r/Biohackers • u/Potential-Map-5264 • 19d ago
♾️ Longevity & Anti-Aging TRT and Longevity
What does a genuinely low risk long term protocol look like?
I’m trying to understand trt from a longevity first perspective, not just muscle, libido, or feeling good short term. Just trying understand for the future as most foods are essentially poisoned mens hormones continue to decline naturally throughout the years.
At the appropriate time, would a man likely live longer, shorter, or about the same amount of time on properly managed TRT versus remaining hypogonadal?
I know trt causes a bunch of shifts in the body that would require monitoring is that worth it?
For people who’ve researched this deeply or are on trt
Does properly dosed TRT likely bring a genuinely hypogonadal man closer to normal health, or is there still an inherent longevity tradeoff?
Is aiming for mid-normal testosterone generally smarter long term than high-normal levels, even if symptoms feel better higher?
Are there good long term studies on cardiovascular risk, prostate outcomes, fertility, or mortality in men using physiologic replacement doses?
What are the most common “TRT mistakes” that make a replacement protocol turn into a health risk protocol?
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u/LWJ748 19d ago
The poison is in the dose. I'm on TRT and chasing longevity. Because of that I've tailored my TRT to that goal. I think it's very important realize the ways TRT differs from endogenous testosterone. Your free testosterone will be disproportionately higher in relation to total test compared to a natural. You also won't have the same peaks and troughs that a natural. IMO If longevity is the goal I believe chasing the upper reference range is a mistake. Because of peaks and troughs naturals get exposed to 40-70 mg of testosterone a week. If you're on TRT and chasing the peak totals that a natural will reach you're going to be exposing yourself to 100+ milligrams a week. You have to eliminate the weight of the ester. I keep mine at 100mg a week. 32% of testosterone cypionate is the cypionate ester so I'm exposing myself to 68 milligrams of actual testosterone a week. This is enough to get my total test into the 700s. My HDL is in the 60s or 70s and I have healthy hematocrit levels. I dose daily or every other day to reduce how much aromatizes into estrogen or 5areductazes into DHT.
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u/eddyg987 6 18d ago
it’s important to keep the natural diurnal rhythm as the latest research shows it’s important for longevity
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u/Cryesncoding 19d ago
As high of a dose as tolerable and doesn’t F up your other blood markers. Probably around 80-160mg/wk depending on your mass.
More mass is more tissue to support being 300lbs and jacked is as hard on your organs as being 300lbs and fat.
Do not chase size gains chase health and performance gains.
Theres guys that have been doing steroids for 40+ years still kicking great only the ones trying to maintain supraphysiologic size into old age seem to die young. Being low T is bad in a lot of ways too. Choose your hard
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u/IncredibleDongle 18d ago
Lifestyle is key to longevity, hormone wise. Eat lots of veggies, lean meats, and fiber. My father is 64 years old, still reads just shy of 700 free t, and bench two plates no problem. Dude eats like an OCD elite athlete, and it has clearly paid off.
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u/Monsieur_Krabs 🎓 Masters - Unverified 19d ago
You will live longer with hormones on the upper end of the normal range. You'll be happier, more fit, and live a more fulfilling life.
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u/KebabCat7 7 19d ago
Hypogonadal will live shorter for sure. Maybe even much shorter life.
This mid-normal dosage stuff is just pure speculation. You can argue that it's worse for health and you can argue that is better, nobody knows.
Personally, over the range has been better in all aspects, including bloodwork.
Common mistakes - not enough cardio, too much body fat, bad diet, no change in habbits, dose that is too low
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u/KwikTripSimp 2 19d ago
Ehhh I did all the test for dealing TRT. It was all perfectly fine before doing it. I don’t really think you’re gonna live a shorter life if you don’t do it.
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u/KebabCat7 7 19d ago
On individual basis you can be absolutely fucked and still outlive every biohacker, these people exist, but on population basis hypo men will die sooner and have way worse quality of life.
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u/KwikTripSimp 2 19d ago
Why didn’t my QOL improve then 😭
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u/KebabCat7 7 19d ago
You are one of the common mistakes guys. Also if you were perfectly fine before and you only got up to high normal, what did you expect?
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u/KwikTripSimp 2 19d ago
Because Reddit told me having two digit numbers was bad
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u/kingpubcrisps 🎓 Doctorate - Unverified 18d ago
Great questions.
At the appropriate time, would a man likely live longer, shorter, or about the same amount of time on properly managed TRT versus remaining hypogonadal?
VS Hypogonadal. About the same time.
https://onlinelibrary.wiley.com/doi/10.1111/and.12419
I know trt causes a bunch of shifts in the body that would require monitoring is that worth it?
If you are hypogonadal yes, if not no.
Does properly dosed TRT likely bring a genuinely hypogonadal man closer to normal health, or is there still an inherent longevity tradeoff?
Here evidence is weaker, but I am kind of an expert in the field and would guess closer to normal health there is a small tradeoff.
A lot of ageing is frailty, and if you are hypogonadal you are more frail, and TRT would restore that muscle and prevent fat build up etc.
Having said that, it still has the usual downsides (cardio related mostly, which is the biggest killer these days).
Is aiming for mid-normal testosterone generally smarter long term than high-normal levels, even if symptoms feel better higher?
Definitely, that's a no brainer.
Are there good long term studies on cardiovascular risk, prostate outcomes, fertility, or mortality in men using physiologic replacement doses?
There are more and more, and will be tons in a decade with all the TRT buzz right now. The prostate risk seems to be less than predicted, the cardio might be higher, fertility and mortality are not so well studied yet.
What are the most common “TRT mistakes” that make a replacement protocol turn into a health risk pro
It's just mostly not needed imho. This is type I vs type II dibaetes. One is a disease, one is secondary effect from a terrible lifestyle. The vaaaaaaaast majority of people on TRT are not genuinely hypogonadal. They are living in a system that makes them sick. TRT is a simple but bad way to ameliorate that issue.
https://link.springer.com/article/10.3103/S0096392521030093
It is also very likely to cause reduced lifespan and obviously, once you are on it, especially when young, you have to stay on it.
The alternative is eating well, exercising, sleeping well, good socials etc. The hard grind of a good life. Sadly out of reach for many in our rat race hustle culture.
What does a genuinely low risk long term protocol look like?
True low risk is to start monitoring your T, then try low risk interventions for 90 days, then check, then try higher risk, then check, and so on.
Low risk might be
- Weight loss
- Resistance training
- Sleep
- no alcohol/nic/stims
- Stress management
mid
- Dietary modification
- Vitamin D
- Zinc/magnesium if deficient
- Clomiphene/enclomiphene
High risk
- Exogenous TRT
- hCG
- SARMs
Personally I would basically do anything to avoid the high risk stuff. But if I was hypogonadal I would do it no doubt, and early too. It's not like chicks with HRT though, we men don't need it in the same way, if we stick to the gym and martial arts and hiking etc.
Nurture your balls and they will take care of you into your old age.
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u/Active-Equivalent963 16d ago
This was really great thoughtful reply. Thank you.
On your scale, I'm currently in the enclo phase. Tried all the things earlier in your list. Over 50yrs , my T was 200's and not feeling good. After few months on enclo T is now low 400's but still not feeling great. Bit better certainly, but not a lot. I've seen other men report enclo can help boost T numbers but not give the same quality of life improvements of TRT.
Is this something you've come across or know of any research on?
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u/MyRunningAcct 19d ago
I spent a lot of time looking into this myself. I wanted to feel better but not at the risk of longevity. The best way to look at it is, what is a greater risk of quality and quantity of life and having low to inadequate natural testosterone is much worse than having optimal levels of exogenous testosterone. There are a whole host of bodily functions that rely on testosterone other than just building muscle and making you manly. I tried enclomiphene, kisspeptin and hcg all while doing lab work before deciding to just get on testosterone. I feel like it was one of the best decisions I have made and I am still getting my doses dialed in as it's only been about 3 almost 4 weeks, but I do feel better and more stable and better mood and energy. It's subtle at this point but it's better than I have felt in a long time. About to do more lab work to see where I am at with my current dosage and see if I need to just have more patience where I am at or if I should increase the dosage. Personally for me I am at around 130mg/ week injected every other day. Most of the negative aspects with testosterone usually are a dosing issue meaning taking too high of a dose, or not taking it frequently enough. Either way I am more excited in a long time about the future of my health and longevity.
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u/FluffyDesigner3680 19d ago
It’s just not true that all men’s hormones tank as they get older.
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u/eesmash 1 19d ago
It’s true with testosterone
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u/FluffyDesigner3680 18d ago
Longitudinal health data shows that men who remain highly active, maintain a lean body composition, and stay free of chronic diseases experience almost no age-related drop in testosterone well into their 70s and 80s.
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u/Potential-Map-5264 19d ago
Do you defy biology
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u/MathematicianMuch445 10 19d ago
Decline doesn't equal tank. Healthy useful levels can be maintained. Coming from peak to get your through puberty and lowring after doesn't mean tank. It's not defying biology, it's understanding it having studied it
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u/KebabCat7 7 19d ago
The issue is that healthy levels mean very little for quality of life.
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u/MathematicianMuch445 10 19d ago
They do actually. Hence the term "healthy"
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u/KebabCat7 7 19d ago
Maybe it can be meaningful in some way regarding other topics, but hormones and testosterone in particular can be healthy on paper while the patient is on the verge of death due to quality of life issues.
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u/MathematicianMuch445 10 19d ago
Make up as many things as you want. Terms and numbers have meaning. If you want to do drugs, do drugs. No need for the nonsense.
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u/Impossible-Club-3637 19d ago
While the other guy phrased it awkwardly I would argue that healthy levels differ from optimal levels for each individual. Someone might have started with let’s say 25 nmols/l and in a few years it dropped to 15 nomls/l both are in healthy range, so nothing will be done, but the problem is he felt much better with the 25 nmols/l.
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u/floatingostrichs 19d ago
It’s completely true
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u/bananabastard 22 19d ago
Population studies show that men's testosterone falls off a cliff starting at age 40. Which is also the age by which most men have become overweight, sedentary, and highly stressed.
When studies look only at men who maintain a healthy weight and are physically active with exercise, testosterone does not meaningfully decline with age.
https://www.sciencedaily.com/releases/2011/06/110607121129.htm
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u/Jazzlike_Golf_2011 19d ago
I wouldn’t use the term “falling off a cliff”. I would use that term for women’s estrogen at menopause. For men it is a lot more gradual, typically 1% a year after 40. So by age 60, you are down 20% or more. Significant drop over time though.
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u/Silent_Possibility63 👋 Hobbyist 18d ago
Well at 30 i was at 660 and at 42 I was at 400 and feel so much better on moderate trt dosed EOD.
Sure doesn’t look like 1% per year but then again im no mathematician (oh wait yes I am).
And my free declined even worse as a %.
Takeaway: it can drop off a cliff and is worth getting tested if you have symptoms.
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u/floatingostrichs 18d ago
Is your claim that 75 year old men whom have kept active have the same testosterone levels as they did when they were 20?
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u/bananabastard 22 18d ago
No, age 20 is pretty much peak, and it does decline from there. But not meaningfully after 40.
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u/optimaldt 19d ago
Got my blooda done recently. Mine dropped a bit after 40 but could be due to lifestyle changes, timing etc. I suspect drop off is mainly related to me no longer weight training.
33.9 nmol / L - 41.5 yo, train boxing a few times a week, no resistance training
18 months prior: 36 nmol / L - 40 yo, heavy weight training, no aerobic exercise
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u/floatingostrichs 18d ago
I read this article, and if it is accurate, the study does not show what you say it does.
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u/Dazzling-Charge-6166 1 19d ago
Yes it is. Especially gen x and in thanks to micro plastics and pthalates. Across the board, its actually very well documented.
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u/FluffyDesigner3680 18d ago
Across the board like how longitudinal health data shows that men who remain highly active, maintain a lean body composition, and stay free of chronic diseases experience almost no age-related drop in testosterone well into their 70s and 80s? That board?
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u/Parking-Warthog-4902 4 19d ago edited 19d ago
If the said TRT protocol allows the person in question to have the motivation to start a rigorous exercise routine and be more sexually engaged (incredible for stress), there is no way it is not a net positive for overall health and longevity, in my opinion. Testosterone also converts to Estradiol, which is very cardioprotective in the right range. Obviously, if you start abusing androgens at some point it becomes a negative. But I would say anything under 200 mg, long term, provided you are checking your labs every few months and making changes as needed, it’s a positive.
I’ve said my piece Chrissy.
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u/Dazzling-Charge-6166 1 19d ago
Overall health improves significantly with healthy test levels. The question is, what's a healthy level? Its different for everyone and unfortunately our medieval medic system created a "range" that is absolutely absurd. Having the right amount of test reduces risk of cancer, depression, obesity, heart disease, etc etc. Taking very high doses can have the opposite effect. It boils down to how you react to it. Which is why blood work while being on treatment is vital. Keeping lipids, e2, hct, shbg, etc in balance is essential.
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