mcs5309
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There are those of us that cannot function without TRT and that have familial (genetic) and/or acquired thrombophilia (risk of clotting). I'm in this boat - had two idiopathic (unknown origin) thrombotic events but need to start TRT. I was not on TRT at the time. Currently not on any prescription thinners.
Anyone else have a history of thrombophilia (risk of clotting) or thrombosis (blood clots) and are on TRT, other AAS, hCG, and/or aromatase inhibitors?
Troubling new research on this very topic:
Can Testosterone Induce Blood Clots and Thrombosis? Interview with Dr Charles Glueck
Here are the recent media articles of concern:
Cincinnati doctor warns testosterone treatment can cause blood clots - Cincinnati Business Courier
Cincinnati doctor warns of 'testosterone mills' as FDA investigates health risks - Cincinnati Business Courier
There have been 10 cases with major gene thrombophilia FULLY ANTICOAGULATED (with warfarin) who had second or even third thrombotic events when exogenous T therapy was continued.
Dr. Glueck’s (the lead researcher) actual studies:
https://app.box.com/s/m050hbaxhj5bxrtp0yco
https://app.box.com/s/nsotn7zf975g6kj70gw3
https://app.box.com/s/hs5sei41i7o3obvjxkx1
https://app.box.com/s/v3qpftyfldfkha9egr83
"After starting testosterone patch or gel, 50 mg/day or intramuscular testosterone 400 mg IM/month, 2 men developed bilateral hip osteonecrosis 5 and 6months later, and 3 developed pulmonary embolism 3, 7, and 17 months later."
One key is to keep E2 well under 40, however all AIs themselves are known to induce thrombosis!
Other takeaways from Dr. Glueck:
1) ALL of the anti-estrogens are reported to be thrombogenic
2) Several studies (Svartbarg, Tromso) have shown that endogenous T throughout its distribution (particularly on the high end) is NOT associated with thrombotic events
3) As far as using alternatives like clomid or hCG, he stated that they are also thrombogenic.
4) T increases platelet aggregation and increases viscosity. As T is aromatized to E2 then the E2 increases resistance to activated protein C and increases clotting. In patients with hypogonadotrophic hypogonadism, plasminogen activator inhibitor is low, and is modestly increased by TT.
I sent Dr. Glueck a follow-up email suggestion that NOT being on TRT (of SOME kind) is not an option. Bottom line is that he simply doesn't think there is any safe protocol to implement along with TRT. I can’t be the only one faced with this dilemma. It's turning out to be a damned if I do, damned if I don't situation.
Anyone have suggestions, please provide!
Anyone else have a history of thrombophilia (risk of clotting) or thrombosis (blood clots) and are on TRT, other AAS, hCG, and/or aromatase inhibitors?
Troubling new research on this very topic:
Can Testosterone Induce Blood Clots and Thrombosis? Interview with Dr Charles Glueck
Here are the recent media articles of concern:
Cincinnati doctor warns testosterone treatment can cause blood clots - Cincinnati Business Courier
Cincinnati doctor warns of 'testosterone mills' as FDA investigates health risks - Cincinnati Business Courier
There have been 10 cases with major gene thrombophilia FULLY ANTICOAGULATED (with warfarin) who had second or even third thrombotic events when exogenous T therapy was continued.
Dr. Glueck’s (the lead researcher) actual studies:
https://app.box.com/s/m050hbaxhj5bxrtp0yco
https://app.box.com/s/nsotn7zf975g6kj70gw3
https://app.box.com/s/hs5sei41i7o3obvjxkx1
https://app.box.com/s/v3qpftyfldfkha9egr83
"After starting testosterone patch or gel, 50 mg/day or intramuscular testosterone 400 mg IM/month, 2 men developed bilateral hip osteonecrosis 5 and 6months later, and 3 developed pulmonary embolism 3, 7, and 17 months later."
One key is to keep E2 well under 40, however all AIs themselves are known to induce thrombosis!
Other takeaways from Dr. Glueck:
1) ALL of the anti-estrogens are reported to be thrombogenic
2) Several studies (Svartbarg, Tromso) have shown that endogenous T throughout its distribution (particularly on the high end) is NOT associated with thrombotic events
3) As far as using alternatives like clomid or hCG, he stated that they are also thrombogenic.
4) T increases platelet aggregation and increases viscosity. As T is aromatized to E2 then the E2 increases resistance to activated protein C and increases clotting. In patients with hypogonadotrophic hypogonadism, plasminogen activator inhibitor is low, and is modestly increased by TT.
I sent Dr. Glueck a follow-up email suggestion that NOT being on TRT (of SOME kind) is not an option. Bottom line is that he simply doesn't think there is any safe protocol to implement along with TRT. I can’t be the only one faced with this dilemma. It's turning out to be a damned if I do, damned if I don't situation.
Anyone have suggestions, please provide!
