
Testosterone Treatment and Alleviation of Depressive Symptoms in Men - bookofjoe
https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2712976?widget=personalizedcontent&previousarticle=2712974
======
throwawaytrt
(throw away because some employers know my actual)

I have been on TRT for several years as a result of a damaged pituitary from a
tumor that was removed. I have played with the dosages alongside my doctor,
and definitely found that (to a certain extent) it really has an effect on my
mood.

From personal experience, I don't know if it would call it an anti-depressent,
but it seems to stifle anxiety at the right doses.

Some people say it's a "confidence drug" but my opinion is it performs more
like an anti-anxiety drug.

I can have a terrible week of work with little sleep, bump my dose a bit and I
calm down - as long as the dose is not high enough to put my estrogen (e2)
levels out of whack.

Dosage and duration are extremely important. If you mess either up it can make
you moody and full of anxiety.

Many doctors today are incredibly unskilled and uneducated regarding hormones.
I know many doctors perscribe trt in one shot per two weeks, and even one shot
per month. I had to go through four doctors to find my current who is a
specialist and very well educated.

With a half life of about 6 days, test-c should be administered at MINIMUM
weekly. Ideally bi-weekly. Dosage should be enough to get you in the
600-1000ng/dl range.

You also need to carefully observe the hormones that coorelate closely with
testosterone, like e2. If that goes to high (aka high converter) your mood
will be worse.

Some people will also see a rise in hematocrit which thickens the blood and
can be a risk factor for a number of things. I do not have this issue as my
hematocrit is very stable on or off trt.

My blood pressure has actually dropped on TRT.

If you can do the balancing act it is overall very good.

\-- Feel free to ask me anything about TRT and it's effects on mood, hormones,
etc. I will try to answer. I have been researching it for years.

~~~
CompelTechnic
Do the mood-changing effects of the TRT medication have any resemblance to the
mood-changing effects of exercise?

I often notice that in the days during/following good exercise, I not only
feel happier, but also more "virile" for lack of a better word, and also more
aggressive. I partially attribute this to testosterone increasing.

Do you have any particular opinions on global trends in sperm count reduction?
[https://www.scientificamerican.com/article/sperm-count-
dropp...](https://www.scientificamerican.com/article/sperm-count-dropping-in-
western-world/)

~~~
throwawaytrt
I still feel happier after exercise. Running a mile or two always making me an
optimist for a couple hours afterwards.

I actually remember the first time I took it, I was euphoric for like 24
hours. It was as if all of the sudden I felt like I had control over my life.

I used to freak out over deadlines and staying late at work, and even if
mentally I told myself not to worry about it I'd get visible anxiety symptoms
like pressured speech and shaking.

On TRT those anxiety symptoms are significantly diminished. I don't freak out
over things that aren't life threatening much anymore. It's like my body's
response system to danger had it's threshold increased.

------
jstewartmobile
With every old dude sporting a jug of AndroGel these days, FYI:

" _It is not known if AndroGel is safe or effective in children younger than
18 years old. ... AndroGel can transfer from your body to others. This can
happen if other people come into contact with the area where AndroGel was
applied._ "

" _Signs of puberty that are not expected have happened in young children who
were accidentally exposed to testosterone through skin-to-skin contact with
men using topical testosterone products like AndroGel._ "

" _Women and children should avoid contact with the unwashed or unclothed area
where AndroGel has been applied. If a woman or child makes contact with the
AndroGel application area, the contact area on the woman or child should be
washed well with soap and water right away._ "

[https://www.androgel.com/important-safety-
information](https://www.androgel.com/important-safety-information)

~~~
i_am_nomad
And soon this stuff will be in the water supply.

~~~
creaghpatr
So it will counteract the estrogenic compounds already there?

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854760/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854760/)

I say this half-jokingly, this particular study concludes there are compounds
but are currently not showing adverse effects.

------
jvanderbot
My personal experience with monitoring free testosterone matches this. Though
I've never undergone treatments.

For example, I only feel like myself when I'm regularly boxing (competitive,
high volume anaerobic+aerobic, physically intense), spending time alone and
outside, adhering to a higher fat diet/lower carb diet, occasionally blowing
off work to do something else, and so on.

What I take from this is that men respond well to testosterone. There are a
number of testosterone boosting activities and foods that might help,
including acute treatment when necessary. Glad this is getting recognition.

~~~
solitus
"For example, I only feel like myself when I'm regularly boxing (competitive,
physically intense), spending time alone and outside, adhering to a higher fat
diet/lower carb diet, occasionally blowing off work to do something else, and
so on."

These are supposed to increase your testosterone levels?

~~~
DiffEq
Yes..they do a great deal; outside activities that get you sun (Vitamin D) and
the high fat (good fats not lard) give your body the raw material to make T.
Exercise boosts it as well as anything involving moderate levels of
fear/stress. Along with sleep.

~~~
solitus
I live in Canada, I'm basically a Vitamin D junkie. Otherwise I get depressed
during November/December.

------
yasp
[https://sci-hub.tw/https://jamanetwork.com/journals/jamapsyc...](https://sci-
hub.tw/https://jamanetwork.com/journals/jamapsychiatry/article-
abstract/2712976)

------
User23
Another downside of TRT is that it greatly reduces male fertility by
suppressing intratesticular testosterone. This is usually reversible by
discontinuing treatment, but in rare cases it can be permanent. However
depending on the cause of low testosterone (talk to your doctor), clomiphene
citrate (clomid) can spur the testes to produce additional testosterone all
the way up to the high normal range. So if you have low T and might want
children in the next couple years, then look into that.

I'm not a doctor, but from my basic undergraduate level understanding of
biology I would expect clomid to be highly effective in cases where low
testosterone is due to xenoestrogen exposure, among others.

------
ncr100
Does this have any correlation to regular aerobic activity?

~~~
mindcrime
As best as I can recall, resistance training has been shown to spur
testosterone production, but I believe the last study I saw showed that the
effect is fairly short-lived. So while resistance training is absolutely
advisable for many reasons, I'm not sure if it's sufficient for somebody who
actually has a noticeable testosterone deficiency.

Outside of the T issue, exercise of various sorts has been shown to have a
positive effect on mood.

Note that for men in particular, loss of muscle mass as you age is a big
health issue, and regular resistance training directly combats that. For (type
2) diabetics, resistance training also seems to improve insulin sensitivity.

~~~
tomp
> Note that for men in particular, loss of muscle mass as you age is a big
> health issue, and regular resistance training directly combats that.

How come this isn’t such a big problem for women?

~~~
mindcrime
Good question. As far as that goes, I'm not sure that it isn't a problem for
women. But as a man who's getting up there age-wise, I've been hearing a lot
about this issue and how men are particularly affected by it. Maybe it is
because we tend to carry more muscle mass in the first place, and is somehow
tied up with the normal decline in testosterone production that men
experience?

------
JohnBooty
This is promising.

However... I'm not a doctor, nor even particularly knowledgable. But isn't one
of the risks of testosterone supplementation a risk that one's own testes will
reduce their testosterone production if there's a bunch of exogenous
testosterone making its way into the body?

Not that anybody's claiming otherwise, but as promising as this is my best
layperson's understanding is that it's not as simple as giving people some
testosterone along with their other treatments.

~~~
gscott
As long as you a producing a normal amount of testosterone then I don't think
you need any treatments of it. It wouldn't do you any good. But if you are
already producing to little or you are in old age...

~~~
JohnBooty

        > As long as you a producing a normal amount of testosterone
    

That's something I'm curious about.

I can't access the full article, but the abstract simply mentions
"testosterone treatment."

I'm not sure if that means your typical testosterone treatment, where
testosterone is given to those who have low testosterone... or if they were
administering testosterone to people in this trial regardless of their
existing testosterone levels, even if they weren't low.

I suspect it's the latter! Which would be interesting.

If it's the former, this barely qualifies as news. We've known for ages that
low testosterone is associated with depression. It would be almost hard to
believe that anybody would bother to run a study on it in 2018.

The latter possibility is interesting though. It suggests that supplementing
testosterone could be an effective way to treat depression even in those who
do not have low testosterone.

(We already know that exercise boosts testosterone, and that exercise is an
effective treatment for depression, so this is not completely surprising. And
yes, I realize that exercise is not a cure-all, nor an option available to
everybody)

------
artichokes
Can someone tell me where this breaks down?

1\. Testosterone and estrogen have an influence on mental characteristics like
disposition, interests, and motivations.

2\. Male and female bodied people have on average significantly different
levels of testosterone and estrogen.

3\. Therefore, male and female bodied people will on average have differences
in mental characteristics like disposition, interests, and motivations.

I understand that 3 does not follow from 1 and 2, but have not been able to
figure out the reason why.

~~~
pogimabus
You are struggling with this because believing there is no difference between
the mental characteristics of men and women on average is to be in denial of
reality.

I think maybe this is a hard pill to swallow for many people because we have
proven over and over that we can't trust each other to both know this AND
still treat everyone, regardless of how we may be able to classify them, as an
individual and to judge each individual by their own actions, desires, and
capabilities rather than by the average characteristics of whatever bucket we
happen to be considering them to be in at the time.

~~~
artichokes
That's not the difficult part for me, it would easily just be another Bayesian
prior like occupation, style of dress, language, etc. It's just that the odds
of me being right and everyone else in the world being wrong about such a
simple, universally understood thing are so unlikely that it's almost certain
that my reasoning is wrong.

~~~
tkmo
It is almost universally accepted (outside of a few small echo chambers), men
("male bodied people") and women ("female bodied people") do have, on average,
differing interests and propensities. Are you under the impression this isn't
the case?

~~~
artichokes
I’ve seen a few people on the internet who believe there are differences, but
I’ve never met one in real life. And not for small sample size- the fact that
there _aren’t_ differences has always been a common topic of conversation in
every social setting I’ve been in- my classrooms, workplaces, hanging out with
friends, etc. It’s amounted to hundreds (thousands?) of people who know that
there are not mental differences between sexes, and none who believe there
are. Every family member, every girlfriend, every professor, every coworker,
etc.

But none of been willing to explain to me why we know this; when I ask they
think I’m trying to make a rhetorical argument that here _are_ differences,
and react poorly. I’ve stopped asking them.

------
teunispeters
As someone living with one of the consequences of near-fatal mumps as a child
(which includes a lot of gland disruption) I can confirm that this has worked
for me. I'm a bit older than wide-spread immunizations. It can take decades
for the mumps damage to fully happen.

And yeah, don't explore this if your testosterone production is still fully
functional.

------
bookofjoe
Minority Report: [https://jamanetwork.com/journals/jamapsychiatry/article-
abst...](https://jamanetwork.com/journals/jamapsychiatry/article-
abstract/2712974)

~~~
metta2uall
Yes, one needs to be careful and get good medical advice. Testosterone also
has a link to prostate cancer, where one of the main treatments is blocking it
(androgen deprivation therapy). There doesn't seem to be strong evidence it
causes prostate cancer [1-3], but unless there is compelling reasons to try
testosterone one can be careful & try other things first (starting with
exercise, meditation, mindful walking). Also, even if one has "low"
testosterone levels it may be that one's androgen receptors are more sensitive
to it.

[1] [https://newsroom.uw.edu/news/study-testosterone-therapy-
does...](https://newsroom.uw.edu/news/study-testosterone-therapy-does-not-
raise-prostate-cancer-risk) [2] [https://prostatecanceruk.org/about-us/news-
and-views/2017/11...](https://prostatecanceruk.org/about-us/news-and-
views/2017/11/testosterone-and-prostate-cancer-risk-the-plot-thickens) [3]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4647137/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4647137/)

------
baccheion
It's been said that 20 minutes of direct sunlight on the scrotum dramatically
increases testosterone.

~~~
culot
I'd like to see fashion better accomodate the solar requirements of our
testicles.

------
zackmorris
I've dabbled in raising my free testosterone levels naturally over the past
year. I'm 41 yrs/6'3/265 lbs (205 lean mass, trying to lose my beer belly),
have a babyface and almost no facial hair, narrow shoulders etc in part due to
my Scandinavian descent. Here's what worked so far for me:

* Eat 4 whole eggs per day (roughly 1 egg per 50 pounds of body weight) and 1/2 cup (dry) cooked oatmeal with a handful of frozen fruit to keep arteries healthy. Cholesterol is like a precursor for testosterone, also the sulfur in egg yolks help preserve and rebuild connective tissue.

* Take a 30-50 mg zinc tablet a couple of times per week (not every day or you'll start feeling queasy). Zinc and other metals are catalysts which speed the chemical reactions in your body, raising metabolism and strengthening your immune system. It's also been linked to higher T levels.

* 1500/1200 glucosamine chondroitin and MSM for joint health. I take Animal Flex which works about twice as well as the next best joint supplement I've found. This also allows you to lift heavier and raise T.

* Lift heavy at the gym 4-5 times per week. For example, 12" box squats with 225 pounds for 15 reps, 315 pounds for 10 reps, stuff like that. The more brutal the exercise, the more your body overcompensates and raises T levels. I benched 225x9 and 300x1 on a 4 day legs/push/pull/shoulders split in my late 20s. Now on a 5 day Mike O'Hearn split for last 3-6 months. Proven lifts: 225x10 and 275x2 bench, 365x3 box squat, 365x3 deadlift but those were all relatively easy because I've been focusing on joint strength and extrapolating 1 RM lately. Planning to test 315x1 bench, 405x1 box squat, 405x1 deadlift at the end of this 3 week on/1 week deload cycle, then will add in heavy 7 sets of 3 and start working towards 405/495/495 over the next year or so. YouTube's been invaluable for reverse-grip exercises and other variations that prevent plateaus, so I'm gaining strength faster now than I was in my 20s (I was also broke then and wasn't focusing on nutrition enough).

* Glutamine 3 times a day to heal leaky gut caused by eating legumes and nightshades for a lifetime, which resulted in acne, joint pain and inflammatory weight gain. Planning to drop to once a day now that my acne is gone.

* Breathe right strips for sleeping. My narrow palette/babyface tightened my airway and left nowhere for my jaw to grow during 20 years of elevated growth hormone from the gym. This affects a lot of people, especially anyone with let's just say geeky facial features.

Figure out any deficits you might have. In my case, sleep apnea and leaky gut
had caused (what I think was) hypothyroidism and absolutely killed my mood and
motivation over the last few years. The last 3 months or so have been life-
changing.

I feel much better but find that I sleep 9 hours a day from all the workouts.
I've been congratulated by strangers at the gym who saw my body fat transition
over the last year, which really helped my self esteem. There is no secret to
getting in shape other than educating yourself and being consistent (not
missing workouts or meals). I've never tried over the counter testosterone
boosters but might think about them after 45. I won't bother until I hit
permanent plateaus.

Disclaimer: I've never had my testosterone levels tested, so this is all
anecdotal. YMMV.

~~~
culot
Nightshade? Like no tomatoes or potatoes or bell peppers? Or like fungus, as
in 'is that wise, avatar?'

~~~
zackmorris
Ya my workout staple was always bean burritos with bell peppers, tomatoes etc.
Also peanut butter and jelly sandwiches and cottage cheese/casein. I started
developing a sensitivity to peanuts after some particularly hard years after
the housing bubble where I lived on PB&J for basically a year straight. Severe
constipation followed by weight gain, joint pain and acne.

Once that happens, there is a transference that can happen over similar
classes of proteins which can lead to other sensitivities to grains, dairy
etc, starting primarily with gluten and lectins. The transference can even
involve the body's own proteins and lead to autoimmune diseases like
arthritis. Here's a pretty good article on it:

[https://www.amymyersmd.com/2017/06/the-problem-with-
grains-a...](https://www.amymyersmd.com/2017/06/the-problem-with-grains-and-
legumes/)

My feeling is that what's really going on is that the body can tolerate toxins
from any source for a certain number of days, but after that, begins to
succumb to them which triggers inflammation. It's a bit like trying to drink
alcohol on the third day. Except we don't notice it immediately with food, so
we keep eating what we're used to instead of investigating what our cravings
mean. That's why eating a variety and rotating meals so you're only getting
the same food a couple of times a week is so important.

Keep in mind that I also had quit working out cold turkey for about 5 years
and lost about 30-40 pounds (including some muscle) and was drinking too much.
I was also getting older and wasn't ready to grow up and be smart about my
nutrition. Luckily it only took about 6 months at the gym and eating right to
get back to where I was. It actually took longer to work around the various
weaknesses and injuries I had acquired, for example having to start over with
135 at deadlift and go up 10 pounds a week to reknit my lower back, than it
did to get the size back on my arms and chest.

For the most part nobody seems to talk about all the above, mainly because
health and fitness are a young person's game (below 35 generally) and also
because holistic effects are not a big part of western medicine yet. My
feeling again is that declining testosterone isn't a cause, it's a symptom of
all these other systems getting out of whack.

Edit: I forgot to mention above that I'm about to start taking cissus for
golfer's elbow. It's apparently highly effective so I'm only going to take it
for a week or two and see if it heals it. It apparently thickens the lining of
the stomach as well which can help with ulcers, which to me indicates another
possible connection between gut health and joint pain. I don't know that I
will take it long term like glucosamine/chondroitin however. Hope this helps
someone.

------
0x8BADF00D
The conclusion is not terribly surprising. Who knows how many xenoestrogens
are in our environment, causing endocrine system disturbances and hormonal
imbalances.

~~~
ambicapter
With all this talk of xenoestrogens, is there such a thing as xenoandrogens in
our environment?

~~~
User23
There might be if TRT becomes as popular as hormonal birth control for women.

------
barrow-rider
> Findings This systematic review and meta-analysis of 27 randomized placebo-
> controlled clinical trials involving a total of 1890 men found that
> testosterone treatment was associated with a significant reduction of
> depressive symptoms, particularly in participants who received higher-dosage
> regimens.

Low-T makes you depressed, or correlates with depression. Cue the inevitable
"soyboy" epithets and related wankery.

~~~
copperx
Is soy associated with lower levels of testosterone?

~~~
wowzap
Yes, soy destroys almost all sexual organ/sexual development facets of the
human experience. Just last week they found that women who were fed soy
formula when they were babies have a higher risk of experiencing bad cramps
during their period.

~~~
GordonS
How do you explain China's population of 1.3 billion?

~~~
jstewartmobile
Could be that different people with different genetics have different
reactions to different foods throughout their lifetimes.

Most asians become lactose intolerant after infancy. Many western europeans
don't. Just because the Chinese can handle soy like champs doesn't mean
everyone else can.

