financltravsty (u/financltravsty)

financltravsty commented on There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests arstechnica.com/health/20... · Posted by u/voxadam

apple4ever · a month ago

Thank you for the info on the TRT, I was getting a little worried reading some of the other comments. I'm getting on it due to years of low testosterone. I'm also getting on Zepbound due to years of obesity. The two may be linked, but I need help controlling my appetite and reducing my fatigue.

financltravsty · a month ago

They're good kickstarts/spark plugs for your use-case.

The obesity likely is the main culprit-- if I had to guess. Fat stores act as sites for testosterone to be aromatized to estrogen -- so if your E2 is elevated that would be a marker.

financltravsty commented on There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests arstechnica.com/health/20... · Posted by u/voxadam

tyleo · a month ago

This reasoning is not flowing through for me. It feels like you are saying:

1. There is an off ramp for TRTs but some people have, “true permanently lowered levels of hormones.”

2. For GLP-1s, “there is no off-ramp, but the only effects I’ve noticed are a return to my baseline.”

To clarify my original post, I consider the ability to return to baseline to mean there is an off-ramp and permanently impacted to mean there is no off-ramp.

financltravsty · a month ago

1. Yes, but that is not -- to the best of my understanding-- because of TRT itself

2. Yes

There is no "off ramp" for GLP-1s in my experience, because the off ramp is so insignificant to not worth a mention. You just don't take another dose after a week has passed from the previous one, and you're back to baseline. Same way there is no off ramp on taking aspirin -- just don't take it.

financltravsty commented on There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests arstechnica.com/health/20... · Posted by u/voxadam

mrandish · a month ago

> GLP-1s are good for impulse and behavioral disorders like ADHD

As someone diagnosed with ADHD, I wasn't aware of this (although I haven't had reason to research GLP-1's). Is this just your N=1 or an effect proven in studies?

financltravsty · a month ago

N=4 anecdata + theory crafting

financltravsty commented on There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests arstechnica.com/health/20... · Posted by u/voxadam

inhumantsar · a month ago

mind if I ask what personality and reward seeking effects you experienced?

financltravsty · a month ago

Lack of spontaneity, lack of energy, lack of zest -- one could say anhedonia. Dialed me personality down and made me passionless

financltravsty commented on There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests arstechnica.com/health/20... · Posted by u/voxadam

Aurornis · a month ago

> That's not how it works. LH and FSH are suppressed when you're on TRT, but they stabilize after cessation.

The testes atrophy over time when LH and FSH are suppressed. Even if LH and FSH return (which isn’t guaranteed) the testes need to be able to respond to those hormonal signals, but atrophied testes do not respond the same.

For someone with true intractable hypogonadism this hardly matters because they weren’t capable anyway. Many people prescribed TRT today don’t actually have intractable hypogonadism, though.

Body builders have some tricks to try to reverse this, but it’s not perfectly effective and even body builders know to cycle their steroids to avoid having prolonged periods of suppressed HPG axis activity. I was involved with weightlifting in my younger years but never dabbled with steroids or TRT. Everyone I know who did try testosterone or steroids thought they were doing it the safe way (HCG, PCT, limited cycle length) but became unable to produce enough endogenous testosterone by their 40s even with SERMs.

Men on TRT for years will have considerable testicular atrophy that is not totally reversible.

> The question is, why would someone with clinical hypogonadism cease TRT?

TRT is no longer limited to men with clinical hypogonadism. Men’s health clinics that advertise on social media, TV, and radio will prescribe to anyone who contacts them (and pays cash for the prescription and gear). In some surveys of patients on TRT, 1/4 of patients didn’t even have testosterone levels measured prior to initiation of TRT.

financltravsty · a month ago

Curious on your thought to my reply: https://news.ycombinator.com/item?id=46059074

Can you share your longitudinal anecdata? I am considering going back on AAS for the QoL benefits, but would like to create a better mental model of long-term ramifications for testicular health.

It's my understanding that 40, it simply is expected that your hormones levels will be much lower (and that is not necessarily a bad thing). However my mind is failing to grasp what long-term damage TRT can do to the HPTA when not using an obscene amount of gear and on HCG.

Trying to figure out the mechanism. Perhaps receptor desensitization and epigenetic compensatory changes?

financltravsty commented on There may not be a safe off-ramp for some taking GLP-1 drugs, study suggests arstechnica.com/health/20... · Posted by u/voxadam

tyleo · a month ago

Interesting. Saying, "there may not be a safe off-ramp," doesn’t feel quite right. The article describes people losing weight while on the drugs and then regaining weight after stopping them. That's not ideal, but it does imply an off-ramp, just with regressions.

Compare that to something with no real off-ramp: testosterone replacement therapy. Once you're on TRT, you can permanently suppress your body's own testosterone production, and many men won't produce enough on their own afterward.

financltravsty · a month ago

As an experienced polysubstance researcher, that's not exactly accurate.

TRT cessation does not inherently cause men to have suppressed hormone levels after. With precautions and extra steps like HCG to maintain leydig cell/testicular function, preventing atrophy, one may safeguard against that risk.

Coming off TRT, yes you will have lower levels as your HPTA has been suppressed by exogenous hormones. One may speed up this recovery using "PCT" (post cycle therapy), which involves taking a SERM (selective estrogen receptor modulator, e.g. enclomiphene) to resensitize and restart your HPTA. However this is not always necessary, and if one takes a look at the HARLEM study, most users return to their baseline levels within a year of going cold turkey.

In the cases of true permanently lowered levels of hormones, I believe the two most common reasons are: using other AAS besides testosterone (1) and lifestyle or health factors that correlate with the need to be on TRT (2).

With 1, this can be seen in users of decadurabolin (deca), which notoriously has hormone receptor active metabolites that last around for atleast a year, continuously suppressing the system. Or trenbolone (tren/cattle bulking hormone) which is inherently neurally and endocrinically otherwise toxic.

With 2, you hop on TRT because there is some reason your hormones are not at healthy levels. Whatever the reason is, it is still there, and once you've stopped bandaiding the issue its effects resurface.

---

I have also used many GLP-1s (semaglutide, tirzepatide, and retatrutide). No there is no off-ramp, but the only effects I've noticed are a return to my baseline of appetite, and neurological state.

N.B. GLP-1s are good for impulse and behavioral disorders like ADHD, which it did help. However, I have decided to not take it due to the negative effects on personality and reward seeking behavior.

They are neuro-active in the brain, and their effects I've decided are not worth it.

financltravsty commented on Manganese is Lyme disease's double-edge sword news.northwestern.edu/sto... · Posted by u/gmays

bitexploder · 2 months ago

Lyme disease and bacteria are always temporary. The long term disease/syndrome many people attribute to it is something else similar to long COVID and still debated.

financltravsty · 2 months ago

Having done the research myself, it seems to be biofilms that the bacteria create leading to a "dormant" yet still metabolically active state that releases inflammatory byproducts throughout the body.

The recommended course of action seems to be disulfiram to bust those biofilms + antibiotics to finally kill it all off.

financltravsty commented on Tim Cook rallying Apple employees around AI efforts bloomberg.com/news/articl... · Posted by u/andrew_lastmile

nunez · 5 months ago

Misinformed take IMO.

M-series chips are insanely cool (literally and figuratively) and have no competition even five years in. Same with the W-series SoCs on watches.

Are there any third-party haptic vibration motors yet?

Shoot, even their trackpads, which already stood alone, have gotten _better_ over the years.

Nobody else will have their own vertically-integrated modem out in production. This will make budget iPhones (maybe all iPhones) so much cheaper once they show Qualcomm the door.

That's before the advances they've made in software, like their camera processing pipeline (which only gets better; their video stack still has no equal) and differential privacy.

Oh, yeah, and the Vision Pro, which basically everyone who has tried it has said that it is the most advanced technology they've ever used.

Almost all of this happened under Cook's tenure.

Apple is still in the business of building insanely cool shit.

financltravsty · 5 months ago

You talk like a nerd.

Cool is a vibe, not tech specs and little things. It's a whole aura.

Apple is not cool.

financltravsty commented on Show HN: Built an email marketing platform after paying $230/month fertit.com... · Posted by u/rasadov

more_corn · 5 months ago

When you’re on the receiving end of it… still spam.

financltravsty · 5 months ago

If it doesn't offer anything of value, sure.

But the good ones do.

financltravsty commented on Show HN: Built an email marketing platform after paying $230/month fertit.com... · Posted by u/rasadov

more_corn · 5 months ago

Email marketing is called spam.

financltravsty · 5 months ago

Only to tech nerds. When it's B2B, and targeted and positioned properly, it's business