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Of Chelsea boys, gels, and prohormones (not in that order)
Apr 29, 2006

The title is not as catchy as "Of shoes and ships and sealing wax..." but there we are.

(1) In recent posts you've discouraged, quite unequivocally, people from taking DHEA (recommending that they get their testosterone levels checked and supplement if the levels are low). I'm not taking, or planning to take, DHEA, but I'm curious why you think DHEA is either a waste of money or dangerous or both. Haven't there been studies (Rabkin I think) showing the benefits of using DHEA in HIV-positive patients experiencing fatigue and "low" mood?

(2) The ol' AndroGel vs. Testim debate. Are they pretty much the same? Testim is supposed to have a better "delivery system," being absorbed better through the skin (and is not supposed to be used on the abdomen, for some reason). Is that just savvy marketing? Basically, does one brand have an edge over the other, that you're aware of?

(3) I cannot believe you love the Chelsea boy look! OHMYGOD! Just too buff, too depilated (I believe there are parlors in Chelsea which specialize in buttcrack/butthole waxing), too uniform. In my humble opinion, of course. My current ideal is Adam Brody... I hope guys like him are getting a helluva lot of sex too.

Response from Dr. Frascino


1. DHEA has sometimes been called a miracle drug. In reality it's been a miracle drug (read: cash cow) for companies that make it, authors who plug it and those who hawk it. DHEA is a hormone (or pro-hormone) made by the adrenal glands that are perched above the kidneys. DHEA is converted into the sex hormones, testosterone and estrogen. If it has any significant effect at all, it would be after it is converted into a sex hormone. That's why I recommend HIV-positive folks check their free testosterone levels and supplement with one of the testosterone-replacement therapies (Testim or AndroGel), if needed rather than take DHEA which works upstream. Hormonal replacement therapy is not without risks and should only be used under the supervision of a physician. DHEA (and all androgenic steroids) can increase the risk of prostate cancer or endometrial cancer. If you already have one of these cancers, DHEA could make it grow faster.

I'll reprint below a post from the archives that discusses DHEA. There is an interesting link to politics!

2. I have heard claims that Testim may have a more consistent delivery system than AndroGel; however, personally I have not yet seen solid scientific data to definitively back that up yet. I believe both products are quite good and a significant improvement over the patch (Androderm) or injections of the past. I'll keep you posted as more information evolves and becomes available on Testim vs. AndroGel.

3. Adam Brody??? The geeky guy who was in Mr. and Mrs. Smith? If he's the guy I'm thinking of, he looks like he could use some testosterone-replacement therapy. Chelsea boys, with or without waxed buttcracks, would certainly not have sex with a geeky wimp like him. (Of course, Chelsea boys are usually much too busy looking at themselves in the mirror, pumping iron or having sex with each other to do much of anything.)

Stay well.

Dr. Bob

Looking for a way to boost my natural testosterone production Apr 17, 2005

I have been poz for over 15 years, am on sustivia,and Epzicom. My health has always been great, and I am 41 and in very good shape. However I just do not have the energy or sex drive or sensation I had just 5 or 6 years ago. My health is very well monitored and my testosterone always falls into the "normal" range. But of course there is no way to know what my normal level should be pre hiv or pre meds. Here is my question, is there something I can take to boost my own natural production of testosterone, a precurser or something? I do not want to take testosterone (well mainly because my doc will not prescribe it for me) but also I do not want to shut off my own natural production of it and be stuck having to take it. I have a very good diet and do take suplements, however I do not eat a great deal of red meat. Any ideas?

Response from Dr. Frascino


First off, I agree you shouldn't take supplemental testosterone if you are not hypogonadal. However, merely having a total testosterone level that falls into the "normal" range is not sufficient to say you don't need testosterone supplementation. If your "Mr. Happy" hasn't been so happy lately and your "get up and go" feels like it "got up and went," I'd definitely suggest you check your "free testosterone," which is the active component of your total testosterone. If it's low, supplementation is warranted. As for ways to boost your own natural production of testosterone, the very best is exercise. Yep, strenuous exercise not only makes you look better naked, but it actually boosts testosterone output, so you perform better when naked as well.

DHEA (dehydroepiandrosterone) is a substance in the steroid family which is still available over the counter, but only because it has special legal protections granted by Congress. In the body DHEA is metabolized into androstenedione and then into testosterone. It is the only anabolic steroid not banned or controlled by the Drug Enforcement Administration. You may ask why. Good question!!!! As it turns out DHEA received a special Congressional exemption as a result of one single member of Congress Senator Orin Hatch (Rep. from Utah). And guess which state is a nexus for vitamin and supplement (including DHEA) production and distribution? Yep, Utah! Senator Hatch's son Scott Hatch is a lobbyist for National Nutritional Foods Association, a trade association for the dietary supplement industry and companies that make DHEA. Hatch pushed the special exemption bill quietly through Congress last year at the very moment the steroid abuse scandal was grabbing national headlines and just months before Congress held hearings on steroid abuse in baseball! Fascinating isn't it? I mention this only to advise and warn you that DHEA is an anabolic steroid that could indeed have the same dangerous side effects as testosterone. The only reason it's still on the market is the father-son Hatch team from Utah. Don't you just those "moral values" guys?

OK, stud, I'll see you at the gym, OK?

Dr. Bob

Needle accindent, on PEP

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