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TRT, 121 flying and your medical

Old 06-02-2012, 06:58 PM
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Question TRT, 121 flying and your medical

My Dr. has been trying to get me on testosterone replacement for a while but I have been afraid to start down that road with 121 flying in my future. On the other hand I feel that I would benefit greatly from it because of the issues of having low test has caused in my life. I hold a current 1st class and I'm in good health other than the sluggish feelings, low motivation, and low sex drive.

So any of you guys on TRT while flying 121? If you could let me know how you handle it with your AME I would appreciate any advice you could offer. I have spoken to 2 AMEs about it. One said it was a huge hassle and the FAA frowned on it. The other said it was no issue as long as it was documented properly and the required Dr. evals were turned in with your medical every renewal.
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Old 06-03-2012, 02:56 AM
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I can't see why it would be a big problem. But worry about your health first, aviation second.

I noticed a drop in sex drive when the stress piled up, no "performance" issues thankfully but I did some research and made some changes which helped noticeably...

Cardio: I tend to manage stress with cardio. I would do at least an hour cardio if I put on the shoes or got in the pool. Turns out cardio is good for you health overall and will help with stress, but a whole lot of it will increase cortisol, which will drives down your T. Three or four 30 minute cardio sessions / week shouldn't have much impact on T, the cortisol boost starts after 40-45 minutes cardio. Long term, I would actually advocate more cardio than what I suggested here, for overall health, but this might deal with the T issue.

Weights: Must do this to increase T, also has fringe benefit of helping prevent random injuries as you age. With weights you want to focus on activating the large muscle groups...all the insecure little boys at the gym who do nothing but blast their biceps are not really generating much T. Go for somewhat lower reps (ex 10-8-6-4), shoot for 80-90% of max reps before fail. You MUST do legs...squats, deadlift, hamstrings, etc. Pullups, rows, bench, etc all get multiple muscle groups. Get the back involved too.

Zinc: zinc supplements may help, look for good quality about 30 mg/day in the evening (more than about 30mg may not be healthy in the long run). Surprisingly this can have a noticeable affect within an hour or so. Some foods have zinc too.

Body weight: If not already, get fit. You may have to do a lot of cardio to get there but after you get near fighting trim you can ramp up weights and reduce cardio.

Caffeine: Puts your body in an elevated state which, while useful, is similar to a stress response (cortisol again). Try limiting to one cup of joe (or soda equivalent) per day. If you're over age 25 and doing monster drinks or 5-hour energy, that's most likely your problem right there.

Last thing, gym membership can definitely improve your sex drive...so buy one for your wife today

Last edited by rickair7777; 06-03-2012 at 03:42 AM.
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Old 06-03-2012, 06:16 AM
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Originally Posted by rickair7777 View Post
I can't see why it would be a big problem. But worry about your health first, aviation second.

I noticed a drop in sex drive when the stress piled up, no "performance" issues thankfully but I did some research and made some changes which helped noticeably...

Cardio: I tend to manage stress with cardio. I would do at least an hour cardio if I put on the shoes or got in the pool. Turns out cardio is good for you health overall and will help with stress, but a whole lot of it will increase cortisol, which will drives down your T. Three or four 30 minute cardio sessions / week shouldn't have much impact on T, the cortisol boost starts after 40-45 minutes cardio. Long term, I would actually advocate more cardio than what I suggested here, for overall health, but this might deal with the T issue.

Weights: Must do this to increase T, also has fringe benefit of helping prevent random injuries as you age. With weights you want to focus on activating the large muscle groups...all the insecure little boys at the gym who do nothing but blast their biceps are not really generating much T. Go for somewhat lower reps (ex 10-8-6-4), shoot for 80-90% of max reps before fail. You MUST do legs...squats, deadlift, hamstrings, etc. Pullups, rows, bench, etc all get multiple muscle groups. Get the back involved too.

Zinc: zinc supplements may help, look for good quality about 30 mg/day in the evening (more than about 30mg may not be healthy in the long run). Surprisingly this can have a noticeable affect within an hour or so. Some foods have zinc too.

Body weight: If not already, get fit. You may have to do a lot of cardio to get there but after you get near fighting trim you can ramp up weights and reduce cardio.

Caffeine: Puts your body in an elevated state which, while useful, is similar to a stress response (cortisol again). Try limiting to one cup of joe (or soda equivalent) per day. If you're over age 25 and doing monster drinks or 5-hour energy, that's most likely your problem right there.

Last thing, gym membership can definitely improve your sex drive...so buy one for your wife today

Well stress for sure is always present but I manage.

The things you mention above is excellent advice. Thing is I already do all of them I am also a personal trainer even though I'm not currently training anyone since jumping back in aviation.

Being active in fitness and eating clean is how I noticed something was wrong. Over the past year and a half I have had a huge issue with fat gain. Honestly it takes alternating HITT and LISS cardio plus weight training to keep the fat from taking over while eating 500 cals. under maintenance. I am far from being as fit as I was in 2008 when I was 250lbs at 10% BF. Now its more like 16-18% and it takes a lot of effort to maintain that.

I know the TRT is the right thing to do for me but I want as much info as possible before trying to maintain a 1st class while on it.
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Old 06-03-2012, 03:09 PM
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Originally Posted by Rotor2prop View Post
Well stress for sure is always present but I manage.

The things you mention above is excellent advice. Thing is I already do all of them I am also a personal trainer even though I'm not currently training anyone since jumping back in aviation.

Being active in fitness and eating clean is how I noticed something was wrong. Over the past year and a half I have had a huge issue with fat gain. Honestly it takes alternating HITT and LISS cardio plus weight training to keep the fat from taking over while eating 500 cals. under maintenance. I am far from being as fit as I was in 2008 when I was 250lbs at 10% BF. Now its more like 16-18% and it takes a lot of effort to maintain that.

I know the TRT is the right thing to do for me but I want as much info as possible before trying to maintain a 1st class while on it.
Sounds like you know better than I do, maybe the therapy is the way to go at this point.
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Old 06-03-2012, 03:51 PM
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Originally Posted by rickair7777 View Post
Sounds like you know better than I do, maybe the therapy is the way to go at this point.
I feel it would be good for me but I really want to find some 121 pilots that are currently on it to confirm its not a huge hassle.


So if anyone is on TRT and doesn't want to talk openly about you can PM me if you would like.
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Old 06-03-2012, 05:51 PM
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Originally Posted by Rotor2prop View Post
I feel it would be good for me but I really want to find some 121 pilots that are currently on it to confirm its not a huge hassle.


So if anyone is on TRT and doesn't want to talk openly about you can PM me if you would like.
POA and AOPA forums both have a good med section. Post your question there. You have to be in AOPA to post on their forum; POA is open to all.
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Old 06-04-2012, 09:35 AM
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Originally Posted by rotorhead1026 View Post
POA and AOPA forums both have a good med section. Post your question there. You have to be in AOPA to post on their forum; POA is open to all.
Well the AOPA AME thats on the forum over there is the one who acted like I asked him if its ok to fly 121 while smoking crack! He was very defensive about TRT and flying in general. He said it made pilots to aggressive The other AME that I talked to deals with lots of special issuance. He said it was no problem at all as long as its documented with each renewal.

Basically after being talked to like a junky by the AME on AOPA it has made me want to research TRT and the FAA a little more along with talking to pilots currently on TRT and flying with a 1st class medical.

Thanks for the suggestion though
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Old 06-06-2012, 02:37 PM
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Originally Posted by Rotor2prop View Post
I feel it would be good for me but I really want to find some 121 pilots that are currently on it to confirm its not a huge hassle.


So if anyone is on TRT and doesn't want to talk openly about you can PM me if you would like.
why not just ask your AME.....
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Old 01-28-2019, 08:42 AM
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Originally Posted by Rotor2prop View Post
My Dr. has been trying to get me on testosterone replacement for a while but I have been afraid to start down that road with 121 flying in my future. On the other hand I feel that I would benefit greatly from it because of the issues of having low test has caused in my life. I hold a current 1st class and I'm in good health other than the sluggish feelings, low motivation, and low sex drive.
Found this: https://www.faa.gov/about/office_org...de/pharm/chrt/

Pharmaceuticals (Therapeutic Medications)
Contraceptives and Hormone Replacement Therapy
Code of Federal Regulations:
First-Class Airman Medical Certificate: 67.113(b)(c)
Second-Class Airman Medical Certificate: 67.213(b)(c)
Third-Class Airman Medical Certificate: 67.313(b)(c)

Medical History:
Use of Oral or Repository Contraceptives or Hormonal Replacement Therapy are not disqualifying for medical certification. If the applicant is experiencing no adverse symptoms or reactions to hormones and is otherwise qualified, the Examiner may issue the desired certificate.

Aeromedical Decision Considerations:
See Medical History above and Item 48, General Systemic, Gender Identity Disorder.

Protocol: N/A

Pharmaceutical Considerations: See Medical History above.
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