Testosterone Therapy Causes Long Term (10 year) Drastic Weight Loss (23kg) in Obese, Overweight Men.

[tankasnowgod]

A really impressive study, both for how long it went, and the results it obtained. It followed men taking Testosterone Therapy injections (1000mg once every twelve weeks), and men who were offered this therapy, but declined. The results are not only "drastic," as the following article says, but long term, as the longer the study went on, the more weight was lost in the Obese group, with no rebound sort of effect to baseline. The Overweight group also lost weight over 7 years, and then appears to mostly plateau at a new, lower weight. As far as "Losing Weight and Keeping it Off," this study does incredibly well in both of those groups.

Testosterone injections 'can trigger drastic weight loss' in obese men

Men in Germany saw their weight drop by 4st and 3lbs (27kg) over a decade after getting testosterone jabs. Those who opted against the therapy saw their weight increase by almost a stone (6kg).

www.dailymail.co.uk

Testosterone injections can trigger drastic long-term weight loss in obese men, a German study has found. Men with an average weight of 18 stone (114kg) saw their weight drop by 4st and 3lbs (27kg) over a decade while having the jabs every three months as part of a study. Their body mass index (BMI) went from the 'severely obese' category, of 36.8, to 'overweight', at 28.8, just four points off the healthy weight range. In comparison, men who were not given the testosterone therapy saw their weight increase by almost a stone each (6kg).

Looking at the study, it would appear that very little weight loss occurred in the first year of injections. It seemed that it really started to occur in the second year, and keep on going over the course of the study.

Differential effects of 11 years of long-term injectable testosterone undecanoate therapy on anthropometric and metabolic parameters in hypogonadal men with normal weight, overweight and obesity in comparison with untreated controls: real-world data

Obesity is a chronic disease, warranting long-term medical intervention. We evaluated effects of testosterone (T) therapy (Th) in men with T deficiency with normal weight, overweight and obesity on anthropometric and metabolic parameters, compared with ...

www.ncbi.nlm.nih.gov

Results​

Long-term TTh in hypogonadal men, irrespective of weight at baseline, produced improvements in body weight, waist circumference (WC) and body mass index (BMI). Furthermore, TTh decreased fasting blood glucose and HbA1c and improved lipid profiles. Gradual decreases in blood pressure (systolic and diastolic) and pulse pressure occurred in men treated with T in each group. Marked reductions in mortality and major cardiovascular events were recorded in men receiving TTh.

Conclusions​

Our findings demonstrate that TTh produces reductions in weight, WC, and BMI. There were 77 (19.5%) deaths in the untreated groups and 23 (5.4%) in the T-groups. Based on these findings we suggest that long-term TTh in overweight and obese hypogonadal men produces progressive and sustained clinically meaningful weight loss and that TTh may contribute to reductions in mortality and incident major adverse cardiovascular events.

The graphs showing the loss in weight and waist circumfrence-

PubMed Central Image Viewer.

The same group of researchers also appeared to post the results at the five year mark of the study-

Error - Cookies Turned Off

onlinelibrary.wiley.com

Now, 1000mg injections every 12 weeks isn't the greatest dosing schedule, and it doesn't appear that any attempt was made to control estrogen with AI's or other drugs, T undecanoate was used, and there was no attempt made to monitor or supplement other hormones, like DHT or DHEA. Still, with all that being said, many Obese men were able to drop 50 pounds (or more in some cases), and keep it off and/or keep losing weight for a 7 to 11 year period, making it one of (if not the) most impressive studies ever conducted involving long term weight loss.

 

[haidut]

A really impressive study, both for how long it went, and the results it obtained. It followed men taking Testosterone Therapy injections (1000mg once every twelve weeks), and men who were offered this therapy, but declined. The results are not only "drastic," as the following article says, but long term, as the longer the study went on, the more weight was lost in the Obese group, with no rebound sort of effect to baseline. The Overweight group also lost weight over 7 years, and then appears to mostly plateau at a new, lower weight. As far as "Losing Weight and Keeping it Off," this study does incredibly well in both of those groups.

Testosterone injections 'can trigger drastic weight loss' in obese men

Men in Germany saw their weight drop by 4st and 3lbs (27kg) over a decade after getting testosterone jabs. Those who opted against the therapy saw their weight increase by almost a stone (6kg).

www.dailymail.co.uk

Looking at the study, it would appear that very little weight loss occurred in the first year of injections. It seemed that it really started to occur in the second year, and keep on going over the course of the study.

Differential effects of 11 years of long-term injectable testosterone undecanoate therapy on anthropometric and metabolic parameters in hypogonadal men with normal weight, overweight and obesity in comparison with untreated controls: real-world data

Obesity is a chronic disease, warranting long-term medical intervention. We evaluated effects of testosterone (T) therapy (Th) in men with T deficiency with normal weight, overweight and obesity on anthropometric and metabolic parameters, compared with ...

www.ncbi.nlm.nih.gov

The graphs showing the loss in weight and waist circumfrence-

PubMed Central Image Viewer.

The same group of researchers also appeared to post the results at the five year mark of the study-

Error - Cookies Turned Off

onlinelibrary.wiley.com

Now, 1000mg injections every 12 weeks isn't the greatest dosing schedule, and it doesn't appear that any attempt was made to control estrogen with AI's or other drugs, T undecanoate was used, and there was no attempt made to monitor or supplement other hormones, like DHT or DHEA. Still, with all that being said, many Obese men were able to drop 50 pounds (or more in some cases), and keep it off and/or keep losing weight for a 7 to 11 year period, making it one of (if not the) most impressive studies ever conducted involving long term weight loss.

Amazing study, thanks for posting!
The dosing regimen comes down to about 12mg daily, which is only slightly above physiological dose but still way below what is usually considered sufficient by athletes/bodybuilders to change body composition. @Yucca and @TheBeard may find this very interesting, as I think there was some discussion in the thread below if doses below 20mg can even exert anabolic/slimming effects.

Testosterone levels on oral test base

Anyone measured their test levels on oral test base? I'm getting tired of rubbing cream and DMSO everyday. So I went ahead and ordered (a lot) more testosterone base powder to try an oral experiment. No idea how to calibrate the dose, I have no idea how it absorbs orally. I will probably start...

raypeatforum.com

 

[tankasnowgod]

Amazing study, thanks for posting!
The dosing regimen comes down to about 12mg daily, which is only slightly above physiological dose but still way below what is usually considered sufficient by athletes/bodybuilders to change body composition. @Yucca and @TheBeard may find this very interesting, as I think there was some discussion in the thread below if doses below 20mg can even exert anabolic/slimming effects.

To that end, there is also this study-

Testosterone replacement increases fat-free mass and muscle size in hypogonadal men - PubMed

Testosterone-induced nitrogen retention in castrated male animals and sex-related differences in the size of the muscles in male and female animals have been cited as evidence that testosterone has anabolic effects. However, the effects of testosterone on body composition and muscle size have...

pubmed.ncbi.nlm.nih.gov

It used 100mg test enanthate per week, which is just over 14mg a day, and the men appeared to put on about 11 pounds of muscle in 10 weeks. So, at least in hypogonadal men, it looks like doses under 20mg a day (or averaging less than that) can have pretty powerful effects. And "hypogonadal" men are still going to be a huge portion of the general population, at probably at least 30-40% of adult males, maybe more?

Also, when you look at the 5 and 10 year results at the top of the thread, there is also the possibility that those same doses could have slimming or the "anabolic" effect in muscle if used in a longer time frame in men not considered hypogonadal. The biggest drop in weight in seemed to happen after the first year of the regimen (between months 12 and 24), and most studies on testosterone seem to max out around the 3 or 6 month mark.

 

[Mauritio]

A really impressive study, both for how long it went, and the results it obtained. It followed men taking Testosterone Therapy injections (1000mg once every twelve weeks), and men who were offered this therapy, but declined. The results are not only "drastic," as the following article says, but long term, as the longer the study went on, the more weight was lost in the Obese group, with no rebound sort of effect to baseline. The Overweight group also lost weight over 7 years, and then appears to mostly plateau at a new, lower weight. As far as "Losing Weight and Keeping it Off," this study does incredibly well in both of those groups.

Testosterone injections 'can trigger drastic weight loss' in obese men

Men in Germany saw their weight drop by 4st and 3lbs (27kg) over a decade after getting testosterone jabs. Those who opted against the therapy saw their weight increase by almost a stone (6kg).

www.dailymail.co.uk

Looking at the study, it would appear that very little weight loss occurred in the first year of injections. It seemed that it really started to occur in the second year, and keep on going over the course of the study.

Differential effects of 11 years of long-term injectable testosterone undecanoate therapy on anthropometric and metabolic parameters in hypogonadal men with normal weight, overweight and obesity in comparison with untreated controls: real-world data

Obesity is a chronic disease, warranting long-term medical intervention. We evaluated effects of testosterone (T) therapy (Th) in men with T deficiency with normal weight, overweight and obesity on anthropometric and metabolic parameters, compared with ...

www.ncbi.nlm.nih.gov

The graphs showing the loss in weight and waist circumfrence-

PubMed Central Image Viewer.

The same group of researchers also appeared to post the results at the five year mark of the study-

Error - Cookies Turned Off

onlinelibrary.wiley.com

Now, 1000mg injections every 12 weeks isn't the greatest dosing schedule, and it doesn't appear that any attempt was made to control estrogen with AI's or other drugs, T undecanoate was used, and there was no attempt made to monitor or supplement other hormones, like DHT or DHEA. Still, with all that being said, many Obese men were able to drop 50 pounds (or more in some cases), and keep it off and/or keep losing weight for a 7 to 11 year period, making it one of (if not the) most impressive studies ever conducted involving long term weight loss.

Interesting study . Thanks for sharing.
But can you compare a 1000mg per 12 weeks to 12mg daily dosage?
I'd say definitely not. A lot of it is going to aromatize, especially in obese patients. Which makes it even more interesting that they achieved such a drastic weight loss. Maybe estrogen is needed for weight loss after all ?

On the other hand, doesn't Testosterone in super high dosages also function as an aromatase inhibtor?

It's also remarkable that they didn't see much weight loss for a whole year! I guess most people would have already stopped TRT after a year, if weight loss was there goal. Maybe the T helped getting the liver in shape and that can take some time.

 

[haidut]

A lot of it is going to aromatize, especially in obese patients. Which makes it even more interesting that they achieved such a drastic weight loss. Maybe estrogen is needed for weight loss after all ?

Very unlikely, not at those doses. I know bodybuilders who inject 700mg+ weekly and still don't have a major problem with estrogen. Also, T is itself an aromatase inhibitor so it is a constant tug of war between its anti-estrogen effects and it being a substrate for aromatase and raising estrogen. T is also a poor substrate for aromatase, and main/preferred one being androstenedione. The latter is a metabolite of DHEA and a reverse metabolite of T. So, I guess that shows DHEA more readily converts into androstenedione than T since doses above 10mg per pop (and 15mg daily) can easily raise estrogen. The back-conversion of T into androstenedione only seems to happen in doses above 50mg daily.
Also, as the other thread by @Hand showed, oral T in doses of 80mg+ daily actually lowered estradiol. Assuming 10% absorption for the oral T undacenoate (TU) this comes down to precsiely the 10mg-20mg range, so it is similar to the studies posted here and the discussions in the thread on oral base T above.

Oral Testosterone Increases Total Testosterone

There was a recent discussion that oral testosterone is ineffective for raising blood testosterone levels unless given in large doses, like 400mg daily. Two studies (R, R) show that as low as 80mg daily is able to increase testosterone nicely. Here's a pic from the second study: Group 1 got...

raypeatforum.com

@tankasnowgod

 

[Mauritio]

Very unlikely, not at those doses. I know bodybuilders who inject 700mg+ weekly and still don't have a major problem with estrogen

That's highly anecdotal, so I'll take it for it's worth.
You can't really compare lean bodybuilders, who take all kinds of heavy pharmacology to obese people who eat a SAD.

Also, T is itself an aromatase inhibitor so it is a constant tug of war between its anti-estrogen effects and it being a substrate for aromatase and raising estrogen. T is also a poor substrate for aromatase, and main/preferred one being androstenedione. The latter is a metabolite of DHEA and a reverse metabolite of T. So, I guess that shows DHEA more readily converts into androstenedione than T since doses above 10mg per pop (and 15mg daily) can easily raise estrogen. The back-conversion of T into androstenedione only seems to happen in doses above 50mg daily.
Also, as the other thread by @Hand showed, oral T in doses of 80mg+ daily actually lowered estradiol. Assuming 10% absorption for the oral T undacenoate (TU) this comes down to precsiely the 10mg-20mg range, so it is similar to the studies posted here and the discussions in the thread on oral base T above.

Interesting.

 

[Yucca]

@haidut : A friend who’s training with weights for years, who did take AAS, and was on PCT has switched with oral test base (ALL other test with added esters won’t really work, never). He found that 20mg/day (like me) was not enough, as he weights 95kgs (210lbs), and train 5-6x/week, so he took 2x30mg/day to replace his 250mg injectable test/week.
It’s about the dose he needs to keep his shape and replace the injectable (7x60 oral = 420mg/w instead of 250mg injectable). It’s about 50% bioavaibility for him, as 250mg test in oil without ester added is about 200mg test.
But his androgen receptor are already quite saturated, as he’s on juice for more than 10 years, not me. So for a newbie, the 20-30mg/day is vastly enough to get huge test levels (and gain some muscle if you eat and train enough)

His saliva test results are almost sky high as mine.
I asked him also to take his last dose 24h before the saliva test.

So it really works. In the real world. Second one. Others will be the same, if they got tested. With real test base, of course, not the toxic crap with added ester from pharma labs.
(and also NO sides for him, no bloating, nothing, no suppression, but he’s also taking 150-200mg preg/day)

 

[tankasnowgod]

Interesting study . Thanks for sharing.
But can you compare a 1000mg per 12 weeks to 12mg daily dosage?
I'd say definitely not. A lot of it is going to aromatize, especially in obese patients. Which makes it even more interesting that they achieved such a drastic weight loss. Maybe estrogen is needed for weight loss after all ?

I would think there would be differences in frequency of dosage, and would think a more frequent dosing schedule would probably show more benefits (or quicker results) than once every 12 weeks.

As for estrogen, I don't think you can get it to "zero," nor "absolutely crush" it. Nor would you want to. With drugs like letrozole and exemestane, men experience a 60-90% reduction. You'd need really extreme protocols to flatten it, potentially using drugs like goserilin acetate, which is going to have far more side effects than benefits.

But aromatase inhibitor do seem to accelerate weight loss in the obese.

Aromatase Inhibitors Plus Weight Loss Improves the Hormonal Profile of Obese Hypogonadal Men Without Causing Major Side Effects

Objective: In obese men, the increased expression of the aromatase enzyme in adipose tissue leads to high conversion of androgens to estrogens contributing to hypogonadotropic hypogonadism (HHG). Our objective is to evaluate efficacy and safety of weight ...

www.ncbi.nlm.nih.gov

The average WL for the whole population was −6.2 ± 6.6 kg. Participants in the AI+WL group experienced greater weight reduction (−8.3 ± 7.5 kg) compared to PBO+WL group (−3.2 ± 3.8 kg) at 6 months of intervention; however, the difference did not reach statistical significance (adjusted p = 0.17) (Figure 3A). There was a higher reduction in total body fat mass in the AI+WL group compared to the PBO+WL group (−4.4 ± 3.9 vs. −0.7 ± 1.9 kg, p = 0.05)

And it's one of those things that appears to continue to be studied-

ClinicalTrials.gov

clinicaltrials.gov

It's also remarkable that they didn't see much weight loss for a whole year! I guess most people would have already stopped TRT after a year, if weight loss was there goal. Maybe the T helped getting the liver in shape and that can take some time.

Since all the subjects in the study were considering TRT, they were likely to attempt other improvements, like dieting and exercise. If you look at the Obese men who were in the control group, their weight appeared to drop slightly in the first year, before returning to baseline and then increasing over the course of the study.

 

[Rasaari]

Testosterone enanthate is 70% testosterone. Undecanoate is 61%. Also injecting such a large dosage once doesn't fully get absorbed, a lot gets wasted. Theres only so much IM can deliver before it gets removed. Splitting for example the dosage between 2x2ml glute injections instead of one 4ml provides much larger absorption.

The european way of doing TRT is really ridiculous. Injecting nebido (test undecanoate) every 12 weeks is really moronic. First the blood levels spike high and generate a lot of estrogen, and then the last 4 weeks you're severely hypogonadal, get moodswings etc. Most TRT patients have a problem with excess estrogen and most bodybuilders that go over 500mg of test need an AI @haidut . Also the larger the ester the more estrogenic it is.

 

[tankasnowgod]

Also, as the other thread by @Hand showed, oral T in doses of 80mg+ daily actually lowered estradiol. Assuming 10% absorption for the oral T undacenoate (TU) this comes down to precsiely the 10mg-20mg range, so it is similar to the studies posted here and the discussions in the thread on oral base T above.

Oral Testosterone Increases Total Testosterone

There was a recent discussion that oral testosterone is ineffective for raising blood testosterone levels unless given in large doses, like 400mg daily. Two studies (R, R) show that as low as 80mg daily is able to increase testosterone nicely. Here's a pic from the second study: Group 1 got...

raypeatforum.com

One of the studies mentioned Andriol, and the ingredients are interesting....

Andriol Testocaps

www.nps.org.au

Each Andriol Testocap capsule consists of 40 mg of testosterone undecanoate (equivalent to 25.3 mg testosterone) in hydrogenated castor oil and propylene glycol monolaurate. The capsule shells contain the following inactive ingredients: gelatin, glycerol, medium chain triglycerides, lecithin, sunset yellow FCF and printed with Opacode WB water based monogramming ink NSP-78-18022 White.

The two things that jump there is first, that 40 mg of undecanoate equivalent to 25.3mg of testosterone. So, if the absorption rate is the same, 50mg should work about the same. Is there anything that suggests that base test is better absorbed orally?

Also, could the oil used make a difference? Hydrogenated Castor Oil seems a bizarre choice, since it was often used to induce vomiting or diarrheas. Wouldn't Olive Oil or even high oleic sunflower oil be a better choice?

I also noticed this part for the second study-

Treatment​

After entry to the study, men were administered oral TU daily for 6 months with men in group 1 receiving 80 mg daily and group 2 receiving 120 mg divided into two daily doses. In addition all men received standard therapy consisting of a mixture of vitamins and mildronate.

Is there anything mildronate can't do?

 

[tankasnowgod]

Also injecting such a large dosage once doesn't fully get absorbed, a lot gets wasted. Theres only so much IM can deliver before it gets removed. Splitting for example the dosage between 2x2ml glute injections instead of one 4ml provides much larger absorption.

What? Injection, by definition, should be 100% absorption.

The european way of doing TRT is really ridiculous. Injecting nebido (test undecanoate) every 12 weeks is really moronic. First the blood levels spike high and generate a lot of estrogen, and then the last 4 weeks you're severely hypogonadal, get moodswings etc. Most TRT patients have a problem with excess estrogen and most bodybuilders that go over 500mg of test need an AI @haidut . Also the larger the ester the more estrogenic it is.

I agree with most of this, I certainly wasn't recommended the dosage schedule or the type of ester.

Still, even with all of these problems, it's still far and away the most drastic long term weight loss study I have ever seen (50+ pound weight loss in Obese subjects with no rebound and keeping it off for a decade!). If you have a better long term weight loss study, please post it.

 

[Rasaari]

What? Injection, by definition, should be 100% absorption.

No, the oil based injections take time to absorb, and after few days it starts to get destroyed. The smaller the injection compared to muscle, the better. I will find you a study on the absorption, but no I don't have anything on long term weight loss.

 

[Rasaari]

Here's one https://paulogentil.com/pdf/Pharmacokinetics and Pharmacodynamics of Nandrolone Esters in Oil Vehicle.pdf @tankasnowgod

As you can see from the graph attached, gluteal 1ml injection had almost twice the absorption compared to deltoid. 1ml to deltoid is just too much to absorb at once, while to the glute its much smaller amount. I'm pretty sure I've seen one study where they split the dosage compared to one dose and I'll try to find it too.

Edit: actually you can also see that 4 ml gluteal injection had WORSE absorption than 1 ml! 4ml is too large for even glute and after about 3-4 days the injection gets removed.

Edit2: "Based on the area under the curve estimates for these two subjects, the absolute bioavailability of nandrolone from i.m. injections of esters was significantly higher for nandrolone decanoate injected into gluteal muscle with a 1-ml volume (73%), compared with the other three groups (53–56%)."

"The present study demonstrates that, in addition to the chemistry of the side-chain ester, both injection site and volume can systematically influence blood nandrolone levels after i.m. injection of nandrolone esters in an oil vehicle formulation. Corresponding to the patterns of blood nandrolone concentrations, pharmacodynamic indices reflecting androgen-induced inhibition of pituitary-testicular function, namely blood testosterone and inhibin concentrations, are also systematically influenced by these factors"

 

[Peroxphos]

It's also remarkable that they didn't see much weight loss for a whole year! I guess most people would have already stopped TRT after a year, if weight loss was there goal. Maybe the T helped getting the liver in shape and that can take some time.

Maybe one year is the time it takes for this T regimen to cure the hypercortisolemia (which all those severely hypogonadal men certainly have) and restore cortisol blood levels and cortisol sensitivity to normal levels

 

[tankasnowgod]

I just came across this review of Testosterone Therapy. It cites 28 studies, and in each one, Lean Body Mass Increased, and Fat Mass decreased. They ranged from 3-60 months, with many lasting 12 months, and five studies lasting two years or more. It looks like Waist Circumference went down in every study, even in the ones where weight and BMI remained constant-

Testosterone and weight loss: the evidence

The purpose of this article is to examine the contemporary data linking testosterone therapy in overweight and obese men with testosterone deficiency to increased lean body mass, decreased fat mass, improvement in overall body composition and sustained ...

www.ncbi.nlm.nih.gov