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Adam Katz always dreamed of being larger than life.
“I knew I wanted to be bigger than what was naturally possible for most guys,” the Arizona-based online fitness coach, who began bodybuilding at 14, told The Post.
After not seeing any results from his natural approach, the 24-year-old turned to testosterone replacement therapy, or TRT, which supplements the reproductive hormone and, in some cases, helps build muscle. The so-called “testosterone-maxxing” trend has taken the fitness world by storm, in part thanks to the widespread use by bodybuilding influencers, who say they started TRT to be “more jacked” or attract women.
But as with most things, the latest bulk-fast fad comes with risks that can impact fertility, the heart and more.
That hasn’t stopped buff men from touting the weekly muscle injections as the holy grail for their Hulk physiques, while claiming that “high-level” or “alpha” men, such as podcaster Joe Rogan, are on TRT.
“The average guy, I think, definitely sees only the big, ripped guys and they think that’s the norm,” supplement company founder Konlan Paul, 26, told The Post, adding that it’s impossible to look like those “giant genetic freaks” seen on YouTube or the Mr. Olympia bodybuilding stage.
The Michigan fitness fanatic started bodybuilding as a teen, going “down the rabbit hole” of performance enhancers, such as prohormones or selective androgen receptor modulators (SARMs), without any education on the risks.
“I was like, ‘What’s the quickest possible way for me to look like a bodybuilder?’” he said.
“That totally messed me up because I didn’t know what I was doing.”
His use of performance enhancers disrupted his endocrine system and sent his testosterone levels plummeting, falling well below the healthy range for a 22-year-old. That’s when he heard about TRT as a method to replenish his hormones.
“There’s no education out there about that type of stuff,” said Paul. “I was just a kid that wanted to get big.”
The therapy — which is used non-medically by bodybuilders who want to boost muscle mass and energy levels — is typically reserved for men experiencing “low T,” which affects approximately 2% of men, according to Cleveland Clinic.
Testosterone, which is primarily produced by the sex organs, is responsible for sperm count, sex drive, body hair growth and strong bones and muscles. Men with low levels might experience symptoms such as low libido, erectile dysfunction, hot flashes, low sperm count, increased body fat and decreased endurance.
The typical range for testosterone levels in men is anywhere between 300 to 1,000 nanograms per deciliter. When Katz started TRT, his level was approximately 450, while Paul’s was down to 64.
“If you’re going to do it, it should be in a controlled environment, not taken at a gym, not sure which anabolic steroids you’re taking and how much you’re taking it,” Dr. Theodore Strange, an internist at Northwell Staten Island University Hospital, told The Post, advising young men to consult with a doctor first.
“Internally, you don’t know what you’re doing to your blood count, your heart, your prostate, your skin and your adrenal glands.”
While the aesthetic appeal and cool factor of taking drugs like steroids are driving young men to TRT, bulging muscles and rippling abs come at a cost.
Florida veterans disability attorney Dan Nolan spent $100 per month on the testosterone shots, which are administered directly into the muscle, after starting them in February.
After a month, he saw incredible results: increased energy, mental clarity, heightened confidence, better recovery and, of course, he started packing on muscle. In August, however, he stopped taking the jabs just to see what would happen if he didn’t want to rely on them forever.
“I did lose some muscle. There was a little bit of a dip in my body,” he told The Post. “I deflated.”
Young men who start TRT, then, are likely subject to taking hormone injections for the rest of their lives.
“I understand young people don’t think about those things longer term because they’re thinking about what it is right now that they want to do and how they want to look,” Strange said.
“In younger men doing this, the side effects are real, which could include something as simple as acne on your skin all the way to decreasing the amount of sperm a man produces with excess testosterone.”
The side effects include potential for testicle shrinkage, low sperm count, acne and an increased risk for blood clots, heart attack or stroke, but the most notable is that the body’s response mechanism and the “ability to bounce back” is “inhibited” as a result of TRT, Strange explained.
That means men who stop the therapy could see their testosterone levels plummet.
“Unless there’s some medical issue of why you’re not producing it, super-therapeutic levels…can affect the glands to not come back to the way they were prior to taking the therapy,” Strange said.
“If somebody says, ‘I’m going to stay on this for 40 years,’ that’s a concern.”
That fact has not deterred Katz, who has no intention of stopping TRT, which he started at 21.
“I’ve already accepted the fact that I’m going to be on it for the rest of my life,” he said.
“I personally would just rather live a life with higher testosterone.”
