A Deep Dive Into TRT with Iron Culture
This past week I had the opportunity to record a podcast with Dr. Eric Helms and Omar Isuf of Iron Culture on a large number of the nuances and simple stories that swirl around Testosterone Replacement Therapy.
It is always a blast to talk shop with Eric and Omar and it was my hope that giving away this information could help some individuals potentially make a more informed and active decision when it comes to hormone replacement therapy.
You can check out that full episode below or any podcast app and you can read a fully-referenced article on this topic HERE on Deconstruct Nutrition.
I also put together a 171 reference document for the show which you can search on this page if you want to read more on any of the authors or keywords we mention.
*A brief note on Varicoceles because we get into it.
Below is a table from a systematic review by Cayan et al., 2020 showing the potential effect of varicocele repair on serum testosterone. It looks like again there is nuance in regards to the potential rise in serum testosterone based on if someone is eugonadal or hypogonadal pre-surgery which you can read more about HERE.
I wasn't really expecting this topic to be the weaving piece of information that varicoceled its way into the episode and I am sure peeps will want the reference for that 60-80% bodybuilder number. It looks like it is a bit of PubMed telephone ending in an Italian article from 2010.
"While genitourinary complaints have been well studied in cyclists, the negative effects of the cyclist's physical position and the resultant perineal hypoperfusion should be relatively obvious. Certain studies have also reported up to 30% of athletes being diagnosed with varicocele, representing a significantly higher incidence than in the general population, and up to 60–80% of bodybuilders are recorded as being affected. The incidence of varicocele has been shown to increase with the number of hours spent training."
"High incidence (up to 30%) of varicocele has been reported in a population of athletes and up to 60-80% in the subgroup of body-builders."
-Gulino et al., 2010 (That original article is in Italian)
The number may not be as high as 60-80% and other papers do have it in the 40-50% range. But, regardless of the citation, the risk is significantly and consistently higher than the general population's risk (where the risk is still relatively high and a big deal when it comes to fertility).
“Varicocele is the most common identified cause of male factor infertility. It is found in 15% of the general population, but is present in up to 35% of men presenting with primary infertility and up to 80% of men presenting with secondary infertility.”
-Whelan et al., 2016
It should be noted that these varicocele percentage ballpark numbers of ~40 to 80% are kind of on par with the prevalence of other pelvic floor issues in lifting populations.
REFERENCES for Iron Culture TRT Episode:
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