TRT and Liver Disease?

[blackbull1]

I have been on TRT for a few months and just wondering what people think of taking it even though I have cirrhosis of the liver. I have read that it could be beneficial but wonder how true that might be. My liver levels are good despite Mildly coarsened echotexture of the liver. In addition I have high blood pressure somewhat managed, 63 significantly overweight out of shape male. Past 4 years or so I have tested A1C pre diabetic but after 7 or so weeks on 100mg test cyp once weekly I now am testing in the normal range. I also have Cardiomyopathy and just had a cardiac cath done which was clean and no blockages. Despite all this all my bloodwork comes back pretty darn good. When I started my total test was 263 but didnt really get baseline tests done until after I started. My total test now is over 1500 ng/dl, which is high. My free test was 1.1 pg/ml and now its 15.4 pg/ml. Cortisol is 8.6 ug/dl. Estradiol is 50.2 pg/ml which is high. My shbg is 77.6 nmol/l which is also high. For the high Estradiol doctor started me on Anastrazole 1mg once weekly. My libido after a few weeks was in the honeymoon stage, but that only lasted a couple of weeks. Now, I do understand taking this is not some magic, bullet but just hoped to start feeling a little better with increased energy and a more stable libido instead of the extreme high/low. I also understand that correcting poor eating habits, and getting at least some exersize would probably fix at least some of the issues that I have. I mean just taking this just for the sake of taking it without benefit seems unwise to me. I wonder if someone could give me some clarity to what I am hoping to achieve.

 

[Conmike41]

I would ask your doctor about it but from what I’ve read it should typically be safe at true TRT dosages

How are you dosing your TRT ? Dose ? Injection frequency ?

Best to get labs done day before you’re next shot of you’re dosing once a week. So for example, if you Inject on Tuesday for instance, you’d want to check your test levels the Monday prior to your next injection

A level of 1500 on 100 mg/week is pretty high, did you get the labs done a day or two after your injection?

What was the cause of your cirrhosis ? If it was fatty liver/obesity etc the GLP’s are also beneficial. Wegovy / semaglutide was just approved for F2/F3 fibrosis. No studies that I’m aware of in cirrhosis, but you’d likely still benefit from the metabolic benefits of weight loss, glucose management and affects on lipids

For the cirrhosis I’d look into supplementing w TUDCA, NAC & Liv 52 (available at @GYMnTONIC )

Your estradiol could be high secondary to the cirrhosis, that’s a common complication of cirrhosis . By any chance do you have your estradiol levels prior to starting TRT?

For the cardiomyopathy, ask your cardiologist about supplementing w Ubiquinol, as it’s shown some benefit in cardiomyopathy patients

Are you on Spironolactone by any chance ? Spironolactone can case gynecomastia and raise estradiol levels in men

Hope this helps!

 

[blackbull1]

I would ask your doctor about it but from what I’ve read it should typically be safe at true TRT dosages

How are you dosing your TRT ? Dose ? Injection frequency ?

Best to get labs done day before you’re next shot of you’re dosing once a week. So for example, if you Inject on Tuesday for instance, you’d want to check your test levels the Monday prior to your next injection

A level of 1500 on 100 mg/week is pretty high, did you get the labs done a day or two after your injection?

What was the cause of your cirrhosis ? If it was fatty liver/obesity etc the GLP’s are also beneficial. Wegovy / semaglutide was just approved for F2/F3 fibrosis. No studies that I’m aware of in cirrhosis, but you’d likely still benefit from the metabolic benefits of weight loss, glucose management and affects on lipids

For the cirrhosis I’d look into supplementing w TUDCA, NAC & Liv 52 (available at @GYMnTONIC )

Your estradiol could be high secondary to the cirrhosis, that’s a common complication of cirrhosis . By any chance do you have your estradiol levels prior to starting TRT?

For the cardiomyopathy, ask your cardiologist about supplementing w Ubiquinol, as it’s shown some benefit in cardiomyopathy patients

Are you on Spironolactone by any chance ? Spironolactone can case gynecomastia and raise estradiol levels in men

Hope this helps!

I am dosing 50mg twice week. The cirrhosis was from Hep C and am F4 on the fibrosis although the Hep C was finally treated unfortunately not before the damage was done. My AFP tumor marker is normal. My Fib-4 score is 2.49. Its funny you should mention both GLP meds and Spironolactone. My cardiologist just started Ozempic which I am about to start. He also started me on the Spironolactone in the last few weeks as I started getting Edema lower extremities. I stopped taking it a few days ago. Blood work from last week show platlets are low and creatinine is high which I believe is from the Cirrhosis. All other labs are normal. Anyways I appreciate your response.

 

[Conmike41]

I am dosing 50mg twice week. The cirrhosis was from Hep C and am F4 on the fibrosis although the Hep C was finally treated unfortunately not before the damage was done. My AFP tumor marker is normal. My Fib-4 score is 2.49. Its funny you should mention both GLP meds and Spironolactone. My cardiologist just started Ozempic which I am about to start. He also started me on the Spironolactone in the last few weeks as I started getting Edema lower extremities. I stopped taking it a few days ago. Blood work from last week show platlets are low and creatinine is high which I believe is from the Cirrhosis. All other labs are normal. Anyways I appreciate your response.

Spironolactone is used a lot in cirrhosis pts as a potassium sparing diuretic in conjunction with furosemide, Also used in CHF pts w volume overload a lot, I know I’ve read about benefits in these cases in the past but I can’t recall the studies / benefits

Ask about Eplenerone as an alternative. It’s highly selective for aldosterone receptors, meaning it doesn't block androgen receptors or significantly affect estradiol levels in the same way, thus avoiding spironolactone's common gynecomastia side effect.

And maybe adding a low dose of furosemide to the above if your kidney function allows

The low platelets is cirrhosis. The creatine could’ve been medication vs volume/fluid overload , cardiac etiology from low ejection fraction

You’ll definitely benefit from the semaglutide/ozempic

Happy you got your Hep C treated, it will definitely help slow the progression of the cirrhosis

I forgot to mention in my 1st comment, might want to look into injectable glutathione (although w the low platelets there’s more risk of bleeding and bruising ) or using oral liposomal glutathione for your liver

Definitely look into TUDCA, NAC & LIV 52

Safety and Effectiveness of Liv.52 DS in Patients With Varied Hepatic Disorders: An Open-Label, Multi-centre, Phase IV Study - PMC

Background The hepatoprotective function of polyherbal formulation Liv.52 in chronic liver diseases is well recognized in published literature. The objective of this open-label, phase IV study was to further strengthen and validate its safety and ...

pmc.ncbi.nlm.nih.gov

Fib-4 score of 2.49 is encouraging. I’d ask your gastro/hepatologist about a fibroscan or liver elastograohy to get a better idea of how advanced the cirrhosis / fibrosis is

Rezdiffra is another option for F2/F3 fibrosis which came out last year, hasn’t been approved for F4, however I think it’s only for fatty liver associated fibrosis

 

[blackbull1]

Spironolactone is used a lot in cirrhosis pts as a potassium sparing diuretic in conjunction with furosemide, Also used in CHF pts w volume overload a lot, I know I’ve read about benefits in these cases in the past but I can’t recall the studies / benefits

Ask about Eplenerone as an alternative. It’s highly selective for aldosterone receptors, meaning it doesn't block androgen receptors or significantly affect estradiol levels in the same way, thus avoiding spironolactone's common gynecomastia side effect.

And maybe adding a low dose of furosemide to the above if your kidney function allows

The low platelets is cirrhosis. The creatine could’ve been medication vs volume/fluid overload , cardiac etiology from low ejection fraction

You’ll definitely benefit from the semaglutide/ozempic

Happy you got your Hep C treated, it will definitely help slow the progression of the cirrhosis

I forgot to mention in my 1st comment, might want to look into injectable glutathione (although w the low platelets there’s more risk of bleeding and bruising ) or using oral liposomal glutathione for your liver

Definitely look into TUDCA, NAC & LIV 52

Safety and Effectiveness of Liv.52 DS in Patients With Varied Hepatic Disorders: An Open-Label, Multi-centre, Phase IV Study - PMC

Background The hepatoprotective function of polyherbal formulation Liv.52 in chronic liver diseases is well recognized in published literature. The objective of this open-label, phase IV study was to further strengthen and validate its safety and ...

pmc.ncbi.nlm.nih.gov

Fib-4 score of 2.49 is encouraging. I’d ask your gastro/hepatologist about a fibroscan or liver elastograohy to get a better idea of how advanced the cirrhosis / fibrosis is

Rezdiffra is another option for F2/F3 fibrosis which came out last year, hasn’t been approved for F4, however I think it’s only for fatty liver associated fibrosis

You were definitely the right person to respond to my post! Thank you very much for your knowledgeable/valuable insight!

 

[Conmike41]

Happy to help man ! Send me a DM anytime brother

 

[Markenarten]

250mg of glutathione m-f will sort you out...