Disclaimer: This article is for informational and entertainment purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before making any decisions about hormone therapy or other medical treatments.
Testosterone Replacement Therapy is booming—and Chris Williamson’s popular video dives into why so many men are turning to it.
From sharper energy to increased muscle, TRT sounds like a dream. But what if chasing those gains comes with hidden costs?
This article breaks down the overlooked risks, why more testosterone isn’t always better, and how using it without true deficiency might backfire.
If you’re thinking about TRT—or already on it—there are crucial health truths you need to know first.
TRT Only Makes Sense if You Actually Need It
The first question that matters when evaluating TRT is: Do you actually have low testosterone?
According to the American Urological Association, low testosterone is diagnosed when total testosterone levels fall below 300 ng/dL, combined with corresponding symptoms—like low libido, chronic fatigue, or loss of muscle mass.
“If you’re already functioning at a high level hormonally and physiologically, taking TRT may actually do more harm than good,” says performance health educator Derek from More Plates More Dates. “If you’re just doing it to look like a bodybuilder or influencer, you’ve got the wrong motivation.”
Unnecessary testosterone use can disrupt your natural hormone production and *suppress your body’s ability to produce testosterone naturally.* Once you’re on TRT, you might have to stay on it for life, as your luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels are often suppressed for good.
Short-Term Benefits Can Come with Long-Term Health Costs
TRT can make you feel like a new man in the short term—more vitality, better workouts, improved sexual performance. But the effects on your long-term health and longevity require serious consideration.
- Cardiovascular risk: Increased red blood cell production (erythrocytosis) can raise your risk for blood clots, heart attacks, and strokes.
- Prostate health: While research is mixed, TRT might fuel growth in existing prostate cancer or benign prostatic hyperplasia (BPH).
- Sleep issues: Elevated testosterone can worsen or trigger sleep apnea, a condition strongly linked with cardiovascular disease.
- Infertility: TRT suppresses natural testosterone production, which can lead to reduced sperm count and infertility—often a major issue for younger men.
A 2017 study published in the Journal of the American Medical Association (JAMA) indicated that men over 65 using TRT had an increased risk of cardiovascular events when their testosterone levels were elevated beyond normal physiological levels.
TRT vs. Longevity: Bigger Isn’t Always Better
Many men equate more muscle with better health. But that’s not always true when you’re pushing beyond what’s naturally attainable.
“If you have too much muscle that your cardiovascular, renal, or hepatic systems aren’t built to support naturally, it could stress your body more than help it,” says Derek. “A small, lean woman might outlive a hulking bodybuilder simply because of the demands their body places on itself.”
Carrying a massive amount of metabolically active muscle tissue increases the workload on your heart. Elevated blood pressure, constant sympathetic nervous system arousal (higher resting heart rate), and trouble sleeping due to excess stimulation are common in men on high-dose androgens.
While there’s no need to shrink down for life-extending reasons (as some longevity advocates suggest), there’s also no reason to overbuild your body past what your health can handle sustainably.
Responsible TRT Use May Reduce Certain Health Risks—If You’re Actually Deficient
For men who truly have clinical hypogonadism, TRT can be transformative in a good way. Restoring testosterone to a healthy level can help prevent:
- Loss of bone density (reducing fracture risk)
- Muscle wasting and frailty
- Depression and cognitive decline
- Decreased insulin sensitivity and metabolic issues
“If you are deficient and use testosterone in a clinically appropriate dosage, the risk isn’t the same as someone pushing super-physiologic doses,” Derek explains. “You’re likely improving your quality of life and potentially preventing issues associated with low testosterone.”
A 2016 meta-analysis in the Journal of Clinical Endocrinology & Metabolism showed that TRT in hypogonadal men helped positively influence markers like insulin sensitivity, waist circumference, and lean body mass while also improving mood and sexual function.
The Importance of Medical Monitoring
No one should be self-medicating with testosterone. Anyone even considering TRT needs to work with a knowledgeable healthcare provider to:
- Confirm true low testosterone through comprehensive blood tests
- Address root causes of low T (such as sleep deprivation, obesity, or stress) before jumping to TRT
- Monitor complete blood count (especially hematocrit), prostate-specific antigen (PSA), cholesterol, and liver enzymes regularly
“If you’re on testosterone and not monitoring your blood pressure, lipids, or hematocrit, you’re playing a risky game,” Derek adds. “The goal should be optimization, not maximization.”
Psychological Effects and the Trap of “More is Better”
One subtle risk is psychological reliance. Once a man experiences the benefits of TRT—like better energy or aesthetics—there can be a temptation to “bump up the dose” for more dramatic effects.
This often leads to a cycle of chasing high performance at the expense of health. That’s when side effects escalate—gynecomastia, hair loss, high estrogen-related issues, or aggression.
“More is not better with androgens,” Derek emphasizes. “The more super-physiological you go, the more you step out of what your body can handle long-term.”
TRT Isn’t a Lifestyle Hack—It’s a Medical Decision
TRT should not be treated like a pre-workout or nootropic. It’s a lifelong commitment for many, and jumping in without due diligence can lead to consequences harder to reverse than to avoid in the first place.
If you’re in your late 30s or 40s and don’t feel like yourself anymore, go ahead and get tested. But also, be ready to put in the work on improving sleep, diet, resistance training, and managing stress—that alone may raise your testosterone naturally.
Here’s the bottom line: If you’re deficient and using TRT under medical supervision, it can be life-enhancing, even life-extending. But if you’re optimizing something that was never broken, all you might be doing is borrowing short-term performance at the expense of long-term wellbeing.
Balance is key. Longevity and quality of life aren’t opposites—they’re parallel goals.
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