Why am I Gaining Weight after Testosterone Pellet Therapy?
Clients often observe a noticeable weight gain over the first 2 to 4 weeks following their testosterone pellet therapy. However, this undesirable consequence of testosterone therapy is reversed long term, with patients observing a reduction of their gut or visceral fat long term. According to a study published in the International Journal of Obesity which studied 411 hypogonadal men receiving testosterone injections every three months, subjects demonstrated continued weight loss over eight years. Subjects were stratified into three classes of obesity with a decrease in waistline circumference and body mass index. All patients demonstrated a sustained decrease in waistline and reduction in weight.
Obesity is a pandemic in the United States that affects approximately 35 % of the population regardless of gender. Obesity negatively affects almost all of our health indexes, with an associated elevation of chronic medical conditions and the inevitable reduction in life expectancy. Interestingly, obesity is also associated with low testosterone levels, as observed in approximately 70% of patients. Testosterone replacement therapy has been associated with a reduction in fat content and an increase in lean muscle mass, which result in improved waistline circumference and body mass index.
Surprisingly, testosterone therapy has been associated with an initial weight gain over the first two weeks of initiating therapy. This weight gain has been attributed to engorgement of the muscles as water influx is observed into the muscle fibers. The muscle cells’ growth further compounds this effect. Testosterone directly increases neurotransmitter triggers in the nucleus of muscle cells, activating cellular growth. Cellular growth results from increased protein synthesis of actin and myosin proteins which are the building blocks of muscle tissue.
Testosterone also increases levels of growth hormone. Growth hormone promotes the growth of muscles, especially when the muscles are strained by exercise. In adult males, administration of weekly injections of 200 to 300 mg/week results in the physical growth of muscles and subjective improvement in muscle strength. The exact mechanism by which testosterone facilitates the hypertrophy of muscle fibers by activating immature muscle cells called satellite cells that act like stem cells. These satellite cells are dormant cells that may regenerate muscle cells and tissues throughout the client’s life. These physiologic changes to muscle tissues will transiently result in weight gain.
Long-term effects of testosterone replacement therapy result in ultimate weight loss even as far as eight years following therapy initiation. Weight loss is attributed to a significant reduction of visceral or gut fat. This is because testosterone directly inhibits the production of cortisol, which has been identified as the single factor affecting visceral fat growth. This is because visceral fat cells are most sensitive to cortisol levels. Visceral fat cells are responsible for producing cytokines, which are proinflammatory markers that induce global inflammation. Cortisol suppression by testosterone results in a reduction in visceral fat cell volumes and subsequently decreased inflammation.
Inflammation has proven to be possibly the most detrimental to developing a whole range of metabolic and physiological disease processes. In summary, the loss of visceral fat results in a reduction in waistline circumference and a decrease in weight loss.