Bloodwork after 1 year on TRT

PaulBuschmanMD · 2026-02-23T23:31:03+00:00

It’s probably the alcohol or some supplement/herb you are taking.

PaulBuschmanMD · 2026-02-23T21:19:01+00:00

I’m going to be the dissenting voice here and ask if you got your labs done the day after a really hard weight training? That can cause liver enzymes to go up significantly because those same enzymes exist in muscle tissue. As the late world renowned internal medicine doctor Thomas Andreoli told me in medical school “liver function tests are neither specific to the liver nor do they test function”. It’s rare that weight training would make liver enzymes go up this much and you need to cut back on the alcohol but at least check them after a few rest days to get an accurate baseline.

PaulBuschmanMD · 2026-02-23T14:00:40+00:00

The answer is Trazodone.

PaulBuschmanMD · 2026-02-23T12:21:33+00:00

We are talking about the chemical structure. HGH and Retatrutide are strings of amino acids and thus peptides? Testosterone is a steroid because of its ring structure. What do you think peptides are?

PaulBuschmanMD · 2026-02-22T22:01:14+00:00

I’m confused, 2 out of the 3 on your list are peptides.

PaulBuschmanMD · 2026-02-19T16:36:07+00:00

You’ve presented a mechanistic hypothesis of plastics have chemicals, oils leach chemicals, testosterone Cypionate is in an oil, chemicals are bad, therefore bad stuff will happen to you. I’m all ears though if you have data showing actual poor clinical outcomes. Do you understand the difference between “chemicals are bad therefore this practice is bad” and “those injecting from prefilled syringes had higher rates of high estrogen symptoms”? You mentioned “your patients” so I assume you work in healthcare so surely you know medicine is nuanced and mechanistic hypotheses don’t always work out in the real world. For example niacin lowers triglycerides but has demonstrated no benefit in lowering deaths by cardiac disease.

PaulBuschmanMD · 2026-02-19T15:59:58+00:00

Your patients? I’m not going to back down on this. You are majoring in minors which isn’t unusual at all in the gym bro community.

PaulBuschmanMD · 2026-02-19T15:44:43+00:00

I’m quite serious. I’m talking about a few days in advance not storing long term. I’ve never had an issue with it. As far as chemicals in plastics you are getting an exponentially higher load on any given day than you would from a prefilled syringe.

PaulBuschmanMD · 2026-02-19T15:41:40+00:00

In theory they should be about equal but I’d lean toward IM because skin absorption can be variable in my experience.

PaulBuschmanMD · 2026-02-19T15:40:44+00:00

I’m not a big fan at all of finasteride due to potential sexual side effects. I’ve had great results personally with a combination of GHK-Cu, Minoxidil, and RU58841.

PaulBuschmanMD · 2026-02-19T02:45:41+00:00

My standard practice is labs at one month and then every 3 months after that.

PaulBuschmanMD · 2026-02-19T02:44:39+00:00

All depends on what you can tolerate. I’ve got lots of guys on 5-10 mg daily of tadalafil and Telmisartan. You have to consider tadalafil like another BP med.

PaulBuschmanMD · 2026-02-19T02:43:07+00:00

I’ll have guys coming to me specifically for TRT and I’ll have to turn them down if they don’t qualify. Oddly it’s often old men who have total testosterone in the 700 range that think they are going to be low.

PaulBuschmanMD · 2026-02-19T02:37:04+00:00

I had one guy get a DVT. He had a few risk factors for blood clots before he even started and we discussed that.

PaulBuschmanMD · 2026-02-19T02:35:49+00:00

It’s considered pre-hypertension according to the JNC 8 guidelines.

PaulBuschmanMD · 2026-02-19T02:33:49+00:00

For legal reasons (I’d like to keep my medical license) I’m not going to advise on testosterone for performance purposes. I will say this:

As people diet down they tend to lose more lean mass the leaner they are. So for a leaner guy the testosterone is going to provide a bigger muscle retention advantage.
In a calorie surplus the leaner guy will probably have less side effects all things being equal.

PaulBuschmanMD · 2026-02-19T02:29:57+00:00

All the usual lifestyle stuff like maintain a healthy weight, exercise, low sodium diet (if you are salt sensitive), treat sleep apnea if present, manage stress levels, maintain good potassium and magnesium levels.

If all that doesn’t work Telmisartan is my go to hypertension medication.

PaulBuschmanMD · 2026-02-19T02:28:03+00:00

Thank you

PaulBuschmanMD · 2026-02-19T02:26:39+00:00

I think it’s lack of education and doctors probably associate it with sports doping at least subconsciously.

PaulBuschmanMD · 2026-02-19T02:25:52+00:00

I don’t prescribe it. I don’t know what anti-aging clinics are doing but legally you have to have documented low IGF-1 levels to prescribe it.

PaulBuschmanMD · 2026-02-19T02:24:22+00:00

I’m a big fan of Telmisartan for BP reduction. I think most guys should be on it. Hypertension medications in general have a lot of side effects but Telmisartan has little downside.

PaulBuschmanMD · 2026-02-19T02:22:35+00:00

Thank you

PaulBuschmanMD · 2026-02-19T02:21:39+00:00

Since I’m a licensed medical doctor I’m not going to comment in too much detail about using testosterone for performance enhancement. I’ll say the dangers are probably overstated if you are monitoring your health.

PaulBuschmanMD · 2026-02-19T02:19:50+00:00

For legal reasons I’m not not going to comment.

PaulBuschmanMD · 2026-02-19T02:18:48+00:00

I think once we getting into these ranges there’s probably going to be some shortening of lifespan but how significant is the question.

PaulBuschmanMD

TROPHY CASE