Testosterone- Still Taboo?

Scott Braver
8 min readAug 7, 2021
Photo by Raghavendra V. Konkathi on Unsplash

Are hormones becoming more mainstream or is there a hush-hush mentality towards them and we aren’t ready to have an adult discussion yet?

For the longest time, hormone replacement therapy has been under scrutiny by many health care providers as the basis for causing many disease processes.

Fortunately, there is much science to support those claims are nothing more than bathroom stall gossip.

We have to leave the notion behind that everything we do to our bodies is segmented. The body is a complex symphony that constantly talks to many different processes at once and works harmoniously to give us the result.

Let’s dive into the hubbub about hormones and how we can have an open-minded discussion about potential effects.

Which Way To The Beach Bro?

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For the sake of time, I will primarily focus on testosterone as the topic of discussion. That should not discredit the numerous other counterregulatory hormones out there that are just as impactful. Testosterone is honestly, more sexy and well known in the eyes of the public.

First and foremost, let’s understand that testosterone is one of the most heavily studied medications that has been around for roughly 60–70 years. It most certainly is not the new kid on the block like SERM’s and SARM’s are and it has YEARS of peer-reviewed literature to support its claims.

Secondly, we are not talking about bodybuilders/pro competitors that ABUSE this medication. This is primarily where the negative connotations come from and where the media has a feeding frenzy with side effects, “roid rage”, emotional instability, irrational aggression, and premature death.

Lastly, for the love of all that’s holy, please don’t inject something into your body that some “bro” told you was “cool” in the back of a gym somewhere. People are so cognizant of what they do nowadays and with information overload, they can ‘research’ anything they want in the blink of an eye.

So why in God’s name would you trust some sleazy dude in the back of a gym bathroom to sell you HGH (human growth hormone) or testosterone because he has “a guy?” I mean the amount of hypocrisy and idiocracy associated with that notion is mind-boggling, but it still happens.

Particularly when individuals spend 20 minutes on “Dr. Google” to go into their doctor's office and tell them how to practice medicine or what they found after doing their “research” compared to years of medical practice and formal education….just saying.

Do your research because you are your own best advocate, but then speak to a professional in the arena that knows more than you. Double-check what you have learned lines up with what they are telling you. It is okay to shop your providers because it comes down to what you feel comfortable with without putting yourself in harm’s way!

Abuse Versus Replacement

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More isn't always better.

At this point, I think everyone is aware of the physical changes testosterone can provide with the anabolic effects of building more muscle.

That is the most superficial and elementary perception of testosterone and what it can do systemically to the body.

More and more research is showing the benefits of replacement therapy for mental health disorders, cardiovascular protection, and metabolic health when those numbers don’t naturally decline with age.

Let’s first understand and differentiate ‘replacement therapy versus abuse.’ Replacement therapy is just that- you simply replace what is not there. The typical dosage per week could range between 100 mg to 200 mg. Contrary to abuse, that could range from 350mg every 3–5 days to 1500mg every 3–5 days for 12–16 week cycles.

There is a LARGE discrepancy with dosages for replacement and abuse and the media tends to put its focus on the abuse because that is what sells and gets the most attention.

Unfortunately, mainstream medicine has a preconceived notion that we need to segment disease processes to treat them effectively. When we try to do that we prescribe one medication that may or may not fix the issue and causes other side effects. That leads to ANOTHER medication to treat those symptoms and before we know it, we are on 5 different medications and we don’t know how that happened!

Especially, since in the states, we like to break down issues into specialties. Specialists don't talk to one another like everyone thinks they do. That’s what a good general practitioner is for, act as a gatekeeper, but those are becoming rarer and rarer due to the cost-benefit spectrum. So individuals are left to fend for themselves in a broken and antiquated system that is fundamentally faulted.

That is why so many things slip through the cracks and people aren’t given the best guidance with their healthcare. It really has come down to who screams the loudest that gets the most attention instead of evidence-based practices that actually work.

Certainly, there is a time and place for anecdotal remarks, but by and large, we need large population sizes to be able to reproduce the desired effects.

Testosterone gives us that and then some!

Benefits Of Testosterone

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Going back to looking past the surface with information. Many people associate testosterone usage with prostate cancer, high blood pressure, heart failure, and man boobs.

First off, testosterone does not cause any of those. There is so much more behind the scenes that contribute to the negative effects of testosterone.

Let’s break these down one by one.

There is NO direct causation of testosterone to prostate cancer. Many studies have disproved this myth. It all stems back to a causation study in the ’70s that created the biggest lie in hormone replacement with no credible backing.

We now know that estrone and DHT (dihydrotestosterone) are the culprits of prostate cancer. Think about it, if high levels of testosterone were to directly cause cancer, wouldn’t every 18-year-old boy have prostate cancer? That’s the age when testosterone is at its highest, so how come we don’t have any 18-year-old boys with prostate cancer?

Because it simply doesn’t work like that!

Be aware though, if you ALREADY have prostate cancer cells and take testosterone, it could be like adding fuel to the fire due to the conversion factor of testosterone to DHT.

Do you see how convoluted this could be and how it’s not just a clear cut, testosterone causes _________?

High blood pressure and testosterone replacement do not go hand in hand. It’s like saying cars cause people who drive drunk to get into accidents.

Multiple external factors play a role in blood pressure regulation. Certainly, if you are deficient in testosterone, you can have high blood pressure as a compensatory mechanism.

Food, external factors like environment, stressors, sleep, caffeine, and hydration status can affect our pressure regulation.

Hands down, testosterone has three factors that can impact blood pressure for the worse. Something called erythropoiesis, sleep apnea, and volume.

Erythropoiesis is a mechanism where our bone marrow produces more red blood cells. As a result, our blood gets more viscous and makes the heart work harder to pump the blood through our vasculature.

Sleep apnea is where we have periods where we don't breathe when we sleep. As a result, our bone marrow compensates by producing more red blood cells that are rich with oxygen since we are depriving ourselves of that when we don’t breathe. This can once again, increase blood pressure.

Volume is an interesting phenomenon. If you build rapid amounts of muscle in a short time, your heart has to compensate to pump all the blood into the newfound muscles. As a result, your pressure will increase because of the sheer workload your heart has to do. Think pregnant women who have increased blood volume to compensate for the developing fetus.

Instead of a short term (9 months time frame), bodybuilders continue to gain more mass and it causes the heart to work harder unless they are properly conditioned to handle the workload.

Often, we don’t see that in replacement therapy because there isn’t a rapid onset of muscle growth with that approach. If you are abusing the medication and gain 30 pounds within 2 months, you will have a blood pressure issue.

Man boobs, or “moobs” for short, are not directly related to testosterone replacement. Contrary to what the masses think, it’s from a rapid conversion of testosterone to estrogen, particularly estrone.

Again, with replacement therapy, you DO NOT get “moobs’’ because the dosages are sensible and there isn’t as much conversion. Think about it, the higher the dose the more conversion there will be.

Less dose equals less conversion. So when you see bodybuilders with “puffy” looking nipples or have scars on their nipple line, it’s because they ABUSE the medication.

We can see that testosterone, in itself, is not a harmful agent. It’s what testosterone converts to down the line of metabolic pathways. Those two primary pathways relate to DHT and estrogen.

Don’t misunderstand. We can’t just have high testosterone and low estrogen. Our body is a symphony and works in checks and balances. We need ratios and equalization.

Estrogen is important for guys, just as it is for women. We all need estrogen for cardiovascular benefits, sexual health, bone health, and joint health.

It is simply not as easy as taking a shot of testosterone, which will fix all your problems. You need to work with a well-educated health professional to monitor your blood and help guide you to optimize your levels and make you feel young again.

Take-Home Points

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I don’t encourage anyone to go and get their testosterone from a bro or from “a guy”. Please do it the right way so we can eliminate the stigma associated with this very powerful medication.

Stress, anxiety, poor diet, lack of sleep, lack of activity are all driving factors that lower our testosterone naturally.

If we want to maximize what we are doing before going down the medication route, get 8 hours of sleep a night. Eat a diet full of nutritionally dense foods with an emphasis on protein consumption. Get outside your house and do an activity that brings you joy. Learn how to properly manage your stress levels.

We can’t expect a magic pill to do the work for us. We need to put in the work to maximize what we are trying to do. 98% of people who follow those instructions see a DRAMATIC improvement in their symptoms alone!

Blaming our hormones is one thing, doing something about it is another. Put your health first, ask questions, be humble and take charge of your healthcare.

Understand that there is more than one way to skin a cat and be open to other's perspectives, but understand that you need to synthesize the information yourself and weigh the pros and cons of FACTS, not anecdotal evidence.

Be strong. Be brave.