Peter Attia MD - Anabolic steroids: effects, risks, and insights | Mike Israetel & Peter Attia
The conversation delves into the use of anabolic steroids, specifically testosterone, in non-medical contexts such as bodybuilding. It explains that testosterone is an anabolic steroid and discusses its use in testosterone replacement therapy (TRT) versus non-medical use for physique enhancement. The discussion highlights that bodybuilders often use doses much higher than those used in TRT, sometimes up to 20 times the typical dose, to achieve super physiological levels of muscle mass and low body fat. The effects of high testosterone levels include increased muscle mass, changes in mood, and psychological effects such as increased aggression and reduced empathy. The conversation also covers the management of estrogen levels, which can be affected by high testosterone use, and the potential side effects of using aromatase inhibitors to control estrogen. The safer use model is suggested, which involves balancing testosterone with other steroids like primobolan to manage estrogen levels without the need for toxic aromatase inhibitors. The discussion also touches on the psychological and physiological effects of high testosterone levels, including changes in sex drive and communication abilities.
Key Points:
- Testosterone is an anabolic steroid used in both medical and non-medical contexts.
- Bodybuilders often use testosterone at doses much higher than medical TRT to enhance muscle mass and reduce body fat.
- High testosterone levels can lead to increased aggression, reduced empathy, and changes in psychological behavior.
- Managing estrogen levels is crucial when using high doses of testosterone; safer use models suggest balancing with other steroids.
- Aromatase inhibitors, often used to control estrogen, can be toxic and should be avoided if possible.
Details:
1. 💉 Introduction to Anabolic Steroids
- Anabolic steroids are tools that can influence genetic limits in physical development, potentially allowing individuals to surpass natural performance boundaries.
- The conversation acknowledges the inevitability of genetic limitations in physical performance and explores how anabolic steroids can be used to overcome these barriers.
- There is an extensive body of work by the speaker on the topic, indicating a comprehensive understanding of the subject.
- The discussion prompts consideration of potential risks and ethical implications associated with anabolic steroid use, which are critical in evaluating their overall impact.
2. 📚 Understanding Testosterone and Steroid Use
- Testosterone is confirmed as an anabolic steroid, clearing common confusion and establishing its role and effects.
- Emphasizes the focus on anabolic steroid use primarily in nonmedical contexts, highlighting the widespread non-prescription use among athletes and bodybuilders.
- Anabolic steroids, including testosterone, are commonly used to enhance physical performance and muscle mass, despite potential legal and health risks.
- The discussion suggests a need for increased awareness and education on the implications of nonmedical anabolic steroid use.
3. 🏋️♂️ Anabolic Androgenic Steroids in Bodybuilding
- Testosterone replacement therapy restores testosterone to the upper physiological limit in men with low levels, providing a baseline for understanding steroid use impact.
- Bodybuilders use anabolic androgenic steroids to exceed normal hormone levels, aiming for significant muscle gains, unlike typical therapeutic applications.
- Discussion highlights both positive physical development and personal experiences, alongside the risks associated with unsupervised use of steroids.
- Certain populations lack experience with these substances, indicating a gap in understanding the full effects outside of bodybuilding contexts.
4. 🧠 Psychological Effects of Steroid Use
- Anabolic androgenic steroids (AAS) are synthetic derivatives of testosterone designed to enhance physical traits while minimizing androgenic effects.
- AAS are popular among athletes, bodybuilders, and gym enthusiasts for their ability to significantly increase muscle mass and reduce body fat beyond natural capabilities.
- Users often consume doses significantly higher than therapeutic levels, sometimes 10 to 20 times the amount typically used in testosterone replacement therapy.
- Psychological effects of AAS use include increased aggression, mood swings, and in some cases, depression and anxiety.
- Prolonged use of high doses can lead to a condition known as 'roid rage,' characterized by uncontrollable aggression and irritability.
- AAS use has been linked to changes in brain structure and neurotransmitter function, affecting mood regulation and behavior.
- Understanding these psychological effects is crucial for developing effective intervention and treatment strategies for users.
5. 💊 Dosing and Effects of TRT vs. High-Dose Steroids
- Patients are typically dosed twice a week to ensure smoother hormone levels, as opposed to once a week, which may cause fluctuations.
- The ideal dose for testosterone cypionate to achieve optimal levels is generally around 100 milligrams weekly, split into two 50-milligram intramuscular injections.
- Higher doses, such as 140 milligrams weekly (70 milligrams twice a week), are the maximum considered for physiological replacement.
- Median dose for effective testosterone replacement is 80 milligrams weekly, divided into 40 milligrams twice a week, which balances efficacy and minimizes side effects.
- Twice-weekly dosing is preferred due to its ability to maintain stable testosterone levels and reduce peaks and troughs that can lead to mood swings or other side effects.
6. 🔍 Exploring Individual Responses to Steroids
- Individuals may take 800 to 1,600 milligrams of testosterone weekly, often in combination with other steroids, to enhance effects.
- Testosterone is used for its health benefits, including being cardioprotective and neuroprotective, beyond just replacement therapy.
- Estrogen, derived from testosterone, plays a crucial role in enhancing strength and sex drive; it is more anabolic in combination with testosterone than alone.
- Testosterone administration ranges from 250 milligrams to 1,000 milligrams per week, with dosages adjusted based on side effects, particularly from excess estrogen production.
- Preferred forms of testosterone include enanthate and cypionate, with some opting for propionate for daily injections.
- Potential risks include cardiovascular issues and hormonal imbalances, necessitating careful monitoring and adjustment of dosages.
- Long-term use can lead to significant health implications, including liver damage, infertility, and psychological effects, highlighting the importance of medical supervision.
7. ⚖️ Psychological and Behavioral Changes from High Testosterone
7.1. Emotional and Psychological Changes
7.2. Social and Behavioral Dynamics
8. 🗣️ Communication and Relationship Dynamics on Steroids
- Anabolic steroid use often leads to deteriorated communication skills, especially in males, significantly reducing communicative effectiveness and straining relationships.
- Steroids can cause a dramatic increase in male sex drive, particularly when estrogen levels are unregulated, leading to both quantitative and qualitative changes in sexual behavior.
- Elevated androgen and estrogen levels can result in a powerful, sometimes overwhelming sexual drive, affecting relationship dynamics.
- High estrogen levels present varied effects on individuals, with some experiencing mood improvement and better physical recovery, while others face adverse effects like disrupted sleep, bloating, and mood swings.
- The hormonal changes due to steroids are highly personal, akin to women's hormone replacement therapy during perimenopause, highlighting the variability in individual responses.
9. 🔬 Safer Use Models and Estrogen Management
- The safer use model for anabolic steroids is gaining traction, with Joe Jeffrey from the UK as a key advocate, emphasizing the management of estrogen levels through androgenous drugs.
- This model focuses on metrics like personal feeling, appearance, and health markers from blood work to guide steroid cycles.
- High doses of testosterone, such as 1,000 mg, can lead to elevated estrogen due to aromatization, which may not be ideal for everyone.
- Individuals sensitive to estrogen might use a balanced approach with 500 mg of testosterone and 500 mg of Primobolan, which does not convert to estrogen, thus offering a strategic alternative.
- Steroids like Primobolan and Masteron not only avoid converting to estrogen but also possess properties that counteract estrogen conversion, enhancing estrogen management.
- Bodybuilding coaches customize steroid cycles, starting with a base cycle and adjusting based on individual responses, optimizing results while minimizing estrogen-related side effects.
- For instance, a coach might begin with a standard cycle and tweak based on how the athlete's body responds, focusing on both performance outcomes and side effect management.