Steroid Interactions with Truvada/Descovy/HIV Medication

Pharma
1

Feel like I’m going to get some interesting responses (or none at all), but here it goes:

I recently started taking Truvada. For anyone not familiar, it’s a medication that preemptively blocks HIV infection. Fairly common for folks with an HIV positive partner, sexually active gay men, whatever.

Point is, I’m beginning to wonder if it’s negatively impacting my progress at the gym and/or interacting with my current steroid cycle (high tren, low test, winstrol. Relatively low amounts of caber and arimidex - those more on an “as-needed” basis.).

Truvada and related medications (descovy and antiviral therapy for folks who already have HIV) are notorious fir making people feel like crap and feel fatigued for the first few weeks, so I’m hoping this is temporary. It’s been about 3 weeks, and even though my energy levels have rebounded, my strength has not.

So, does anyone have experience with this? Are there concerns about being on both truvada or similar preexposure prophylaxis drugs and steroids at the same time? Is Truvada detrimental to weightlifting progress, generally? Any feedback appreciated.

Additional info:

I had blood work done when I first requested the prescription and my liver and kidney values were all within the normal range.

I’ve already searched the forums for similar info and haven’t really found anything.

If I think of anything else I’ll edit or add below?

Also, yes, obviously I’m gay. Hoping this doesn’t lead to heaps of abuse. (Not necessarily expecting that from this community, but it wouldn’t be the first time, sadly)

2

I guarantee you, no one on here cares about this… Or if they do, they’ll keep it too themselves.

This forum is fairly libertarian minded. Being gay isn’t a choice, from my perspective there is no justification to deny homosexual individuals the same rights heterosexual people have.

Discrimination on the basis of a character trait an individual has no control over, a characteristic that doesn’t directly harm anyone is unjust from my perspective. I’m sorry to hear you’ve had to deal with abuse for simply being who you are.

Are you on Truvada as a preventative treatment? Or to treat HIV?

Back in the day prior to the development of antiretroviral drugs… And even for some time after but before the DEA/FDA clamped down on anabolic steroids these drugs were used to treat HIV associated wasting. Uncontrolled wasting vs AAS use mediates one of the few situations within a therapeutic context wherein the benefits associated with use tends to outweigh the risk. Being on steroids and having a heart attack twenty or thirty years down the line is better than dying six months from now.

As to your question, it’s not so simple. It depends as to how you as an individual respond to this medication. Off of the top of my head Truvada can cause renal and hepatic dysfunction. Like any other form of polypharmacy, but particularly with more dangerous meds like AAS you’d need to be extra vigilant with blood work, regular testing etc as to ensure no complications arise

It’d be a smart choice to avoid orals. Im aware oxandrolone is or was considered the “golden standard” for HIV related wasting, but imo it’s not the best choice for men in this circumstance.

I wonder if AAS are still used to treat HIV/aids wasting…

3

I appreciate the overall tone of your response. Thank you. It’s rarely in issue in person any more: on the one hand, I think it helped that I left the rural, conservative town where I grew up for college and rarely go back. But on the other, the world has definitely changed for the better, to a remarkable degree, during my lifetime. Unfortunately, I’m still amazed by what people will say in front of me when they don’t know. Or behind online anonymity.

Anyways, I am on Truvada as a preventative. It’s 99% effective at preventing HIV, which is actually a good deal better than condoms (some studies suggest condoms are as low as 85% effective at preventing HIV). Over the last couple of years, Pre-exposure Prophylaxis (i.e. medication taken as prevention) has kind of become the standard for HIV prevention for gay and trans folks. There’s some stigma/vontroversy there because Truvada/Prep doesn’t protect against anything other than HIV, and people are definitely having more unprotected sex since it came into widespread use. But a full STD panel and bloodwork seems to be standard for prescription renewals (every 2 or 3 months).

Final note - I think the medication (think there are technically two?) in Truvada is rarely used by itself to treat/suppress HIV. It’s my understanding it can be used with other drugs for that purpose, but isn’t effective on it’s own. The medical progress there has been gradual but remarkable - I have a few friends who are around 5 to 10 years older than me that are HIV positive, were diagnosed in their late teens/early twenties, and were basically handed a slow death sentence. They’re in more or less perfect health and completely undetectable.

2 Likes
4

Low e2 could also do this (since you’re low test + an AI). Lowering PRL too low with Caber can be as bad as high PRL (so I’ve read, no personal experience). I’d get e2 and PRL tested just to make sure they aren’t too low and rule those out as causes

5

I think I said I used arimidex and caber sparingly? Basically, I seem to respond really strongly or be really sensitive to any sort of estrogen inhibitor/aromatase inhibitor/etc. Arimidex doesn’t seem to be as bad, but I know from this cycle and previous PCT that Caber and Nolvadex / tamoxifen both do crazy things (good and bad? LOL) to my sex drive. It’s a toss up whether they’ll make me constantly horny, but unable to perform; horny and able to go for hours, but difficult or unable to get off, or, on a really good day, able to have get off repeatedly, back to back.

Anyway, the goal has been to take as little caber and arimidex as I feel comfortable taking. Even so, they may be (part of) the problem…

6

Really it’s not about the dose, it’s about where that puts your e2 and PRL. They’re both pretty strong drugs and a little goes a long way. That’s assuming you need them in the first place; labs would be your best guide

7

At the risk of sounding stupid (and I’ll also search the forums), what’s the easiest and most cost effective way to get these tests? Are people just going to the doctor and requesting them? Is there a home option?

Just trying to keep costs under control and maintain some degree of privacy. I also think I need to find a different doctor - I already hate talking about my sex life with my doctor. She’s great, but talking to 60+ year old woman about the sex shenanigans my partner and I get up to is already extremely awkward. Add steroids to that conversation and the poor woman’s head may explode… but I digress

8

Plenty online resources. Discounted labs . Com is one

1 Like
9

I’m not going to judge you vis a vis your sexual orientation, but I am with regard to your priorities. You’re concerned about how PReP might impact your AAS use??!! Shouldn’t it be the other way around? Have you discussed the potential impact of AAS on Truvada efficacy with your doctor?

1 Like
11

That’s a completely fair assessment. Fwiw, I’ve read what I can find about the matter and it doesn’t seem to be an issue (someone else just posted a related study. Though it doesn’t address the issue directly/perfectly).

I have not talked to my doctor about the matter because I actually get truvada/prep medication online. It’s an online consultation/prescription type service that sends the medication and blood test kits quarterly. I mentioned in a previous response that my primary care doctor is a 60+ year old woman. She’s very knowledgeable, very friendly, but I just don’t feel like I can talk to her about any of this stuff. I realize that may sound ridiculous to you - but finding a healthcare provider that I feel like I can be open and honest about steroid use with AND That’s LGBTQ friendly is a lot harder than you’d think.

Also - nevermind the potential for any doctor to just not have any answers/knowledge about the subject, regardless of their personal opinions…

2 Likes
13

Okay, this is encouraging in terms of knowing that the medication will remain effective. In some countries, people take these medications purely on an as needed basis - partially because of cost, I imagine, but maybe because of long term health concerns as well. I think the protocol is to take a higher dose the day of a potential HIV exposure, or ideally the day before, and then a slightly lower dose for so many days after. In the US, it’s only approved for daily use as this is seen as safer. If I’m reading the study correctly, this should be a non issue for me, as it sounds like they are recommending a daily dose for trans folks on hormones…

…this is assuming that the study results are directly applicable to folks on AAS as well, which may not be the best assumption, but it’s a lot better than nothing

2 Likes