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testosterone benefits vs. dangers
Sep 19, 2001

Hi, I looked through the archives and I don't think I'm repeating covered ground, so here goes:

I'm HIV+ and have asked my doctor (an HIV specialist) about going on testosterone therapy to give me more sex drive, energy, and keep muscle mass. My t cells are 475 and my viral load varies from around 100, - 200,000. I'm not on an antiviral program - taking the attitude I'll monitor it and can keep off the drugs as long as possible.

He has refused to prescribe testosterone saying my level, while low, is within the "range" of acceptability. I went to a doctor out of area who "advertises" for body builders, and people wanting to receive medically prescribed testosterone, steroids, etc. I told him the above reasons why I wanted hormonal therapy - that I didn't want excessive doses for body building. For the record, I exercise regulary 3x a week at the gym. He said my testosterone level was low (sorry I don't remember the number) for an active 45 year old man. He also said the range quoted for "normal" is an average for men 18-80, and that I should be on a program. He prescribed 200mg 1/2cc of nandrolone, 200mg 1/2cc of testosterone twice a week. He also prescribed 1mg of armidex, twice a day, and a dietary supplement Ultra Prostagen, 2 tablets, twice a day. However, he sells these drugs through his office at very high rates, along with very high office visit charges and expensive lab work that has to be done through his lab. My insurance would cover about 50 of his charges. Obviously, I know what he is doing, so I asked my primary doctor about the above treatment program because during the time I was doing it -4 weeks- I noticed improvements. My doctor refused saying the side effects out-weighed the benefits. He's mainly referring to my body stopping it's own production of testosterone; my thinking is if it's unsatisfactory, what difference does it make?

I think that's the whole picture. What is your opinion? Is testosterone so bad, even in the above mentioned amounts, that it's not worth starting up with?

Response from Dr. Fisher

Many doctors are reluctant to prescribe testosterone or anabolic steroids because of the potential for abuse and for adverse effects. In HIV+ men many studies have confirmed a fairly high preponderance of hypogonadism as demonstrated by low testosterone levels. The best level to check is the free testosterone level, in the morning. If low and especially if associated with symptoms of hypogonadism (not just sexual dysfunction but also weight loss, fatigue) I would recommend testosterone replacement. At physiologic replacement doses testosterone is unlikely to cause significant long-term problems. The possible exception is shrinkage of the testes. But the testes were not producing sufficient testosterone in the first place. I would not use nandrolone as part of a testosterone replacement program. But testosterone alone will not have much effect on muscle mass and you might need nandrolone (or oxandrolone or oxymetholone) for that effect. A body composition study is indicated/recommended before you start any of these 3 (nan, oxand, oxymeth). Hope that helps. AF

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