42 years old, first cycle (of anything)- not your average 1st cycle questions

[gangof4]

first post after lurking for the past 4 months; here and on other sites (i hate dumb, easily answered questions so i try real hard not to be the one asking them). sorry, this is long; but it contains Q's and goals that i haven't really had answered in the couple of 100 hours of reading i've done. i have a lot of respect for the intelligence and knowledge on this board- you guys have taught me a lot already.

background: i've been training for 17+ years, about the last 10 of them i've actually known what i'm doing (diet, more core exercises, recovery, etc). i'm 6' 3" 192, 11-12% body fat. never done PH's or AAS. i've always been the stereotyptical hard gainer- with the genetics of a 12 year old girl. when i was 20, i weighed 145- same height. i have been stalled for about 5 years. regardless of training, protein intake (i've even gone up over 380gm/day for 3 months- no change beyond an unhappy digestive tract) etc etc. in short: all the things you can think to ask, are in check. once i get over 190lbs and raise calories above maintenance, the result has been like 80% fat gain to 20% lean mass gain. after trying everything, contemplating using gear but deciding against it, i decided to stay around 190 lbs and, though not a great body, i was fairly content and accepted my genetic realities. now i'm backsliding though. the past 3 years or so i've had that aging thing make maintaining bf% and the 190 a bitch; and, as before, getting above that= fat (my genetics are now more like a middle aged woman who has spit out 3 kids!). i've always wanted the look that another 15 or so lbs of lean mass would give me- now is the time.

my goal: add 15 pounds of lean mass that i KEEP after PCT and can maintain; and, with the metabolic advantage of the the extra lean mass and some hard work, drop to/below 9% bf with a cutting cycle once things stabalize after bulking/PCT. in a perfect world, i would acheive this in one bulking cycle and never do another- is that realistic? i have no desire to get huge- too old to care about that. if i were 200-205 and 9% bf, i would be exactly at my ideal.

now, the question is how to achieve it. i have read a ton about the current gereration of PH's and, it seems, i might be able to achieve my goals that way and stay legal (a concern). the chemically altered nature of PH's worries me a bit though, and i'd hate to waste my fresh receptors on PH's and have PH's not get me to my goal. that said, sources for AAS are also a concern (both the legal issue and getting safe stuff). i have used an overseas indian pharmacy for regular scripts, and already ordered nolva from them for my pending cycle. they carry AAS; but i'm nervous about customs. i know a couple guys @ my gym who use gear; but they're clueless users who don't even understand PCT and have a pretty shady source (too shady to trust my health/body with).

i realize that the standard 1st cycle thought is test. i also know many here are anti orals due to toxicity and amount lost in first pass thru liver. still, i have read sooooo many people saying they did oral winny only for a first cycle and gained 15-20lbs of lean mass that they kept- with many not using an anti-e with their PCT because of the nature of winny. given that winny isn't very anabolic, seems that it gives credence to the other school of thought: a 1st cycle of just about any AAS will yield 15+ pounds of lean mass gains if done right with proper PCT. in fact, i don't recall anyone doing an oral 1st cycle with proper PCT who didn't have great gains (except someone who did dbol only and lost it all). in big cat's profiles, he even debunks the oral only naysayers and says that the detractors never base their opinions on 1st hand experience. most actual experiences i've read suggest that with fresh 'virgin' receptors you'll have great gains with any AAS. i'm not thrilled at the idea of pinning for a variety of reasons- especially if it's not really necessary. i also like the sides profile for winny over test. if an oral would get me to my 15lb goal, i am not too worried about the liver toxicity if it's only 1 cycle and i mitigate it with NAC, milk thistle, etc. also, with my travel schedule for work, pinning would be quite a challenge and nerve wrecking- not to mention the issues on the home front. all that said, i'll pin if needed- espcially since a long ester test only requires 1x week.

my main questions:

1. if i tried PH's first, would that make my virgin receptors less receptive to an AAS cycle later, than they would be now having never taken anything (iow, if i tried PH's 1st and didn't achieve my goal, i would then turn to AAS and i'd hate to have my fresh receptors diminished because i tried PH's first)?

2. given my fresh receptors and my modest goals, do you think there's a high likelihood that i can achieve my goals thru PH's witout needing to cross the line into illegal AAS?

3. for those who would lean towards AAS's: do you think, with my fresh receptors again and goals, that i *should* be able to gain/retain 15lbs of lean mass on an oral like winny vs test (for reasons mentioned above).

4. do you agree with this: any AAS (including orals) will yield impressive 15+ lean mass gains for 1st cycle with proper PCT. if no- on what do you base your opinion on (ie: is it based on first hand expereince)?

5. is it realistic to think that i can hold onto 15lbs of lean mass over the following year(s) with only 1 cycle (with good PCT) if i train/eat properly (i ask this in light of my hard gainer history)?

6. not many 1st cycle 42 year olds- anyone have a clue whether my experience with PH/AAS should be noticeably different than someone in their 20's?

7. any other suggestions given my age and goals (ie: i've read a lot of the gh and igf-1 threads; but don't want to get in over my head)?

thanks!

 

[bad rad]

I just read an extensive write up on AAS use for men in your age bracket. the cycle looked like this:
week 1&3 600mg test cyp
week 2&4 800mg deca
day 1-28 25mg anavar
It was based on issues of BPH and such. I think with a good diet you could gain 15 lbs. As always pct is a must and I would forget prohormones.

 

[gangof4]

I just read an extensive write up on AAS use for men in your age bracket. the cycle looked like this:
week 1&3 600mg test cyp
week 2&4 800mg deca
day 1-28 25mg anavar
It was based on issues of BPH and such. I think with a good diet you could gain 15 lbs. As always pct is a must and I would forget prohormones.

if you recall where you read it and have a link, i'd be interested in reading it. that's an odd (and short cycle). i assume 'BPH' refers to blood pressure- yes? that has been 1 of my concerns with doing a cycle since the risks associated with higher BP while on cycle would seem to be greater at my age. having seen some people in their 40's drop dead with no warning, i no longer feel indestructible like i did in my 20's- so i figure i'll stay away from a very long cycle. that said, i thought test cyp took 3-4 weeks just to really kick in; being a long ester. also, deca seems odd given its sides. you'd think they'd stack EQ instead. strange...

 

[jas123]

BPH = benign prostate hypertrophy

 

[bad rad]

It was an article by Author L. Rea called "Things that go bump in the night". Deca was chosen due to the low androgenic nature. The AAS used were supposed to peak and slowly reside in conjuction with natural hormone variations.

 

[Greenguy]

I'm 50 and just started prohormones at 48. The best prohormones for mass gains are 4ad and 1-test.

Pinning is best, then transdermal. M1T is very effective but has the most/worst sides of anything out there.

I would get some 4ad cyp and 1-test cyp and pin it. I gained 20lbs in one month doing this, and I am a hardgainer.

Real test and tren can be obtained thru cattle implant pellets. Find some HCG (Internet pharmacy), as it make recovery very smooth.

Greenguy

 

[gangof4]

It was an article by Author L. Rea called "Things that go bump in the night". Deca was chosen due to the low androgenic nature. The AAS used were supposed to peak and slowly reside in conjuction with natural hormone variations.

thanks. did a google and didn't get hits on 'bump in the night' but got plenty for author l. rea- i'll keep browsing thru to find it.


thanks for the definition jas123- guess i missed that one.

 

[gangof4]

I'm 50 and just started prohormones at 48. The best prohormones for mass gains are 4ad and 1-test.

Pinning is best, then transdermal. M1T is very effective but has the most/worst sides of anything out there.

I would get some 4ad cyp and 1-test cyp and pin it. I gained 20lbs in one month doing this, and I am a hardgainer.

Real test and tren can be obtained thru cattle implant pellets. Find some HCG (Internet pharmacy), as it make recovery very smooth.

Greenguy

geesh- good for you. 20lbs in a month! thanks for the input. i initially thought running a 1ad/4ad or 1-test/4ad cycle. then looked hard at M1T, maybe stacked with 4ad again. learned more about orals vs transdermal vs pinning and then thought- geesh, if i'm going to go thru all that and risk AAS type sides, maybe better to go with the real thing.

i still hope someone answers my question about whether i'll 'ruin' my one shot at having virgin receptors on PH's (obviously only a issue if PH's don't do the trick). also, just read a few more posts on mesomorphosis from guys gaining 20 lbs of lean mass on winny only cycles (both tabs and drinking the liquid)- and not just first cycles. i guess i'm kinda drawn to the winny because of the easier PCT, less bloat and the fact that most report keeping the gains.

i've been seeing HCG a lot in my recent reading along with IGF-1. did you use nolva and HCG?

 

[Greenguy]

i still hope someone answers my question about whether i'll 'ruin' my one shot at having virgin receptors on PH's.

i've been seeing HCG a lot in my recent reading along with IGF-1. did you use nolva and HCG?

I did several cycles of various transermal and oral prohormones before this, and gained and lost before this "20 pounds in one month" deal. So even though my receptors were no longer cherry, I got very good gains.

Sorry, I made a mistake. I just looked at my log and it took me 8 weeks to gain 20 pounds. I was cutting for the first ten days of this cycle, and went from 170 to 166 from May 1st to May 9th. (I was cutting for a doctors appt because I did not want to freak him out with weight gain (I am type 2 diabetic).

then I started bulking and reached 193 on 22 June, gaining one inch on my waist. That was my peak. I have been taking HCG through this cycle, which I am still on.

I dropped the 4ad cyp and switched to Test prop (first time) 600mg week, from Syno, and dropped the 1-test due to lethargy. I have not gained any more since that change, I think I am "maxed out" for this cycle. Now I am still on T prop with M4OHN (24mg/day) and cutting. I was 187 this morning.

Hopefully using the HCG (first time for me) will help me recover easily and keep these gains.

I also have a bottle of IGF-1 L3 which I will use during PCT.

 

[serengo]

I would recommend a basic B&B cycle:
30mg/day dbol
500mg/week Test Cyp
400mg/week Deca

It's also easy to pin,test dosed @250mg/ml and deca dosed @ 200mg/ml , twice a week mix 1cc test & 1cc deca and alternate glutes.

Have Nolva on hand just in case (better to have it and not need it, than need it and not have it)
PCT with HCG & Nolva

Even though the dbol is optional, it's nice to have some early strength gains since it takes a while for the test to truly kick in.
Deca did wonders for joints, and also helps a bit with tendon growth. Test only is an option, but you have to be careful since muscle growth will outpace tendon growth, you can be injury prone for up to 6 mos after a test only cycle.

 

[gangof4]

I would recommend a basic B&B cycle:
30mg/day dbol
500mg/week Test Cyp
400mg/week Deca

It's also easy to pin,test dosed @250mg/ml and deca dosed @ 200mg/ml , twice a week mix 1cc test & 1cc deca and alternate glutes.

Have Nolva on hand just in case (better to have it and not need it, than need it and not have it)
PCT with HCG & Nolva

Even though the dbol is optional, it's nice to have some early strength gains since it takes a while for the test to truly kick in.
Deca did wonders for joints, and also helps a bit with tendon growth. Test only is an option, but you have to be careful since muscle growth will outpace tendon growth, you can be injury prone for up to 6 mos after a test only cycle.

already got the nolva on the way- i've learned from the mistakes of others on that. few questions:

i'm assuming you'd just run the dbol the 1st 4 weeks- right?

all the stuff i've read about test cyp says 1x week injections- why 2x?

are you talking about an 8 week cycle?

this is a pretty major cycle- i'm assuming this would put on more than my 15lbs of lean mass target- yes?

in all my reading i don't recall that deca would help with joints. some times i think i've learned a lot (which i have); other times it seems the more i know, the less i know! i've read that deca can be pretty harsh on the sides. hmmm....

what is your opinion insofar as: if i did do a PH cycle 1st (had poor results for the sake of this example) and then did an AAS cycle- do you think i would lose a lot of the 1st cycle benefits because of the PH's?

thanks again bro.

 

[Matthew D]

2 times a week keeps the test levels more stable and you don't have a big up and down with the levels in your bloods stream.
Deca does help some with joint peoples, but it can mask symptoms. As for sides, it does have a pretty suppressive nature to it, you can use EQ in its place
As for cycle length I would suggest 10-12 depending on what compounds are used..

 

[Skye]

my main questions:

1. if i tried PH's first, would that make my virgin receptors less receptive to an AAS cycle later, than they would be now having never taken anything (iow, if i tried PH's 1st and didn't achieve my goal, i would then turn to AAS and i'd hate to have my fresh receptors diminished because i tried PH's first)?

I wouldn't worry about this Even most of the 1-test poducts are not really comparible to regular gear.

2. given my fresh receptors and my modest goals, do you think there's a high likelihood that i can achieve my goals thru PH's witout needing to cross the line into illegal AAS?

Yes, but PH tend to work best for very fine tuned wieght lifter or athalete. It has been my experance (not personal, just observing) that you only gain about half as much at best using twice as much PH as you would for a normal amout of gear. For you hear I don't think that much of anything is going to compair to real test.

3. for those who would lean towards AAS's: do you think, with my fresh receptors again and goals, that i *should* be able to gain/retain 15lbs of lean mass on an oral like winny vs test (for reasons mentioned above).

Not winny but yes, you could easily gain 15 to 20lb in about 6 weeks or so. Dbol would be your best bet here, search for my post on dbol only cycle and how to run them. Even so oral only is still the poor cousin compaired to injecting.

4. do you agree with this: any AAS (including orals) will yield impressive 15+ lean mass gains for 1st cycle with proper PCT. if no- on what do you base your opinion on (ie: is it based on first hand expereince)?

Depending on what you take and your diet+training yes. but this is too broad of a question.

5. is it realistic to think that i can hold onto 15lbs of lean mass over the following year(s) with only 1 cycle (with good PCT) if i train/eat properly (i ask this in light of my hard gainer history)?

Let us put this to rest here. I have yet to meet anyon that has done "only one cycle", esp the older guys that get back on test. To answer your question it is in thoery postible but if your not gaining now then your not going to maintain the new wieght with out some sort of change. You can do it but most people that reach " there genitic limet) have really reached there routines limets.

6. not many 1st cycle 42 year olds- anyone have a clue whether my experience with PH/AAS should be noticeably different than someone in their 20's?

I have heard, but cannot conferm that true PHs are less effective in older people due to reduced conversion of the PH. I recomend real test anyway

7. any other suggestions given my age and goals (ie: i've read a lot of the gh and igf-1 threads; but don't want to get in over my head)?

thanks!

IGF might be a nice leagal option for you, you should look into it. If you want to stay legal then do what Greenguy sugested and get some cattle pellets (check my sig). If you really can't inject then get some tgel (do a search) and run it transdermally.

For the (better) legally questionable options I am going to sugest that you use an EQ based cycle. For one EQ is mild and your goals are mosdest. Second EQ make you eat more, sounds like you could stand that too. Also you can get away with a once a week inject. (twice is better)
so for the first one EQ only

600mg of EQ weeks 1 to 14
PCT is nolvadex 40mg ed starting week 17 for 2 weeks then 20mg ed for another 2 weeks.

EQ and Long ester test cycle
500mg Test deca (Neo Test) weeks 1 to 14
400mg of EQ weeks 1 to 14
250iu of HCG twice a week weeks 6 to 16
PCT is nolvadex 40mg ed starting week 17 for 2 weeks then 20mg ed for another 2 weeks.

Test CYP or E cycle (my pick here)
500mg of test a week 1 to 12.
PCT is nolvadex 40mg ed starting week 14 for 2 weeks then 20mg ed for another 2 weeks.

The above with EQ
Test CYP or E cycle (my pick here)
500mg of test a week 1 to 15.
400mg of EQ weeks 1 to 14
PCT is nolvadex 40mg ed starting week 14 for 2 weeks then 20mg ed for another 2 weeks.

 

[crazydoc1]

Lab work

I would urge you to work with a physician particularly in your age bracket, though
this is not meant to excuse other age brackets from this same manner. There are
many groups out there that are amenable to larger dosings of HRT geared exogenous
Test and who will mandate regular lab updates and help you to avoid cardiovascular,
liver, and metabolic pitfalls to some extent.

I think it preposterous to begin any Test treatment above age 35- without an initial baseline
quantitative understanding of just how low your test has fallen, where you IGF-1 is for GH considerations,
eyeballing initially and continuously your hemoglobin and hemocrit, eyeballing AST, ALT, GGTP, and bili for
liver health, and ideally utilizing a VAP cholesterol panel to breakout your lipid subtypes and understand
where your risks are there.

Order a PSA, and ideally you'd have a digital rectal exam ahead of this to keep an eye out for prostate
health the risk parameters for which increase with Test increase even when only restoring to the 700-900
targets.

The softer version of HRT/Growth and one of hollywood's preferred places in Cenegenics.com.
You'll pay about 2,000 upfront for lab work and the initially day of medicine there and then 2,000 annually
for professional fees. Its nice to have an M.D. Ph.D. in anti-aging who can issue cat 1 CME credits in this area.
They offer price matching with external script options if you don't like their pricing. You'll not find heavy Test
dosings nor anabolics their though. You do have to go to Las Vegas though.

Others places such as Palm Beach Rejuvenation, AntiAgingGroup, etc, ... there are many others out there....
can help you on the anabolic front with physician issued prescriptions and none of the worrying about quality
or legal compliance. I need to travel with my pharmaceuticals and do regularly..... carry a physicians letter but
in my experience, I've never been asked for it... I tell security that I'm carrying insulin and mixing syringes and have
a physicians letter... in 50+ legs, no one has ever asked to see it .. even when I was randomly flagged for a search.

If your going to go ahead with these other types of sources.... then by all means.. order your own labs... and continue through with updates..... you have to be extremely careful of precipitous drops in HDL-2 and HDL-3 oftentimes with an
elevationof the LDL and LDL classes..... assumign your liver function is good, starting a statin along with this might be advisable. If your hypertensive, expect the additional blood volume from the water to make you more hypertensive.... not the worst time to get an echo ahead of this as a baseline so that if you wind up with issues later, you'll know if the hypertrophy originated with the program..

I don't want you to be scared away from this..... I think that HRT is a wonderful thing.. in males anyway... I just like to see people approach this the right way. Ideally under medical or quasi-medical supervision and certainly while eyeballing the lab work on a regular basis.

You can also order your own labs.... Lab-Safe.com --- Life Extension Foundation --- and many other places.... get used to paying for labs out of pocket... not via insurance ... you can get some reimbursement here and there but don't expect to get the uber lab runs covered..

Also-- a personal favorite of mine in Kronos Labs... 150 panel run which includes antioxidant profiling.. with a retail of $1,500... this you'll need to work with a physician who has an account with them on....

It would also be nice for you to know if your Test and IGF-1 have naturally gone sub-optimal (which they likely have) and
understand the role this plays in your pullback. Normalizing these alone may be a good bet since your not in a hurry and long term health is a big concern... subtle movments.... maintain 700-900 test... try to get IGF-1 350-400... keep the DHT in range... we want to keep our hair... keep the H&H in clinical range.... monitor the lipid profiles... watch PSA.. get the DRE .... and perhaps think of it more an optimization and anti-aging than the pure anabolic side..

Hope this helps..

 

[IdahoSpud]

Here's my personal (and very limited) experience. I'd say you roughly described me when you described yourself, except that I'm 20 lbs lighter and a couple years older. You never mentioned *this* in your post, but I would have a serious problem with injecting some unknown black market goo into myself.

That said, here's what didn't work for me: Andro, 19Nor (diol and dione). Here's what did: M1T. If you are going to try staying legal (an issue for me as well), try that. I picked up 10 lbs, although the M1T made me feel horribly hungover at first. It *is* harsh stuff, but it works.

If your goal is 15 lbs in a single cycle, you can *probably* get it with M1T if you stack with 4AD, eat smart and lift bigger as the M1T makes you stronger. If you didn't get there on a simple 2 week cycle, you could certainly do it by going 2on/2off/2on followed by PCT...

My 2 cents. Going the legal route also eliminates a lot of obvious pitfalls that you might find unattractive. Looking forward to seeing how you decide to go on this issue.
Best Wishes

 

[crazydoc1]

With Physicians

All U.S. FDA approved pharmaceuticals are an option (unless their schedule I -- hehehehe joking). I would not utilize the grade of materials or 'unknown' grades of contraband out there. Not worth the risks to health or freedom. I am a patient of Cenegenics in Las Vegas and also work with several other groups as well. Palm Beach Rejuvenation is another. I also hear positive things about AntiAgingGroup but did not proceed beyond initial discussions with the latter. In addition I discuss these things with my endocrinologist and cardiologist (more peripherally) - in the interest of safety. I will have an extra -echo here and there to monitor for L-R hypertrophy. I will pull off water water volume at a certain BP threshold and/or jump to an ACE inhibitor temporarily.. and things of the sort. I will migrate dosages of statins to improve or maintain the lipid profile intra-cycle. etc.etc.

One of the major themes that I do not understand is doing illegal things to avoid working with the medical community. I don't know how people sleep at night without spending a few thousand a year on the panels...... especially with the hepatotoxic stuff....... This is not the say that I expect most PCPs and many anti-aging groups to support anabolics in most cases, but the Testosterone esters and HGH and oestrogen maintenance and PCT-- absolutely.

I guess I can understand people who really want non-FDA labeled products---- so many products are excluded from the
traditional domestic prescribing market; but they should at least work with the medical channels for the domestic stuff. Also, compounding pharmacies can produce the dosages that you prefer for you and may these saves on pricing.

I simply choose to work with physicians with experience in these areas. This is not to imply that I am limited to prohormones. I get frequent labs and monitor the lipids, glucose, ketones, and creatine at home.

I am very new to all of this but knowing that there are groups specializing in this, I wish that more people desired to try to work it the legal and legitimate way. Many people have a healthy dose of medical background on these boards, but I notice cardiac issues avoided left and right and the future path of living with cardiomyopathy and LR hypertrophy.--- but that's not my point-- my point is that most users don't have the background at all and interpret the lay or quasi-lay opionions as factual.

Lots of folks with 'illicit' sources could potentially still order the labs, maintenance monitor, and inform their physicians of what they plan on doing, but I just doubt it and I think its sort of everyone's collective responsibility to try and push more responsible monitoring.............. the fuel that feeds the negative press and leads to restrictive legislation are storylines whihc are oftentimes byproducts of the issued I've been mentioning...

I'll start another non-rambling thread on my modified cycle in a moment..

Here's my personal (and very limited) experience. I'd say you roughly described me when you described yourself, except that I'm 20 lbs lighter and a couple years older. You never mentioned *this* in your post, but I would have a serious problem with injecting some unknown black market goo into myself.

That said, here's what didn't work for me: Andro, 19Nor (diol and dione). Here's what did: M1T. If you are going to try staying legal (an issue for me as well), try that. I picked up 10 lbs, although the M1T made me feel horribly hungover at first. It *is* harsh stuff, but it works.

If your goal is 15 lbs in a single cycle, you can *probably* get it with M1T if you stack with 4AD, eat smart and lift bigger as the M1T makes you stronger. If you didn't get there on a simple 2 week cycle, you could certainly do it by going 2on/2off/2on followed by PCT...

My 2 cents. Going the legal route also eliminates a lot of obvious pitfalls that you might find unattractive. Looking forward to seeing how you decide to go on this issue.
Best Wishes

 

[crazydoc1]

Be Nice to Thy Prostate

The original poster should make certain that his PCP

or prescibing doc give him a Digital Rectal Exa and check for prostate

enlargement plus verify the PSA in range------- please ..

Also-- It would give me some warm and fuzzies in your shoes to sort
of get a cardiac clearance/checkup from a cardiologist-- start a statin
ahead of the heavier test ...

Also--- its nice to order a CRP and Homocysteine.... keep the ticker happy..
other labs aside..

 

[lifted]

First off, that cycle from L. Rea is probably the dumbest thing I've read in a while. This guys seems to be going down hill with his articles and advice lately.

Next, I agree with the points that Crazydoc made. The very first thing you should do is go see your doc and get some tests run. You could very well be having poor results due to low test levels. Not only that, but you're older, treat yourself that way and get to know what your body is up to these days.

From there, if still wanting to go with AAS....I would advise a short cycle of prop, say 6-8 weeks MAX. Take 20mg Tamoxifen EOD at least to keep cholesterol levels in check. Remember, older guys have to watch their lipid's, etc a hell of alot more than younger guys.

If still wanting to cycle after the first, use the prop again with some EQ or Deca if it doesn't shut you down too hard. Other thna that, I might get flamed here, but after 40, I don' think it's a wise choice to still be using AAS unless it's used in a HRT plan with regular tests w/ your doc....JMO...

 

[IUStudent]

Aromatase inhibition might be enough

Gangof4, I realize that you are not in the elderly category, but what might have caused you to stall with your training goals could be age-related lowering of testosterone. I recommend talking to your doctor and having a complete physical and appropriate blood tests done; below is the abstract for a journal article that suggests a fairly simple therapy.



The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 3 1174-1180
Copyright © 2004 by The Endocrine Society

Effects of Aromatase Inhibition in Elderly Men with Low or Borderline-Low Serum Testosterone Levels

Benjamin Z. Leder, Jacqueline L. Rohrer, Stephen D. Rubin, Jose Gallo and Christopher Longcope



Endocrine Unit (B.Z.L., J.L.R.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Departments of Medicine and Obstetrics and Gynecology (C.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655; and AstraZeneca Pharmaceuticals (S.D.R., J.G.), Wilmington, Delaware 19850

[size=-1]Address all correspondence and requests for reprints to: Benjamin Z. Leder, Endocrine Unit, Massachusetts General Hospital, Bulfinch 327, Fruit Street, Boston, Massachusetts 02114.[/size]

As men age, serum testosterone levels decrease, a factor that may contribute to some aspects of age-related physiological deterioration. Although androgen replacement has been shown to have beneficial effects in frankly hypogonadal men, its use in elderly men with borderline hypogonadism is controversial. Furthermore, current testosterone replacement methods have important limitations.

We investigated the ability of the orally administered aromatase inhibitor, anastrozole, to increase endogenous testosterone production in 37 elderly men (aged 62–74 yr) with screening serum testosterone levels less than 350 ng/dl. Subjects were randomized in a double-blind fashion to the following 12-wk oral regimens: group 1: anastrozole 1 mg daily (n = 12); group 2: anastrozole 1 mg twice weekly (n = 11); and group 3: placebo daily (n = 14). Hormone levels, quality of life (MOS Short-Form Health Survey), sexual function (International Index of Erectile Function), benign prostate hyperplasia severity (American Urological Association Symptom Index Score), prostate-specific antigen, and measures of safety were compared among groups.

Mean ± [size=-2]SD[/size] bioavailable testosterone increased from 99 ± 31 to 207 ± 65 ng/dl in group 1 and from 115 ± 37 to 178 ± 55 ng/dl in group 2 (P < 0.001 vs. placebo for both groups and P = 0.054 group 1 vs. group 2). Total testosterone levels increased from 343 ± 61 to 572 ± 139 ng/dl in group 1 and from 397 ± 106 to 520 ± 91 ng/dl in group 2 (P < 0.001 vs. placebo for both groups and P = 0.012 group 1 vs. group 2). Serum estradiol levels decreased from 26 ± 8 to 17 ± 6 pg/ml in group 1 and from 27 ± 8 to 17 ± 5 pg/ml in group 2 (P < 0.001 vs. placebo for both groups and P = NS group 1 vs. group 2). Serum LH levels increased from 5.1 ± 4.8 to 7.9 ± 6.5 U/liter and from 4.1 ± 1.6 to 7.2 ± 2.8 U/liter in groups 1 and 2, respectively (P = 0.007 group 1 vs. placebo, P = 0.003 group 2 vs. placebo, and P = NS group 1 vs. group 2). Scores for hematocrit, MOS Short-Form Health Survey, International Index of Erectile Function, and American Urological Association Symptom Index Score did not change. Serum prostate-specific antigen levels increased in group 2 only (1.7 ± 1.0 to 2.2 ± 1.5 ng/ml, P = 0.031, compared with placebo).

These data demonstrate that aromatase inhibition increases serum bioavailable and total testosterone levels to the youthful normal range in older men with mild hypogonadism. Serum estradiol levels decrease modestly but remain within the normal male range. The physiological consequences of these changes remain to be determined.

This work was supported by National Institutes of Health Grant K23-RR16310 (to B.Z.L.), the Massachusetts General Hospital Clinical Research Center grant (RR-1066), and AstraZeneca Pharmaceuticals.

Current address for S.D.R.: Glaxo SmithKline Pharmaceuticals, Collegeville, Pennsylvania.

Current address for J.G.: Eximias Pharmaceuticals, Berwyn, Pennsylvania. Abbreviations: DHT, Dihydrotestosterone; PSA, prostate-specific antigen.

 

[mrbig]

I just finished my first cycle ever @53 I saw I needed help I started with M1T did 4 weeks and now I'm doing a 3 week cycle of Test I saw great results from M1T thats
why I went on to do TEST.I hope this helps you make the right move.

 

[lifted]

I just finished my first cycle ever @53 I saw I needed help I started with M1T did 4 weeks and now I'm doing a 3 week cycle of Test I saw great results from M1T thats
why I went on to do TEST.I hope this helps you make the right move.

You did a 3 week cycle of test? With what, suspension?

 

[crazydoc1]

If you can afford it -- have your PCP signup with Kronos Laboratory.. .kronoslaboratory.com

They have a 150 panel --- UBER run as I call it that covers a ton of ground for you including the bulk of your hormonal interests and a full anti-oxidant profiling.. Their retail is 1,500 and they'll only work with an account with your physician....

The thing is .. with 3x -- they told me I could get to about $1,100 and I know a doc who got their pricing down to $800 which is sick for that much work..

Its consolidated into a kit that is only 5 tubes... you could do it with portamed for 150 and never leave home....

Ignoring this comment---- Life Extension Foundation, Lab-Safe, and others have Anti-Aging panel offerings direct to the end user which give you some basics. I would argue that if you'll spend 80,000 on a car, you can spend a few thousand a year on labwork when the risks are higher like this--- and it doesn't need to be this high..

I would do the following run:--- my start off run -- but its pricy..

1. CBC Diff

2. Blood Chemistry (a full 23 or a 20-- add in the pieces if they don't have the full
either way it should have the full liver panel)

3. Thyroid Panel--- NOT just TSH, FTI, and bound T3 and4... pay the money for the FREE T3 and FREE T4----- TSH, FT3,FT4 is closer to $300-- the free's are pricy

4. Cardiac Reactive Protein
5. Homocysteine
6. Cortisol
7. PSA
8. LH & FSH
9. Test --Total & Bioavailable
10. Estradiol -- high sensitivity
11. Hemoglobin A1C
12. Lipid Panel & VAP
13. IGF-1
14. GH
15. Insulin
16. DHT -- frozen serum-- takes a little longer

This is more than most people will use--- it is very similar to what one prominent anti-aging clinics runs for their starter lab run.........

In the anti-aging market the GH/Test synergy is fantastic as you'll having waning GH and hence IGF-1 levels.

YOU SHOULD DEFINITIVELY HAVE A Digital Rectal Exam..........
Notwithstanding some debate from a hint of contradiction between studies on HRT and prostate issues --- you really should have the DRE and more frequent PSAs on this. Up the frequent of prostate checks while on HRT.

A minimum hello for some clinics is closer to:
Total Test & Free Test
CBC-Diff + basic Blood Chem
THyroid--- TSH, T3, FTI
IGF-1
Lipids
PSA
--------------------------------

Good luck-----------

 

[Greenguy]

One of the major themes that I do not understand is doing illegal things to avoid working with the medical community. I don't know how people sleep at night without spending a few thousand a year on the panels...... especially with the hepatotoxic stuff....... This is not the say that I expect most PCPs and many anti-aging groups to support anabolics in most cases, but the Testosterone esters and HGH and oestrogen maintenance and PCT-- absolutely.

Maybe you've been hanging around only people in your own income bracket, but myself and most people I know are just getting by, and don't have the disposable income to spend on hiring a specialist doctor to prescribe and follow-up on all this.

Also, most who have medical insurance are in stingy HMOs who have strict limits on what they allow. HRT is only for those who can justify it based on blood tests, and sometimes you can't even get a PCP to order the test.

Going to special "anti-aging" clinics is not covered by any insurance I know of, and is only for the wealthy few. The median family income is less that $50K per year, I beleive. Mine sure is...

Greenguy, Impoverished Older Person

 

[crazydoc1]

true

I wasn't trying to offend but I conceed your point. Anti-Aging is not mainstream by virtue of its price principally. I expect that you can convince your PCP to run some of the labs referenced and have a suitable code for insurance to pick it up... certainly the CBC-D, Blood chem, thyroids, lipids, A1c, etc are not likely to be rejected the first time around...

Some clinics make money on professional fees- but most through their affiliated pharmacy relationships. The rules I thumb for insurance coverage for Test or GH for IGF-1 deficiency are very very extreme. I've heard of IGF-1's at 110 being declined coverage for GH. Its doubtful you'd find coverage for these therapies.

My commentary was geared at safety moreso than price.....

Maybe you've been hanging around only people in your own income bracket, but myself and most people I know are just getting by, and don't have the disposable income to spend on hiring a specialist doctor to prescribe and follow-up on all this.

Also, most who have medical insurance are in stingy HMOs who have strict limits on what they allow. HRT is only for those who can justify it based on blood tests, and sometimes you can't even get a PCP to order the test.

Going to special "anti-aging" clinics is not covered by any insurance I know of, and is only for the wealthy few. The median family income is less that $50K per year, I beleive. Mine sure is...

Greenguy, Impoverished Older Person

 

[IdahoSpud]

I wasn't trying to offend but I conceed your point. Anti-Aging is not mainstream by virtue of its price principally. I expect that you can convince your PCP to run some of the labs referenced and have a suitable code for insurance to pick it up... certainly the CBC-D, Blood chem, thyroids, lipids, A1c, etc are not likely to be rejected the first time around...

Some clinics make money on professional fees- but most through their affiliated pharmacy relationships. The rules I thumb for insurance coverage for Test or GH for IGF-1 deficiency are very very extreme. I've heard of IGF-1's at 110 being declined coverage for GH. Its doubtful you'd find coverage for these therapies.

My commentary was geared at safety moreso than price.....

I have to agree with Greenguy on this one. There's a good reason most of these boards have pix of real and fake steroids. Most people simply cannot afford (or in my case, justify) that kind of expense for an elective treatment/therapy. I agree with you though, that it by far the safer path, if you have the means to go that route.