Testosterone: how long before effects show? We all know of the potent anabolic effect of testosterone. Such effects were demonstrated over 70 years ago, but were nonetheless long debated among scientists. With the advent of synthetic versions of testosterone, known as anabolic steroids, in the late 1950s, the debate concerning testosterone’s health effects grew even more strident. For years, official statements issued by such organizations as the American College of Sports Medicine and others, held the curious position that any apparent mass gains induced by steroid usage was entirely attributable to merely water retention. In the meantime, bodybuilders were getting much larger muscles, and world records were dropping thanks to athletes use of the “water-retaining” drugs.
The debate ended once and for all with the publication of a landmark 1996 study in the New England Journal of Medicine. That study showed, beyond a doubt, that providing 600 milligrams of testosterone enanthate a week for 10 weeks increased muscle mass and strength, even in men who didn’t lift weights compared to those provided with a placebo. Testosterone injections provided even greater results (as expected) when weight-training was added to the mix. But this information was old news for those in the bodybuilding world. Although rumors of testosterone use among athletes started not long after the hormone was isolated in 1935, the first documented use of testosterone for athletic purposes occurred in the mid 1950s, when it was revealed that testosterone was being used by Russian weightlifters.
But even before that happened, many health benefits of testosterone had been suggested. In the late 1940s, testosterone was hailed as the cure for male depression. Although this use of testosterone soon fell out of favor, due to fears about long-term health effects of testosterone, more recent studies have shown that indeed, testosterone does appear to offer some relief for depression through altering certain brainneurotransmitters. That brings up a question not often discussed: just how long does it take for the effects of testosterone to become apparent?
A recent review[i] examined all the existing research pertaining to the time of onset for the various effects of testosterone. The one caveat about this review to consider is that the time effects pertain to men with clinically diagnosed low testosterone levels. As such, a person with testosterone levels in the normal range (as measured by accurate free testosterone, rather than total testosterone levels) might show different responses than that documented by this review. In any case, here’s what the review found.
How long for muscle mass and strength effects to show? The famous 1996 study that proved the muscle-building effects of testosterone noted that these effects were dose related. Simply put, if you use too low a dose of testosterone, you won’t show the same anabolic effects as when taking larger doses. This is interesting, since the major goal of testosterone replacement therapy (TRT) is to boost deficient levels of testosterone to a point midway in the scale of testosterone blood measurement. Yet, according to the 1996 study, building muscle mass would require a minimal level of testosterone that would be on the high end of the scale, or about what a male teenager would produce. That level is the highest level ever produced by most men. One study that involved use of testosterone with growth hormone found a significant increase in lean body mass. Maximal muscle strength had occurred by the 16th week of use of both hormones. Another study showed that it took 12 weeks to reach maximum strength levels with testosterone use alone. Studies examining the time course for muscle and strength effects related to testosterone usage have varied. If you average them out, however, the maximum muscle and strength levels occur 12-20 weeks after using testosterone, depending on the dose. Obviously, the higher the weekly dose, the quicker muscle and strength gain manifest. The maximum effects are achieved in 6-12 months of continual usage of testosterone (T).
Bone density Many people are aware of the fact that women with long-term estrogen deficiency are more prone to getting osteoporosis, a bone-thinning disease. Less well known is that men deficient in testosterone can also be afflicted by this disease, and strangely, for the same reason. A certain amount of testosterone produced daily is converted by the aromatase enzyme into estrogen. Estrogen, in turn, protects bone from excessive breakdown. But less testosterone in men doesn’t necessarily mean less estrogen. In fact, an imbalance of estrogen to testosterone is common in older men. What happens is that while the natural production of testosterone in men drops each decade past age 40, estrogen continues to made through the actions of aromatase, which doesn’t drop with age. As a consequence, estrogen goes up, while testosterone drops, and much of the smaller production of testosterone in older men falls prey to conversion into estrogen through aromatase action. This has implications for health, in that higher estrogen levels in older men are linked to onset of prostate cancer and cardiovascular disease. But that higher estrogen also may protect bone mass. This scenario would only be applicable to men with higher bodyfat levels, since fat is a prime area of aromatase activity. In men who are lean, the lack of sufficient testosterone could result in osteoporosis.
Similarly to estrogen, T favors an increase in bone density, especially in the spine. The longer T is used, the greater the boost in bone density.
Body composition Testosterone is known to play a significant role in helping to prevent obesity. One way it does this is by controlling the pathway of pluripotent stem cells.These are immature cells that can take a pathway to become either fat cells or muscle cells. With sufficient levels of testosterone, these cells take the pathway to muscle, rather than fat. T also prevents the conversion of such cells into fat cells. With age, men tend to accumulate fat in the abdominal area of the body. The deep-lying fat in the abdomen, known as visceral fat, is the most dangerous fat found in the body. This fat is labile, meaning that it’s constantly being broken down. When that happens, the fat is transported to the liver, where it’s converted into cholesterol.Visceral fat is also associated with diabetes, insulin resistance, and cardiovascular disease.
It turns out that one reason why men begin to accumulate abdominal fat is because of a downgrade of adrenergic fat cell receptors in the abdomen. This downgrade is related to lack of testosterone. When testosterone is provided, the dormant beta adrenergic receptors open up again, and men lose fat in the abdominal area, along with a concomitant reduction in health risks related to having fat in that area. Fat loss in the abdominals usually shows up after 3 months of supplemental testosterone use in deficient men.
Testosterone and lipids Although many doctors refuse to prescribe testosterone because of a belief that it promotes cardiovascular disease, in fact, the opposite is true. Testosterone begins to lower elevated cholesterol levels in about a month after starting usage. The average significant drop happens in about 3 months. Serum triglycerides also drop after about a month. Low density lipoprotein (LDL) takes a bit longer to drop, averaging 3 months, with maximal effects occurring by the two year mark. As far as high density lipoprotein (HDL), which is considered protective against CVD, some studies show a rise, others a drop. Since much of the effect of testosterone on HDL levels depends on conversion into estrogen, if you also use an aromatase inhibitor drug, which blocks the conversion of T into estrogen, the beneficial effects of T on HDL may not be as apparent. Recent studies with Arimidex, a popular AI drug, show that this effect isn’t as common as previously believed. HDL increases follow the same time frame as that of LDL with testosterone.
Testosterone and blood glucose levels The incidence of diabetes is increasing alarmingly world-wide. In most cases, this is due to a combination of obesity and lack of physical activity. But since testosterone also helps to control bodyfat levels, especially the type of fat most linked to insulin resistance (visceral fat), it makes sense that testosterone may help prevent diabetes onset through ameliorating some of the early symptoms of the disease, such as insulin resistance. Testosterone helps to lower elevated blood glucose levels, but doesn’t affect normal glucose levels. It also lowers insulin levels (which itself helps you lose fat). These effects show up in 3-9 months, according to studies. In fact, the lowering of elevated blood glucose and insulin resistance can show up after only a month on testosterone, especially if you also exercise. T can lower elevated glucose in only one week!
Blood pressure and CVD effects A lowering of diastolic blood pressure by T happens in 3-9 months. A drop in resting heart rate occurs after 40-44 weeks of T therapy.T also lowers arterial stiffness, a prime cause of CVD, in only two days. T relieves angina pectoris, linked to atherosclerosis of the coronary arteries, after 14 weeks, and increases exercise capacity in heart failure patients after 3 months.
T and inflammation Excess body inflammation is now known to be the cornerstone of most major diseases. Low levels of both T and estrogen are associated with higher levels of overall body inflammation. T lowers cytokines, or mediators of body inflammation, in about 16 weeks. But it lowers elevated levels of C-reactive protein, a marker of inflammation, in only 3 weeks. Other markers of inflammation drop after a month on T. T lowers the levels of a chemical produced in the body that blocks synthesis of nitric oxide in only 10 days.
Other effects T boosts libido or sex drive in an average of 3 weeks. It provides beneficial effects on erections after 3 weeks of use. Depression is relieved after 3 weeks, along with a significant mood elevation. Anxiety goes down, while self-confidence goes up after a month on T. Fatigue drops after a month, too.
So there you have it. As noted earlier, these listed time effects of T are based on giving the hormone to deficient men. The times will vary if T is used by younger men not deficient in the hormone.
Jerry Brainum has been involved in all aspects of fitness and nutrition research for over 50 years. He has acted as a nutritional advisor for world-class athletes, including professional boxers Oscar De la Hoya, Floyd Mayweather Jr, Vassali Jirov, and basketball star, Vlad Divac. All of the professional boxers were undefeated with Jerry’s expert assistance. In fact, he is a widely sought “go to” guy working behind the scenes to help world class athletes increase performance and prevent injuries. He has also designed personalized diet plans for numerous celebrities and business persons, including the late Ed McMahon and multi-Academy Award winner, Stan Winston. Considered an authority in sports nutrition and ergogenic aids, Jerry has had over 3,500 articles published in a wide range of magazines. He served as Science editor for Muscle and Fitness for 10 years; Editor-at-large for Flex magazine; and has contributed to among other publications, Let’s Live, Penthouse, and Muscular Development. He is currently a contributing editor for Ironman magazine, having written continuously for that publication since 1986. Jerry is also the science editor for Planet Muscle magazine. His blog is located at: www.appliedergogenics.blogspot.com. When not engaged in writing or research, Jerry acts as a nutritional consultant and product developer for numerous national and international food supplement companies, such as Bill Grant Nutrition and many others.[i].Saad,F, et al. Onset of effects of testosterone treatment and time span until maximum effects are acheived.Eu J Endocrin 2011: in press.