muscle repair and DHT
- 12-14-2011, 01:58 PM
muscle repair and DHT
I suffer from muscle injuries that do not seem that serious but do not heal even after a very long time despite relatively high testosterone and IGF-1 levels. MGF helps me but does not cure the problem.
Recently after trying arimidex and aromasin it seems that I ruled out my high estrogen levels as the culprit in my muscle repair problems leaving my low DHT as a possible suspect. My DHT levels are low because I am taking Avodart which lowers them by ~ 95%. The problem with me testing whether or not my low DHT levels are to blame is that it takes so long to go on or off Avodart. So it has occurred to me that another way to test this is to just try some DHT short term and see if that helps. I know this is not equivalent to going off Avodart but it should answer the question about DHT.
My questions for this forum are:
1) What do you think of this experiment?
2) What is the best form of DHT to use and how should it be dosed?
3) What are the risks?
4) Any other ideas?
For the back story to this thread please go to my previous threads:
Muscle injuries despite high T and IGF-1
Free estrogen testing
- 12-14-2011, 02:30 PM
why are you on Avodart? There is a great write up in the latest issue of Mens Health (Ashton Kutcher on the cover) explaining the issues men are having due to anti-DHT meds. I would talk to your doctor about coming off. There are other prostate remedys you can take. Maybe try and low dose stinging nettle. Anti-DHT meds can cause fatigue and muscle pain
- 12-14-2011, 03:16 PM
12-14-2011, 05:49 PM
Do you have BPH? I wouldn't take it unless you have BPH. There are better OTC supplements to take instead of Avodart to prevent BPH and prostate cancer. The FDA gave a warning about 6 months ago warning that anti-DHT meds may increase the rate prostate cancer accelerates and spreads. Research it!
12-15-2011, 01:42 AM
OK, can anyone out there answer my questions?
12-15-2011, 04:37 AM
12-15-2011, 12:08 PM
12-15-2011, 02:17 PM
I'm sharing an interesting abstract (pasted below) on a possible role for DHT in tendon healing that may be relevant to this thread.
Effect of dihydrotestosterone on cultured human tenocytes from intact supraspinatus tendon.
Denaro V, Ruzzini L, Longo UG, Franceschi F, De Paola B, Cittadini A, Maffulli N, Sgambato A.
Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Via A. Del Portillo, 200, Rome, Italy.
The role of hormones in the pathogenesis of tendinopathy is not well recognised, even though the use of anabolic steroids is correlated with a higher incidence of spontaneous tendon ruptures. The aim of this study was to investigate the effects of dihydrotestosterone (DHT) on human tenocyte cultures from the intact supraspinatus tendon of male subjects. Cultured human tenocytes were seeded into culture plates at a density of 5 x 10(4) cells per well and incubated for 24 h. Then, 10(-9) M-10(-7) M DHT or Dulbecco's modified Eagle's medium (DMEM) only (control) was added to the culture plate wells. Cell morphology assessment and cell proliferation tests were performed 48, 72 and 96 h after DHT treatment. DHT-treated tenocytes showed an increased proliferation rate at DHT concentration higher than 10(-8) M. Differences in cell numbers between control and DHT-treated cells were statistically significant (P < 0.05) after 48 and 72 h of treatment with DHT concentrations of 10(-8) and 10(-7) M. The tenocytes treated with DHT (10(-8) and 10(-7) M) became more flattened and polygonal compared to control cells that maintained their fibroblast-like appearance during the experiment at each observation time. In conclusion, in vitro, progressive increasing concentration of DHT at doses greater than 10(-8) M had direct effects on male human tenocytes, increasing cell number after 48 and 72 h of treatment, and leading to a dedifferentiated phenotype after 48 h of treatment. This effect can be important during tendon-healing and repair, when active proliferation is required. Our results represent preliminary evidence for a possible correlation between testosterone abuse and shoulder tendinopathy.
12-15-2011, 02:26 PM
Here is another interesting and recent abstract. Based on this study taking exogenous DHT should not affect my prostate.
Dihydrotestosterone administration does not increase intraprostatic androgen concentrations or alter prostate androgen action in healthy men: a randomized-controlled trial.
Page ST, Lin DW, Mostaghel EA, Marck BT, Wright JL, Wu J, Amory JK, Nelson PS, Matsumoto AM.
Division of Metabolism, Endocrinology, and Nutrition, University of Washington School of Medicine, Box 357138, 1959 NE Pacific Street, Seattle, Washington 98195, USA. email@example.com
Concern exists that androgen treatment might adversely impact prostate health in older men. Dihydrotestosterone (DHT), derived from local conversion of testosterone to DHT by 5α-reductase enzymes, is the principal androgen within the prostate. Exogenous androgens raise serum DHT concentrations, but their effects on the prostate are not clear.
To determine the impact of large increases in serum DHT concentrations on intraprostatic androgen concentrations and androgen action within the prostate.
Double-blind, randomized, placebo-controlled.
Single academic medical center.
31 healthy men ages 35-55.
Daily transdermal DHT or placebo gel.
MAIN OUTCOME MEASURES:
Serum and prostate tissue androgen concentrations and prostate epithelial cell gene expression after 4 wk of treatment.
Twenty-seven men completed all study procedures. Serum DHT levels increased nearly sevenfold, while testosterone levels decreased in men treated with daily transdermal DHT gel but were unchanged in the placebo-treated group (P < 0.01 between groups). In contrast, intraprostatic DHT and testosterone concentrations on d 28 were not different between groups (DHT: placebo = 2.8 ± 0.2 vs. DHT gel = 3.1 ± 0.5 ng/g; T: placebo = 0.6 ± 0.2 vs. DHT gel = 0.4 ± 0.1, mean ± se). Similarly, prostate volume, prostate-specific antigen, epithelial cell proliferation, and androgen-regulated gene expression were not different between groups.
Robust supraphysiologic increases in serum DHT, associated with decreased serum T, do not significantly alter intraprostatic levels of DHT, testosterone, or prostate epithelial cell androgen-regulated gene expression in healthy men. Changes in circulating androgen concentrations are not necessarily mimicked within the prostate microenvironment, a finding with implications for understanding the impact of androgen therapies in men.
12-15-2011, 03:02 PM
Let's assume that the Avodart is depressing DHT and hampering muscle repair - as you hypothesize.
Would that fact make you quit taking Avodart? It seems to me that you very much like Avodart for certain reasons.
There are always trade-offs when taking drugs. You feel better "here" ... but you live with a negative "there".
In some instances, additional drugs can mitigate those trade offs - but I don't think personal experimentation or bro-science is a good way to find them.
Might want to see a doctor.
12-16-2011, 02:19 AM
As for seeing a doctor, well, that is where the prescription for Avodart came from. A doctor, however, is not going to be able to answer my questions - I've already talked to several about these problems. Bro-science as you call it, however limited, is the only resource unless there has been some study and I'm quite sure there isn't. These forums are all about personal experimentation. Anyone that has done anything with anabolics is further out than I am in terms of experimentation. I'm only here trying to treat pre-existing disease.
12-16-2011, 02:55 AM
Below is the abstract for another clinical trial with DHT. Seems fairly safe but too bad it lowers T. This study suggests it does not lower SHBG but elsewhere I read it does. It also contradicts something I read that it doesn't change LH or FSH. As this is a primary source I'll believe this paper unless someone can show me another.
A double-blind, placebo-controlled, randomized clinical trial of transdermal dihydrotestosterone gel on muscular strength, mobility, and quality of life in older men with partial androgen deficiency.
Ly LP, Jimenez M, Zhuang TN, Celermajer DS, Conway AJ, Handelsman DJ.
J Clin Endocrinol Metab. 2001 Sep;86(9):4078-88.
Department of Andrology, Concord Hospital, Concord, New South Wales 2139, Australia.
The efficacy and safety of androgen supplementation in older men remains controversial. Despite biochemical evidence of partial androgen deficiency in older men, controlled studies using T demonstrate equivocal benefits. Furthermore, the importance of aromatization and 5α reduction in androgen actions among older men remains unclear. Dihydrotestosterone is the highest potency natural androgen with the additional features that it is neither aromatizable nor susceptible to potency amplification by 5α reduction. Therefore, the effects of dihydrotestosterone may differ from those of T in older men. This study evaluated the efficacy and safety of 3 months treatment with transdermal dihydrotestosterone gel on muscle strength, mobility, and quality of life in ambulant, community-dwelling men aged 60 yr or older. Eligible men (plasma T ≤15 nmol/liter) were randomized to undergo daily dermal application of 70 mg dihydrotestosterone gel (n = 18) or vehicle (n = 19) and were studied before, monthly during, and 1 month after treatment. Among 33 (17 dihydrotestosterone, 16 placebo) men completing the study with a high degree of compliance, dihydrotestosterone had significant effects on circulating hormones (increased dihydrotestosterone; decreased total and free testosterone, LH, and FSH; unchanged SHBG and estradiol), lipid profiles (decreased total and low-density lipoprotein cholesterols; unchanged high-density lipoprotein cholesterol and triglycerides), hematopoiesis (increased hemoglobin, hematocrit, and red cell counts), and body composition (decreased skinfold thickness and fat mass; unchanged lean mass and waist to hip ratio). Muscle strength measured by isokinetic peak torque was increased in flexion of the dominant knee but not in knee extension or shoulder contraction, nor was there any significant change in gait, balance, or mobility tests, in cognitive function, or in quality of life scales. Dihydrotestosterone treatment had no adverse effects on prostate (unchanged prostate volumes and prostate-specific antigen) and cardiovascular (no adverse change in vascular reactivity or lipids) safety markers. We conclude that 3 months treatment with transdermal dihydrotestosterone gel demonstrates expected androgenic effects, short-term safety, and limited improvement in lower limb muscle strength but no change in physical functioning or cognitive function.
12-16-2011, 04:35 AM
again how about using a anti-DHT drug that is OTC. OTC products would not be as strong therefore you would have more DHT in your body. Just a thought
12-16-2011, 02:23 PM
But this is missing the point, I am trying to find out IF low DHT is the problem. It would take around 6 to 8 months to find out by going off Avodart all the while suffering from increased symptoms. No thanks. I did actually go off the drug for one month before and started to have symptoms and did not notice any benefit for my muscles. After one month my serum levels of Avodart would be at about 50% of full dose. This made me think that it is less likely that Avodart is the problem but I would like to test this more.
04-22-2012, 02:48 PM
I went ahead and did some experimentation. Currently, I have 3 separate long term muscle/tendon injuries affecting my lower legs (>4 years), the back of my left knee (> 1year) and my shoulders (>6 months). I got some DHT cream and started to apply it to my lower legs. The recommended dosage gives 7x normal levels of DHT so I cut the dose to about 1/7th to give normal DHT levels.
After about 1 week of treatment I noticed that my legs felt more "springy" when I went running. I did not, however, notice any strength changes during my calisthenics. After 2 weeks it seemed that the gradual improvement in my shoulders continued, my lower legs may have a minor benefit from the improved springiness and the back of my knee did not seem to budge at all. Overall the results were disappointing but it did seem to do something and perhaps with longer term use larger benefits would be had. The problem is that my thermoregulation problems came back. This is really annoying especially during sex because I can overheat and it sometimes kills the mojo. Controlling thermoregulation is one of the big benefits I got from dutasteride. I also started to grow more hair on my chest. So at this point I stopped the DHT and things went back to the way they were.
A few weeks later I had increased my shoulder exercises to the point where there was some signs of strain and had to level off. Then I did some archery shooting about 60 arrows. This proved too much for my shoulders and they got really bad again. Even though I stopped my exercises the pain (unresponsive to ibuprofen) kept increasing for over a week. Finally, I decided to do a one time application of DHT to my shoulders. This cut the pain levels dramatically in a very short time (within 1 hour) and the benefit persists even now after a week.
My conclusion is that loss of DHT is the most likely culprit in my muscle/tendon problems but that once they are injured it is not easily reversed. Dutasteride may also affect muscles in other ways than just its impact on DHT. I still don't have a good solution as the trade offs are pretty bad. If I could get my gut/immune system issues under control perhaps I would no longer have the thermoregulation problem and could resume the DHT. It would be nice to get off dutasteride instead but I think it is my best weapon against BPH. In the mean time, I will probably see if I can use DHT occasionally to try to control muscle issues without going too far and getting the thermoregulation sides.
04-22-2012, 07:38 PM
2) Reducing DHT is taking away the benefits form test. You're nullifying it.
3) DHT can cause an enlarged prostrate, but my discussions with the doctor last week convinced me that E2 caused my enlarged prostrate, not DHT.
4) There is no logical reason to control DHT.
04-22-2012, 09:03 PM
1) Large scale studies have shown that dutasteride decreases the incidence of prostate cancer although there is a debate about whether is slightly increases the rate of high grade cancers. My position on this debate is detailed earlier in this thread. These studies do not specifically address whether DHT causes cancer or not.
2) I don't know what you are talking about here. Testosterone is the primary actor in muscle. DHT is rapidly degraded in muscle. The research I found shows that DHT may have a role in tendon repair and that is what I suspect is the case for me.
3) There is also a debate about DHT versus E2 in BPH. The weight of the evidence favors DHT. Quote from Wikipedia:
"While there is some evidence that estrogen may play a role in the etiology of BPH, this effect appears to be mediated mainly through local conversion of estrogen to androgens in the prostate tissue rather than a direct effect of estrogen itself. In canine in vivo studies castration, which significantly reduced androgen levels but left estrogen levels unchanged, caused significant atrophy of the prostate.Studies looking for a correlation between prostatic hyperplasia and serum estrogen levels in humans have generally shown none." Prostatic DHT appears to be necessary. My prostate did improve with dutasteride. Have you fixed yours by controlling E2?
4) It is absolutely clear that people differ in regards to their response to DHT. Obviously you did not pay attention to the fact that I get major benefits from controlling DHT. Not everyone is the same although the BPH benefits should apply to most.
If you had read my earlier posts you would see that I reported a slightly elevated E2. I did try to control this with arimidex and aromasin. These drugs had very bad side effects for me including a major loss in strength/endurance and the benefits were unstable and not durable. Others have also reported lots of trouble controlling E2. Have you tried this?
04-23-2012, 12:32 AM
04-23-2012, 05:57 AM
How did you conclude that you gained major benefits form controlling DHT? What did your blood tests show before and after, or is all of this just a "feeling?" And when you attempted to control E2, what were your levels before AI and after? It makes no sense at all that you suffered a loss of strength due to reducing E2 levels. I suspect it was also just a feeling? If you're reducing DHT levels you will lose strength, which is an obvious side effect of reduced DHT, but not E2. What are you using to measure the health of your prostrate? Hopefully not PSA.
This is what Dr. Houser said about my question regarding DHT as the prime antagonist regarding prostrate health:
Well, a key we are missing here is delineating ERalpha and ERbeta.
Androgens and estrogens exert similar, yet different, effects in the prostate, and it is becoming clear that a finely tuned balance between the effects mediated by AR, ER-A, and ER-B is required for the maintenance of prostate health.
When talking about estrogens in particular, the action is complex having both adverse and beneficial roles via ER-A and ER-B respectively (I believe we have talked about this somewhere on this forum in the past). The adverse effects, specifically aberrant proliferation, inflammation, and malignancy all require the presence and activity of ER-A and establishes a rationale for the use of ER-A-specific antagonists in the chemoprevention of prostate pathology. ER-B, however, appears to mediate beneficial effects through preventing hyperplasia and potentially preventing inflammation and carcinogenesis, thus establishing the rationale for using ER-B agonists for the treatment of benign prostatic hyperplasia and, potentially, PCa.
In other words, if you are trying to mediate BPH or PCa, your best bet would be to completely eliminate E2 all in all, merely because we don't have great ER-A and ER-B specific agents at this time. That said; my prostate protection option is very simple:
1) AI (although 2nd and 3rd generation have produced mixed results)
2) Nettle (bathe in it; sounds unfortunate, but the reality is that it blocks the inherent binding of IGF-1 and E2 in prostatic and hair follicular membranes preventing very cumbersome sides).
3) Phytosterols - prevent inflammation to the prostate better than any pharmaceutical agent I could offer you.
4) Pumpkin Seed Oil...again, this is one to keep an eye on; if you're lucky - you can get one that tastes pretty good; use it 2-3 times per day.
04-23-2012, 07:39 AM
I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
04-23-2012, 08:12 AM
04-23-2012, 11:06 AM
04-23-2012, 07:27 PM
04-23-2012, 10:52 PM
According to many posts on this board and including from the Matrix, controlling E2 is not easy. Controlling DHT, however, is very easy if you want to lower it. For me, AI sides are much worse than Avodart sides too.
04-24-2012, 12:59 AM
04-24-2012, 05:54 AM
04-24-2012, 12:25 PM
04-27-2012, 01:17 PM
I fully agree with this. E2 is the primary culprit for prostate issues. Current studies support this.
DHT is THE main male hormone. It is the most powerful hormone in a male's body. Why would you want to lower it?
It is only harmful if estrogen is very high. If estrogen is in check, high-normal levels of DHT = great.
Avodart is very dangerous. Why in the world would anyone want to lower their primary hormone, responsible for all things male. May as well castrate yourself and remove your prostate.
04-28-2012, 10:48 PM
Obviously you are another poster that does not actually read my posts or has the simple minded notion that everyone is exactly the same. Lowering DHT actually improved my sex life. I know this is a less common response to Avodart but I've seen others report similar stories.
04-28-2012, 11:00 PM
1) My story might help someone with similar issues.
2) I have not resolved my issues fully and I thought someone might know something useful and post a reply.
04-28-2012, 11:08 PM
04-28-2012, 11:09 PM
I don't see the point of trying to self-diagnose yourself instead of going to a doctor. A qualified medical professional is going to be able to help you a lot more than a bodybuilding message board on the internet. Your personal doctor also knows your medical history. Self diagnosis over the internet is a recipe for disaster.
04-28-2012, 11:22 PM
04-28-2012, 11:29 PM
If you don't like your doctor than search for a new one. It seems as though you already self diagnosed yourself though, saying that low DHT is your problem. Just go to the doctor and tell him what is going on and he should be able to give you an answer. If you don't like the answer he gives you than I don't know what to tell you. You shouldn't be going into the doctor and telling them what is wrong with you. Would you go to the mechanic and tell him how to do his job also?. Just go in and describe your symptoms. Sure someone else might have injuries that may not heal very fast also, but that isn't really going to help you any. You are your own person with your own medical and psychiatric history. We don't know that history and are not doctors.
04-29-2012, 02:43 AM
I did not conclude that low DHT is my entire problem or even the main one. I have done a series of experiments. Initially I suspected high SHBG and high estrogen. Taking an AI was not helpful and had bad side effects. Taking DHT was somewhat helpful but not enough to be sure that is my main issue. Avodart itself could have additional specific sides in me or my immune system issues may be partly responsible. My gut problems which are tied to my immune system issues are also a candidate. The problem with the later 2 issues is that so far I have not solved those problems either. Most of the time my focus has been on these problems but since progress has not been made I have also started to address the newer problems directly that may or may not be related.
There are lots of people that have medical problems beyond the reach of medicine. These can be with or without a diagnosis. Many of those people post on these boards. Haven't you noticed how many people post here that have seen doctors for their problems and got no help? That's why they come here. Of course, they usually don't seem to be getting help here either. It seems that you have been so fortunate as to not had a problem beyond what your doctor knows. If you ever do then you will better understand what I am talking about.
04-29-2012, 04:41 AM
I saw Matrix 3 weeks ago and I am already improving. I saw docs on and off for 10 years and all gave different approaches to my prostate issues. My prostate issues are largely do to my GI issues!
04-29-2012, 10:31 AM
Problem with controlling e2 in some people is the issue of the Cyp 450 and how the drug may be metabolized. In proper modulation of estrogen in general you need to look at the process from start to finish. As noted before elevated SHBG is a response to something else inflammatory going on in the body. (liver, GI, prostate, or some kinds of meds). With out knowing the whole story behind the case it makes it virtually impossible to get the information needed. I had suspicion of what fanzdslpwr1 issue was but it did not dawn on me until I saw the testing results which prompted me to ask a few more detailed solution. His case is similar to mine is that WTF can a person have good e2 levels, good DHT levels end up with BPH? It most likely from the translocation of the bacteria from the GI tract into the prostate. Until you have all the data one can not make any educate recomendations. As I find out many times on forums, what appears as one thing on here is totally different when the person is sitting right there in front of you. I understand there are complex cases which go out side the realm of traditional medicine. These cases take more time and further investigation into other areas such as epigenetics, neurotransmitters, environmental, ect..
04-29-2012, 10:38 AM
05-05-2012, 02:23 PM
Seriously Bro you need to take a look in the mirror and stop focusing on your muscles - your post here describes yourself.
05-05-2012, 05:46 PM
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