MD: Stopping T will be misery

Monday, March 03, 2014

The Nevada Athletic Commission recently voted unanimously to end Therapeutic Use Exemptions for Testosterone Replacement Therapy. That means some number of fighters, including Vitor Belfort, will have withdraw from TRT. In a interview with the ever-excellent FightLand, Dr. Neil Goodman, chairman of the Reproductive Endocrinology Scientific Committee for the American Association of Clinical Endocrinologists, explains that quitting ain't easy.

If a young guy comes in with low testosterone, my first thought is this guy’s been taking steroids,” said Dr. Goodman. “And I’m usually right.”

“When you come off of it, your testes are not working. And it may be months or years, or never, until they ever start making testosterone.”

“I’ll say to him, 'Okay, what are you taking?' He’s honest with me and says he’s just taking injectable testosterone. I’ll say, 'Stop it.' In a couple of weeks, I’ll do some blood work and see what his baseline level is after he comes off the stuff. Then I’ll put him on some gel that’s going to give him a steady amount of testosterone, bring his level up to give him a 'normal' level of testosterone that he can stay on, let him have a chance to recover, and see what we can do after a few months.

“Some guys, I can get their testes to start working again. We use a drug called Clomiphene, and for those guys, it wakes up the brain computer that runs the show because it’s been shut down. If I have a shot at them coming back to normal with tapering down their gel and keeping them on Clomiphene, over about three or six months or more, I’ll start to see their testosterone production come back. I do a lot of infertility work, and a lot of the reason that we’re treating these guys is because they want to have a baby: They’re making zero sperm because the whole thing is shut off, and over time, I might be able to get them to produce sperm again.

“Every single guy whose exemption is getting taken away is going to come up with very low testosterone, and he won’t be able to compete, at least on the level that he might have been competing at.”

“Their muscle strength will decline. They’ll put on some fat weight. Their moods will become depressive. They’ll have fatigue. It’ll be horrible—I feel bad for them. It’s going to be misery … I’m not saying all guys are going to have serious problems. It depends on what they’ve been on, how much they’ve been taking, what other drugs they’ve been on. It’s a mixed bag.

Any guy that’s coming off testosterone because of this ruling, he needs to see an endocrinologist. Do not go to any of these anti-aging guys. Don’t go to the family doctor. If he wants his health restored, he must see an endocrinologist. That’s my message, because that’s the only person with the training to help him deal with coming off the testosterone.

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