Ashim Matthan: Hi, everyone. Welcome to the RhinoMight podcast. My name is Ashim. And I’m here with Dr. Kanishk.

Hi, everyone.

Ashim Matthan: This is Episode-8 of the RhinoMight podcast. And today we want to talk about something that.. It’s a topic that I think we were asked a lot by some of our patients. It’s something that we see online all the time, every time on message boards/reditt It’s a very common topic, common question that people have. And that is – How long do I have to be on TRT?

And we wanted to go over this like in a step-by-step manner because there are lot of angles in answering this question. A lot of perspectives that you have to take into account. So, we’re going to go about it in the systematic manner but the question is being asked very frequently. It’s a Frequently Asked Question on TRT – How long do I have to be on TRT?

Dr. Kanishk Jain: Most probably these questions are asked before somebody starts TRT. And we just wanted to put it along the way that nobody has to be on TRT. You have to opt for TRT. TRT is something that is a responsibility that you take.

Ashim Matthan: Yeah. So the very first part of the question is, how long do I have to be on TRT? You don’t have to be on TRT. You don’t have to ever take TRT. Even if you have low Testosterone or whatever your symptoms maybe, you don’t have to be on TRT. TRT is not something that is, there is no life-threatening situation that I can think of where you have to be on TRT. TRT is exactly as Kanishk said, it is a lifestyle. It is something that you opt for. And you choose to adopt that lifestyle. So you don’t have to be on TRT at all. So the first part of the question is that. Then let’s modify the question a little bit as to how long should I be on TRT? How long can I be on TRT? Because that makes more sense.

Dr. Kanishk Jain: TRT can be run for the rest of your life as long as you are taking measures to be very, very meticulous about your health. You must make sure that you do blood tests. You must make sure that you are getting regular checkups done. And if you feel anywhere below where you are supposed to be feeling good, you take steps to correct it. It may be with your dosing. It may be with the chemical. It may be something else in your life that is interfering with TRT giving you the benefits that you want.

Ashim Matthan: Yeah. So if say you wanted to — the question, another way to look at this is, can I do TRT as a trial just to see if I like it? Or is it like as soon as I start it, I have to commit for the rest of my life? Now the way if you have a good TRT doctor, if you have a good TRT team, if you have a good approach to TRT, you will be running HCG along with your TRT. So because you are running HCG along with your TRT, that’s a common international standard that everybody adopts. And if you are having that, then you can stop TRT whenever you want, like you just wake up one fine morning and say, “I don’t want to take my injection anymore. I want to stop it permanently or I want to go on a small break.”, whatever it is that you decide, you have that option on the table. And there is no blow back that you got to worry about. Because you are running HCG the whole time, HCG will maintain your internal production of Testosterone. And you can choose to stop Testosterone from an exogenous source whenever you want. The thing that Kanishk mentioned, which I really want to reiterate is that when you are taking TRT, there is no one single parameter that matters, but collectively all your parameters will be significant. Because you have all seen bodybuilders and you have seen fitness influencers who will say that, “Oh, yeah, I have got a doctor that monitors my chemical usage etc. We do blood tests etc.” And then they end up with heart attacks and stuff like that. So it’s not just looking at blood reports that is the end all and be all of this. There is a qualitative way of looking at your progress as well. It’s about how many chemicals you are pushing, how much of each chemical you are pushing, how long you have been using a certain chemical? Your blood reports come into this. ECGs come into this. So there are multiple parameters that you got to take into account.

Dr. Kanishk Jain: When you start TRT and you decide that I want to run this for the rest of my life, you make sure that you have certain things in place, like you make sure that you have the availability of investigations; you have the availability of HCG. We are lucky that we are in India because we have one of the most potent and I think the most potent HCG in the market which is there, and it is relatively cheap. So anybody who takes Testosterone should take HCG along with it to maintain their internal production. They should not be just taking Testosterone. When you do HCG along with Testosterone, it has other benefits as well, like it will make you really fertile. So you never have to go off Testosterone if you are trying to plan a baby or you are somebody young who wants to have a baby in the future.

Ashim Matthan: Exactly. So you have got internal production going. Your fertile immune system is also functioning well because you are not having a drop in any case in any way. Another thing that I think that we should talk about is the trial period, you know, The three months trial period. So, normally, there are so many textbook ways of going about TRT. And there are so many protocols that are out there. You can do daily dosing. You can do every other day dosing. You can do three times a week dosing. You can do twice a week dosing. You can do once a week dosing. You can do once in two weeks dosing. There are like so many protocols that are there. And you have to figure out which one of these protocols fits you, it fits your goals, it fits your lifestyle and which protocol agrees with you on a biological level. And I don’t want to really want to make this about me or Kanishk. But there are people that have, for example, very low SHBG. If you have a low SHBG, you cannot take big doses of Testosterone infrequently. You got to take really, really small doses or like steady doses of Testosterone as frequently as possible. So that’s one end of the spectrum. The other end of the spectrum, you got people who have very, very high SHBGs.. whether Sex Hormone Binding Globulin holds on to Testosterone and doesn’t free it, so you never get the benefits of having Testosterone. And in that case you need something where you overload the SHBG and break it. So you are going to take Testosterone, like maybe once or twice a week and you are going to take a DHT like Proviron along with it to crack it. So there are so many protocols that are in play that you need two to three months to figure out which protocol suits you. And once the protocol suits you, then you will start seeing the benefits of Testosterone because let’s face it. There are so many people that in the beginning when until your dose is dialed in, you feel really horrible. You don’t like how you feel. So the transition period is not always very smooth.

Dr. Kanishk Jain: Yeah. Because in cases like personally I can tell you that for Ashim who suffered from a lot of allergies for the first three months because of the chemical being suspended in peanut oil, because that was the only one which was available to us over here. He did not feel the benefits of TRT. But with the first dose of TRT, I started feeling better. It may be a placebo effect, but I started feeling better. Like my mind was — I was mentally very sharp. My energy shot through the roof. But these kind of benefits did come to Ashim after he got the oil that suited him. So the oil also plays a very big factor or the carrier oil plays a very big factor in your Testosterone Therapy.

Ashim Matthan: Yeah. So when you talk to bodybuilders who have been taking Testosterone, these types of like subtle nuances that are there or like I would not call them caveats, but like the finer points, for example, the frequency of dosing, the type of carrier oil that you have, these things are like they are not always like looked at with that much importance because you have to face it. Like, I mean, bodybuilders are taking 250 mg of Testosterone three times a week. We are not doing that. This is TRT. TRT is about taking a little bit more, maybe a little bit more than what you should take if you want to. But otherwise you are more or less following a system where you are not taking — replacing Testosterone, but you are like supplementing Testosterone. You want to get to a good value that you feel good at. So it’s not just about like a numerical value on a report, but it is also about how you qualitatively feel with your life, like your quality of life should improve. So if you have to merge or balance both these out, all these tiny details make a very big difference. So what type of oil you are using, like, for example, I cannot handle peanut oil. I would rather not be on Testosterone than take Testosterone suspended in peanut oil.

It’s a horrible experience for me. It’s like my body is constantly sick, and it’s fighting itself, which it is, because I am literally injecting poison into myself every single day because my body hates peanut oil. I have a peanut allergy. So peanut oil is a No-No for me. Absolutely. And then you have got like, for example, right now I have got MCT oil or whatever olive oil or whatever it’s that I want to play with. So you have got all these other options that are on the table now. So it’s like, it takes two, three months to figure out what your body likes, what’s available to you. Like Kanishk said, both offers available to you from the perspective of what chemicals are available to you and also from the perspective of what type of investigations and lab tests you can do. And that’s how you should be, like you should know all of these things before you get into it. And the first three months is when you basically feel what you are going through, and you understand – Oh, yeah, I should be doing an ECG once in six weeks or like once in two months depending on what I am running. And then that’s how you slowly, slowly progress.

Dr. Kanishk Jain: So if you are somebody who is backing lot of issues, let’s say that you are somebody who is having diabetes, blood pressure. If you are having other issues as such like allergies, you should understand that Testosterone is the best healer in the body. It will first go in helping in correcting these issues, and then you will see the benefits. So guess what? On BP medicines, you will feel horrible on Testosterone. On diabetes medicines, you feel horrible on Testosterone. We have had patients who have said that we don’t feel good, like we feel much worse than when we started. But that is the correction that happened. Suddenly, they are experiencing low blood pressure. The blood pressure is getting corrected. Their blood sugars are coming under control. That’s how it is helping. It is causing nutrition partitioning. It is causing better utilization by your muscles for Blood Glucose to be into a normal range.

So when these kind of things happen, you should understand that okay, it’s time to get myself checked, get myself assessed. Do I need to be revise my medication before I continue my Testosterone?

Ashim Matthan: Right. So we made this about me with allergies. But yeah, we have patients who have been on diabetes medicines for like 10, 15 years. Same thing with BP medicines. Some have both of them together because often these things get clubbed together. And the first three months is just like going back and forth or figuring out whether that medicine even needs to be in the system anymore. And that transition period can feel really horrible. And once the patient or anybody fells that — Oh! I don’t have a BP issue anymore. I am not taking BP medicines anymore. I don’t have diabetes. I am not taking diabetes medicines anymore. I am just running Testosterone. Then the benefits of Testosterone brings to the table. You can start feeling them, because until then you are just trying to deal with all the baggage that you are carrying.

Dr. Kanishk Jain: Correct.

Ashim Matthan: And now this leads us to the final point that I wanted to make, which is actually quite complicated. It’s about three different types — well, let’s just say to make it very simple, like if the question is to be reworded as to how long can I be on TRT? And that from what we have seen in our clinical experience, there are three types of people that fall into this category. We have like regular people, like regular Joes — normal people who just want to be on test and HCG and that’s it. They are just happy not having any diabetes, not having Hypertension, and/or they want to reverse that. And then they just want to be on tests and HCG. Then the second category of people is regular people who have goals, like Kanishk and me, like where we want to get bigger with gym rats, right? So we want to work out. We want to get bigger. We have got goals, but we are not Pro-Bodybuilders. We are not amateur bodybuilders either . And there was not anything on a professional level as far as bodybuilding goes. But we do want to look a certain way. You want to look good. You want to feel good. So you are not going to be running just TRT. You are going to be adding chemicals to TRT, but in different, different doses, etc. So that’s TRT plus. So we categorize as TRT plus.

All then you have got the other end of the spectrum, which is your celebrities, and your actors, and your bodybuilders where you have to push the envelope. You have to look a certain way. How your body look determines the food that you can put on the table for your family. And in that case you are going to be pushing big, big chemicals and big dosages. And at that point also TRT will play a role. So let’s just cover each of these topics, each of these categories.

Dr. Kanishk Jain: So we will start with regular people, regular people who like to just feel the mental benefits of Testosterone and the physical benefits of it where they feel energetic, where they feel strong, where work out to work out if you are somebody who is a gym rat who likes to workout will feel good. You will recover very, very quickly. For them Testosterone is not just about pushing the limits. It’s about feeling good and keep on continuing to improve your life. And you do it in a slow and steady manner.

Ashim Matthan: So for category one of people who just want to run test and HCG, yes, you can do it your whole life. And you don’t have to change the dose or anything unless you really want to, but you can do that. You can even take a break in the middle if you are traveling or if you can — normally for our patients, they get a kit with the prescriptions and stuff like that. So there is no worry going from airport to airport. And of course, right now with COVID, nobody wants to travel. So the question doesn’t arise.

But, however, yes, if you a taking a break, you want to go on vacation, you don’t want to care about the injections or whatever, you can flip from taking injections to apply gels and creams of Testosterone. So there are lot of options that you have on the table. And if you fall into the category one so to say, you can run this your whole life.

That takes us to category two, which is for people who are slightly more serious about how they need to look, how they want to feel. And in that case you can always use chemicals like Thyroid T3, T4, which is good Thyroid Supplementation, Insulin, Growth Hormone. You can add all of these chemicals into your system. And you can call this like an informal blast or cruise. You can call it Low Dose Cycling where you add other chemicals. You can even add a DHT onto your TRT dose, your basic, your base TRT dose. And you can play with these chemicals, and you can weave them in and out of your system based on how you feel as long as your blood parameters, your critical assessments, your ECG or whatever investigations that you are running. As long as everything checks out, you can keep playing with whatever chemicals that you want in low doses.

And at the end of the day, when you want to think about Anabolic Steroids, you got to remember that these were medicines. They were all created for medical purposes, like Anadrol was given to children. For Angioedema; you were given Winstrol. So these things, each one of these chemicals was used for medical purposes. So as long as you keep that type of system in mind where you are not over-using anything, you should be fine. And you can do this blasting and cruising system for ever as well, just like you can do for a category one. But you are responsible at the end of the day for your actions. You are responsible for making sure that all of your blood values, etc., everything lines up, and you are healthy at all times.

Dr. Kanishk Jain: One of the things with dosing that we want to reiterate and also make it very, very easy to understand is that you always start at the least dose. Don’t go by prejudices of other people saying that Oh! this chemical has to be dosed at 100 mg every week for it to be effective. That is not the case. If the chemical agrees with you, even a small dose as 10 mg a day will agree with you and will give you the benefits, which a 100 mg dose may not. So be open to it. Try the least amount of doses so you don’t need to do more amount of work to correct any damage that may be done.

Ashim Matthan: A lot of this has to do with, one, availability of correcting damage.. well first finding out that there is damage that has been done. Two, correcting the damage and whether you can afford to correct that damage. So, for example, you may take something that is extremely liver toxic. And it worked for person-A, person-B, person-C, but you came along as person-D, and it completely failed on you. And even a small dose messed you up really bad. Well, guess what? Now you got to correct it.

So if let’s say you identify that okay, I have this problem, my liver is affected, I got to reverse it. Well, guess what? Not everybody can afford the type of heavy supplementation that’s required for that. So guess what? Don’t take that risk then. Do things that are within your budget that you can afford. And if you can’t afford it financially, then don’t get into it because if in low doses it’s not so much of a health situation where you are going to like crash your liver or die. That’s very, very rare. I can’t even imagine a situation in low doses why that would even be applicable, but I am just being politically correct in saying maybe it can happen. But, however, in a practical manner, it’s very, very rare for that to happen. So that means that if there is any form of damage done, say your SGOT, SGPT were at good values before, and then you added something like, I don’t know, like let’s see you added Anadrol at really, really low doses. You added Anadrol, which is liver toxic. And you ran it. And even in those low doses, it caused a negative effect. And your liver values deteriorated to an unacceptable level. Let us say that they were no longer as good as they are supposed to be. So you have to improve it now. So Anadrol is not that expensive, which anyone can afford it. You take that out of the picture, then you got to figure out on how you are going to repair your liver. And that’s the point of expenses.

Dr. Kanishk Jain: So another thing that we had mentioned in previous podcast as well is ‘Don’t Ignore the Signs’. Your body will tell you when it doesn’t like something. Let’s say that if you have taken Anadrol. That is what the example which was used by Ashim that if Anadrol is not agreeing with you, you will start experiencing a little bit of pain or your performance in your gym will be deteriorated. Instead if Anadrol agrees with you, you will be going crazy in the gym like your strength will go through the roof. Your recovery will be very, very good. You will have aggression in the gym. So you have to understand these signs. If a chemical is not agreeing with you, your body will tell you. So just listen to the body. Before you do any blood test, you should understand that okay, these are the signs. I need to be aware of them. I have everything planned out. Okay. Now I can run this chemical. I can try it for some time.

Ashim Matthan: Exactly. And what happens is that because you keep in mind that it’s all about relativity. I am not telling, I am not talking about someone running 750 mg of Testosterone, adding 50 mg of Anadrol per day. That doesn’t make sense. What I am talking about is people on TRT, people who are just using Testosterone to improve their life decide to add other anabolic medicines like Anadrol. And they say, “Maybe this is going to make me feel a little bit better. Let me add it.” And then you take say, for example, half a tab or whatever. You do it for a few days. And because you are going to daily dosage, its lifecycle is not that large. So you are going to feel the benefits or whatever negatives pretty quickly. You start observing; Oh, I got pimples, I got this. Like I am getting pain in my liver area, around my abdomen. Okay. Guess what? Like stop. These are signs. And the thing is because you are taking such low doses of everything, every single sign will be seen.

Often people think that oh, because it’s low doses, you won’t really see the benefits. That’s not true. Something as small as taking Primo of 10 mg a day, which is 70 mg a week, it will show. If everything else is dialed in, if Primo agrees with the system, a low dose like that will be very apparent to you as someone who is using it. And sh*t… it might be apparent to other people because your body will change as well. So don’t have these prejudices just because you read things online that oh, yeah, I need to blast everything to feel it. You don’t have to do that at all.

In fact, before you blast everything, like Kanishk said, you got to start out with baby doses and just see whether on a small level is it agreeing with you? On a cellular level, okay, yeah, this chemical agrees with me. Maybe I can increase it a little bit. Oh, this chemical doesn’t agree with me. Then guess what? No one is compelling you to do this. We are not doing this to — we don’t earn money on our body. So guess what? Just move the chemical out. It’s not a part of your buffet. Add another chemical if you want or just take a break from all these chemicals, run TRT, let it heal your body, and then you can open yourself to whatever else that you want.

And that takes us to our third category, which are professionals, people who are like pro-bodybuilders. And so normally, I will just make this about like actors or bodybuilders. What happens is that they have either shoots or they have competitions. And when it comes to pro-bodybuilders or amateur bodybuilders or very, very competitive bodybuilders, they will want to run like one or two competitions, one or two set of competitions in a year. Since they are six months apart, and to prep for these competitions, there is going to be lot of other chemicals, like Nandrolone etc., that are added in at high doses. So at that time you want to have a break from all these chemicals where you just run something like Testosterone that will up regulate all of the receptors that have been down regulated. So one of the problems that we see happen very often is that someone has been running say Trenbolone at 200 mg. I am just being very, very conservative. I know it’s almost laughable to imagine a pro running only 200 mg of Tren, but if say someone has been running Tren for 200 mg for like six months, guess what? Those receptors are completely down regulated. That 200 mg is not doing its job. And if they want to get the same effects, they are going to have to start increasing the dose from 200 to whatever. And if you don’t want to do that, because at the end of the day, these are chemicals that at these high doses will not be good for your body, you do want to run Testosterone for a brief period of time. So it up regulates all of those down regulated receptors.

Dr. Kanishk Jain: Plus what happens is with the Testosterone added to let’s say after Trenbolone, your body gets a signal of getting the natural Testosterone receptors firing as compared to Trenbolone, which is a synthetic compound. So the Nandrolone compounds work indifferent and they are very, very sensitive for androgen receptors where they saturate them. Once Testosterone comes in, it tends to reverse the saturation and also up regulate the receptors making those receptors active for another cycle that you may be running later on as you go for another competition.

Ashim Matthan: Yeah. So in conclusion, I mean, I think we summarized everything. But in conclusion to the question of how long can I run, how long can I be on TRT? You can be on TRT for as long as you want to. And as long as you are being responsible for this you are going to be fine. And that’s the most important thing. You got to accept personal responsibility which everybody talks about, but it is something that you really need to think about. And you can always take breaks from TRT. You can always if you are doing TRT the way we do it internationally with HCG running along with it, you can stop whenever you want at the drop of a hat. And if you want to continue, you can continue. You can add chemicals to it. You can even put transition from being a pro-athlete to being just on TRT to maintain yourself to becoming a pro-athlete again or whatever. So you can use TRT as a tool, as part of your career. You can use it as a part of your life because it’s, that’s the way it makes you feel and perform at your work and in general as your quality of life is improved. So it’s up to what your individual goals are, what you expect out of TRT because TRT, the way we see it, is just a tool. It’s a way to make you feel good and be healthy. So if that’s what you want out of it, get that out of it, and you can move, and you can keep it for your whole life as long as you are responsible medically, and you are healthy at all times. And is there anything else that you want to add?

Dr. Kanishk Jain: No, I don’t think so. I think we have covered everything in detail, and we summarized everything.

Ashim Matthan: Sure. So if you guys have any questions, or if you want any clarifications, please feel free to ask us questions. And we’d love to hear from you. This is Episode-8 that we are wrapping up. It’s been a big gap between the Episode-7 and Episode-8. And I apologize for that. We have just been busy. Hopefully, we can churn out a few episodes this week. But if not, we see you on Episode-9. It will happen at some point. I guarantee you that. Yes. Thank you.

Dr. Kanishk Jain: Thank you.