Should I stop taking prescription testosterone while using anabolic steroids?

Stopping Prescription Testosterone While Using Anabolic Steroids

You should stop taking prescription testosterone while using anabolic steroids due to the significant health risks associated with combining these substances, including increased cardiovascular risks, liver toxicity, and hormonal disruption. 1

Health Risks of Combined Use

• Anabolic steroid abuse, particularly when combined with prescription testosterone, can lead to serious adverse reactions including cardiac arrest, myocardial infarction, hypertrophic cardiomyopathy, congestive heart failure, and cerebrovascular accidents 1
• The combination can cause excessive testosterone levels far beyond therapeutic ranges, potentially leading to more severe side effects than either substance alone 1
• Chronic anabolic steroid use has negative impacts on blood pressure and lipid profiles in athletes 2

Cardiovascular Concerns

• While studies on prescribed testosterone alone show mixed evidence regarding cardiovascular risk (Peto OR, 1.22 [CI, 0.66 to 2.23]), combining with anabolic steroids significantly increases this risk 2
• The TOM trial was stopped early due to excess cardiovascular adverse events in the testosterone group, highlighting potential risks even with prescribed testosterone alone 2
• Athletes using anabolic steroids may experience elevation of blood pressure and depression of serum high-density lipoprotein (HDL) cholesterol levels 3

Hormonal Disruption

• Combined use can severely disrupt your hypothalamic-pituitary-testicular axis, potentially causing:
  • Testicular atrophy 1
  • Subfertility or infertility that may be irreversible 1
  • Hypogonadotropic hypogonadism upon discontinuation 1

Psychological Effects

• Anabolic steroids, especially at high doses, can cause serious psychiatric manifestations including:
  • Major depression, mania, paranoia, psychosis, delusions, hallucinations 1
  • Increased aggression and hostility 3
  • Potential for addiction and dependence 1

Proper Testosterone Therapy Approach

• If you have legitimate testosterone deficiency, proper treatment should:
  • Target total testosterone levels in the middle tertile of the normal reference range (450-600 ng/dL) 2
  • Be prescribed only after proper diagnosis with laboratory confirmation 4
  • Include regular monitoring of testosterone levels, hematocrit, and liver function 4

Withdrawal Considerations

• Abrupt discontinuation of supraphysiologic testosterone doses can lead to withdrawal symptoms lasting weeks to months, including:
  • Depressed mood, major depression, fatigue, restlessness 1
  • Insomnia, decreased libido, and hypogonadotropic hypogonadism 1
• Consider consulting with a healthcare provider about a tapering schedule rather than stopping abruptly 1

Important Caveats

• Anabolic steroids are controlled substances with significant legal implications for non-prescribed use 1
• The adverse effects reported in medical literature may underestimate actual risks because studies typically use lower doses than those used illicitly 3
• If you're concerned about low testosterone symptoms, work with a healthcare provider to properly diagnose and treat the condition rather than self-medicating 4