Let us first distance ourselves from advertising illegal substances from the group of anabolic steroids. The point of our presentation will not be doping, defending it, but one we can say is a hit in the world of anti-aging medicine, the so-called TRT, testosterone replacement therapy.

When the word testosterone is mentioned, the first associations for all of us are increased muscle mass, strength, better recovery from training. Let’s not forget that testosterone also affects libido, “regular” erections, attention, memory, mood, insulin sensitivity, fat distribution, bone density. Of course, we must clearly distance ourselves from testosterone replacement therapy in cases of “castration” of various causes (testicular injuries, surgical removal of them due to malignancy …), disorders related to the pituitary gland and gonadotropin production (affecting testosterone production, so-called hypogonadism), etc.

Anyway, in the foreground is the group of middle-aged men with a significant decrease in natural testosterone production due to various causes and clearly manifested symptoms of “low testosterone syndrome” – poor diet, chronic stress, smoking, alcoholism, liver problems… with a more severe hormonal imbalance that consequently affects total and free testosterone (prolactin, estradiol…). Let us emphasize that cases that are the consequences of real pathology are “excluded”.

In some cases, changes in lifestyle habits with natural stimulation with ashwagandha, poppy, tribulus and ZMA can achieve excellent results in terms of optimizing testosterone levels, as well as reduced libido and erectile dysfunction.

We emphasize that the point of TRT is to maintain total testosterone within the reference values, but close to the “ideal” upper limit. We must make a clear demarcation between supraphysiological doses of testosterone that are administered during the “anabolic steroid course” and the optimization of normal values. The choice of “drug”, i.e. the form of application, is also important. In our market, we have testosterone enanthate, better known as testosterone depot, which is administered intramuscularly (for 2-6 weeks). There is also an oral, safe, but slightly “potent variant”, testosterone undecanoate capsules (taken daily). Namely, the formulation of the “drug” allows absorption through the intestinal lymphatic system, so there is no stress on the liver, as with the 17 alpha alkylated version of methyl-testosterone. We also have the same ester, only intended for intramuscular application.

There is a real craze in the world for forms with transdermal absorption, which is the least traumatic if we take into account the sometimes very unpleasant muscular injections or the obligation to take testosterone undecanoate capsules 2-4 times a day.

In addition to the total, a very important item is free testosterone, which directly acts on target tissues, and is closely related to the level of total testosterone, the activity of the aromatase enzyme, i.e. the level of estradiol, as well as the intake of estrogen-like substances through diet.

Let’s not forget that the enzyme 5-alpha reductase affects the conversion to DHT, which is responsible for prostate problems, increased hairiness, and male pattern baldness. Keeping estradiol and DHT low enough with the “upper limit” of total testosterone is the key to the success of TRT, as well as the safety of use.

Many point the finger at TRT because of the cardiovascular risks related to the HDL/LDL ratio, which is somewhat justified, but still normal testosterone levels will even prevent most cardiovascular risks. Recent research shows that low testosterone and IGF-1 levels are directly related to insulin resistance (type 2 diabetes) and cardiovascular disease…METABOLIC SYNDROME X!

Is it possible to create an ideal hormonal milieu that will give us all the benefits of testosterone supplementation even in later years, or is it just a matter of adequate dosage, or just a balanced diet and “must have” supplementation? Can supplements help here, or can drugs from the group of aromatase inhibitors and 5-alpha reductase blockers? And there is even a dilemma whether synthetic and “natural” testosterone are ideally equivalent? We all know the answer of AAS abusers…

Do the “white world” fans of this treatment have the right to say that TRT is the “fountain of youth”? All in all, without jumping into the unknown, as long as there is no reliable research on this topic, my personal recommendation would be natural testosterone boosters.