Let me start with a common misconception:  going on “the juice” will get you jacked.  “The Juice” is a frequently mis-used term, including the aggressive chemistry experiment conducted by professional bodybuilders and Testosterone Replacement Therapy, replacing the testosterone your body once produced naturally.  Not only are the protocols different, but so are the body composition and health implications.  If you want to shed fat and gain muscle, having your hormones optimized is an important, but non-crucial tactic.  But as a mono-treatment (magic bullet), it’s not very effective.  Or at least that’s what we see at Stark.  The most powerful tools to achieve your health and fitness goals remain the complex, drawn-out solutions:  exercise, nutrition and lifestyle.  And in my opinion, Testosterone Replacement is too big of a commitment for the hope of an aesthetic change, alone.  Here are a couple of before and after pics.  The before pics were taken fifteen months ago; the after pics, a week before posting this article.

Todd Vande Hei before Testosterone Replacement Therapy

BEFORE

Todd Vande Hei After 15 months of Testosterone Replacement Therapy

AFTER

Before TRT

BEFORE

After TRT

AFTER

Here are my reasons for starting TRT at the end of 2017:  I was tired all the time, I was sore all the time, joint pain was increasing as was my ability to focus.  The same story was told in my labs:  total Testosterone of 280 and Free Testosterone as low as 3.  But the most important consideration was surrounding new research showing that Low Testosterone in men leads to long-term problems with cognition and cardiovascular health risks.  The natural solutions applied over the preceding twelve months included meditation, eating nearly perfectly, a training program not too taxing, lots of mobility work, and getting eight hours of sleep every night.  And, yes, even with “Low T” I was able to look like those before pictures.  

After having experienced the contrast between “Low T” and optimal levels, I regret not having agreed to the therapy sooner.  However, I hated the thought of starting a life-long therapy with needles, so I fought and struggled through the symptoms.  At fifty, with the advice of my doctor, it seemed like the timing was right.  

On a related note, it’s common where I live for Primary Care Physicians to scare their patients away from this kind of therapy; it’s just as common to under-treat out of fear of hurting the patient.  Here’s the latest, and for me, the most relevant, research on the topic:  https://meetinglibrary.asco.org/record/157216/abstract

https://www.sciencedirect.com/science/article/abs/pii/S0960076006002743?via%3Dihub and http://ascopubs.org/doi/abs/10.1200/JCO.2017.35.6_suppl.33

The following is from a journal I kept on my replacement experience and what it’s like to go from total Testosterone levels of 280 to 1,100 and Free Testosterone levels of 3 to 25. . . . 

45 days

  • Fasting glucose down from 93 to 75
  • Free Testosterone up from 3 to 10.9
  • Glutes are 3/4″ larger
  • Waist is 1/2″ smaller
  • Quads are 3/4″ larger
  • 5 pounds heavier
  • My appetite is much stronger
  • My desire to work and work out has seemingly increased
  • My erections are more frequent and harder
  • My libido has increased slightly

90 days

  • My mind feels sharper:  focus, memory, creativity
  • I’m no longer perpetually sore
  • My weight loads are increased for the first time in many years
  • Much of my joint pain is either gone or diminished
  • I’m retaining water and have gained 15 pounds!
  • My testes are 1/2 the size
  • I’m having a minor reaction/irritation from Cypionate (the form of Testosterone prescribed for me)
  • We experimented with Propionate but it left large welts at the injection site
  • We slowly increased the dosage from .45 ml per week to .9 ml, sub-cutaneously (into the fat, just beneath the skin)
  • I’ve noticed a slight decrease in the fat on my lower abdomen
  • The increased dosage lead to “off-the-charts” T levels, so we backed it down to .33 ml, two times per week
  • I couldn’t feel the difference in the dosage
  • The rest of my labs were stable
  • I experienced something called “T Flu,” lasting a week, which felt like–you guessed it–the flu
  • At this stage, I’m infertile which, in other circumstances (not mine) would be the world’s greatest form of birth control.  Strangely, doctors prescribe women hormones to be taken daily to prevent the same, but never men.  Hmmm

180 Days

  • I’ve lost all of the 15 pounds I gained and now weigh the same as before starting therapy
  • My body fat percentage has dropped to 10% from 14% (in the before pics)
  • As per my DEXA scan results, my bone density has improved by 15%
  • Because of how lean I am, I’m very vascular

360 Days

  • Minimal change in body composition:  with my focus on quality nutrition and intelligent training, I can be ready for a photo shoot in ten days
  • Strangely, the only area of my body which continues to change are my glutes:  they are still getting leaner and stronger
  • No change in recovery
  • No change in labs, brain function, and energy

We are presently adding HCG to my therapy, in addition to .33 ml sub-cutaneous injections of Testosterone Cypionate and Anastrozole to prevent converting testosterone to estrogen (that conversion, apparently, can be quite dangerous and should be monitored).  The purpose is to come off of TRT (testosterone replacement therapy) for a month.  HCG re-establishes the connection between my brain and my testes, telling my testes to start producing its own testosterone, again.  The other result is that they grew back!  Because our brain has lots of testosterone receptors (which is why it works so much better when I have proper hormone levels), my doctor thinks is a good idea to stop therapy once every 18 months for a month to give those receptors a break.

During that month, I expect to go back to my previous physiological self.  I’m not looking forward to it!  One minor detail:  do not take this article as medical advice.