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Testosterone -- my perspective
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Let me state that I don't take anything illegal in my sports pursuits. Also, let me state that I try to take every legal advantage that I can. I think most people on this site fall into my same category.

That being said I am troubled by this huge, new "low T" marketing campaign. For me, it brings up some issues that need to be resolved.

First, I thought that it was understood that drugs were illegal, not because they helped us, but because they were dangerous. I don't understand making something illegal just because it makes you better. Sorry, I want protection from danger, not great performances. If doctors -- in great numbers -- are prescribing this drug, then it seems the onus is on the governing bodies to defend themselves here. I guess I've got nothing more really. The docs and the drug rules have got to fight this out. Personally, I don't think more "T" will help me much because I don't think mine is low. I also would never do it because it's cheating and I have seen how passionate folks here are about cheating in triathlon. However, in the battle for hearts and minds, the "if it works just don't use it" folks are losing me here.
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Re: Testosterone -- my perspective [SH] [ In reply to ]
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I don't know, ever since I started training to be a MOP age grouper, I haven't gotten morning wood. I think I might qualify for T therapy.

OR

We can go with...it's against the rules of the sport I want to play, therefore I will not use. Screw the morning wood, it wasn't good for anything anyways.
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Re: Testosterone -- my perspective [SH] [ In reply to ]
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SH wrote:
Let me state that I don't take anything illegal in my sports pursuits. Also, let me state that I try to take every legal advantage that I can. I think most people on this site fall into my same category.

That being said I am troubled by this huge, new "low T" marketing campaign. For me, it brings up some issues that need to be resolved.

First, I thought that it was understood that drugs were illegal, not because they helped us, but because they were dangerous. I don't understand making something illegal just because it makes you better. Sorry, I want protection from danger, not great performances. If doctors -- in great numbers -- are prescribing this drug, then it seems the onus is on the governing bodies to defend themselves here. I guess I've got nothing more really. The docs and the drug rules have got to fight this out. Personally, I don't think more "T" will help me much because I don't think mine is low. I also would never do it because it's cheating and I have seen how passionate folks here are about cheating in triathlon. However, in the battle for hearts and minds, the "if it works just don't use it" folks are losing me here.

Doctors are prescribing the drug because it is a lucrative practice. People are clinging to low T because they are afraid of aging. I won't go into how they could prevent this by eating better and being in better shape to hang on to the muscle, but it's all built on people wanting to never get old.

John



Top notch coaching: Francois and Accelerate3 | Follow on Twitter: LifetimeAthlete |
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Re: Testosterone -- my perspective [Devlin] [ In reply to ]
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Devlin wrote:
Doctors are prescribing the drug because it is a lucrative practice. People are clinging to low T because they are afraid of aging. I won't go into how they could prevent this by eating better and being in better shape to hang on to the muscle, but it's all built on people wanting to never get old.


How is this related to whether the drug should be legal or not? I don't see you saying that the doctors are endangering these people.
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Re: Testosterone -- my perspective [SH] [ In reply to ]
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SH wrote:
If doctors -- in great numbers -- are prescribing this drug, then it seems the onus is on the governing bodies to defend themselves here.

Totally ignoring the performance argument, the fact that doctors are prescribing a drug in great numbers is no assurance at all that the drug is safe or the regimen is not harmful.

One only needs to look at history for confirmation of that.

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Re: Testosterone -- my perspective [SH] [ In reply to ]
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I feel like we are slowly being brainwashed by advertising. All day on sports radio, magazines, its a constant message to get yourself checked out and that its the fountain of youth. Stupid me did get checked out few months back for the hell of it. Yeah it was on low side, who's isnt after 40, but no way was i going to get a shot FOR REST OF MY LIFE, let alone the whole cheating factor if you dont get a TUE which most likeky would not past mustard. Can we a new Masters division for those on T?

Sidebar, i noticed you can get Clenbuterol and steroids Andriol and Deca-something OTC at the airport in Cozumel?

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Re: Testosterone -- my perspective [Devlin] [ In reply to ]
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Do you think hormone replacement therapy for women is bogus? After all menopause is a natural occurrence of aging.
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Re: Testosterone -- my perspective [SH] [ In reply to ]
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Your assumption that taking Testosterone isn't dangerous is wrong. It has significant impacts to your body, a lot of them, good, but it also shuts off whatever natural production of T you already had. You're stuck supplementing the rest of your life.

I had mine tested, and it was very low for a 30yr old. Right at 300. Doctor would have given me T, but there was no way I'm going down that road. I plan on living a lot longer and I'm going to do it naturally...



-Andrew
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Re: Testosterone -- my perspective [DarkSpeedWorks] [ In reply to ]
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DarkSpeedWorks wrote:
Totally ignoring the performance argument, the fact that doctors are prescribing a drug in great numbers is no assurance at all that the drug is safe or the regimen is not harmful.

One only needs to look at history for confirmation of that.


Hmmm, maybe I didn't make my case as well as I could have....what about FDA approval then? This stuff was double blind tested and approved by the FDA. There is no higher standard for safety to my knowledge. I would think that would qualify, at least, as "some assurance".
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Re: Testosterone -- my perspective [AMT04] [ In reply to ]
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I'm not saying that you have to like it and use it. I'm not saying it's for everyone. I'm just saying that what you wrote isn't, in my opinion, a good reason to make it illegal. You seemed to be saying "I evaluated the pros and cons and decided against it, personally. Therefore, it should be illegal for everyone."
Last edited by: SH: Nov 27, 12 13:48
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Re: Testosterone -- my perspective [SH] [ In reply to ]
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I think one thing to keep in mind when evaluating if "doctors are endangering ... people," is that no medical intervention is without risk. The key is that a treatment is useful (and indicated) when the benefits outweigh the risks. Extreme example: a diabetic patient with an infection of the bones in the foot is often unable to clear the infection with antibiotics. As long as the infected area persists they are at risk of the infection spreading which could potentially lead to death. Therefore a surgeon can perform an amputation to treat the infection. The risks of an amputation are obviously high, but the potential benefit: preventing sepsis and death, means that in this case it is an indicated and useful intervention. I think the ethically confusing issue related to testosterone is that the benefits of supplementation are often not to treat or prevent disease, but rather to augment performance or quality of life beyond that which is considered normal for a given patient.
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Re: Testosterone -- my perspective [NormM] [ In reply to ]
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Testosterone deficiency syndrome is now becoming a newly accepted medical issue. It's very controversial and I treat men everyday with this issue. I won't get into details about the diagnostic process but there is legitimacy in using testosterone replacement in the appropriate individual.

Prescribing testosterone replacement is not lucrative for physicians. It is for pharma, but not for physicians, not in Canada anyway.

HRT in women is also a very well researched and common practice for the appropriate individual with functionally impairing symptoms in the post-menopausal part of life. It's not fighting against nature, it's more about offering a safe treatment option to someone that is suffering from hot flashes, for example.
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Re: Testosterone -- my perspective [Jpro19] [ In reply to ]
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I agree with Dumples. Any medication or therapy that is offered, benefits should clearly outweigh risks.
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Re: Testosterone -- my perspective [Jpro19] [ In reply to ]
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Jpro19 wrote:
I agree with Dumples. Any medication or therapy that is offered, benefits should clearly outweigh risks.


Well, I can agree with both of you, too. However, the issue is, after your doctor decides that the benefits clearly outweigh the risks, should USAT decide that you cannot compete in a triathlon ever again?
Last edited by: SH: Nov 27, 12 14:00
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Re: Testosterone -- my perspective [SH] [ In reply to ]
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SH wrote:
...drugs were illegal, not because they helped us, but because they were dangerous. ...

I don't believe that to be the case. It's an ethical standpoint.
Athlete A takes performance enhancing drug X.
Athlete B must then do the same to compete.
As must athlete C.
After a while the field is level and the only benefactors of the drug are the doctors and the drug companies.

Introduce Drug Y.
Athlete A takes it.
Athlete B...
...

Introduce Drug Z
...

It is not a desired sporting framework.

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Re: Testosterone -- my perspective [Jpro19] [ In reply to ]
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Post: Do you think hormone replacement therapy for women is bogus? After all menopause is a natural occurrence of aging.


Post: Testosterone deficiency syndrome is now becoming a newly accepted medical issue. It's very controversial and I treat men everyday with this issue. I won't get into details about the diagnostic process but there is legitimacy in using testosterone replacement in the appropriate individual.

Prescribing testosterone replacement is not lucrative for physicians. It is for pharma, but not for physicians, not in Canada anyway.

HRT in women is also a very well researched and common practice for the appropriate individual with functionally impairing symptoms in the post-menopausal part of life. It's not fighting against nature, it's more about offering a safe treatment option to someone that is suffering from hot flashes, for example.


Thanks, that was my point. I was posing the question to Devilin because it seems no one questions hormone replacement for women which is also a quality of life issue and poses some risks along with the benefits just like male hormone replacement.
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Re: Testosterone -- my perspective [SH] [ In reply to ]
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SH wrote:
If doctors -- in great numbers -- are prescribing this drug, then it seems the onus is on the governing bodies to defend themselves here.

Huh?

In the same way that just about any potential PED has legitimate therapeutic uses, so does testosterone. Hypogonadism is a real problem, and I assure you that someone with true symptoms of hypogonadism who's getting exogenous T isn't going to suddenly show up at a tri and stomp his AG.

The wave of "ask your doctor about condition X" commercials only means that there's a new/better drug available for condition X. Nothing more. Sometimes that means that there's better awareness, conditions get diagnosed more readily, etc., and sometimes it means that doctors will be over-treating.

Not everyone who uses a drug that's on the banned list is cheating. That's what TUEs are designed to cover. I don't think the dialysis patients getting weekly EPO shots are going to hurt your chances at Whateverman this year.
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Re: Testosterone -- my perspective [NormM] [ In reply to ]
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NormM wrote:
Do you think hormone replacement therapy for women is bogus? After all menopause is a natural occurrence of aging.


Yes, it is. And there was a clinical study recently showing that for one type of HRT in women, risks hugely outweighed the benefits. HRT dropped significantly.

Am I against HRT in men or women? No, if it is medically necessary. By that I mean abnormally low, posing a health risk. The ads for "Low T" therapy are aimed at people who have 350 on a scale of 300-600 as normal, and think that more T is going to be a life fixer.

And honestly, many of the benefits that the low T ads promise (More energy! Better sex! etc) are also side effects of ...what was that...oh yeah, healthy eating and exercise.

John



Top notch coaching: Francois and Accelerate3 | Follow on Twitter: LifetimeAthlete |
Last edited by: Devlin: Nov 27, 12 14:56
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Re: Testosterone -- my perspective [DrPete] [ In reply to ]
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DrPete wrote:
SH wrote:
If doctors -- in great numbers -- are prescribing this drug, then it seems the onus is on the governing bodies to defend themselves here.


Huh?

In the same way that just about any potential PED has legitimate therapeutic uses, so does testosterone. Hypogonadism is a real problem, and I assure you that someone with true symptoms of hypogonadism who's getting exogenous T isn't going to suddenly show up at a tri and stomp his AG.

The wave of "ask your doctor about condition X" commercials only means that there's a new/better drug available for condition X. Nothing more. Sometimes that means that there's better awareness, conditions get diagnosed more readily, etc., and sometimes it means that doctors will be over-treating.

Not everyone who uses a drug that's on the banned list is cheating. That's what TUEs are designed to cover. I don't think the dialysis patients getting weekly EPO shots are going to hurt your chances at Whateverman this year.

Well said, the question should be whether WADA should change the TUE rules for testosterone, not whether testosterone should be allowed at all. Bottom line though, you'd still need a TUE.
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Re: Testosterone -- my perspective [NormM] [ In reply to ]
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You also forgot, there is NO performance enhancement gained from taking estrogen. If so, after 15 years on it, if there is some sort of performance enhancement, I sure as shit have not gotten it. I just don't get hot flashes, insomnia, migranes, bloating, bitchiness / general psycho crazy time (oops, okay maybe not) anymore.

FWIW, I would be ON estrogen even if I were not a triathlete, as I started early menopause (at age 30) before I really got into endurance sports.

Susan
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Re: Testosterone -- my perspective [SH] [ In reply to ]
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Testosterone is legal for use in sports if your levels are low enough that your health is in jeopardy (and there aren't any viable alternative treatments that aren't prohibited) and thus it is a medically necessary and unavoidable treatment. Testosterone is not legal for use in sports if you are a "low normal."

Summary: if your life is in danger and T is your only option you should theoretically be allowed to get a TUE and continue competing. If your T is low enough that your quality of life isn't as good as it could be, but your life isn't in danger, you have options:
1. Continue competing without T.
2. Take T and continue competing (i.e doping).
3. Quit the sport, take T, cease T therapy, rejoin the sport.
4. Quit the sport forever.

In my mind, only two of those are conscionable. Remember, your life isn't in danger, your quality of life is simply suboptimal. Choosing option 2 in this case is pretty clearly unethical because if violates the rules of the sport, and puts your interests above the interests of others in spite of ample dissuasion and naysaying. Option 3 is more of a gray area--the therapeutic use exemption is in place to allow athletes to use drugs in specific circumstances until their values reach the low-normal. The WADA literature specifically prohibits an athlete who is deficient from using a TUE to achieve high-normal levels. There is no excuse in my mind for taking option #2. #3 is a gray area that will probably never be policed.

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Re: Testosterone -- my perspective [SH] [ In reply to ]
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SH wrote:
I'm not saying that you have to like it and use it. I'm not saying it's for everyone. I'm just saying that what you wrote isn't, in my opinion, a good reason to make it illegal. You seemed to be saying "I evaluated the pros and cons and decided against it, personally. Therefore, it should be illegal for everyone."

It's not illegal. My point is that it's a drug with negative side effects and it's been determined that it's safe only with a doctors supervision. Just like EPO and many other pharmaceuticals.



-Andrew
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Re: Testosterone -- my perspective [SH] [ In reply to ]
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SH wrote:

Hmmm, maybe I didn't make my case as well as I could have....what about FDA approval then? This stuff was double blind tested and approved by the FDA. There is no higher standard for safety to my knowledge. I would think that would qualify, at least, as "some assurance".


FDA approved means nothing on its own. Clinical trials are designed with respect to a target population. In the case of doctors supplementing middle-aged guys with low-T, in the range encountered typically in triathletes, you're not talking about the target population...The large majority of the folks exercising a lot will have total T and free T well outside the inclusion criteria for the clinical trials. Therefore, the argument that it's FDA approved can't be made.
Last edited by: Francois: Nov 27, 12 15:50
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Re: Testosterone -- my perspective [SH] [ In reply to ]
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SH wrote:
I don't see you saying that the doctors are endangering these people.
http://www.navarra.es/...297/Bit_v20n4_e1.pdf
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Re: Testosterone -- my perspective [SH] [ In reply to ]
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SH wrote:
First, I thought that it was understood that drugs were illegal, not because they helped us, but because they were dangerous.
PEDs don't have to be dangerous to be illegal for use in sports. The rules are also there to create a level playing field. There are many PEDs which could be taken safely but that doesn't make them legal.
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