A 4% increase in htc could increase one's VO2max by several percentage points. Seems substantial.

It's a marginal gain, certainly, but VO₂max doesn't rise proportionally to total hemoglobin mass (tHb). Estimate based on several studies:



So if you're one of the lucky ones who sees a 4% gain in hemoglobin from testosterone supplement, you could see a 2.6% gain in VO₂max (in addition to all the negative risks). For most of us, that's about a 1-1.5 point VO₂max increase.

I'd call that amount of gain "modest". And a crummy bargain.

More reading: Saunders et al, Relationship between changes in haemoglobin mass
and maximal oxygen uptake after hypoxic exposure, Br J Sports Med 2013

A 4% increase in hematocrit from TRT is common, and can translate to 5-7% increase in VO2max.

Regardless, my point is that the change I've personally witnessed in my buddy isn't placebo - it's significant and measurable. It's not worth the risks to me personally, but everyone makes that decision for themselves and he's clearly realizing a performance gain from it.

Really? I haven't found evidence that you can see that large of a VO₂max gain. Can you cite a source?

While V02 max can be a strong predictor of ones athletic endurance potential, it's not a guaranty. Perhaps the testosterone users in your group also just simply ride more often and/or train better.

And have you actually checked to see what the total makeup of your group is for those that do and don't use testosterone. Perhaps you might find a almost equal number of those that do use, but don't excel in cycling performance. Or a almost equal number of those that don't use testosterone and do excel in cycling performance.

Still, the common wisdom applies. If the group you cycle with is too fast for you, then you need to find another group.

I understand the need. There are a lot of benefits from testosterone supplementation. The big factor is the risk of Prostate Cancer and BPH with testosterone supplementation. Whats your family history, are you African American. Just these two risk factors should be closely considered.

The other factor we need to consider is Statistical Insignificance. We do not have reliable numbers on whether testosterone supplementation causes prostate cancer. We do know that lower testosterone levels, in those that have a family history of prostate cancer, can decrease the incidence of prostate cancer.

Off the OP: I personally have a family history of prostate cancer. I also have a history of low testosterone levels. Right now I hover around 5 to 6 on the Gleason scale so no surgical intervention needed. For me to take testosterone supplementation at 72 years of age with prostate cancer is ludicrous. I do know it would increase my athletic performance, and my sexual drive, and my overall productivity. And at my age its a question of what would take me out first, other risk factors or cancer? Ha... Frankly I don't have the balls to do it...

It was a while back that I dug through all this but I think it was this one that pointed to an increase in hematocrit of 4% and RBC count of 9%, and subsequent googling that indicated that an RBC increase of that magnitude could lead to a 5-7% increase in VO2max.

To be clear, I'm not suggesting that this person's increase in fitness is all due to a direct increase in VO2 max from TRT. He trains hard, prioritizes sleep and recovery, and eats reasonably well from conversations we've had. But the first two are significantly improved by TRT (in his own words).

I'm assuming this was directed at me. I don't have any trouble keeping up with my group ride but thanks for the advice

I have no idea what percentage of that group takes testosterone. I've been referring to one specific person with whom I ride regularly, mostly just the two of us but in groups as well.

It's your thread. So you should assume the comment was directed at you. If it was intended for someone else, I would have quoted them or mentioned them.

Well you referenced a bunch of stuff I didn't say so it was hard to tell.

There are also a lot of downsides and negatives and some of these include:

- skin irritation
- acne
- man boobs
- mood swings
- anger {AKA roid rage}
- decrease in sperm production
- risk of heart attack
- risk of stroke
- liver problems
- prostate issues
- blood clots

Thanks. I see that the subjects were >60-year-old men with hypogonadism. Maybe that explains the higher than typically reported increase in RBC/hemoglobin, since they were starting from a low level of testosterone.

Certainly could be, although the positive relationship seems pretty consistent until viscosity becomes the limiting factor. At least that's how I interpreted what I read.

You have no clue what you are talking about. But thanks for the selectively edited Google search.

Sure, any clever BF-type 50+ cyclist can figure out that any health risk or lack of monetary reward from "supplements" may be outweighed by the ego boosting "reward" received from boasting and flexing on social sites about performance/fitness gains (real or imagined).

I'm 74 and would not take it. I do take a statin, but without it, my cholesterol was very high. Don't like taking that, but beats clogged arteries.
Aging gracefully but working like hell at trying to stay as young as possible thru diet, avoiding alcohol, tobacco, and getting plenty of exercise. Seems to be working good for me so far. May sound like bragging, but people who I've met never think I'm in my 70's, some even think late 50's, despite the grey hair and hair loss. Disclosure--must have inherited good genes, counting myself lucky.

I think fortunately boasting and flexing has nothing to do with the satisfaction which comes from improved health and ability which can come from some supplements. That's internal, from improved physical condition. It's feels good when one can continue to do what has brought one joy in the past. Just be very careful. Look into the long-term effects of anything you might consume, especially food.

As an individual with numerous prostate cancer tumors in my lymph system, testosterone is taboo and I’m on two drugs to ensure that my testosterone stays below 10. My neighbor on the other hand gets testosterone shots on the advice of his doctor and I do envy his healthy physique compared to my flabby body.

Bizarre how abusive and ignorant you can be towards someone’s medically recommended treatment. Unsure where this aggressive insecurity comes from but perhaps channel it elsewhere. You have ranted earlier about hormonal treatments yet billions of women have taken the pill, millions of women are on HRT for post menopausal treatments and millions of men are taking TRT to assist with the reduction in testosterone when they age.

If after thoughtful conversations with a medical professional someone chooses to pursue TRT and the results were transformative with none of the ridiculous side effects you cut and pasted it makes your rants sound idiotic. Find another dead mule to flog.

To those who’ve thought about TRT talk to your Doctor but in my case it’s been amazing. I get after it hard, and feel 10 years younger easily, coming from a very athletic base. Recovery time, Drive and enthusiasm is fantastic. I really don’t give a crap about whatever foolish rewards you were referencing but I do love having energy with my grandchildren like I did with my own children 30 years ago.

That's fine, but what I really want to know is, "Who is John Galt?" (Some of you will understand...)

As others have already stated, the "pros" of testosterone supplementation don't seem to outweigh the "cons", at least not for me. One thing I find particularly troubling about our day and age is that we're apparently exposed to all sorts of "endocrine disruptors" that lower our testosterone levels, such as plastics, various pharmaceuticals in our water supply (like birth control pills), and probably things I don't know about... as if aging alone wasn't enough of a testosterone challenge by itself!

AFAIK it's banned, in and out of competition, unless you can get a TUE, which isn't that easy. But I suppose if you never compete that isn't an issue; for masters racing I think it is (I don't race so no first-hand knowledge).

I've been on TRT on and off since 2023 for clinical hypogonadism. So far it's been all good for me.

But my endocrine system has been a mess for years due to an autoimmune disorder, and possibly related to head injuries (boxing, lots of falls and crashes in other sports, and hit by cars twice). I've been on thyroid supplement for decades and had thyroid cancer, removed by surgery several years ago, no chemo or radiation, no recurrence.

Without TRT I was making good progress in my fitness from 2015 when I resumed cycling at age 57 after a 30 year hiatus, through 2021 when I was snagging a few local Strava top tens in my early 60s, against some younger, stronger riders who had better stamina. I was just the right size for certain climbs and could expend full steam for 5-10 minutes on climbs. But I never had the stamina for longer challenges, even in my youth (lung scarring from TB as a kid, many bouts with pneumonia and bronchitis). I was more of a full gas, short duration guy, including in amateur boxing with three 3-minute rounds. I'd never have made it as a pro with my crappy endurance.

But in late 2022 I felt like I hit a wall and never got any better. I had to cut back on cycling and my running slowed to jogging, then walking 3-5 miles a day, and even walking was difficult some days.

Doc said it might have been long-term effects of COVID, might have been one of half a dozen other respiratory viruses floating around at that time. Might have been the autoimmune disorder worsening. No way of knowing without specialized testing (which the VA wouldn't do), but I never recovered. By late 2023 I asked my civilian PCP about TRT (my VA doc refused to consider it for anyone other than men with full orchiectomy or Total Testosterone below 200). A friend had suggested it several years ago but I was skeptical for the same reasons other folks in this thread have mentioned -- although some of those concerns were based on faulty studies and conclusions, since superseded by more accurate data and studies.

There's also evidence TRT can improve bone density. I had already developed osteopenia and osteoporosis runs in the family -- my mom's was so severe her femur snapped spontaneously just standing in the kitchen one night. Her doc described her bones as cheese filled pretzels.

My PCP authorized it with close supervision and regular blood tests to check results, especially PSA. I wasn't expecting much. The usual dose of 1 ml, 200 mg testosterone cypionate is pretty minimal, far below the PED level used by some athletes to gain an edge.

TRT has been a game changer for me. My energy rebounded, my hematocrit returned to normal. My bone density is close to normal (takes longer for that to recover, compared with anemia and other factors which respond fairly quickly).

Total T doesn't tell us much, so even when my total T was 250-300, my other factors were very low -- free T, bioavailable T, etc.

I was also borderline anemic (37-38 before, 47 after TRT). And I had chronic low grade inflammation with elevated monocytes and related issues -- that also improved with TRT.

I can't say I noticed any significant performance enhancing effects. My fitness remains well below where I was before getting sick in 2022. But I'm also older now at 67 and can feel my clock winding down quicker now. I can't ride a bike or run like I used to, mostly due to chronic neck pain from injuries (my C1-C2 are permanently damaged and I'm not a candidate for surgery). So I've needed to switch to no/low impact cardio. It's hard to compare the indoor spin bike with outdoor rides. The few times I have ridden a bike outdoors the past year (maybe three or four times) my average speed is the same on my usual favorite 15-25 mile route on roller coaster terrain.

I've switched to more strength training in the gym and have put on upper body muscle, but nothing dramatic. Probably nothing different than without TRT. Bodybuilders and weight lifters generally use a cocktail of far more anabolics. And a younger guy would get more dramatic results from 200 mg of test cyp than I would.

Mostly it's helped stabilize joints that were suffering from the onset of arthritis, another family curse. My thumb joints are gradually deteriorating, same as my granddad's. But strength training helps stabilize the joints and my thumbs don't pop out of joint as easily now.

I wouldn't recommend TRT lightly, but if your condition warrants it and your doc agrees, it's worth a try.

Regarding the long-term effects, I don't see any evidence of permanent negative effects from discontinuing TRT. I stopped taking test cyp voluntarily in late 2024 for a few reasons:

• After a year on TRT (2023-2024), while the benefits were noticeable it wasn't dramatic. But it was definitely noticeable and measurable, while I got zero perceived or measurable benefits from any non-prescription supplements that claimed to boost testosterone. In my limited experience, nothing boosts testosterone other than TRT.
• My right testicle shrank to about half normal size. The left remained the same.
• My PSA stayed around 5 ng/mL. But even before TRT it varied between 3 and 5.

So I was curious to see how I felt after discontinuing TRT. I figured if the decline was noticeable I'd resume TRT and stay with it. My doc agreed.

It was a pretty miserable year. My energy was in the toilet. I was in bed 12-16 hours some days. Arthritis pain was much worse and didn't respond to other treatments. My crit dropped back to 38-40. Bone density loss worsened again. And my PSA still fluctuated between 3-5 ng/mL.

On the other hand, my right testicle size returned to normal during the months I discontinued TRT. But it didn't improve my testosterone levels.

So I've been back on TRT since July and plan to continue until or unless complications arise.

That's my story, your mileage may vary, not available in some states of mind, etc.