Just had this conversation with my urologist over the weekend at dinner. He's prescribed 200 mg/wk to guys since the 1980's, no patient has ever had a problem. He was often criticized for that dose by his colleagues (endos and interns) but they had nothing to support that being a negative. Some of his patients were/are docs at his institution. He had the largest HRT practice at a major hospital. I also saw my 81 yr old friend, been on ND/TC about 200 mg/10 days for decades. Still doing very well. Gave the guy at hug before dinner and he felt like a 50 yr old lifter (hard physique), not at all weak, wirey and frail. His dad and uncle both died in the 40's from MIs and he has a Gleason 6 PCa that is stable but he's stayed fit (run and lift since his 20's). Regardless, we need data (echos and CT angiograms in particular) from the numerous HRT clinics that are prescribing 200 - 300 mg/wk of TC or TC/ND. A long term data set would help considerably with resolving these questions. The big question is, lets say that long term HRT does shave a few years off of life span, but you enjoy a significantly enhance QOL because of it. What is more important?
1. Genes are the most important variable. Nearly every supercentenarian (living to 110 years old and above) had continuous behavior such as smoking, drinking alcohol, and eating sweets like chocolate. Their genes allowed them to have extreme longevity despite "bad" choices. The same rings true for those who use AAS continuously yet maintain great health.
2. The majority of AAS users that have adverse effects usually originates from disregarding conditions such as hypertension, dehydration, etc. For example, kidney failure, heart failure, and other organ dysfunction can happen from solely living with severe, untreated hypertension. Neglecting adverse changes due to AAS use is pure gambling with one's health.
3. Dose a d duration of use with AAS does matter. The higher the dose, combined with longer duration, is a quick path to adverse physiological effects, especially if combined with diuretic, thyroid, and GH use.
No one should lower caution simply because others have the genetic capacity to stave off adverse effects from AAS use. Always make an informed, cautious choice if AAS and ancillaries are being used. Always stay on top of bloodwork and other physiological data (e.g. MRI on joints).