I disagree, lifelong HRT is just that… lifelong. Not everyone is willing to pin weekly for the remainder of their lives, it’s quite the ‘literal’ pain in the ass. For those who can recover adequately post cycle (which… many can), there is no incentive for said individuals to hop on TRT aside from perhaps enhanced retention of post cycle gains given there is window of excess hypogonadism associated with traditional PCT.
It does however appear that a fairly large portion of ex steroid users are hypogonadal
https://onlinelibrary.wiley.com/doi/abs/10.1111/add.12850
Within this data, 5 of 19 ex steroid users exhibit a TT below 200ng/dl, despite having abstained for 3-20+ months! Furthermore a fairly large portion (over 20%) report having experienced a major depressive episode during AAS withdrawal
Having bottomed out TT/FT also tends to manifest neurologically, making the user feel depressed, run down and irritable. This in itself is a prime example as to why a younger individual probably shouldn’t run gear. Being young tends to be associated with an emotionally volatile period of ones life, I can vouch for this, I’ve been having an incredibly difficult time recently. The induction of a borderline manic state followed by a depressive state can lead to a seriously deleterious outcome. A major depressive episode can be incredibly detrimental to ones wellbeing, ask anyone with bipolar disorder how they feel when they’re ‘low’, theoretically one could argue “if 20%+ experience this, then why not hop on TRT ato mitigate the crash”… I’d say “just stay away from drugs like tren”.
Duration of AAS use here within subjects here averaged around 3 years (three years ON that is)
One can see within the box plot, the first quartile (lowest 25% of men, YEARS after ceasing AAS use had a TT below 11.9nmol/l) had a TT, 27% of former AAS users had TT below the ref range (12.1 nmol). Is this to say one can’t have symptomatology relating to low T with levels above 12.1? Absolutely not, it’s individualistic, some feel shit at 15,16,17… it’s dependent on FT/AR sensitivity, as it was specified some users exhibited symptoms of low T despite having undergone T replacement, perhaps hinting at neurological dysregulation and/or AR down regulation. The hypothesis regarding altered neurology can be backed when looking at studies regarding structural/cognitive abnormalities stemming from prior AAS use. Certain cognitive, neurological alterations may be permanent from prolonged, heavy abuse… i’m probably going to create a thread discussing this often very overlooked issue (AAS mediated neurotoxicity)
Furthermore, decreased sperm counts, testicular volumes of prior users hint at long term, permanent endocrine damage (damage to the HPTA). With this said, what about the good 50-60% that aren’t clinically hypogonadal. The majority of men who use/have used probably don’t run cycles throughout their entire life. The truth is, the average steroid user is probably you’re average guy joining a gym, runs some winny/dbol for a few weeks and quits after it doesn’t work out
So perhaps those who wish to use for a long period of time ought to invest within TRT… even then, it doesn’t appear as if the majority of users are “hypogonadal”. With TRT, despite it being physiologic replacement, certain risks do exist. Even within the physiologic range, if T hurdles past a genetic set point erythrocytosis does occur… this may be 500ng/dl for one and 5000ng/dl for another. There are those who say extremely high hct/RBC count doesn’t elevate any known risk factor for clots… I beg to differ, whilst a HCT of 50-54% may not be significantly deleterious in nature, values around 55-60% most certainly are.
What about donating blood? The requirement for repeated blood donations risks crashing iron stores and ferratin, iron deficiency with or without associated anaemia can present with a myriad of very unpleasant symptoms… TRT has the potential to induce complications, as does blasting. Why add more potential complications when it isn’t required.
I’m of the opinion that unless you need TRT, don’t hop on, it’s illogical.
As to the risk portion, I believe many underestimate the level of risk involved. As more and more data piles up, these compounds (long term), may be far more insidious than we believe… prove to be silent killers. Bloodwork isn’t the be all end all of ensuring longevity on AAS. Absence of elevation in LFT’s, visible deleterious change in renal function measured via bloods etc doesn’t indicate that no cellular damage is occurring. Bloods won’t rule out cardiomyopathy (though BNP does elevate in response to the stretching of cardiac myocytes)… Nor will it rule out neurotoxicity etc.
There are obvious ways to mitigate risks
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eat healthily
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get plenty of aerobic exercise
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antioxidant supplementation
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bloods/ecg’s (if you can get them that is)
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limit the use of substances known to elicit a directly cardiotoxic effect.
You’re right, water, Advil in excess can kill you, acutely they’re more dangerous than anabolic steroids ever will be. But this is a mute point as anabolic steroid induced toxicity stems from chronic usage, it creeps up ever so slowly. Both substances share differing profiles regarding induction of toxicity, water being acute in nature whilst AAS mediated toxicity is chronic… fatty food would be a similar example, I can go out and binge eat as much KFC as I so please today without future consequence, do that daily for ten years and you’ll probably have clinically evident development of arterial plaque.