alternatives. However, robust evidence on their effectiveness and safety is currently lacking, and there is no consensus on the actual regimes that are effective in treating ASIH or in shortening the recovery interval, which is highly variable between individual patients. More research is needed in this area in the form of therapeutic trials to assess the effectiveness of ASIH treatments. In the meantime, by ensuring that they are well-informed and have a good understanding of what supplements their patients use, clinicians will be more likely to retain the credibility and trust of AAH users, who will in turn be more open to engaging with lifestyle modification. We would also like to caution physicians against prescribing agents with significant resale value within the index community without first involving their local community drugs team.
Conclusion
Widespread misperception that AAS use is safe with manageable adverse effects has contributed to their growing use. When evaluating hypogonadism and infertility, it is important for clinicians to inquire about AAS use because it is more prevalent than is generally thought and AAS users are often reluctant to disclose this to their clinicians.
The long-term adverse consequences of AAS use needs further investigation. Some studies suggest a potential benefit of adjuvant medications in the treatment of ASIH but quality data on the effect and safety of these medications are lacking. The limitations of the present literature with regards to the pathophysiology and treatment of ASIH necessitates more research that will facilitate the reach of consensus on the treatment of ASIH and resultant male infertility.
As well thought out and worked through as that may be, you know there’s a guy reading it right now saying “Yeah, but…”.
As with everyone else I’m no endocrinologist…
I’m not convinced that getting your liver enzymes, hormones, and kidney function checked tells the whole story. Obviously it’s measuring those organs, but it isn’t measuring everything.
For example, cardiomyopathy doesn’t necessarily show up in your standard steroid blood work (based on what I had have seen them talk about ordering)
It’s also certainly possible that the damage being done is not amenable to testing, or just isn’t an obvious test to get. Something like receptor site damage maybe?
So just because someone’s bloodwork has been good I’m not sure that tells us everything about what these drugs are doing.
Disclaimer not necessary, but I do appreciate it. Honestly, I like to think that you and I could openly criticise each other quite strongly without any kind of ill-feeling, so if you ever feel inclined to tear me a new one in future then by all means do so!
Now, a disclaimer of my own. Your post is awesome and I agree with 99% of it, but there are a few things that I feel I should point out as much for the sake of devil’s advocate as anything else.[quote=“BrickHead, post:16, topic:230170”]
And usually it’s the same topic over and over, his health, and a seeming inconsistency in his concern for health while at the same time appearing to be reckless with his health. In my view, one can eat all the organic and grass fed items, vegetables, fruits, and whole grains till their hearts content, but this in no way safeguards someone for the effects of decades of drug use in modest to high doses, drugs that one does not even need for normal function unless they have medical disorders requiring them, let alone that they produce supraphysiological levels in the body with which the organs can’t deal. Even if one takes anabolic in low doses, the body is not equipped to handle them without some disturbance at best, and failure at worst. Of course dosage and duration account for the amount of damage or lack thereof that the drugs can induce, but either way, their use is not healthy.
[/quote]
heh, I find this aspect of bodybuilding utterly hilarious. People will inject themselves with all kinds of garbage they buy from shady online sources, but think because they’re using 800mg a day of curcumin that they’re covered.
Imagine how healthy an individual would be if he engaged in all the healthful behaviours bodybuilders like John (supposedly) engage in without the steroids?[quote=“BrickHead, post:16, topic:230170”]
the blood work simply points to the obvious: supraphysiological levels of hormones and other blood values that are abnormal such as kidney and liver function and lipid values, such as HDL, GFR, BUN, creatinine, AST, ALT, as well as estradiol
[/quote]
I think this downplays the importance of blood work, particularly for an AAS user. I would say it is very important to get these things done, particularly as AAS can wreak absolute havoc on those values mentioned above. If you are using a drug and it puts your HDL in the shitter, then bloodwork will tell you to come off the drug. I realise the really smart thing to do would be to not take the drug in the first place if it has that potential side effect, but if you have made up your mind to do so then why not make sure everything’s hunky dory when you’re running it?
There’s also some quite insidious side effects that you’d never even really know about until you’re too late. A lot of bodybuilder types go by feel when it comes to their hormones, by which I mean that if they feel fine then they believe they must be so. These dudes don’t realise that you might feel fine but your oestradiol is off the charts and has been for a very long time. You won’t feel a hepatic adenoma, but high E can absolutely cause it. Without blood work you’d potentially not find out until it was too late.
Again, these scenarios only really apply to drug users, and not those smart enough not to use the drugs in the first place (but fuck those guys, amirite?).
As for destructive behaviours, well… sometimes it just has to be done.
I know guys who have absolutely ruined their bodies through sports. I know guys who have caused horrendous damage to themselves on motorbikes. I know guys who have worked so hard in a job they were passionate about that they practically destroyed themselves. Bodybuilding (with or without AAS) is just one of several billion destructive ways you can behave.
The general theme I have personally found (n=1, I know) is that those who engage in destructive behaviours find too much pleasure in them to ever give them up. Is it the destructive nature that makes them addicting? You’d have to be a smarter man than I to work that out.
Fun fact: the phenomenon of acting against your better judgement is known as “akrasia.” I thought that was cool.
One question though, Brick. If we consider this:
If you didn’t have the injuries or responsibilities you do now, would you feel different?
Interesting discussion this thread has turned out to be!
Oh shit!
Oh thank sweet baby James for that…
Thank you. I am glad that we can converse as empathetic adults here, with no hurt feelings. That is, we can see one another’s point of view without feeling insulted and we understand we are not trying to slander anyone. Criticize perhaps, but not slander.
I can name an internet guru who never competed, owns a supplement company and several other business, I believe, who pushes this line of shit and other healthy practices, when I believe none of them can counter the chemical assault that many bodybuilders subject their bodies to.
These are fair points, but I highly doubt that any bodybuilder hell bent on being the best or his personal best or is plagued with the compulsion to remain the behemoth he is will stop in the face of such bad side effects. Some will stop drug use or lighten the dosage, but I believe many absorbed in bodybuilder or operating on a high level won’t stop. Seriously, what can come out normal on blood work for a high-dose-using bodybuilder? Perhaps I am not knowledgeable because I don’t use PED’s (TRT is not performance enhancing, and it’s not used for anything but to restore and maintain normal physical functioning), but I’ve yet to see a bodybuilder who boasts publicly that he regularly gets blood work provide the actual blood work results! I mean, I sometimes feel like saying, “Hey pal, if you’re gonna tell all on FB or on a vlog on YouTube or on a meathead forum that you get blood work because you’re cautious, post all of the results, not just your estradiol and T values.”
But it’s their lives. Live by the sword, die by the sword! Right? Well, it doesn’t actually work like that considering no man is an island, unless he lives like a bodybuilding monk. If their are partners or spouses or kids and family members part of their lives, I don’t think those people will just brush it off and say, “Oh well, my dad/boyfriend/cousin/son/husband is sick/dead, but he got sick/died because of what he loved.”
Yes, side effects of drugs or any harmful substance or experience can be insidious. Even injuries or structural abnormalities can be insidious. When I herniated my discs, I had some pain. But I was prepping for a show at 100 miles an hour, so to speak, constantly filled with adrenaline, and my body was probably chronically tight from all the training. The sciatica and other nerve pain really heated up when the prep ended, when I actually took a planned two week break from training, which actually turned out to be several weeks of no training because of the pain and not know what to avoid or continue physically, was unsure what was wrong yet, and didn’t start physical therapy yet.
I spoke to my physical therapist three weeks ago about this seemingly ironic, belated pain. He said with bodybuilders there is a catch-22. While they are continually training, the body has a lot of tension or tone (the real meaning of the word, that is), they are in many cases inducing degenerative changes, but the excessive hypertrophy is “keeping everything together”. Even Ronnie Coleman explained this in an interview. While he was in the thick of everything, training like a madman, he didn’t experience many symptoms, if any at all, from his training. It’s when he backed off that the symptoms came up. The same goes for obese people who lose weight. They might have herniated discs and other spinal abnormalities because of their oversized midsections, but such girth is keeping everything together so to speak. But when some lose weight, then the symptoms arise. So those who scoff at mobility drills, proper form, activation drills, and just fling weights into place for lifting (getting dumbbells into place for presses, say) might pay a price. Ever see Ronnie deadlift? Or internet celebs? I cringe when I see such clips. Ever see how their heads and neck shake when the bar hits the floor as they keep their heads out of line with their spine, looking forward? No wonder Ronnie has herniated cervical discs.
He actually does promote balanced eating and the pre-exhaust and activation lifts he preaches are great!
That’s correct. And see above for this. Again, live by the sword, die by the sword. If someone knowingly engages in destructive practices, eventually others have to clean up the mess. But its their lives.
I would still feel as I do. I’ve always been one to have healthy fears. However, if I was much younger, say in my early to mid-20’s I would compete a few more times. Who knows, if I was much younger, I might have gone full speed into trying to be an IG-internet bodybuilder celeb of sorts, and going batshit crazy with social media, as others have done.
And yes, like the people you mentioned, I have desired to do things in my life that are dangerous and destructive, but, not be a smart aleck here, I’ve always known and have been cautious of bad consequences. I can actually give a fair example that is not related to bodybulding at all!
I’ve said this before in the Get a Life forum. I grew up in a part of Queens that had loads of prolific graffiti writers. The first time I noticed graff, I was a measly seven years old! The highways, trains, handball courts, and streets here were filled with that stuff, and little me thought to myself, “Wow! These guys are crazy! How do they do that? Why would they do that?” I would be glued to the window in my mom’s car as we drove around, particularly when we drove to the Bronx, a borough where there were hundreds of writers (the Bronx was for a long time known to be a rough-and-tumble area). Just the grittiness of NYC had me amazed as a little guy. But… little did I know at that that the graffiti scene had highly violent and deviant elements in it, no matter how artistic some writers were and are. If you wanted to write in the 80s and 90s, you had to “hold it down”. Some have gone onto lucrative art careers with tattooing, advertising, animation, hip-hop, and so on.
So… when I was eight years old, I found a can of gold spray paint in my mom’s garage. By the way, an eight year old had no street business doing that considering the age of writers in their teens and 20’s typically. I had my friend look out while I took a tag, and I was so nervous I could barely have myself finish a measly four letters. I knew deep down that if I got caught my mom would beat the shit out of me. I never tried it again, and I knew it wasn’t for me. As I got older and went to high school, and met some writers, this idea that it was not for me was confirmed: there are serious consequences and nearly all the writers I met were violent and confrontational. Sure some just liked writing for whatever reason, and were even highly artistic, but even more loved confrontation, stealing, and drug use.
Along the way, I’ve collected books on graffiti, been to graffiti-themed art stores, been to art shows put on by graff writers, and finally met some of them men I looked up to as a kid, most of whom are now in their 40’s and 50’s. Some are really cool guys and carved out a living for themselves with graft-themed work and have greatly matured.
But one time my wife said to me, “You know you would have loved to do it.” I answered, “That’s correct!” Morally and rationally speaking, as a man in my 30’s I don’t want to live in some graffiti infested shithole or have public property wrecked, but I’d be lying if I said that on an emotional level I would’ve loved to do it. But I simply didn’t want to have the trouble graff gave to most who were heavily involved. And we’re not just talking neighborhood kids who wrote their names around town, but people who went “all city”.
I pardon for possibly digressing too much, but I think I provided an example of something that fits in the context of this conversation: do something dangerous and pay the consequences or don’t partake.
@BrickHead - Are you saying you wouldnt want to look as brutal as John Meadows? 
All joking aside I can easily see why judges just dont give Meadows the nod most of the time; he has a particular “look” about his physique and “pretty” isnt a word that comes to mind. No one can argue thaat he isnt as passionate about the pursuit as anyone who ever lived, and he obviously has a very, very “built body”… but he deson’t necessarily have the kind of body many people can relate to wanting to have if that makes sense. And given this is a aesthetics driven endeavor, if you dont “look as good” as the person next to you, you aren’t going to win.
life is built on disappointments. i find it very sad.
you devote your life to one thing, it takes you decades to be a professional and you place dead last in every contest you enter.
phil heath decides to become a bodybuilder, turns pro in his 5th contest, becomes Mr O in his 4th try and i am pretty sure john knows much more than phil when it comes to training & nutrition.
Very true.
I think John has received the recognition he deserves for his work, dedication, and passion for the sport. It came from the participants and fans instead of the judges, and depending on how you look at it that may be a good/bad/better/best thing.
If I were to hire a trainer John would be my number one pick, and I think many people feel that same way (including many top people in the sport). He has probably one of the only active, successful pay sites on the net for BBing info… think about that.
He accomplished his own sort of success, which is uplifting in its own sort of way.
it makes me hang my head some of the OTC supp recommendations to apparently offset AAS use. Running something that’ll punch holes in your liver like halo or drol? Better get some milk thistle, bro. The idea that some concoction of herbs can in any way counteract drugs like that is just irresponsible.
Completely agree for the most part but they do exist. Ken Hill had an interesting series of podcasts where he chronicled his journey to get healthy again after getting some really worrying blood work. Patrick Arnold is doing a similar thing just now after having some very serious health complaints. He’s deliberately lost a shitload of muscle which is pretty cool to see (in terms of him having the maturity to actually accept he needs to lose muscle. How many other BB types would do that?). I haven’t followed the Patrick Arnold thing too closely but you might want to check it out.
As a slight aside: that graffiti thing makes me picture you in oversized baggy jeans, tye-dyed shirt and backwards cap.
did his brand not recently get valued for like a million dollars? I’m sure I remember reading that somewhere.
Edit: here it is
Absolutely well said and NEEDED to be said.
Thank you.
Welcome!
Thought I would share this clip from John seems a pretty recent release.
