Ep. #1079: Dr. Guillermo Escalante on Using Anabolic Steroids Intelligently

Hello there. I’m Mike Matthews and this is Muscle for Life. Thank you for joining me today for an interesting episode. I thought it was interesting because it’s on steroids, and I have written and spoken a bit about steroids in the past. I’ve never used anabolic steroids and I don’t generally recommend them.

I understand why some people use them, like professional bodybuilders, professional athletes, professional actors who have opportunities to become superstars and make millions of dollars. If they can gain a lot of muscle, we’ll say 30 pounds in not a lot of time, like 3, 4, 5 months. But in the case of your average gym goer, I do not recommend.

Anabolic steroids because I think the risk reward ratio doesn’t make sense for that person. They should just be patient. Because you can get jacked naturally. It just takes longer. Now, if you want to get super duper jacked, super physiologically jacked, then you gotta take steroids. But that kind of brings us back to, alright, are you a professional bodybuilder and are you very passionate about that?

Because chances are you are not going to make money. It’s going to be a net loss over time. So it really is a hobby. And so anyway, that’s just some context for most of the content that I’ve created on steroids. Here’s how they work. Here’s how effective they are. Here’s why you probably shouldn’t do them, but what if you are somebody who is going to use them?

Maybe because you want to be a competitive or a professional bodybuilder or maybe a professional or high level athlete. Or maybe you just want to get super jacked. Maybe you’re a guy and the look that you really want requires gaining, let’s say. 50 to 60 pounds of muscle from starting as just an average type of guy, an average build.

And to do that, you are almost certainly going to have to take steroids. The best and natural man can hope for. Realistically the rule, there are exceptions, but the rule is probably around 40 pounds of muscle gains. That’s total muscle gain over the course of their entire lifting career. So if you are going to use steroids for whatever reason, how do you go about it intelligently?

How do you go about it in an evidence based manner? How do you maximize the benefits and minimize the downsides? You can’t eliminate them, but you can minimize them, and that is what today’s discussion is. About, and today you are going to be learning from somebody who knows a lot more about steroids and the science of intelligent steroid use than I do, and his name is Dr. Guillermo Escalante, and he is a professor of kinesiology and Dean fellow for the College of Natural Sciences at California State University, San Bernard Bernardino. And Guillermo is especially unique in that he has one foot in academia. So he has authored over 52 peer reviewed publications. He regularly presents at regional, national, and international conferences on his research, but he also has a foot in professional body building. He has been a competitive bodybuilder and coach for decades now, and that practical experience gives him special insights into the matter that you simply can’t glean from just doing research as a scientist or being a desk researcher, someone like me who reads research.

I’m not actively involved in research, although I am contributing to one study actually that is underway with Dr. Bill Campbell, but I don’t consider myself a scientist or a researcher, I’m a desk researcher. I read the research that other people do, and then I interpret it for people like you and try to make it easy to understand and try to make it easy to apply.

And that’s great, but when you have somebody who’s actively doing research and has practical, firsthand experience, then you often get access to a very deep level of expertise, a level that is simply not attainable without that practical, firsthand experience. And so anyway, that’s what today’s episode is going to be about.

And if you are simply curious about the science of anabolic steroids, or maybe you are concerned about potential health implications because you are using steroids or you plan on using steroids, this interview I think will provide you with a balanced and informed perspective on how to use these compounds responsibly.

Hey, Guillermo, thanks for taking the time to come on my podcast. 

Thank you, Mike. Thanks for having me. I really appreciate you bringing me on. 

Yeah, yeah. I’m looking forward to today’s talk. I’m looking forward to learning a bit myself because this is a topic which everyone listening, you probably know by the title, but it is going to be on anabolic steroids, and it’s something that.

I’ve written, and I’ve spoken a little bit about, I’ve done an interview or two or three over the years on it. But I like our outline for today’s talk because it’s, it’s different than anything else I’ve produced on the matter. And it’s going to address some topical issues that and, and some perennial issues, some perennial questions that I get asked.

And so why don’t we start with the topical and then we can move into some of the more, I guess, evergreen questions that we wanna address here on the podcast. And the topical one that people have been asking me about is bodybuilders dying. Suddenly, over the last several years, there have been a number of cases of this high profile cases for people who pay attention to body building at all.

And so people have. Reached out to me just for my commentary on it, my thoughts on how dangerous these drugs actually are. Have those dangers been downplayed, and then I think we can go from there into a discussion of when it. Might be appropriate to consider using anabolic steroids. And if you’re going to do that without necessarily encouraging people to, but if you’re going to do that, how do we mitigate some of these risks in an evidence-based way?

Yeah, absolutely. I think it’s great. And to your point with regards to these bodybuilding deaths in relatively young bodybuilders, it certainly raised a lot of flags. And particularly when they came about, you know, we saw it in In men, we saw it in women, and that that actually led to my interest in recently publishing an investigative study looking at autopsy reports of these dead bodybuilders.

In fact, our article just published just a few months ago, in late 2022, I think it was December or November of 2022, the title was actually Dead Bodybuilders Speaking from the Heart, an analysis of Autopsy reports of Dead Bodybuilders. So what we did is we actually did a search of people that had died in body building.

We wanted to look at specifically, Males, we wanted to focus on the male demographic and people that had died under the age of 50. And there were actually more that had died between 50 and 60, which is still pretty young to die. But I really kind of don’t wanted to highlight. It’s like these are people that are dying before they’re even 50 years old.

So we ran through an analysis and we’re able to find out causes of death, et cetera, and the paper dives into the methodology of how we described it. But ultimately, we only were able to get access to a handful, a little more than a handful of these autopsy reports. But nonetheless, it was pretty interesting when we actually found, and one thing that I wanna mention is we still don’t have a direct cause and effect link.

It’s very hard to determine that. However, we cannot ignore that there’s a smoking gun and we need to investigate this a little bit further. So I always wanna highlight that, that, you know, this report even just kind of gives us some insight into things that we need to look at a little bit further and dive into the evidence a little bit more.

And it just brings us some again, A look into the smoking gun. So it, it, it begins to, for us to analyze critically because to your point, some of these things have been downplayed and I think it’s important for us to, even though there’s no direct cause and effect, doesn’t mean that there isn’t some, and there’s definitely some linkages there that we need to look into a little bit further.

And of course, this research can help with developing more accurate hypotheses that evidence can accumulate for or against over time. And of course, that’s the nature of scientific inquiry, right? I mean…

absolutely. And, and that’s a great point is all of these studies are meant, you know, no one study’s gonna give you the answer to everything.

It’s just a building block. And then each study builds on each other to help us get to more clearer answers, to be able to, to develop these more accurate hypotheses, hopefully, and test these hypotheses over time to develop a better, clear understanding of, of what is going on. So what was interesting about our study, Was, we actually had six reports were actually available.

The average age of the bodybuilders was only 36 years old for these people that that died. So, I mean, these are young individuals, the youngest one being in, in their twenties, the, the oldest one being in their, in their late forties. What we also see is the weight of the heart was significantly bigger than the average individual man.

Now, I know one caveat to that is naturally, when we look at just weightlifters who don’t use anabolic steroids, Compared to the average individual, their heart is gonna be larger as well. However, some of these averages were significantly bigger to the tune of, uh, you know, 575 grams versus 332 grams for the average man.

So we’re talking almost 74% bigger in terms of this hypertrophic effect that occurs. We also see some left ventricular myocardium thickness, which is another component that, that was very similar all across these six different studies. And then a lot of ’em had different type of abnormalities in there compared to these drug-free bodybuilders.

So what we can draw from is, again, we can draw a direct link cause and effect, but we can say is there’s definitely a smoking gun there. Let’s look at this a little bit further and let’s look at some of the evidence. And when you look at some of the other evidence that has been published over the years where they’ve actually looked at, for example, ventricular hypertrophy, they look at blood pressure, they look at L D L H D L cholesterol levels over time.

You know, again, you start seeing these small pieces of the puzzle that do potentially, I’m gonna say at least there are some associations there. And again, association does not mean causation. But nonetheless, it allows us to look things a a little bit further to be able to investigate more, 

especially when we’re looking to make personal decisions and weigh potential risks with, you could say, known benefits in the case of anabolic steroids.

But hopefully a discussion like this can help people make a more evidence-based assessment of these potential risks and weigh them against, okay, what are the benefits for them personally? Does that make sense? 

Yeah, absolutely. And, and of course these individuals were, you know, if not professional, they were, they were top level type of bodybuilders.

We don’t know exactly what dosages they were taking. You know, some of the autopsy reports did reveal some of the, the police report findings of what kind of things they found. But, but we can’t know exactly how much they were taking. But just from working with a lot of these athletes, you know, we do know, and actually I just published a recent study looking at just amateur bodybuilders and the mean dose for those that we’re using in this particular sample.

And these were not professional bodybuilders, these were amateur bodybuilders in a local bodybuilding show, you know, these guys are using upwards of one to two grams a day, or not a day per week of anabolic steroids. And this is at the amateur level, those that are using. So you can imagine it’s not abnormal for these professional bodybuilders to be using, you know, upwards of two to three grams per week of these anabolic substances in different combinations and iterations.

Yeah. Yeah. I want to get to those details in a moment, but let me just back up and ask about cause of death. With these bodybuilders, were they all related to heart issues or some heart issues? 

Yeah, so these were particularly related to death, related to some sort of heart issue and we, we see a lot of these, so we definitely see these different causes of death and we identify what some of these were in particular.

So pretty interesting. Again, we see the cardiac hypertrophy in there. We see the enlarged myocardium, we see some our thorough sclerotic type of changes in the vessels there that obviously can lead to, to death of from a heart issue there. 

And can you explain to listeners why a bigger heart is not a good thing and why, uh, thicker ventricle walls not a good thing.

Yeah, absolutely. So it all kind of boils down to that ejection fraction, so it, the, the heart can become so big that basically it can’t pump out as much blood efficiently and effectively out of that left ventricle. So one thing that, that we actually look at is that the ejection fraction, which is basically how much volume of blood is actually expelled out of that left ventricle in relation to how much is actually goes into that full ventricle.

And a healthy heart should be, you know, at the very least 50% and actually 50 to 55% ejection fraction rate is kind of on the borderline low end of what’s considered healthy. Ideally, you wanna be above that 55% threshold, maybe in the 60 to 65% ejection fraction. So those larger hearts usually have relatively lower rejection fractions over time.

That’s a marker that you should actually look at if you’re, if you’re a body builder. You know, an echocardiogram can go a long way, and that’s something that should be done periodically to see, you know, is this affecting you? And, and if so, how can I mitigate these risks? 

Makes sense. And I’ve heard some people claim that this is more of a matter of correlation than causation.

Just to come back to something you commented on already and that, and, and again this, and this is me kind of parroting some of the things I’ve heard that there isn’t. Enough good evidence that anabolic steroids cause this to happen and therefore it’s not something you should really be worried about.

What are your thoughts? I’m sure you’ve seen people make the same claims and often these are people who are using the drugs, but 

Yeah, absolutely. Yeah, I think that’s kind of a, a head in the sand approach of just, you know, because I’m using and you wanna justify it as like, hey, you know, there’s definitely no risk there, but again, there is some merit to some of that, right?

There are no direct links, and when you look at some of the evidence, there are some variations in what we see. However, when you start reading some of these different studies and you start putting them together, You start putting some of these pieces together and, and you do see a growing evidence that there is a potential risk.

Now that being said, the risk really comes with, of course, the dosages used, how long you’re using them for, and that length of exposure. I mean that, those are the two biggest factors that, that are gonna to lead to that. You know, obviously, how much are you using and then what are your other factors? Of course, your genetics are gonna play a role.

You know, there are some, just like anything else, right? Some individuals may respond very well to weight training, and you’re gonna have non-responders to weight training that don’t respond as well. Well, similarly, some of these drugs may affect people severely negatively, whereas others they might not impact them as much, or there might be a threshold as to where it begins to affect them.

So some individuals may need, and this is where again, that genetic component comes in that you touched on. If you’re already kind of a genetic freak. You might not need that much to get to that next level and be a, a pro body builder, whereas somebody who is not as genetically gifted, they may need more.

At the same token, you may have somebody who. It takes very little for them to have deleterious effects and somebody who may be able to handle a large dosage before deleterious effects are seen on them. So these are some of the nuances that you have to kind of look at and, and the inter-individual differences in interactions with how well you’re gonna hypertrophy, uh, how well you’re gonna recover and how you’re gonna respond to these drugs.

Yeah, quite a few high level bodybuilders have commented to me just along those lines that typically the people at the top already were genetic freaks for getting big and strong, and then they had the additional advantage of responding very well to certain anabolic compounds. And so big positive effects and minimal negative side effects.

That’s really the physiological foundation that’s required to make it at a high level in the sport. 

Yeah, absolutely. And I mean, it’s really like any other sport, right? It’s like, you know, looking at Tom Brady for example, how many Tom Bradys can actually, can actually play football at that high of a level for, you know, well into their forties.

The answer is probably not many. Right? And, and of course there’s a lot of things that kind of contribute to that more than genetics is gonna be, you know, how well he took care of himself, he had resources to be able to do that. So to your point, yeah, I think these are some of the different approaches of, of what you’re doing.

Also, how long are you competing for, right? You know, if you’ve been competitive for maybe 10 years, 12 years, that’s different than somebody that’s been competing for 20 or 25 years who’s been exposing themself to high dosages of these drugs for a longer period of time. 

And that’s a good segue for another question that I wanted to, wanted to ask you.

This is also something that I hear. People saying in the context of, of this topic and that is that the risks, we can focus specifically on the risks related to the heart, but, but just in general that the risks associated with steroid use are mostly applicable to people who are using large amounts. And you had mentioned amateur bodybuilders, one to two grams a week, professional bodybuilders more than that.

Can you talk a little bit more about that and even individual drugs and maybe put that in context of T R T, what some people claim is T R t because I think a fair amount of people. Listening, for example, they hear one to two grams, but they have no context. Is that a lot? Is that little, and many people know about testosterone, of course maybe they’ve heard about DAL or a couple of other drugs.

But I think some details in the context of the research that you recently published and just your knowledge in the topic would be helpful. 

Yeah, no, absolutely. That’s a good point. So androgenic anabolic steroids are essentially derivatives of the hormone testosterone. So you, you can get straight testosterone, which is in its own right, gonna have anabolic properties.

And then you basically have, you know, different trees that, and from that, so you have some that are oral, which are gonna be typically alkylated at the 17th carbon atom, which allow you to basically bypass the digestive system and then your liver’s gonna process those. So sometimes people at the beginning they say, oh well, It’s easier to take a pill than it is to put an injection, but actually that root of delivery is actually more deleterious and ha can have more consequences than, than the injection.

Which is why most physicians, when they’re gonna prescribe hormone replacement therapy, it’s usually an injection that’s done, you know, maybe two or three times a week, maybe once a week. Or they maybe do a pellet that they’ll put in and, and it, it’s a slow release hormone where they’re doing it. Or they may do a topical cream, which, which is effective as well.

So, a, among those different testosterone derivatives, you also have the, basically the 19 No. Type of steroids. And then the D H T derivatives, which are basically kind of two trees, which is basically just a chemical manipulation of how of that testosterone backbone and how the drugs are essentially done.

And there’s different uses, but essentially the goal of all of these is to basically increase testosterone levels over time and and to create increased anabolic signaling in the body to help to create more muscle tissue over time, and obviously increase strength and all of the other benefits that could be associated with it.

Now that being said, there are potential side effects with those as well, because it targets more than just muscle tissue, essentially, that to make it simple, when testosterone is administered, it’s gonna bind to the androgen receptor and then the androgen receptor’s actually gonna bring it in. But there’s androgen receptors.

I mean more than just muscle tissue, there’s gonna be androgen receptors in other tissues in the body, which is why it’s gonna affect other tissues in the body as well, in addition to that muscle tissue. And some of those may not necessarily be favorable, particularly when you’re doing it in, in larger dosages.

To put it in context, in terms of dosing and, and what is considered medicinal dose for testosterone replacement therapy, cuz I think the term gets thrown around a lot. 

I joke that it’s a red flag online when you have some dude who’s huge, strong, shredded and then they mention, well, I, I’m on t r t, joke, that that’s a red flag.

That often means something else.

 Yeah, absolutely. And t r t is very specific. So if you’re on T R T number one, you know, unless you have some weird medical condition, if you’re under 30, 40 years old, you’re probably not on t R t because number one, there’s no medical need for it unless you have, again, some other underlying medical condition because it’s meant to treat hypo hypogonadism, which means your testosterone levels are, you know, suboptimal at that point in time, in in a reference range that is well below what’s considered normal and in terms of normal levels of testosterone.

Typically, you know, 300 is kind of on the low end of considered normal. So 3, 4, 500. I still kind of consider that maybe 500 is probably not quite abnormal, but maybe on the lower end. But if you’re in, in the 500 to maybe 1100 nanograms per deciliter of blood, you’re gonna be in the normal range. And there’s really no necessary benefit.

If your levels are, say 600 or 700 or 800 in that normal physiological range, you do start seeing some potential deleterious effects once you kind of start dropping below that threshold. And if you’re dropping in that 400, 300, 200 level, now you’re gonna be in seeing some potential side effects. And that’s the other thing that’s associated with.

Some of these symptoms, if it’s medically indicated, your levels alone aren’t enough to tell you that you need testosterone replacement therapies. What other symptoms do you have? Do you have, are you tired? Are you unable to recover? Do your muscles hurt? What’s your sexual desire like? What’s your anxiety, your fatigue?

All of those things are gonna be put together, which again, a medical provider should be the one that’s making that diagnosis. So when a medical provider takes that blood and looks at all of your symptoms and. And does a, a full examination and then they, they diagnose you with, as a candidate for testosterone replacement therapy.

They’re gonna typically provide you with a dosage that’s gonna bring your levels up to that normal physiological range. So again, the goal for that physician is gonna be to get your levels up in that 600 to 1100 nanograms per deciliter range. If they’re aggressive, they might go on the high end of that normal, closer to that 900 or a thousand.

But really that’s what t r t is meant for. Now, what dosages do they prescribe to do that? So the dosages are, are actually quite low. Typically it’s in and maybe as little as 25 to 50 milligrams a week up at the very most to maybe 200 to 250 milligrams a week, depending on the individual and how you’re responding to that drug and what type of drug they’re gonna be prescribing to that particular individual.

So that said, even if we use the high end of 200 to 250 milligrams a week, That is high-end prescribed T R T dosages by a physician. Absolutely high-end. When bodybuilders say T R t, they’re very typically doing much more than that. Typically double to triple that, which is again, two to three times what is considered prescribed.

Because again, if you’re normally taking 2000 or 3000 milligrams a week coming down to 500 milligrams a week, you’re definitely way reduced your dosage, but you’re still far above T R T dosages. So I think that’s a really good nuance to identify. And I’m glad that you brought it up because it’s very important to understand when somebody says they’re on T R T, A lot of times how they define T R T is still two to three times the dosage that is prescribed by a medical physician 

and that that would just be the testosterone.

And there might be other things, as you’ve mentioned as well, that could bring it up to one two grams a week or more.

 Absolutely. Yeah. And cuz we’re talking about right now anabolic servers, but they may be utilizing other. Peds or other antibiotic steroids, which again, could actually definitely bring it to, to higher levels.

The other component that we also wanna look at is, again, the combination of some of these compounds, you know, because they’re gonna, they’re gonna have compounding effects. So just because you’re taking testosterone as a backbone, you know, you may be adding one of these 19 nor testosterones like a deco durain, or you might add a D H T derivative, like a prema and depot, and then those are also gonna have, and they can also raise your levels to higher levels.

So really important to kind of keep in mind, you know, what’s going on and what’s going on with, with the body in regard to that. So I think people need to realize when, when they say t r t, what they really mean, 

and just for people who are curious, why can you take these testosterone derivatives and use them together with testosterone to achieve even higher levels of anabolism or higher levels of testosterone?

For people who don’t know the details, it sounds. Kind of strange, like, you know, it sounds like wouldn’t you just keep taking more testosterone? Why do you take these other things that come from testosterone? 

Yeah. Well, I think typically after you get to a certain dosage of testosterone levels, the side effects are gonna tend to accumulate a little bit more.

Things like gynecomastia that are gonna creep up over time. So you may actually want to utilize some of these other ones that maybe where the, they don’t aromatize as much. And then you’re gonna be able to see some of these other, other potential benefits. And also, again, if you’re competing, you may also kind of figure out.

And you’re gonna be tested. For example, there are certain drugs, there’s certain clearance rates for certain drugs. So you need to kind of keep that in the back of your mind because there are like fast acting testosterone compounds, slower acting ones that have different half lives, which can stay in the system a little bit longer.

And again, if you’re playing the, you need to do a drug test game, you know it’s not hard to pass a drug test if you know what you’re doing and how to utilize some of these compounds. Of course, the science of that is evolving as well, but the science of how to beat those tests is also evolving at a faster rate.

It’s not something that I’m an expert in, but I definitely know if you just know some basic organic chemistry and you understand what the testing is like, you can actually play around and modify with some of these compounds or use, not even use anabolics altogether. You can use things that are not necessarily.

Detectable that are still performance enhancement drugs that are not necessarily androgenic antibiotic steroids. To this point, I wanted to also highlight this other thing is because people always say, well, there’s no good studies with direct cause and effect of some of these compounds. But you also have to understand that as a scientist, I can’t necessarily prescribe somebody extremely high dosages of something that are gonna have deleterious effect on that individual.

So no institutional review board is gonna allow that for me to do that type of testing on an individual. So no institutional review board is gonna do, cuz we know that if I put you on two to three grams of anabolic steroids for a period of eight weeks, 10 weeks, 12 weeks, it’s gonna have some potential deleterious effects.

So as a result, when we see the literature. The highest dosages used in, in terms of anabolic steroid use or in terms of testosterone use is only 600 milligrams a week. So that’s still three times the physiological dose. And that experiment was carried out for I think, 20 weeks. So we basically have a couple of confounding variables there as when you’re actually trying to look, when you’re looking for real evidence.

Well, you know, nobody’s gonna be able to do an experiment where they can give somebody two grams of something a week for a period of 10 years or five years. So what we’re left with is we have to basically study what’s people are already doing. So in other words, we’re gonna recruit individuals who are voluntarily doing whatever it is they’re doing.

I’m not prescribing it, nobody’s gonna prescribe, no doctor would ever prescribe that to them. It’s whatever they’re doing, which brings a few other kinks into the the cause and effect equation because now you have to figure out, they’re not taking the same things necessarily. They’re gonna be taking different compounds at different dosages.

And because they are not legal compounds, they’re gonna have to be getting them from underground sources more than likely from different underground sources, which now you question the purity of these compounds and the the quality of these compounds. So realistically, you have a lot of confounding variables.

To really look at a, a direct cause and effect link. So unless you really know that evidence and know the nuances of scientific research, you are never gonna find a direct cause. You have to draw some inferences from the methodologies that are available with the limitations that are available or that are there and that are present to be able to do this.

So the best thing we can really do now is look at individuals, for example, who have self-reported to be, have been using these compounds for maybe five years, 10 years, 15 years. Bring them into the lab and then that’s the other thing you have to rely on. They’re self-reporting. So are they actually being truthful and what they’re reporting, did they take more?

Did they take less? What kind of compounds were they taking? What kind of combinations? What other lifestyle factors did they have? Did they drink? Did they smoke? Did they do cocaine? What was their diet? Their diets are gonna be different. Their training’s gonna be different. So you have a lot of these different variables that are hard, but that’s the best we can do.

Take a group of, you know, recruit people who have been self-reported using anabolic steroids for the last 10 years on a regular basis, and then bring ’em into the lab. And then maybe take another group of 10 individuals who have been self-reported lifetime drug free. And bring them into the lab and then let’s do some tests.

And that’s what we kind of start to see now is some of these tests have been done and we actually do see some differences in things like ejection fraction. We do thi see some differences, for example, cholesterol levels in terms of L D L levels and H D L levels. We do see some things in things like blood pressure.

So we do see some of these differences with the nuance that we know that there are limitations into the methodologies there. 

And I’m glad you mentioned lifestyle factors because that’s a, a question I wanted to follow up with because that is also something that I’ve seen many people claim is that the people who have had the biggest problems with these drugs either were using huge amounts, way too much, way too many, like were doing it wrong, or they were using what would be quote unquote appropriate for body building, which is large amounts, but they had.

Unhealthy lifestyles, alcohol use, recreational drug use, didn’t eat well, didn’t get enough sleep, and because they didn’t take care of themselves, that exacerbated the deleterious effects from the steroids to such degree that people who take care of themselves don’t need to worry about it nearly as much, if at all.

What are your thoughts about that type of argument? Cause I’m sure you’ve seen that and heard that. 

Yeah, I think lifestyle factors definitely do play a, play a factor in, in addition to the genetic factor combining them together. Right. But I think it’s not a strong enough argument really to say that it’s, it’s only those lifestyle factors that are gonna do it.

Because when we see some of these body builders, actually, I didn’t disclose the names of the body builders in the autopsy reports that we do, but I actually knew a handful of those individuals, less than a handful, but a few of those individuals personally, on, on a personal level that unfortunately I had met over the years in, in the body building circuits and I know their lifestyles and, you know, they were not utilizing other substances or drinking alcohol.

They, they were people that were very much taking, I mean, their body was their income. In a sense, right? So they were personal trainers, so that meant marketing was something that they utilized their bodies for photo shoot sponsors, et cetera. I mean, their body was the way to make a living. So they took care of their body quite well.

You know, they, they slept well. They didn’t abuse alcohol. They were not using some of these particular, and again, these are individuals, I dunno, not to say that everybody does that, but you see that there are people who do take care of themselves in all of those things, and yet they’re still. Potentially gonna die at an early age because of the, the quantities that they’re using over time, in addition to, of course, their genetics themselves that are gonna make me predispose them to have deleterious effects due to dosages that they utilize.

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And we can tee that up, I think, appropriately. So we’re not necessarily encouraging people to do it, but some of these genetic factors, unless you are monitoring your body in the right ways, you really will have no idea. Right? 

Yeah. And I think, I think that’s actually a perfect tee up almost to what we’re talking about, which is really the biggest thing you need to do is, you know, be mindful of, uh, when you’re starting a protocol, if this is something that you decide to do.

And again, I no way encourage it. And in fact, before you even. Considerate. I kind of want to touch on all those lifestyle factors that you touched about, right? So number one, are you training enough? Have you been training long enough? Are you eating right? Are you getting enough protein? Are you getting enough, you know, fruits and vegetables into your diet?

Are you sleeping enough? Are you training? Right? They’re either over training or under training, and they’re not really maximizing.

 I see that all the time in the gym. I mean, all the time I see guys usually, at least they’re the ones who just openly talk about it, and young guys using various anabolic steroids.

And because often I can think of one guy in particular, I just had this conversation semi-recently. He just felt like he plateaued at a certain point and he couldn’t really make any more progress. And so he then got on a number of drugs and. And then now he considers a t r T to what you’re saying, but I think he keeps his testosterone around 2000 and g d L.

So I, and this guy’s like 25, I’m like, all right. That’s, that’s not t r t. But ironically, because of, just because of how he trains, I don’t need to know anything else. He might not eat well, he might not sleep well, but I can tell you just by how he trains and he makes a number of mistakes. I am more muscular than he is, and I, I recently, it was a saliva test, so they actually, they just gave my free tea and it was just in the middle of normal. So if we extrapolate that, you know, it’s probably, if I have a, a normal conversion of testosterone free tea, probably my total testosterone is probably also just gonna be right in the middle of normal.

Despite that though, you know, he again, and not to knock him like personally, but it’s just kind of ironic. 

Yeah. And you bring a very good point. People, when they talk about supplements, I mean, the first two questions that I usually get from people is, you know, what supplements are you using? And you know, hey, like, what stack are you on, bro?

Instead of thinking about, how about like, how long have I been training? You know, how do I train, how do I eat? How consistent am I in doing those things on a regular, what’s my sleep pattern like, what’s my recovery like? And then when you add all of those things together, you know, and then of course your genetic starting point to begin with, right?

If you have a bad genetic starting point and you’re doing all those things wrong, now you’re gonna try to make up by, you know, putting all this extra stuff in you, whether it’s dietary supplements or. These anabolic steroids, you’re probably gonna still be not making as many gains as you can. And this is where you see people, where you really use that much stuff and they, they look like a normal Joe, or worse than a normal Joe.

And it’s sad because before you even cross that bridge to consider utilizing, it breaks my heart when I see young kids doing this. You know, if you’re a teenager, you know, even if you’re under 25 years old and, and you’ve only been weight training for, you know, one or two years before you even consider any of that, you know, maximize your genetic potential by doing all these other invest money.

And time and energy and education and doing all the other things correctly. You know, training appropriately, loading appropriately, deloading when needed, getting enough protein intake, getting a, a regular diet with enough calories that are gonna, it’s gonna support muscle growth. Doing that for a regular basis for a two or three year period over time, where your training’s consistent, your diet’s consistency then and only then, and you maybe want to compete at a higher level, and you think that you see yourself maybe doing that, that may be now a conversation where you have, and you, you have the money and resources to be able to do that.

And by that I mean not just money and resources to buy the substances that you’re gonna need to buy, but also have the money and resources. An insurance policy, for example, health, health insurance, to be able to see a medical provider to pay for all these medical tests and the blood work that you’re gonna need to do.

Because that is the responsible approach. And again, I don’t advocate people to do it, but if they choose to do it, then those are kind of the main things that I kind of wanna make sure. Are you doing all these other things first? Yes. Okay. Do you have money and resources to be able to, do you have a medical provider that you can go see, that you can talk to, that you can trust that you have rapport with?

That you can get these tests on a regular basis? Because you need to see the doctor more than once a year. You should see them probably minimum two, probably three or four times a year to get regular blood work done on, on a regular basis. And then you can actually start monitoring from there, you know?

And you don’t need to go crazy in terms of quantity. So you probably wanna start with a, what you wanna do is the least effective dosage possible is, should be your starting point, right? So,

 Sorry to interject, but I, I, I want to hear all of this, but I, I wanna offer a quick counterpoint that I hear from guys in the gym, and then I would love to again, talk more about some practical strategies for mitigating downsides and maximizing efficacy and so forth.

But here it is, some guys, their line of thinking is, and maybe some women as well, but I’ve only heard it from guys. It is, well, yeah, okay. I’m new to this and my body’s very responsive. Or maybe I have a year of training, so like my newbie gains are kind of gone. Why don’t I use steroids for. A period of time, let’s say 1, 2, 3 years, and I’ll try to go about it intelligently and in those few years I can gain what will take two or three times as long, naturally in the way of muscle and strength.

And then I’ll just come off. I don’t have to wait eight years, seven years, six years to achieve at least 80% of my genetic potential. What are your thoughts about that? 

Yeah, well, I mean, there’s definitely a dose response relationship to the drugs. That being said, you know, I can see where that mindset kind of goes in.

I’m just gonna use more and blast and, and get the gains. 

Or even, not necessarily use more, just start. So I’m gonna be natural. I’m, I’m natural for a year. I’m, I got my newbie gains. I like this. I’m impatient. I don’t wanna wait. And so I’m not, this is not somebody who’s looking at being a competitive bodybuilder or athlete, just a gym goer.

Probably a guy who wants to get girls until he realizes that we care far more about our muscles than girls ever will. And the only people who. Care as much as us, our other dudes in the gym, but they haven’t realized that yet. And so their thinking is, all right, I’ll just get on some steroids. I’ll do it intelligently again for just a couple of years, and then I can be jacked at the end of that period and not have to wait six years naturally or whatever.

Yeah, and I think that’s definitely the wrong approach. Cause number one, like you said, one year of weight training, you’re still, maybe you’re not, you’re out of your newbie gain stuff, but you, there’s still a lot of gains to be made over that period of time when you’re programming correctly. But you also have to remember the risk to benefit ratio, which we kind of talked about, right?

So if you’re not gonna compete, if you’re not gonna be making a living doing this stuff, realistically, you know, why would you wanna expose yourself to these compounds? And if you do, Then make sure that you’ve been training long enough to do these other things. Cause most of those guys haven’t checked all the boxes yet before they even need to consider it.

And as we just mentioned, there are a lot of guys in gyms, and I’ve seen this in papers I’ve read and, and it checks out with my anecdotal experience as well. 

There are probably more people, for people listening, more people. And it tends to be men, in my experience, in your gym, using drugs than you realize.

And if you knew and you looked at a lot of these guys, you. Would be a little bit puzzle because they don’t look like jacked bodybuilders.

 Yeah, you can’t tell. You absolutely can’t tell. And to your point, there was a paper that my colleague Rick Collins co-authored a few years ago, and they actually looked at, you know, who is the primary user?

And there’s been a few papers, but uh, his paper rings rings a bell because I’ve cited it quite a few times. But they basically interviewed close to 2000 gym goers and they were trying to kind of figure out the demographic of who’s using. And it was not actually the adolescent in sports, it was not the athlete or the pro bodybuilder.

It was not the, it was basically a, a 29 year old man or maybe a 30 year old man, white guy. Who paid a higher than average income and his goal was exactly what you said, to basically look better naked. That was basically who the demographic of the stereotypical user is. 

That aligns perfectly with the t r t craze that we’re seeing right now, by the way.

Absolutely. Absolutely. And and really they’re not, they’re not going to compete. They’re not gonna make money on it. They just basically wanna look better. And to your point, they’re thinking that, you know, it’s gonna attract more females. But yeah, realistically what you’ll realize, you know, even when you are Jack, you’re gonna get far more guys to tell you, bro, you look amazing.

Rather than girls, 

you might never hear anything actually from a single female in your entire, all the time you’re gonna spend in the gym for the rest of your life. You actually may never get one random compliment from a woman. 

Exactly. They really don’t care. Yeah. For the majority part, they, they really don’t.

Yeah. So it, it’s funny. So yeah, I definitely advocate against that mentality and, you know, encourage you. To look inward. And again, and there’s nothing wrong with vanity. I mean, if we wanna look better and you wanna, you wanna do it, that’s fine. But if that’s the case, then again, now your reward to risk ratio is, is even more important because what dosages do you want to utilize?

And you know, what kind of risk are you willing to tolerate or do you want to tolerate? Because you’re not gonna make any more money on it. You’re not gonna get any fame from it. You’re not gonna transform into Brad Pitt. 

It’s just not. Even if you have his Troy body, you’re unfortunately, we’re still just not Brad Pitt.

It doesn’t work like that. Exactly. 

Exactly. Yes. So it’s it’s very true. And I definitely, I’m glad that you pointed that out. Cause it, I think it’s a, it’s a not necessarily the best mentality to go forward. And that being said, I think even if you are utilizing, you know, let’s say that you are considering competing, you’ve been doing things right for five years.

You’ve checked all the boxes. You’re gonna say, you know, maybe you’ve done a natural show or two and you say, I really like this. This is something that I can see myself doing. Maybe you’re, you know, genetically gifted where you’ve done well in, in these competitions and. You look better than the average individual, you know, just naturally with heart training and hard work.

You know, I’m thinking the person that comes to mind is Kai Green, right? If you look at Kai Green, I mean, Kai Green turned pro as a natural bodybuilder, right? He, he won the universe, which was tested, and, and when you look at Kai Green as a natural, he looks better than 99% of the people that are utilizing Ronnie Coleman too.

Have you seen the, the picture of him at 23 or so when he said that’s when he started to use, and anybody listening, if you find that picture online, you can find it just by, by poking around a little bit. There are many form threads and so forth where this is the discussion. So at 23, which again, by Ronnie’s own admission, I don’t know why it’d be weird for him to lie about.

When he started using steroids, he openly said he started using them at about 23, and you can see pictures of him. Then at 1213, jacked, absolutely jacked, the most jacked 13 year old you’ll ever see. He played high school football. He looked like a college linebacker. He looked ridiculous in high school.

And then at 23 before he started using steroids, there’s, I can see the picture. I don’t know if you’ve seen it. He’s shirtless and he’s, he’s posing, but he looks, he would be the most jacked person, probably top three to five that I’ve. Ever seen if you were in a gym that would be in the top three to five that I would ever have seen up until this point in my life.

And that was before he started using trucks? 

Yeah, absolutely. And to that point, I actually competed against Phil Heath at the 2005 USA Championships. It was the day he turned pro. Was that that show? Phil Heath, you know, they call him the gift for a reason because he, he had extremely gifted genetics and.

You know, here he was, you know, he was a basketball player, had only been lifting really for basketball and then kind of had just been body building for about a year. I mean, I had four years in, five years in, and I looked nothing like Phil Heath in his first U S A show. I mean, I had done two or three u s a body building championships and some junior national championships under my belt.

And then Phil Heath comes in and everybody was weighing in and very cocky. He said, you know, I don’t know why I’m even here. They should have just mailed me the trophy. And everybody in in there was like, really? Who is this guy? And then he took off his stuff and you’re like, well, you know, he’s right. I mean like we can’t compete.

And of course he won the overall term Crow. And then Phil Heath became Phil Heath. Right. And those are the genetics that are there, you know. So after, you know, realistically less than a couple of years of true bodybuilding exposure, less than a couple years of probably. I’m gonna guess minimal dosages of utilizing compounds.

You have the U S A champion beating guys that have been competing for years and unanimously winning, you know, hands down best amateur bodybuilder in the, in the country. That came became window Mr. Olympia, obviously a few years later. 

Let’s get back to then, or let’s, I guess kind of shift gears back to what we were talking about, which is, okay, so you have somebody, they’ve been training for a period of time, they’re eating well, they know what they’re doing and they want to pursue body building.

Seriously, you could lump in some sort of sport that may require it simply because so many other people are using things that. Allow them to perform and recover. And the only way to really compete at that level, depending on what it is to use anabolic steroids, you can start wherever you want with this.

You, you gave a good overview of some of the things that you should keep in mind to mitigate the risks. And if I’m hearing you correctly, you can never completely eliminate them, but you can mitigate them, you can avoid blunders. That will almost certainly cause major problems. At least you can do those things.

Yeah, absolutely. And, and the biggest thing is just, I kind of do the analogy of like a car, right? You wanna look under the hood, right? You don’t just wanna look at the, the outside of the car. You wanna look at what’s, what’s going on under the hood. So with that, you should know what your baseline levels are.

So number one, Work with a physician and a healthcare provider that you trust that you can communicate with and with that individual, of course, they’re gonna try to discourage you. That’s their job from utilizing it. But be upfront with them and then do specific tests that you can actually monitor, right?

So, of course, on a regular basis you would want to check your, your blood pressure. I recommend that at least once a week. Maybe wanna check your starting blood glucose levels at the beginning, you know, do that at least, you know, two, three times a month to, so you can kind of have those baseline. What’s your resting heart rate?

All of those things are things that you wanna kind of start considering and, and keeping documentation of on a regular basis, because if any of those variables start to escalate or go off track, then you can intervene on a regular basis. Your blood work should definitely consist of complete metabolic panels, so you wanna look at specifically like your hematocrit levels.

Those are very important. Your red blood cell count, that’s very important. Because typically those levels are gonna increase to a point that you can have deleterious effect on those. So your blood cell count can increase, your blood can become so thick that it can now potentially cause other problems.

So those are things that you wanna, again, look at what the dose response relationship is to those levels. You wanna look at things like your cholesterol levels, your L D L, your hdl, your total cholesterol, your triglycerides, and making sure that those are staying, you know, somewhat within, within normal reason.

Because typically what happens, we typically see the L D L levels start to rise. We see the HDL levels start to drop, 

which is bad for everybody listening. Please don’t listen to the carnivore crowd. Who says that? That No, no, that’s good. You want high L D L? No, you do not want high L D L. 

No, you do not.

Especially in combination with the low H D L. And again, there’s a lot of, lot of literature which kind of talks about, well, you know, if it’s low, it’s not too bad. But, but I’m not talking about just marginally low, you know, because typically it’s recommended for that to be at, at 40 nanograms per deciliter of blood, ideally over 60, right?

So 40 to 60 is considered normal, but if it’s over 60, that’s actually a positive health risk factor or something good. But what happens with genetically, you may already be on the low end. Like personally, I am very low on my H D L levels naturally. So if I were to use these compounds, it would drop significantly lower to, to maybe even single digit levels.

And that’s when you see some of these potential deleterious effects. So you wanna monitor what these ratios are looking like over time. And then of course you may be, depending on how long you’re using, you probably wanna do eventually, especially as you’re aging, you want to do things like an echocardiogram, calcium score for your heart.

And then you can actually see are there any of these deposits going on? And then keeping a record of all of these things. So you know, I have a file of, I don’t know how many years back of every blood work that I’ve done and, and I literally track some of these particular metrics that I’m looking at to see what’s going on.

And then as you’re using things, you can actually say, that’s the other thing that I want to emphasize. Don’t just test when you’re off. You want to test when you’re on, right? If you’re on eight months out of the year and off for four then, and you’re only looking in the window of the four months, you’re missing the boat, right?

So you want to utilize like, what am I when I’m, when I’m on nothing, what am I on? When I’m on minimal stuff? What am I on when I’m on higher dosages stuff? And how long does it take those levels to come down? Do they come down? Do they stay elevated? Because that’s gonna give you a bigger picture of what’s going on.

And then over time, this is where you can catch a lot of these things, whatever protocol you’re utilizing, and you see that your redlining all the time on all of these things. Your hematocrit levels are high, your blood pressure is high, your HCL L levels are low. Your L D L levels are high. And then maybe over time you’re looking at ejection fraction.

And your ejection fraction went from 60% to 58% to 56% to 49%. You should probably be looking out at what you’re doing right and pay attention. And then that’s where it’s really important where you’re just not sticking your head in the sand and saying, I feel good. Cuz this, the reality is, is a lot of times if, if you have just borderline hypertensive, you probably don’t feel it.

If your h DL levels are low, you’re probably not gonna feel it. If your hematocrit levels are high, you’re probably not gonna feel it until it’s finally a problem and it’s too late.

 Yep. And to your point, you might generally feel pretty good. On these substances. So how you feel energy levels and you know, I, I often I’ve heard from people who have been open to me about cycles and on and off and just how much better and, and really, quite frankly, how great they feel, at least for short periods of time when they’re on a number of these compounds and they feel like they don’t, it’s not smart to not sleep much, but they quote unquote, don’t need to sleep as much and they have high energy all the time, and their workouts are great big pumps.

They feel unstoppable. It, it can be counterintuitive for them to consider that they might be actually on the road to dying even though they feel great, quote unquote. 

Exactly. And that road is actually quite slow because that’s one thing that I wanna emphasize is a lot of these things, You know, one cycle for 12 weeks is gonna maybe get you a little bit to the outside barriers, but you know when you come off more than likely things and we see that it’s gonna come off.

So the problem is when you’re taking high dosages for a long period of time, over and over again, and that’s when we see these issues build up over time where, and that those people are sticking their head in the sand. And to your point, when you’re on these high dosages, I mean, in the gym, you’re like a beast, right?

You’re gonna be super strong, you’re gonna be recovering, you know, you’re gonna be alert, you’re gonna have energy. A lot of things kind of feel good, but internally they’re not necessarily looking good. And I didn’t mention some other important things I kind of focus on related to the heart. But you still wanna look at your liver enzymes, you wanna look at your kidney function.

These are all different blood biomarkers that, that again, You should work with your healthcare professional to evaluate these on a regular basis. You know, I spent a lot of time with my, especially, you know, I’m 46 going on 47 this year, so, you know, especially over the last six, seven years, it’s something that I have done on a regular basis, and we’re going over all of these biomarkers, you know, to be utilizing them.

And this goes for people on t r t as well, right? If you’re working on with a physician on t r t, they should be monitoring these things closely as well because again, you’re, you’re taking a drug just like any other drug. If you’re in a hypertension drug or a cholesterol drug, you should be monitoring all of these levels accordingly on a regular basis.

And then working with your doctor to, to see, it’s like, okay, these levels look good. You’re not seeing any changes, but if you see something occurring going up or down, that’s going to be a road to potentially major deleterious effects. Not necessarily right away, it’s gonna be a. Five years, 10 years, 15 years down the line that if you don’t catch it early, you’re gonna have problems.

Which is why I like the regular blood pressure checks, because if your blood pressure’s out of control, I see that all the time. I have guys that come into my lab that are using stuff and first thing I check is their blood pressure as part of one of the biomarkers that that I look at. And sure enough, their blood pressure’s often elevated, and these are guys in their twenties and early thirties who should not have elevated blood pressure levels on a regular basis 

and coming back to dosage I’m glad you mentioned that with T R t because that’s another thing. Another comment that I will hear now and then is that, well, a lot of what you’re describing here applies to bodybuilders using a lot of drugs, different types of drugs. I’m only using, well, they might say T R T, let’s just say I’m only using testosterone, therefore it doesn’t require as much diligence and and vigilance.

So if I’m hearing you correctly, you disagree with that point that if you are. If you are introducing exogenous testosterone in your body, depending on how your body responds to it, there could be causes for concern. And you do want to start paying attention to these things more closely than you would if you were not using even just testosterone.

Yeah, absolutely. I think anytime you introduce any drug, even if it’s prescribed by your doctor, it’s your doctor’s duty to do some periodic checks. Now, depending on what it is you’re taking, you know, that might require a once a year check, maybe once every two years, maybe every six months, maybe every three months.

You know, it depends on, on where you are and and what it is, right? So if your doctor prescribes you thyroid medication for hypothyroidism, initially, you’re gonna probably need to go every two to three months to check your thyroid levels to get the right dosage. And then once you’re on that appropriate dosage and they stabilize.

Maybe you need to go every six months to every year to make sure that that dosage is doing what it’s supposed to do. No different than testosterone. Your healthcare provider that is providing and prescribing that to you initially should probably, you know, you should probably go get tested maybe every two to three months initially to make sure that those, the dosage used is gonna get you to those normal levels.

And then maybe every six months to every year, you’re doing periodic blood work and physical work where you actually go see the individual. At the very least, they order lab work for you. And then you do a telemedicine call and you review the lab results on a regular basis. They ask about your symptoms, your health, maybe they’ll ask you to measure your blood pressure and then you can give that information to them.

You mentioned earlier also coming back to mitigating the negative effects, the potential negative effects. In the case of using these drugs that you want to, you might have said start with, or just generally use the minimum effective dose. Can you talk a little bit about that? Because that, that’s a mistake.

I know that a lot of guys make, I mean, I’ve seen guys talk to other guys in the gym and get their stack, so to speak, and just jump right into that, oh, a bunch of testosterone and some trone and this and that. Sure. Let’s do it. 

Yeah, I, and I think that’s something that is important to emphasize because. I mean, again, I’ve said this before, there’s a dose response relationship where 200 milligrams is better than 50, and 400 milligrams is better than 200 and 600 is better than than 400.

But that curve is not, it’s not a straight line, right? There’s gonna, it’s more of a, there’s gonna reach a point of diminishing return. So yes, there’s a dose response relationship, but it starts to kind of plateau at a certain level. And then, and that’s where you kind of wanna be at that sweet spot where, and the sweet spot for that is, is how much can you tolerate and get the maximum benefit with the least deleterious effects, right?

So if you have that sweet spot where you know you’re not getting a gynecomastia, you’re not getting elevated blood pressure, you’re not getting, and, and you’re, you’re having no symptoms, but you’re still making gains, then that would be an ideal spot. Now, of course, if you’re a competitive bodybuilder and you’re making a living on this stuff, You’re gonna have to, you know, I’m gonna say redline it a little bit more, you’re gonna have to go to points where you’re gonna go, you know, redline it for a time being.

But even then you can still probably mitigate some symptoms. And again, this is why it’s important to work with your P physician because there are other drugs that can actually be utilized to help mitigate some of those symptoms. But you can’t self prescribe this stuff, you know, so there’s things like telmisartan, there’s things like maybe cholesterol medication that you can go on, that you can actually utilize that can actually help mitigate some of these risk factors.

But again, it’s not something you just wanna blindly self prescribe because you’re not a pharmacist. You’re not a physician, you have no medical training and neither does your coach, by the way. So I’m gonna say, you know, talk to your doc. Even though there are some very well educated coaches that advocate safer use models.

And I would say that they’ve probably taught some physicians some things as well. But again, having that relationship with the doctor and then letting them know, it’s like, Hey, here’s an article related to this. And then now you can, they can put the pieces together and then they can actually give appropriate dosages and then monitor your health biomarkers, and then now you actually have a prescription for these certain things to help mitigate some of these risk factors.

That’s the smartest approach to do it. 

I’m assuming though, it’s probably difficult to find a doctor who knows enough or wants to know enough about this to be able to manage it in this fashion, or am I wrong there? 

No, it definitely is. You need to do your, your research into which providers are actually gonna, you know, provide the best service for you.

You know, your, your general practitioner is probably not necessarily trained in this, you know, even if you work with a cardiologist, you know, you’re, this is why you have to have that open line relationship, and it’s probably important that, you know, if you’re. If you’re gonna be talking about certain things, you know, investigate some things yourself, provide ’em some medical literature, not some, not some website that you read this from, you know, some peer reviewed medical literature that they can actually glean us, maybe bring the paper with you and say, Hey, I read this.

You know, then you can help have that conversation with them. They’re gonna be open to that. And if they’re not, find a new doctor. If they’re judging you, find a new doctor, and this is why, I mean, it’s important to have the financial resources and stability. To be able to do that, because if you can’t do that, then you’re doing yourself a disservice and you’re not gonna have that accountability factor on yourself to look at these, these particular health markers.

So, you know, I invest a lot of money in my health and I know how many, I have a concierges, you know, there’s three or four different doctors that I work with, and they all work together. And some of ’em are concierge doctors that don’t even accept insurance where I’m, I’m paying out of pocket for me to, to see them.

But they are there to kind of coordinate all of this stuff and to be able to, to do that. How important 

is it to come off altogether? I know I’ve heard debate around that and it seems like the conversation has kind of shifted to, or, or at least it’s common for guys again, usually it’s guys to never come off of certain drugs like testosterone and, and keep that basically elevated to super physiological levels.

Indefinitely and then periodically use other compounds aggressively with the idea that when they’re not using the more aggressive compounds their body is recovering in, in some way. What are your thoughts on that? 

Well, I think, again, it becomes an individualized approach at that time because if you’re, if you’re able to utilize, you know, lower dosages and still maybe have, maybe your, your testosterone levels are double of normal physiological range, right?

And you’re working with your healthcare provider with, and again, no healthcare provider’s gonna prescribe that much to you. They’re gonna advocate for you to be on the lower end, but nonetheless, Maybe you’re managing, you have no symptoms, right? So you have, your blood pressure is under control, your cholesterol is under control, your hematocrit levels are under control.

If you’re able to control those variables for a prolonged period of time, then I think no harm, no foul at that point in time. But for more often than not, you’re not gonna be able to have your cake and eat it too. You’re going to typically have some issues with that, which is important again too, if that is the case, for you to have some time off and, and this is another time when guys often, especially nowadays, the time off is often.

Such a small window that it’s not really enough off time. Right? Because, you know, if you finish a bodybuilding show, you’ve been blasting for five months, right? To finish, you took your, your last dosage of things. Say, you know, three, four or five days before your show, a week before your show to make the date easy.

Let’s say you finished competing on July 1st, right of, of this year, and then now you’re gonna be off for two months, but you did your last shot on June 25th. Right. So the halflife of that, depending on what you took, is gonna be in your system for a while. So even though you’re, you’re off, you know, those first three to four weeks, you’re actually not really off.

That stuff’s still in your, a lot of these things are still in your system and they’re working. So realistically, it’s about three to six weeks after that last dose that you’re really off off, right? Because that’s when your levels are gonna start to come down. A lot of people are only off maybe for two or three months, which is not nearly enough time to, to let your body recover, to, to really kind of feel that and let your body go into a full recovery mode, you’re probably gonna need to be off or maybe four or five months and then depending on.

What you took and other different factors, your levels were probably gonna crash down significantly. Right? Like, and that’s the issue with a lot of people that have been dosaging for long periods of time, is their normal is not normal anymore, right? So when they come off of this stuff, their normal testosterone levels are hypogonadal levels, and you’re gonna have the symptoms and issues, you know, with erectile dysfunction, with anxiety, with fatigue, with loss of muscle mass, with loss of strength.

Those are all gonna come to me down. And then, and that’s very hard psychologically and mentally to deal with. So this is where I think there’s not necessarily a physiological addiction to it, but there’s definitely a psychological component to it because if you’ve been in that high and then you come off for 4, 5, 6 months and now you, and you’ve been on for a while and then now you’re, this is where you have a lot of struggles and there’s a lot of physicians that specialize in that.

Sometimes that stuff doesn’t even come back. You might need to be on t r t literally forever at that point in time. And the longer you’re on the, the higher the chances of that. One other thing I wanted to mention too, that some of the young guys aren’t careful with is this can cause infertility as well, right?

So you need to be careful with this if, if you aspire to have children, And your, maybe in your late twenties, you know, or early twenties. We wanna be a dad when you’re 30, 35. You need to be careful because these things do have consequences if you’re not careful. 

And just to be clear with that. And consequences that can be irreversible.

Yeah, they, they can be IRR or very difficult to overcome over time. Some of these, you know, the typical post psychotherapy type of protocols that can work short term if you’ve been on stuff for a long period of time. No post psychotherapy stuff for most people. Is gonna typically bring levels back up to normal over time.

And, and again, there’s a lot of physicians that actually work with athletes with this. And what they usually end up doing is they have to put ’em on long-term, lifetime testosterone replacement therapy at true physiological dosages because that’s the only way that their body’s gonna be able to do that.

And I wanted to ask you about post psychotherapy, cuz that’s also something that people looking into this should know about and they wonder about. So how does that fit into responsible and intelligent use of these drugs? You mentioned, for example, coming off for several months at a time to allow your body to recover.

Is a post psychotherapy often included in that off time or It depends on circumstances. 

Yeah. And that’s, and that’s a good point. So I mean, ideally if you’re, again, I’m gonna use that example of you finish your show July 1st, so now you’re gonna need to be off everything for at least probably. Four weeks, six weeks, maybe eight weeks, depending on, on what compounds you were taking.

Before your body starts to kind of start feeling some of the things of not being, oh, that’s being outta your system, essentially at that point in time, that is when you would be, be appropriate to start the post psychotherapies. If you’re starting post psychotherapy, you know, one or two weeks after you finish your show, that’s the wrong time to start it, right?

So you probably need to wait again, at least probably four weeks, maybe six or eight weeks after you finish your show to actually start it. And then that process may take anywhere from four to eight weeks, typically maybe even 12 weeks. So realistically, if you’re off for two months, minimum off time would be four months.

Probably more like five to eight months is really the amount of off time. But some of that off time is gonna be part of that post psychotherapy. And then after that, if you just jump right in to another blast cycle, my question is, is why did he even do the post psychotherapy to begin with, right? Because.

You’re never letting your body be at normal physiological levels, and this is the case for most bodybuilders today. That’s why they don’t come off, is they basically just kind of stay on lower dosages, mitigate those risks because it’s kind of pointless to come off. And again, if your paycheck and you’re living is dependent on you competing and you’re doing two shows a year there, there’s no way that you can come off for a prolonged period.

You’re just basically taking smaller quantities or larger quantities and mitigating the risk as much as you can, which is where the health concerns come into picture. 

Because p c t is just not enough to give the effects required to do what you need to do in the case of shows and photo shoots and the rest of it.

Yeah. And you’re also the time required, right? So let’s say you do the Olympia in December. You do well, you wanna compete in next year’s Olympia. You’re gonna make progress in the off season, right? And they’re so, and during that time, you’re not gonna be using, you’re gonna make no progress. So by the time you show up to the next Olympia, you’re not gonna look good.

You’re not gonna win. 

And just so people can understand then, what is the purpose of post psychotherapy then? What’s its ideal use? 

So, it’s ideal use would be, in my opinion, it is to bring your, your hormone levels back to normal level. And leave them there. And leave them there and, and not mess with it, right?

If you’re gonna be continuing to mess with it, then there’s really no, no need or benefit to utilizing it, in my opinion. 

That makes sense. And you’ve mentioned duration a few times in our talk, and I think before we wrap up, we should talk about that as well as any other points you want to mention, again, about the healthiest and most responsible way to go about this.

So on this point of duration though, you had mentioned that the longer you use larger amounts of these drugs, the greater the risk. And so I wanted to hear more of your thoughts regarding that, just to help people understand in their own circumstances than how they should be thinking about the duration and at what point maybe is it, is it time to stop, right?

Yeah, I think it, it’s all definitely dependent on your goals. You know, if you’re a bodybuilder and you’re gonna, again, you’re gonna make a living doing this, then you’re gonna need to redline it for a period of time and, and that may be the time of your competitive career. If that’s the case, hopefully you get to the point where you’re, you’re good enough where you can, you have the luxury to maybe take a year off competing.

But the reality is, is sponsors that pay your bills are gonna want photo shoots and appearances and all of this stuff, and they’re gonna want you on stage because if you’re not on stage, people forget you. And then now you’re essentially worthless for that sponsor. So the reality is, is the guys that are, that are making a decent living, doing body building, remember even the, the best in the world only wins $400,000.

And that’s only one person. So, I mean, that’s pretty good money, but that’s only one person. If you’re 10th in the Olympia, you won 10 grand. You can’t even pay for what it takes to compete on stage, basically. So you need to make your living otherwise. And that’s gonna be with sponsors, right? So you can make a, a decent living at that point in time, but that’s gonna require you to be competing regularly, showing up, flying, and looking good.

So for those guys or women, you’re gonna have to be redlining pretty much all the time responsibly. You’re gonna either be, you know, blasting to peak for a particular show, or you’re gonna maybe be, you know, just cruising for a short period of time. And this is why the people that are competing, like at the Arnold and the Olympia, like at due to different pins of the year, it’s like they’re basically on blast almost the whole time.

And, you know, I, I often wonder what does their health look like? Because I don’t think there’s enough. You. Enough other things you can do to mitigate the, the health risks that are there. I, I think it’s, it’s inevitable, but that’s the game that they choose to play. So that individual aside, cuz that’s not the majority of people, right?

The, I’m gonna say the other individual, I’m gonna say maybe you do wanna make some, some short term gains for, uh, for yourself and you wanna, you wanna look good. So, 

or maybe, maybe just do body building as a hobby, but you know, it’s a hobby you really enjoy and it’s not gonna make you any money per se, but you do want to do it competitively for a, a period of time simply because you really like it.

And maybe we can even assume this person wants to do it as long as they. Can while still maintaining their health, but at the point where they can no longer maintain their health, that’s when they would walk away from it. Yeah. 

And I think that’s where it’s important to, again, using that least effective dose, kind of finding that sweet spot to be able to do it.

Or if you do do it, maybe you’re gonna say at that point in time, maybe you have the luxury to compete cuz you’re not making a living on it. Maybe you compete every other year. Right. And then you would maybe do a, a blast for, you know, four or six months and then you can maybe take a little bit of time or maybe you do one blast a year and then you’re kind of cruising the rest of the time to be able to kind of make the gains possible while still making, doing all those particular health checks to make sure you’re not, that things are kind of coming back to normal and they’re not necessarily drifting into potential deleterious long-term effects over time.

And then of course, when is it time to retire, you know? Well, When it’s no longer fun and, and you don’t, you no longer wanna do it, you can still live the lifestyle. And then in terms of, you know, utilizing stuff, there are gonna be individuals that are gonna choose to utilize stuff, you know, for long term.

And, and that’s okay. But if that’s the case, find that sweet spot where it’s that least effective dosage and you’re not having these other potential health consequences there. Or the alternative is, is just stop and then let your normal levels come up to normal. But that’s the hard part I think for a lot of individuals.

Cuz once they’ve. Once they’ve seen what it’s like to be on there and you’re, you feel really good and you, you see the results on that, it is often hard to revert back to not, but it’s definitely possible and it’s definitely something that that can be done.

 So if I’m hearing you correctly, then. The risks. If as long as you, you do a lot of what you’ve shared here and you’re mitigating the risks, there’s not necessarily a cumulative effect over time, whether you’re doing it for five years, 10 years, 15 years, 20 years, if you go about it responsibly and you don’t make any. Major mistakes, then you should be able to maintain your health regardless of the total duration.

Yeah, I think as long as, as long as all those biomarkers are in check, there’s a possibility. I’m not saying that it won’t, cuz everybody’s gonna be different and that’s why it’s important to monitor those if those things are not going out of balance. So if your blood pressure is healthy, you know, all your blood work looks good, your ejection fraction looks good, et cetera, et cetera, you know, your liver function looks good.

If all of those things are in line and, and you’re, you’re able to find that least effective, minimum effective dose and you’re seeing the the results, then you may be able to do that. Some people may not be able to do that and the reality is, is most people that are utilizing any that’s beyond super physiological dosages.

You’re probably gonna run into problems. I mean, that’s just the reality and, and that’s where you have to kind of make that that decision. That makes sense. 

And so are there any other key issues that you wanna, you wanna mention again regarding going about this in a healthy evidence-based manner? 

Yeah, well I’m gonna kind of state the obvious that obviously if you’re, a lot of things work, right?

So you know, but it’s not about what works, it’s about what’s safe. And I think finding that combination of works and safe and meeting somewhere in the middle is where what’s effective, because you can blast a ton of stuff for a long period of time. And yes, you will look, especially if you have good genetics and you’re doing all the other things right, you’re probably gonna look pretty amazing.

But. It’s gonna come at a consequence of health issues over time. And again, it doesn’t creep up in necessarily three months or six months. It’s gonna creep up typically over years and years and years. Where now you know, you started when you were 25 and then now you’re 40, 45, 50. And then now you, you start seeing all of these major effects on, especially if you’ve never checked those things to begin with, that’s when you’re gonna have major issues.

And ironically, it requires the same patience really, to do everything that you’re talking about as it does to just. Except a slower rate of progress is a natural weightlifter because I’m sure psychologically and even physiologically, it’s kind of like probably similar to newbie gains. You start lifting your body’s hyper responsive, it’s fun, and then things slow down and you have to recalibrate your expectations.

Or it’s not so fun because you don’t know what happened. I’m assuming it’s similar with steroid use. In the beginning. Your body’s hyper responsive. It’s a new, it’s new and it’s fun, but to progress past the newbie gains phase, so to speak, of steroid use, then it requires the same self-control really to understand that while you can just double your doses and add these other things, chasing what you experienced in the beginning, that is going to have negative consequences.

And so as far as the, the personality that’s required to go about this intelligently, that is the same person who could. Stay natural and accept that you gotta work really hard for not a lot of muscle and strength after a few years. 

Yeah, and I think that’s a great point because there is a point of diminishing returns.

You know, even if you do go the path of utilizing the anabolic steroids where you’re right, I mean you’re your first, you know, cycle or two, you’re gonna experience similar newbie gains over time. And those, those definitely diminish. And if, if that wasn’t the case, you know, we would have 600 pound monsters, not 280 pound monsters.

Right. And these are individuals with extremely good genetics already. I mean, realistically, most people, if you can add 50 pounds of muscle to your frame, Enhance. There’s very few people that I think are gonna be able to gain much more than that with or without drugs, right? Well, probably without drugs.

There are a few anomalies where maybe they’re, they’re kind of getting a little bit beyond that, but, but about 50 or 60 pounds of muscle, if you can add that, enhance over time, right? You’re probably not gonna add 50 to 60 pounds of quality tissue unenhanced, right? No matter what kind of genetics you have.

But if you’re, if you’re enhanced, you may be able to maximize that. And, and we see that in a lot of these great bodybuilders, right? And I mean, you look at Jay Cutler, you look at Dexter Jackson where you know, now you see them. Now they are legitimately more on t r T type dosages, but Jake Cutler is still an amazing physique, even at 50 years old, you know, utilizing, you know, significantly lower dosages, even if he’s on a, at a T R T dose, even if he’s.

It’s significantly lower than it was. You know, he’s a 50 some year old man. Obviously he sold trains well, he still eats well, takes all the boxes. And he’s genetically gifted, but he’s definitely not, you know, the Jay Cutler, when he was Mr. Olympia, he’s probably 40 pounds, less than that, 30 pounds less than that.

Dexter Jackson kind of on the same boat where he was probably a two 30 pound individual. You know, he might be about 200 pounds now. Still looks great, great structure, great physique, still lean, but not the Dexter of when he won the Olympian 2008. 

Of course. Yeah. Yeah. And that, that is a good point just for people to understand that.

And you know, I’ve heard from people who have just shared their experience with me of when you do eventually, or if you are going to be using a lot less, you need to understand that that is going to happen. And you just have to be psychologically, you have to accept that you are not going to look the same, you’re not going to perform the same to expect otherwise is to set yourself up for disappointment.

And, um, that then can, and, and people have shared with me that. That psychological component has driven them back to using more drugs and larger amounts of drugs, even when they knew that they should, that that period of their life should be over. They should be more on the t r t now and accept that they can still look great and by normal standards, let’s say, and have great workouts and so forth, but it’s just not going to be the glory days forever.

Exactly. And, and for me, you know, I, I mentioned a few guys, but one guy that really sticks out to me is Leela Brata, who, he’s in his sixties now. He was one of my favorite bodybuilders from back in the day. And I mean, you look at him at 60 some years old and. I mean, the guy still chiseled great Muscle Bellies, and again, I don’t know him personally, but I, you know, he, he looks selfie.

I don’t, I don’t imagine he’s, you know, blasting on a ton of stuff, probably on t r t type stuff. But again, somebody with good genetics, good work ethic, knows how to train, takes care of his body. And even though he’s 60 or in his sixties I should say, you know, that physique is still amazing. 

Totally agree.

Well, I, I’ve kept you 30 minutes longer than I originally planned. I, I actually just noticed it now. And so I wanna be, I wanna be respectful of your time and just ask, was anything else that you wanna mention before we quickly wrap up here? 

No, I just wanted to say thanks for bringing me on and I, I appreciate you having me here.

If you wanna follow me on Instagram, I’m at Dr. G Fit and you can follow my, my research on that. Or if you can go to my university website csb.edu and you can find my name there and hopefully Id love to hear from you as well. 

Yeah. And thanks again for of time. This was a great discussion. 

Thank you for having me.

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