Progress brokers have a spot in medication¹, and a few sports activities successfully require them at increased ranges. That stated, there are dangers if you flip the quantity to 11 inside advanced hormonal cascades with equally advanced suggestions loops. I’ve some private expertise right here. Once I way back had my shoulder fully reconstructed (video right here; viewer discretion is suggested), a portfolio of anabolic medication was a part of the restoration plan. This wasn’t suggested by my surgeon. I discovered gray-area longevity docs really helpful by world-class athletes, and the cocktail was extremely efficient for regaining full vary of movement.

Bodily optimization is basically about trade-offs.

And should you ask “Is that this dangerous?,” the follow-up query is usually relative: “Dangerous as in comparison with what?” On this case, I made a decision that utilizing these highly effective medication with supervision was an appropriate threat relative to the chance of in any other case by no means regaining full perform of my left shoulder.

I did a ton of homework, I budgeted for attainable issues, and I didn’t take it flippantly.

It’s alarming what number of people now deal with “T” or “TRT” (testosterone substitute remedy) as one thing akin to taking a multivitamin, after they by no means would have thought-about taking androgenic-anabolic steroids (AAS) a number of years earlier. Like Patagonian toothfish has develop into Chilean sea bass on trendy menus worldwide, it’s fairly the rebrand story, however that doesn’t change the underlying biology.

It additionally doesn’t change the underlying “substitute” a part of TRT, which applies to many medication.

In the event you take one thing exogenously (originating from exterior an organism; suppose “exo” of exoskeleton) that your physique produces endogenously (originating from inside an organism), your physique—in its infinite knowledge—will scale back or cease producing stated one thing. Endocrinology abhors waste. That is why many males’s testicles will shrink right down to Raisinets after they take supplemental testosterone, and for a good proportion of these males, the deflated balloons won’t return to baseline perform with out post-cycle remedy (PCT) medication like Clomid/clomifene and/or hCG. Facet observe: simply as with testosterone, you shouldn’t casually take hCG. Faustian bargains abound should you don’t have a primary grasp of the techniques you’re tinkering with.

This additionally applies to dietary supplements and meals. The extra technical FDA definition of “drug” highlights a authorized distinction, not a pharmacological one. If one thing’s supposed to provide a change in your physique, think about it a drug and also you’ll make fewer errors. That is useful reframing, whether or not the enter is a prescription drug, illicit drug, peptide, mineral, complement, or banana.

Individually, many development brokers aren’t hyper-selective (e.g., human development hormone [HGH], IGF-1), that means that they don’t simply have an effect on one tissue kind. If, like some enhanced Main League Baseball gamers, your head jumps a number of helmet sizes, that enlarged skull received’t shrink when your muscular tissues atrophy after getting off the sauce. Ditto should you unknowingly supersize your liver and spleen. It’s exhausting to hit undo on Dolph Lundgren jawlines should you’re a girl, it may be tough to unwind drug-induced breast tissue development (gynecomastia) should you’re a male, and it’s exhausting to whisper your organs down a dimension should you’re a human.

Suppose very rigorously about which doorways are two-way doorways—reversible—and that are one-way doorways. Finest to measure twice and lower as soon as.

This isn’t to say there isn’t a spot for TRT. There’s. However the use case issues, and the dose makes the poison. If I have been 50+ years previous and had chronically low testosterone plus signs of low testosterone plus I’d been evaluated for attainable reversible causes of low T, I would think about TRT to carry me inside physiologically regular ranges. That is basically totally different from somebody taking supraphysiological doses—quantities larger than usually discovered within the physique—for getting swole like a kangaroo.

This all might sound difficult, however most of what I’m saying boils right down to primary logic and some tips. 

I’m not a health care provider, and I don’t play one on the Web, however the under heuristics have helped me keep away from loads of issues with performance-enhancing “medication,” as broadly outlined earlier:

1. Assume there isn’t a organic free lunch.
2. Assume that the bigger the amplitude of optimistic impact of *something*, the bigger the amplitude of unintended effects, whether or not they’re recognized or unknown. This might apply to modafinil or a high-octane macchiato.
3. Don’t ask a barber should you want a haircut. If somebody is promoting the factor you’re contemplating, or its use has develop into their identification, count on biased recommendation.
4. Replicate earlier than you escalate. This comes again to “measure twice, lower as soon as.” I’ve seen many mates take dramatic steps earlier than replicating their assessments. In the event you booze over the weekend, sleep like rubbish, after which do a blood draw later AM on Monday, you would possibly discover that—gasp!—you’ve low testosterone. Earlier than you pull out the large weapons, maybe it’s best to repeat the take a look at on two Wednesdays and achieve this earlier within the morning, when T will sometimes be increased. Some proof additionally suggests predictable seasonal differences in T ranges. Final however not least, labs make errors. I recall one well-respected lab for allergy testing returning 100% optimistic outcomes for black bean allergy to all of their purchasers for a two-week interval. It was a lab error. Earlier than any intervention with attainable unintended effects, replicate.
5. I routinely cycle off of medication and dietary supplements I can safely cycle off of for brief intervals of time. This may be one week each two months and one complete month a 12 months. These are principally intermittent wash-out intervals, supposed to permit my physique to reestablish some homeostasis and suggestions loops with out a bunch of confounding variables. Put one other manner, we don’t know what we don’t know, and a few medically supervised type of pharma-fasting is an insurance coverage coverage. I take into consideration low cost insurance coverage in life quite a bit. THIS DOES NOT APPLY TO CRITICAL MEDICATIONS, AND YOU SHOULD SPEAK WITH YOUR DOCTOR BEFORE MAKING ANY CHANGES TO YOUR HEALTHCARE REGIMEN. Please don’t win any Darwin Awards.
6. Understand how you may get off of any substance earlier than you get on it. Our understanding of biology is incomplete, so as with every type of playing, irrespective of how knowledgeable, know your exit plan earlier than you sit down on the desk.
7. Biceps are non permanent, baseball helmet sizes are without end.

Select properly and play the lengthy sport, my mates.

– T

P.S. Honest due to AS, PA, SG, KS, and MN for studying drafts and offering suggestions. In fact, any screwups are mine. In well timed information, the next got here out in Forbes, simply as I used to be about to hit publish: “Billionaire Peter Thiel Backs Doping-Pleasant Olympics Rival — What To Know About The ‘Enhanced Video games.’” I’ll definitely watch this competitors, however reality be instructed, the doping Olympics already exists, and it’s known as the Olympics. Athletes and coaches simply should be champions in two classes concurrently: their sport and cat-and-mouse drug testing. I recommend the podcasts, documentaries, and books under for a style of how refined this has develop into.

Extra sources:

Use of Progress Hormone, IGF-I, and Insulin for Anabolic Function: Pharmacological Foundation, Strategies of Detection, and Antagonistic Results

All issues testosterone and testosterone substitute remedy by Dr. Peter Attia. (Solely for my viewers, Peter kindly made this podcast episode—a 2-hour deep dive on testosterone and TRT—accessible totally free. It’s usually behind a paywall and a part of Dr. Peter Attia’s membership, which presents in depth present notes for each podcast episode, member-only “Ask Me Something” episodes, premium articles produced by Peter and his devoted workforce of world-class analysis analysts, and rather more. Click on right here to be taught extra about turning into a member.)

Larger, Stronger, Sooner (Documentary)  

Icarus (Documentary)

Anabolics, eleventh Version by William Llewellyn

Sport of Shadows: Barry Bonds, BALCO, and the Steroids Scandal that Rocked Skilled Sports activities by Mark Fainaru-Wada and Lance Williams

“The World’s Most Well-known Efficiency-Enhancement Chemist” (Podcast episode on The Tim Ferriss Present with Patrick Arnold.)

Patrick Arnold, extensively thought-about “the daddy of prohormones,” is an natural chemist recognized for introducing androstenedione (bear in mind Mark McGwire?), 1-Androstenediol (marketed as “1-AD”), and methylhexanamine into the dietary complement market.

He additionally created the designer steroid tetrahydrogestrinone, finest often known as THG and “the clear.” THG, together with two different anabolic steroids that Patrick manufactured (finest recognized: norboletone), weren’t banned on the time of their creation. They have been hard-to-detect medication on the coronary heart of the BALCO skilled sports activities doping scandal, which thrust Barry Bonds and others into the highlight. BALCO distributed these worldwide to world-class athletes in all kinds of sports activities, starting from observe and discipline to skilled baseball and soccer.

Associated and Advisable

The Tim Ferriss Present is one of the preferred podcasts on the planet with greater than 900 million downloads. It has been chosen for “Better of Apple Podcasts” thrice, it’s typically the #1 interview podcast throughout all of Apple Podcasts, and it has been ranked #1 out of 400,000+ podcasts on many events. To take heed to any of the previous episodes totally free, take a look at this web page.