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Building Muscle Mass

By Sam Page

Summer 2009

I've been HIV+ for about three years and recently started working with a trainer. I've always had trouble putting on muscle mass (called "scrawny" in high school). My trainer told me that doctors sometimes prescribe testosterone for people with HIV. Do you think this is something I should consider? Would it help me put size on faster?

-- Rob, Pasadena, California

Most people know that testosterone (like growth hormone) is an androgen that your body produces, so you need to see a doctor to determine if your natural levels are in keeping with a "normal" medical reference range. This is really the first question you should be answering: "Are my natural levels of testosterone too low?"

It may also be worth kicking around some questions developed by St. Louis University to screen for androgen hormone deficiency. You can answer the questionnaire at

If your natural levels fall below the normal reference range, you should weigh your options. There are many new delivery methods available -- from patches, gels and creams to injections -- so be sure to have a robust discussion with your provider.

Incidentally, there are many other hormones which can be screened by your doctor, including thyroid hormone, growth hormone, and free/total testosterone. These levels could also be checked and taken into account before making a decision.

I'd do everything you can to enhance your natural levels of testosterone before you consider replacement therapy. Make sure that you are eating a balanced diet, taking a multivitamin, getting enough sleep, and avoiding excessive caffeine, alcohol and nicotine. While it's true that supraphysiological levels of testosterone and growth hormone will increase lean body mass, reduce fat, and improve well being -- the long-term effects are largely unknown.

Also, ask your trainer to customize your workout. For instance, there's some evidence that "multiple joint" exercises, (such as the bench press and squat) may play a role in higher levels of post-workout testosterone in the people who do them.

Sam Page is a certified fitness trainer and freelance journalist. As director of Sam Page Fitness, he operates three private studios in Southern California. He contributes to several national magazines and also publishes a weekly e-newsletter from Sam Page Fitness and a daily blog called Peace Love Lunges.

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