Testosterone Replace Therapy on HCV Treatment

[jmjm530]

Have any of the men had experience with testosterone replacement therapy on or evern off treatment?

My med team has suggested TESTIM gel primarily because of significant weight/muscle loss as well as lethargy and weakness.

For those not familiar, testosterone replacement as well as certain steroids are often used prescribed for  cancer and aids patients to help stop wasting and build them back up. I started tx at my ideal weight of 176 and am currently trying to stablize it around 150. My current Total testosterone is 429 and within normal range for a man of my age.

Any and all replies are welcome, but I'm more interested in hearing first-hand from those who have been there, and what difference it has made. I'm aware the whole issue of testosterone replacement in men within normal range complex and somewhat controversial, and does not have a long track record. On the other hand, I still have 19 weeks left of treatment and would like most of what is left of me to cross the finish line. :)

-- Jim

[LvdByGod]

I have no experience obviously...heeheehee being a gal, but i would never take a steriod of any type while on treatment unless it was a life or death situation... because of the natural  adverce effect of steriods on the immune system...that would be my largest fear about it...

[scruffy]

I would hesitate to take it unless the levels tested were low. That is below normal range. Our bodies take enough of a hit from tx. Just an opinion. My muscle mass has returned after tx and I've kept the weight down on purpose cause I'm just about right where I want to be. frank

[DoubleDose]

I do not believe that I have seen testosterone ever recommended as an adjunct while on treatment.  I would think that it could be counterproductive, by adding a medication that might have a negative impact on the immune boosting characteristics of interferon.  I know of no studies to assess potential interaction with the tx meds.  Also, I believe testosterone has been cited as potentially hepatoxic in some patients, usually when used for libido or erectile improvement.  I would think this potential for hepatoxic effect would be a big red flag while on tx.

As far as using after tx, there may be some possibilities, and I did read of one research article discussing possible testosterone replacement therapy for those who have developed sexual dysfunction after tx (ED or libido loss).  They were also concerned about hepatoxic issues, especially in those who had moderate to severe liver damage, etc.  They also questioned whether testosterone replacement would be of any benefit at all in those who did not have severely depressed testosterone levels to begin with.

I would be very wary of this strategy, and would discuss with both a highly knowledgable Hepatologist, and maybe also an Endocrinologist, making them fully aware of your tx, and liver status.  I think there may be less risky and drastic ways to rebuild muscle and bone mass after tx, and your doctors may be able to provide some very safe alternatives.

Hope this helps.  I would also Google the testosterone/ liver toxicity issue to find further info.  

DoubleDose

[DoubleDose]

Here is a link to a somewhat related article about testosterone levels DURING tx, and their potential implication in sexual sysfunction.  Their conclusion are very vague, and they do not seem to see a need to provide replacement therapy.  

http://www.natap.org/2005/HCV/062005_02.htm

DD

[jmjm530]

Thanks guy's (and gal :) ) for your comments.

I have similiar concerns which is why the testosterone gel isn't currently smeared all over my chest. LOL. However, if my weight/muscles continue to deteriorate the risk/reward ration may swing in favor. I was hopefully loooking for someone with actual experience but I guess this discussion group is just for manly men. LOL.

-- Jim

[LvdByGod]

i just saw this at http://www.hepcnet.net/drugsandliverdamage.html
when looking for something else...

Drugs that may cause LIVER TUMORS (benign and malignant)

anabolic steroids
oral contraceptives
thorotrast
danazol
testosterone

[Califia]

Dare I suggest (in my butchest voice, of course) that you trawl The Body and other HIV-specific sites for any possible info on this?   Although something tells me you've already been there.   Maybe a question to Dr. Dieterich?  Best to you!

[jmjm530]

LOL. Been there. Done that. Just haven't spoken to anyone on combo tx who has done the testosterone. Thanks for your thoughts, we're on the same page.

-- Jim

[Califia]

And a dog-eared, coffee-stained page it is....

[LvdByGod]

hey jimbo, you could try excersize...yeah i know its a four letter word and were not suppose to swear here...but i thought it worth the risk...

[iceboy]

I have been working very hard, (trying to save up for the unknown! Actually working with some of your fellow americans over here.)  I see the liver specialist on the 23rd. Treatment decisions will be made then. I´m presenting the 4 week plan.

been reading your treads. Sounds like you are going through some rough period now. You are almost done with 2/3 of the treatment, yes? Still, one day at the time. It´s magic in that..

[MichaelT]

I confess to be a bit shakey in this area, but I believe it is not just the "free" testosterone that needs to be accounted for, but how much estrogen is present too. Estrogen is preferably bound over testosterone. An estrogen blocker may produce more positive results than adding testosterone.

Besides, adding testosterone will shrink your, uh, you know, those two thingies under the other thingie.

[jmjm530]

Thanks. I'm aware of the negatives but it was suggested by a fairly knowledgeable heptologist and these drugs are currently used in leading teaching hospitals for aids/chemo patients.

If I go that route, it will only be if necessary. Yes, exercise. I was doing OK in that area but the psoriasis on my feet has now limited my walking considerably. I'm trying a stationery bike at the gym but it's hard for me to get the same benefit. Anyway, if you're operating below your ideal weight, and you can't eat enough calories to maintain mass, gym work can become counter-productive.

Meanwhile I can't remember if I just took my riba. LOL. So I just popped two extras instead of my usual nightly 3. So today I've either had 1000mg or 1600mg. I guess that means either sweet dreams or late, late night TV. LOL :)

-- Jim

[jmjm530]

Well, that was quick. I def took 1600mg today. LOL. This happened once before and it's amazing how fast the xtra riba hits you.

[iceboy]

Christ, I’m so bad at maths, I’m trying to work out what dose you are on and it’s doing my brain in. I always failed on the easy questions on the exams in Kindergaden School. "Peter had 3 apples. He ate one, how many has he left"...

[iceboy]

Ok I have cracked it. 1200. no It doesn´t ad up.....

[jmjm530]

LOL. 1200 is CORRECT. Except today I took 1600 by mistake. It's OK, at one point I was taking  2000 mg/day. Of course I ended up in the ER with anemia. LOL. So one day at 1600 won't hurt. I actually find the riba energizing -- unfortunatly MS Anemia follows shortly. Thanks for stopping by.  How have you been?

-- Jim