I coach a guy who is 75 and I wanted to ask a couple of questions on his behalf.
He is tough as nails and he has seen a dramatic improvement in day-to-day activities as a result of strength training, but as the weight is steadily increasing his ability to recover just can’t keep up with the frequency in which he would like to train.
If I’m correct, I believe that the most current data on TRT for the elderly shows the benefits far outweighing the risks. I’ve told him to ask his doc about hormone replacement therapy.
I’m a little skeptical about advice from PCPs who don’t train and I would like to get your opinion on the subject.
Would you recommend TRT for a 75 y/o male who wants to build and retain strength? What risks would he be facing and are the benefits enough to outweigh the cons? What exact reasoning should he approach his doc with?
I’m not sure what specific data you are referring to there.
We would recommend considering TRT as an option for someone with clinical hypogonadism (i.e., characteristic signs/symptoms as well as the appropriate confirmatory lab evaluation) who does not have clearly treatable/reversible factors for hypogonadism (e.g., obesity, obstructive sleep apnea, alcohol/opioid medication use, etc.).
We would not recommend TRT (particularly for someone who just “wants to build and retain strength” in the absence of clinical hypogonadism. Rather, if there are issues with respect to his fatigue and recovery, we would likely be altering programming parameters, utilizing an autoregulation strategy, etc.
We discussed hypogonadism/TRT at length in our two-part podcast series on testosterone, which is where I’d direct you to next.
Both of these references specifically describe people with clinical hypogonadism, i.e., characteristic signs and symptoms as well as confirmed low lab testing. They are not just throwing TRT at people because they’re old.
If you would like to take a look at recent randomized, placebo-controlled trials on the topic, search for the “Testosterone Trials”.