MairUnderwood(Researcher)
Member
Testing the boundaries: Self-medicated testosterone replacement and why it is practised
PDF attached if you are interested in reading it
PDF attached if you are interested in reading it
MESO-Rx
Anabolic Steroids
My latest paper (on self-medicated TRT) has been published. Thanks to those of you who contributed
- Thread starter MairUnderwood(Researcher)
- Start date
MairUnderwood(Researcher)
Member
Abstract
Background
Testosterone is used therapeutically in medical settings. Non-prescribed testosterone use is typically illegal, described as ‘enhancement’ or ‘doping’, and considered a problem. However, research has found that some non-prescribed testosterone use may be therapeutic (i.e. self-medication). Little is known about testosterone self-medication. It has been noted among individuals who use image and performance enhancing drugs (IPEDs), but never systematically explored.Approach
This paper describes the findings of a 4-year ethnographic study in online forums and social media groups frequented by people who use IPEDs. It focusses on 31 men who used enhancement doses of testosterone, but who described some of their testosterone use as ‘testosterone replacement therapy’ (TRT). In particular, it focuses on the 26 (84%) of these individuals who self-medicated TRT. Data was analysed thematically (using NVivo) in order to answer the question: ‘how and why is testosterone self-medicated?’. Using Bacchi's (2016) problematization approach to policy analysis, this paper also asks, ‘what happens to the ‘problem’ of non-prescribed testosterone use if such use is therapeutic?’.Findings
Self-medicated TRT was found to be very similar to TRT as practised in medical contexts. Self-medication was often practised because of an inability to access testosterone through health practitioners (who were either reluctant or unable to prescribe). However, some individuals were found to prefer self-medication because of price, ease of access, reliability of supply, and because health practitioners were perceived as lacking expertise regarding testosterone use.Conclusion
By documenting the therapeutic use of testosterone outside of medical settings, this paper calls into question previous conceptualisations of all illicit testosterone use as ‘abuse’, and the utility of the repair/enhancement dichotomy as a foundation for discussions of drug use. It suggests that in some cases the problem may not be non-prescribed testosterone use per se, but policies that prevent access to medical treatment.Great article and excellent work! It is refreshing to see someone write a paper that captures the feelings of the community around testosterone.
Personally, I am of the mindset that a large cause of this issue has several factors to it. One, the overall decline in testosterone levels in the broader population of men over the last several decades. In my opinion, all the evidence points to the plethora of endocrine disrupting chemicals (EDCs) in the environment. The pesticides, herbicides, plastics, preservatives, etc., that are used around the world in massive (and increasing) quantities, as well as drugs/drug metabolites in our water, very commonly have some amount of suppressive effect on the endocrine system. This, in turn, causes low testosterone symptoms in men and I believe also damages the overall maximal ability of the testes to produce testosterone due to impaired development during puberty.
Another issue here is the horrible, almost offensively bad diet of modern people and children. People are eating worse than ever, even with the overall "health-conscious movement" and trends towards interest in health and wellness. We know that diet, lean/fat mass, sleep, and general health all have an impact on testosterone levels. So many people nowadays are fat, sleep-deprived, and might as well be eating literal garbage because their diet is so bad (a slight exaggeration, lol). We know these things suppress the endocrine system, too.
Lastly is stress, which is particularly evident this last year with record unemployment, social isolation, and increasing levels of alcohol and substance use/abuse. High stress and cortisol levels have a suppressive effect on the endocrine system as well. With the majority of people seemingly in debt, overworked, and lacking the ability (for a variety of reasons) to take time off to recharge, it's no wonder testosterone levels are dropping.
Combine all those things together and you have a recipe for widespread, population level declines in testosterone, leading to low T symptoms. Pair that with a healthcare system that prefers prescription drugs over Testosterone prescriptions, doctors that know little-to-nothing about the endocrine system and a stigma towards testosterone in general, and the fact that you're often hard-pressed to even get a blood hormone panel performed. People wind up self medicating. Personally, I think that a hormone panel should be a regular part of people's yearly checkups, even pre-teens and teenagers. For whatever reason, it is deemed completely unimportant and doctors have the attitude that it will just somehow be totally fine, even with record obesity levels and constant exposure to EDCs. We need to start treating low testosterone, and endocrine disruption in general both in males and females, as a serious problem.
It seems unlikely that widespread bans on EDCs will take place, given the influence that big business has over governmental policy. It would simply cost too much for them to not use chemicals, switch to organic practices, or put R&D time and dollars into finding new, non-EDC chemicals (if they even could). So we are left with this being a widespread, serious problem for the foreseeable future. Doctors need to be educated on this, our healthcare providers and insurance companies need to change their stance towards hormone replacement therapy, particularly in younger people. Obviously a LOT of people are totally fine and nobody should go on HRT unless they truly need it. But I have a feeling that a not-unsignificant portion of the teenagers getting diagnosed with depression, anxiety, and even bipolar/borderline personality disorder COULD be suffering from hormonal disruption, and maybe, just maybe, HRT could help them AND prevent them from having to be put on synthetic pharmaceutical drugs that have bad side effects and black box warnings.
Thank you for your work here!
Personally, I am of the mindset that a large cause of this issue has several factors to it. One, the overall decline in testosterone levels in the broader population of men over the last several decades. In my opinion, all the evidence points to the plethora of endocrine disrupting chemicals (EDCs) in the environment. The pesticides, herbicides, plastics, preservatives, etc., that are used around the world in massive (and increasing) quantities, as well as drugs/drug metabolites in our water, very commonly have some amount of suppressive effect on the endocrine system. This, in turn, causes low testosterone symptoms in men and I believe also damages the overall maximal ability of the testes to produce testosterone due to impaired development during puberty.
Another issue here is the horrible, almost offensively bad diet of modern people and children. People are eating worse than ever, even with the overall "health-conscious movement" and trends towards interest in health and wellness. We know that diet, lean/fat mass, sleep, and general health all have an impact on testosterone levels. So many people nowadays are fat, sleep-deprived, and might as well be eating literal garbage because their diet is so bad (a slight exaggeration, lol). We know these things suppress the endocrine system, too.
Lastly is stress, which is particularly evident this last year with record unemployment, social isolation, and increasing levels of alcohol and substance use/abuse. High stress and cortisol levels have a suppressive effect on the endocrine system as well. With the majority of people seemingly in debt, overworked, and lacking the ability (for a variety of reasons) to take time off to recharge, it's no wonder testosterone levels are dropping.
Combine all those things together and you have a recipe for widespread, population level declines in testosterone, leading to low T symptoms. Pair that with a healthcare system that prefers prescription drugs over Testosterone prescriptions, doctors that know little-to-nothing about the endocrine system and a stigma towards testosterone in general, and the fact that you're often hard-pressed to even get a blood hormone panel performed. People wind up self medicating. Personally, I think that a hormone panel should be a regular part of people's yearly checkups, even pre-teens and teenagers. For whatever reason, it is deemed completely unimportant and doctors have the attitude that it will just somehow be totally fine, even with record obesity levels and constant exposure to EDCs. We need to start treating low testosterone, and endocrine disruption in general both in males and females, as a serious problem.
It seems unlikely that widespread bans on EDCs will take place, given the influence that big business has over governmental policy. It would simply cost too much for them to not use chemicals, switch to organic practices, or put R&D time and dollars into finding new, non-EDC chemicals (if they even could). So we are left with this being a widespread, serious problem for the foreseeable future. Doctors need to be educated on this, our healthcare providers and insurance companies need to change their stance towards hormone replacement therapy, particularly in younger people. Obviously a LOT of people are totally fine and nobody should go on HRT unless they truly need it. But I have a feeling that a not-unsignificant portion of the teenagers getting diagnosed with depression, anxiety, and even bipolar/borderline personality disorder COULD be suffering from hormonal disruption, and maybe, just maybe, HRT could help them AND prevent them from having to be put on synthetic pharmaceutical drugs that have bad side effects and black box warnings.
Thank you for your work here!
Adarsh Balak
Banned
For some of us that have backgrounds in healthcare and in my case 2.5 decades working in clinical labs. I have no reason to go through a doctor for anything I need, either scheduled or non-scheduled.
I run and interpret my own labs. I have a large library of Clinical Chemistry and Molecular Diagnostic texts that are the gold standard of running clinical chemistry labs. I perform my own self phlebotomy every 6-8 weeks. I brew my own gear, send it off for testing when I get raws.
What pisses me off is that I could sit down with most doctors and explain what I do and they wouldn't have a clue and for that I'm a criminal by the letter of the law.
We live in the information age, lets not pretend we are stupid or that only certain privileged credentialed members of society can possess knowledge. We have to get away from this mindset and acknowledge that personal experience and wisdom that comes from that should count towards making our own choices in life.
I run and interpret my own labs. I have a large library of Clinical Chemistry and Molecular Diagnostic texts that are the gold standard of running clinical chemistry labs. I perform my own self phlebotomy every 6-8 weeks. I brew my own gear, send it off for testing when I get raws.
What pisses me off is that I could sit down with most doctors and explain what I do and they wouldn't have a clue and for that I'm a criminal by the letter of the law.
We live in the information age, lets not pretend we are stupid or that only certain privileged credentialed members of society can possess knowledge. We have to get away from this mindset and acknowledge that personal experience and wisdom that comes from that should count towards making our own choices in life.
Adarsh Balak
Banned
I read the entire paper, that was about as honest as I could have hoped for considering the subject without going into the problems with the drug war.
We need decriminalization at the very least.
There's no way we're gonna get domestic big pharma to produce our products here in the states because of liability, so at the very least by decriminalizing both possession and distribution of these compounds we can arrange for domestic testing to ensure our safety.
Combine this with access to lab testing without a doctors prescription and you have a system of harm reduction that works, instead of this bullshit of all of us sneaking around playing games to get the stuff we want.
Free Markets are really the way to solve this problem. The puritanical mindset of legislators against all drugs and the monopoly of health providers that claim you can do nothing without first going through them(putting a lot of cash in their pockets) has to come to an end eventually because it doesn't work.
We need decriminalization at the very least.
There's no way we're gonna get domestic big pharma to produce our products here in the states because of liability, so at the very least by decriminalizing both possession and distribution of these compounds we can arrange for domestic testing to ensure our safety.
Combine this with access to lab testing without a doctors prescription and you have a system of harm reduction that works, instead of this bullshit of all of us sneaking around playing games to get the stuff we want.
Free Markets are really the way to solve this problem. The puritanical mindset of legislators against all drugs and the monopoly of health providers that claim you can do nothing without first going through them(putting a lot of cash in their pockets) has to come to an end eventually because it doesn't work.
MairUnderwood(Researcher)
Member
Thanks for your kind words, and sorry for the delayed response. I have been avoiding my emails whilst on leave.
I agree that this needs to be treated as a serious problem. Would you believe that I had a government agency contact me asking me to fill in an 'adverse event' form after I published this? I asked why and they said that it was an adverse event because these men were using test without prescription. I replied saying I didn't see their testosterone use as an adverse event, rather the fact that doctors refused to treat them is the adverse event!
MairUnderwood(Researcher)
Member
Couldn't agree more. I am hoping that my research can convince people in positions of power that not all AAS users are meatheads (although I am sure some are). I have been very impressed by the level of knowledge in these communities - way more than what I have as a social scientist. I am currently writing a paper on insulin with a world leading endo and we are going to conclude that often bodybuilders are well informed and can sometimes know much more than the 'experts'
MairUnderwood(Researcher)
Member
yes, i have to tread carefully so as not to just put people off-side by being too 'controversial'. No point preaching to the converted, but rather I hope to get the rest of the scientific/clinical world thinking about these issues in new ways
Hey no worries at all. Everyone needs breaks!
That is absolutely insane, but I love your response! The way we do hormones in this country is just bananas. It should be a standard panel for people starting with developing teens and then all throughout adulthood. But pharma companies would rather prescribe people patented antidepressants and whatnot than hormones. Personally I noticed a MASSIVE difference when I got on TRT both in my general well being as well as that I no longer get seasonal affected disorder (SAD). I used to get it really bad, I would have suicide ideation during winter time, bad anxiety, etc. After getting on testosterone I didn't even noticed that it wasn't happening until my girlfriend commented in like February about how well I was doing mentally that winter. Then the next winter, same thing! I also had a chronic pain issue heal almost 100% (still flairs up here and there with intense activity for bad sleep deprivation, but that's it). I wasn't expecting it to heal, but something was obviously wrong due to my low T that was preventing my body from being able to heal properly. There is so much to these psychiatric and physical disorders that we don't understand yet. I just hope as HRT becomes more normalized for younger people that it will be more studied and hopefully more widely accepted by doctors...so thank you, Mair, for dedicating the hard work and time to further our collective knowledge about HRT!
R
readalot
Guest
Feedback on my ideas about steroid harm reduction
Bugchasing... Wtf... Good lord. Wish I never looked that up. Bahahaha!
thinksteroids.com
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