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What Are The Stages of Topical Steroids Withdrawal?

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What are Steroids?

             Steroids are the hormones the human adrenal cortex produces. They also refer to the synthetic drug with cortisol effects. Steroids, also known as corticosteroids, are very different from steroid compounds used by athletes to enhance their performances. Usually used in medical cases. Medical conditions steroids used to treat include allergies, asthma, dermatitis, hives, Addison's disease, Crohn’s disease, leukemia, prostate cancer, etc.

         Steroids are classified into types depending on the effect they create within the body. They also produce many side effects, such as depression, anxiety, insomnia, hypertension, fluid retention, muscle wasting, decreased height, cataracts, glaucoma, peptic ulceration, and TSW (topical steroids withdrawal).

Must Read:: Can Blocking Cortisol Lead to Steroid-Like Muscle Gains?

Topical Steroids:

          These are medications in creams, lotions, ointments, solutions, serums, gels, sprays, foam, oils, shampoos, and other substances made for the skin or scalp. Also used for anti-inflammatory purposes, to treat or control skin infections such as eczema and dermatitis. Other names for topical steroids are topical corticosteroids, glucocorticosteroids, and cortisone.

Effects of Topical Steroids:

            These steroids cause the same effects as the corticosteroids produced by the adrenal glands above the kidneys. Other side effects of applying these steroids on the skin or scalp include narrowing blood vessels, suppression of immune response, and reduced cell turnover. All the effects of using these steroids can be classified under the following:

  • Anti Inflammatory
  • Immunosuppressive
  • Anti-Proliferative
  • Vasoconstrictive

The Potency of Topical Steroids: 

The potency of topical steroids refers to the working capacity of the medication, and they can be grouped into four:

  • Low Potency: Topical Steroids classified as having low potency include alclometasone dipropionate, hydrocortisone, and desonide. 
  • Moderate Potency: Topical Steroids with medium potency include betamethasone valerate, clocortolone pivalate, flurandrenolide, fluocinolone, fluticasone propionate, and hydrocortisone valerate.
  • High Potency: Topical steroids grouped under this category include desoximetasone, halcinonide, amcinonide, and triamcinolone acetonide.
  • Very High Potency: Topical steroids in this category include betamethasone dipropionate, diflorasone diacetate, fluocinonide, clobetasol propionate, and clobetasol propionate.

 

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The potency of a Topical Steroid would largely depend on the following factors:

  • Formulating components
  • The amount that reaches the target cells
  • The specific molecule
  • The rate of absorption through the skin.

         You can purchase topical steroids with mild potency, just over pharmaceutical counters, but those with high and very high potency should only be on doctor’s prescriptions.

Conditions that would require being treated and controlled by the use of Topical Corticosteroids include:

 

  • Eczema (atopic eczema): This skin condition causes the skin to feel itchy, scaly, dry, and cracked. It may even lead to severe skin inflammation. This inflammation causes the skin to become red, dark brown, or gray, depending on skin tone. It usually is a long-term condition that affects the central part of the skin, such as the hands, backs, knees, faces, scalps, etc. However, it can still be controlled and treated using topical steroids. It is the most common form of eczema.

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  • Dandruff: This skin condition usually affects the scalp, making it dry and itchy. It causes white flakes on the scalp and hair. Using a shampoo containing topical corticosteroids should help in treating this skin condition.
  • Psoriasis: This is a skin condition that usually occurs on the elbows, knees, scalp, legs, and lower back but can occur on any part of the body. It causes a small patch of red, flaky, crusty, and itchy skin. This chronic disease is caused by the multiplied production of skin cells resulting in a build-up. This skin condition can also be controlled by the use of topical steroids.
  • Nappy Rash: This is a skin condition in babies that causes a sore and itchy red patch of skin on the baby’s bottom most. It can also happen in the form of spots or blisters. Using a cream containing topical steroids can help with this situation, especially when it is in its severe state.

Lichen Planus:

This skin condition can occur in the mouth, groin, nails, and other body parts. It causes a cluster of glossy elevated colored blotch on the affected area. This area is usually sore, itchy, and red. Using a medication containing topical steroids can help with this condition.

  • Discoid Lupus Erythematous: This condition causes skin rashes, extreme fatigue,, and inflammation of the joints. It can also lead to weight loss and extreme joint pain. This condition can be controlled by using creams that contain topical steroids.
  • Skin Irritation: Skin irritation characterized by swollen, itchy, and red skin parts can be caused by many factors. An insect bite is a factor. Applying a medication that contains topical steroids would be effective in alleviating the pain.

Combination with Other products:

         Topical steroids are usually used with other ingredients, such as anti-bacterial and anti-fungal, to create a more effective result. The risks involved in using topical steroids with other drugs are quite low, and there is no significant effect on the potency of topical steroids when combined with other products. 

        These other drugs do not affect the concentration or effect of topical steroids. However, it is strongly advised that other topical medications should not be carried out simultaneously as topical corticosteroids to avoid creating more adverse effects.

How Topical Corticosteroids Are Used:

           If you purchase any topical steroid from over the pharmaceutical counter, ensure you follow the instructions on the leaflet. Otherwise, you should adhere strictly to the doctor’s prescription. These substances are often applied to the affected part once or twice daily for two weeks or more. It should be used less frequently as treatments commence. The use of these medications should be reduced to once a day to avoid the occurrence of topical steroid withdrawal. 

 

            Also, it should not be applied all over the body but to the affected parts. It should be applied gently to the skin. If you use emollients, avoid using both substances at the same time. Give a 30 minutes time difference between the applications of both substances. These emollients help to relieve skin irritation and dryness.

The Finger Print Unit

            The fingerprint unit acts as a guide for using the right dosage of topical steroids in treating skin conditions. You squeeze a quantity of the product from the tip of your finger to the first crease. This quantity should be enough to treat skin conditions over a patch of your skin two times the size of your palm. However, the dosage will still depend on what is being treated and the part of the body it is being treated. This is major because some body parts have thinner skin layers and are hence more sensitive than others. This dosage is often referred to as FTUs(s).

 

           The absorption of topical steroids into the body occurs in different ways. For instance, the greatest absorption happens through the skin layer of the genitals, eyelids, and creases. Hence, potent and highly potent topical steroids should not be used on these parts of the skin.

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             The least absorption of topical steroids occurs through the skin layer of palms and soles. Hence, low and moderately potent topical steroids may seem ineffective when applied to these parts of the skin. Using bandages or wraps to occlude the affected part would also help to increase the absorption of topical steroids through the skin layer.

Below is the recommended dosage for each part of an adult's body, using the Finger Print Unit 

  • 0.5 FTU for the skin found around the genitals.
  • 1 FTU for skin located around the hands, elbows, and knees.
  • 1.5FTUs for the skin located around the feet, including the soles.
  • 2.5 FTUs for skin located around the face and neck
  • 3 FTUs for the skin located around the scalp
  • 4 FTUs for the skin located around the hand, arm, and the buttocks
  • 8 FTUs for the legs and chest or the legs and the back

Who should use Topical Corticosteroids?

             Adults and children can use topical steroids. However, avoid using topical steroids for treatment if you have infected skin, broken skin, or skin conditions like acne and open sores. Pregnant and nursing mothers should only use topical steroids in necessary situations. Research shows that the prolonged use and abuse of these substances can cause defects in the unborn child.

         Therefore, using topical steroids with high potency should not be practiced by nursing and breastfeeding mothers. There is no proof that the content can contact the breast milk mother. Apply all caution during usage, topical steroids, and even low potency. Do not apply topical steroids to a nursing mother’s breasts; if she must use these medications, she should also be careful to wash off the cream before breastfeeding her child. This safety measure is significant to prevent the child from being harmed.

Side effects of using Topical Steroid Withdrawal:

           For the use of most medications, there are side effects that may occur with different individuals. These side effects should not be confused with Topical Steroid Withdrawal. The side effects include:

  • Some individuals may experience specific internal side effects that are similar to the symptoms of crushing syndrome.
  • It can also result in skin thinning, that is, the reduction of skin elasticity.
  • Stretch marks in armpits or genitals.
  • Tearing of the skin due to the extreme thinness of the skin layer.
  • The enlargement of blood vessels.
  • The thickness and increased length of hair.
  • It can also lead to cataracts and glaucoma when used frequently over the eyelids.
  • Stinging of the skin can also occur when topical steroids apply to areas of the skin that have inflammation or are broken. 
  • Topical steroids can also heighten the effects of other skin infections, such as herpes simplex.

Topical Steroid Withdrawal:

          This is also known as red skin syndrome or steroid dermatitis, which occurs after a person ceases to use topical steroids after prolonged regular use or the abuse of topical steroids. This condition usually occurs with the use of topical steroids with high levels of potency. The symptoms are mostly on the face and genitals. However, there is no exact time or duration for these symptoms to appear. It differs in individuals; in some, it may be a few months, while for others, it could take many years. Individuals with atopic dermatitis and women who blush often are at more risk. Very few reports have occurred in children. The first known case of topical steroid withdrawal happened in 1979.

Causes:

           This condition is mainly caused by the abuse, prolonged or regular use of topical steroids for more than a year. It was once believed that the adrenal glands only produce cortisol. However, recent research has proven that keratinocytes in human skin should also be included in the list. The prolonged or regular use of topical steroids would cause an adverse expression on the surface of lymphocytes.

Diagnosis:

           We mustn't attribute every skin condition to Topical Steroids Withdrawal. Some symptoms of Topical Steroid Withdrawal are redness and rash on the face, excluding the nose and around the lips. This rash usually begins from the part of the skin that initially had the condition to be treated. Redness of the arms except for the palms and fingers. The reduction of the skin's elasticity can also be a way to tell if you have this condition. A burning feeling under the skin also forms part of the diagnosis. The reddened part of the skin may not just be a patch. It may also appear as the original skin condition the topical steroid is applied to treat or control. Your skin can also feel thickened and swollen.

          Using this product with the right frequency and dosage and over the appropriate duration helps treat and control skin conditions. Side effects and topical steroid withdrawal only occur when you use the product in larger quantities or frequently over a long period, beyond the prescriptions of doctors, dermatologists, and physicians. It is also important that the use of this treatment need to be under the supervision of a dermatologist.

             Deciding not to use topical steroids to treat or control skin conditions due to the knowledge of these side effects and topical steroids withdrawal may not be the best of choices as these substances can prove effective in the treatment of skin conditions, mainly when used according to prescription and over the right duration. Besides, this condition is pretty rare both in adults and children. 

Significant signs and symptoms of topical steroid withdrawal include:

  • Spreading Dermatitis through the skin, usually starting from the location or region previously affected by the skin condition that creates.
  • Skin Inflammation accompanied by a burning, stinging sensation.
  • Redness of the skin, usually the face, excluding the nose and around the lips.
  • Swelling of different regions of the skin. This particular symptom is one the affected individual should waste no time in informing the physician or dermatologist.
  • Intense itching in various areas of the skin is also a sign or symptom.
  • Increased skin sensitivity to other topical products or atmospheric conditions.
  • Oozing of liquid substances from the different parts of the skin.

      These symptoms may develop weeks or months after the stoppage of topical steroid withdrawal. It is usually different per individual, but most cases happen with individuals who have used the product for more than 12 months.

Must Read:: How Do You Get Rid of Steroid Acne?

        These signs and symptoms can also be classified into two types. Both are referred to as erythema to edematous and papulopustular. The erythema to edematous type is found in individuals with atopic or seborrheic dermatitis, accompanied by swelling, burning, redness of the skin, and heightened skin sensitivity. All these symptoms would occur within a fortnight from the stoppage of topical steroids.

          The papulopustular type is found in individuals who have used these medications to treat acne. This comes with symptoms such as pimples, nodules, and redness. This is when this product is for cosmetic purposes.

Prevention of Topical Steroids Withdrawal

             The most effective prevention method is using these medications strictly based on prescriptions. These symptoms are more likely to appear in these medications that are misused. The more frequently topical steroids are used, the more likely the individual to develop topical steroids withdrawal. The more potent the topical steroid and if used for a longer period than prescribed, the higher the probability of having topical steroid withdrawal. Use topical steroids to treat or control skin conditions and not for cosmetic purposes. Preventing these withdrawal symptoms is simple if you adhere to the above guidelines. However, in totally preventing topical steroid withdrawal, treatment of chronic skin conditions with the use of topical steroids shouldn't avoid or discourage.

Treatment of Topical Steroid Withdrawal:

           No one treatment widely agrees upon this. However, the first step would be to consult your dermatologist or skin care physician. There has to be a diagnosis to be sure that the symptoms noticed are of topical steroid withdrawal and not another skin condition like eczema. 

 

          Once the diagnosis has been made, the next step would be to stop the wrong use of these medications. There have been some arguments about stopping these medications' use abruptly or gradually. However, there is no significant difference in the results produced by both actions. It highly advises stopping the use of the medications immediately.

Psychological Support

 

          Support and psychological care should also be patient. Other ways to help with the condition include using ice compresses, systemic doxycycline, tetracycline or calcineurin inhibitors. Ointments and balms such as shea butter have also be found to be helpful during this time. Epsom salt bath is also helpful in the recovery process. Antihistamines should be used to help with the intense itching of the skin that also occurs as a symptom. Immunosuppressants suggest helping as well.

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       Another method would be to use oral steroids to reduce the symptoms. If it has led to secondary infections, oral antibiotics should be used. Patients should use soaps and detergents that would be suitable for sensitive skin. Also, wear clothes that are milder and softer on the skin to help reduce irritation. There have also been suggestions for natural and alternative medicine. However, these methods take approval from your doctor before attempting to use them so they do not worsen the condition.

Duration of Treatment:

           The duration of treatment and recovery is not the same for everyone. However, it usually influences by the period through which these medications are used; the longer the period of use would mean a more extended period for recovery. The duration of recovery and the time it would take for the skin to return to normal would also depend on the treatment used. This duration can be months or even years for specific individuals. It advises taking steps to prevent this from occurring instead of waiting so long for your skin to return to normal.

Conclusion

              In conclusion, topical steroids are very effective in controlling and treating skin conditions, both mild and chronic. It may lead to an eventual cure for some but for others, it may help relieve the symptoms. However, if used in excess, abused, used in large quantities and over a long period, it may lead to topical steroid withdrawal. Though this condition is quite rare, it advises that it prevents strictly following prescriptions. It would be good to also have your treatment monitored by your dermatologist or physician.

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Using Insulin Needles to Inject AAS: Pros and Cons

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Bodybuilding has long been associated with the pursuit of physical excellence, where athletes and enthusiasts dedicate themselves to sculpting muscular physiques. You need rigorous training, disciplined nutrition, and, in some cases, the use of performance-enhancing substances. Among these substances, anabolic-androgenic steroids (AAS) occupy a controversial space. While medically prescribed for specific conditions, AAS are often used to accelerate muscle growth, improve recovery, and enhance overall performance. Their use, however, is fraught with ethical, legal, and health-related concerns.

One practical issue that arises in this context is the method of administration. AAS are typically injected intramuscularly, requiring needles that can deliver oil-based solutions deep into muscle tissue. Yet, some individuals turn to insulin needles—originally designed for subcutaneous delivery of insulin—as an alternative. This choice is often motivated by the perception that insulin needles are less intimidating, less painful, and more discreet. For bodybuilders who may be inexperienced with injections, the appeal of a smaller, finer needle can be strong.

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However, the suitability of insulin needles for AAS administration is highly debated. While they may offer certain conveniences, their limitations in terms of depth, absorption, and compatibility with thicker solutions raise significant concerns. Misuse can lead to complications ranging from ineffective dosing to infections and tissue damage.

Must Read: Running and Bodybuilding: Is it a Good Idea to Mix Them?

In bodybuilding culture, where experimentation and peer influence often shape practices, understanding the pros and cons of using insulin needles for AAS injections is essential. By examining both benefits and the potential risks, we can better appreciate the complexities of AAS injection and emphasize the importance of informed, responsible decision-making.

Why Insulin Needles

Insulin needles are generally preferred for many types of injections because they are shorter, thinner, less painful, and reduce the risk of complications compared to larger needles

Patient comfort: Insulin needles are designed to minimize pain. Their fine gauge and short length make injections less intimidating and more tolerable, especially for people who need frequent injections.

Reduced risk of complications: Shorter needles lower the chance of hitting muscle or nerves when delivering medication subcutaneously. This reduces risks like bruising, bleeding, or accidental intramuscular injection

Effective delivery: For insulin and other subcutaneous medications, shorter needles are just as effective as longer ones. They ensure the drug reaches the correct tissue layer without unnecessary depth.

Ease of use: Their design makes them simple to handle, even for patients self-administering injections daily. This accessibility encourages adherence to treatment

Compatibility with subcutaneous injections: Many medications besides insulin—such as certain vaccines, hormones, and biologics—are delivered under the skin. Insulin needles are well-suited for these because they match the required depth and absorption rate.

Insulin Needles vs. Intramuscular Needles in Bodybuilding

When it comes to injecting anabolic-androgenic steroids (AAS), bodybuilders often weigh the choice between insulin needles and traditional intramuscular needles. Insulin needles are very fine and short, usually ranging from 29 to 31 gauge and only a few millimeters in length. This makes them far less intimidating and significantly less painful to use. For athletes who inject frequently, the reduced discomfort and minimal scarring are appealing, especially since visible bruising or scar tissue can detract from the aesthetic goals of bodybuilding. Their wide availability in pharmacies and association with legitimate medical use also adds to their convenience and discretion.

However, insulin needles are designed for subcutaneous injections, meaning they deposit medication just under the skin. AAS, on the other hand, are typically oil-based compounds that require intramuscular delivery for proper absorption. The fine bore of insulin needles makes drawing and injecting these thicker solutions difficult, and their short length often fails to reach muscle tissue. This mismatch can lead to poor absorption, underdosing, or even localized complications such as abscesses and tissue irritation.

Intramuscular needles, by contrast, are longer and thicker—usually 21 to 25 gauge and 25 to 40 millimeters in length. While they cause more pain and can be intimidating for beginners, they are specifically designed to deliver oil-based substances deep into muscle tissue. This ensures that AAS are absorbed effectively and reduces the risk of complications when used correctly. Over time, repeated intramuscular injections may cause bruising or scar tissue, but medically they remain the appropriate tool for this type of administration.

In short, you may prefer insulin needles for their comfort, accessibility, and cosmetic advantages, but intramuscular needles remain the medically suitable option for AAS injections. The perceived safety of insulin needles does not outweigh the risks of improper delivery, making the choice more about convenience than effectiveness.

Downsides of Using Insulin Needles for AAS in Bodybuilding

For bodybuilders, the downsides of insulin needles in AAS use are significant: poor absorption, infection risk, tissue damage, and wasted product. While they may reduce pain and appear more convenient, they compromise both safety and effectiveness. In bodybuilding culture, where results are paramount, these drawbacks make insulin needles a risky and counterproductive choice.

Improper absorption

Insulin needles are designed for subcutaneous injections, but AAS typically require intramuscular delivery. Injecting into fat or shallow tissue can lead to poor absorption, reduced effectiveness, and unpredictable results.

Also See: Fitness Lessons from A Navy Seal’s Training Routine

Viscosity mismatch

AAS solutions are often oil-based and much thicker than insulin. Fine-gauge insulin needles struggle to draw and push these solutions, leading to blocked syringes, incomplete injections, or excessive force that damages tissue.

Risk of infection and abscesses

Because oil may pool in subcutaneous tissue instead of dispersing into muscle, it can irritate the area and create a breeding ground for bacteria. This raises the risk of painful abscesses that may require medical intervention.

Underdosing and wasted product

If the steroid doesn’t reach the muscle, the bodybuilder may not achieve the intended anabolic effect. This not only wastes expensive compounds but also tempts users to increase frequency or dosage, compounding health risks.

Tissue damage

Repeated shallow injections can cause lumps, irritation, or necrosis in fatty tissue. For bodybuilders focused on aesthetics, visible damage under the skin undermines their goals.

False sense of safety

Many athletes assume insulin needles are “safer” because they are smaller and widely used in diabetes care. In reality, this perception can mask the fact that they are medically inappropriate for AAS, leading to dangerous practices.

Related Article: Best Syringes for Steroid Injection on Amazon

Overall

Bodybuilders and athletes often face difficult choices when it comes to performance enhancement, and the method of administering anabolic-androgenic steroids (AAS) is one of them. Insulin needles, with their fine gauge and short length, are attractive because they reduce pain, minimize scarring, and are easy to obtain. For individuals who inject frequently, these qualities can seem like practical advantages.

However, the reality is that insulin needles are not designed for oil-based compounds that require intramuscular delivery. Their short length and narrow bore make them unsuitable for reaching muscle tissue, leading to poor absorption, underdosing, and potential tissue irritation. The risk of infection or abscess formation is also heightened when AAS are deposited into fatty tissue rather than muscle. What may appear to be a safer, more comfortable option can ultimately compromise both health and performance outcomes.

Athletes who prioritize long-term progress must recognize that convenience should never outweigh safety. While insulin needles may seem appealing, they are not always appropriate for AAS administration. The discipline that defines bodybuilding and athletic success should extend to responsible decision-making, ensuring that choices made in pursuit of strength and aesthetics do not undermine overall well-being.

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Is NAD+ The Best Anti-aging Molecule for Men Over 40?

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NAD+(Nicotinamide Adenine Dinucleotide) has become the quiet obsession of athletes and bodybuilders who care as much about longevity as they do about performance. For men over 40, the game changes: recovery slows, energy dips, and the margin for error—sleep, nutrition, stress—gets razor-thin. That’s where NAD+ steps in. As a central coenzyme in cellular metabolism, NAD+ powers the mitochondria that generate ATP, supports DNA repair, and helps regulate inflammation and oxidative stress—the exact pressures that compound with age and intense training. The catch? NAD+ levels decline as we get older, and that drop doesn’t just feel like “getting tired”; it shows up as reduced work capacity, stubborn recovery, and a harder fight to preserve lean mass.

For the seasoned lifter, anti-aging isn’t about turning back the clock—it’s about staying dangerous: maintaining strength, clarity, and resilience year after year. By supporting NAD+—through smart training, lifestyle, and targeted precursors like NR or NMN—you’re not chasing a miracle; you’re reinforcing the cellular systems that keep you strong. Think steadier energy across sets, cleaner recovery between sessions, and a more robust response to stressors that typically erode performance after 40.

This article explores how NAD+ intersects with muscle metabolism, hormonal signaling, and recovery pathways, and what practical steps can help you sustain the physique and output you’ve built. If you’re a man over 40 who refuses to age passively, NAD+ isn’t hype—it’s a lever worth understanding and pulling with intention.

Must Read: How to Manage Joint Stiffness While on AAS

Why NAD+ Levels Drop in Men Over 40

NAD+ levels decline with age because the body’s ability to produce and preserve this vital coenzyme weakens, while demand for it increases.

Reduced biosynthesis: The enzymes and pathways that create NAD+ from precursors like niacin and tryptophan become less efficient over time.

Increased consumption: NAD+ is used by repair enzymes such as PARPs (for DNA repair) and sirtuins (for regulating metabolism and aging). As DNA damage and oxidative stress accumulate with age, these enzymes consume more NAD+, depleting reserves.

Greater degradation: Another enzyme, CD38, becomes more active with age. CD38 breaks down NAD+, and its rising activity is strongly linked to age-related decline in NAD+.

Mitochondrial dysfunction: Aging cells often suffer from less efficient mitochondria. Since NAD+ is central to mitochondrial energy production, dysfunction accelerates its depletion.

Lifestyle and stress factors: Poor sleep, chronic stress, alcohol, and high-intensity training without proper recovery can further drain NAD+ levels, especially in men over 40

Why This Matters for Men Over 40

  • Lower NAD+ means slower recovery, reduced energy output, and greater susceptibility to inflammation.
  • Declining NAD+ is linked to fatigue, cognitive decline, and accelerated aging.

For athletes and bodybuilders, this translates into harder muscle maintenance, longer recovery windows, and plateaus in performance.

Remedies to Boost NDA+ Levels in Men Over 40

Men and athletes over 40 can boost NAD+ levels through a mix of lifestyle strategies (exercise, fasting, sleep), dietary choices (niacin-rich foods), and supplementation (NR, NMN, NAD+ IV therapy).

Lifestyle Approaches

Regular exercise: Endurance and resistance training stimulate mitochondrial function and naturally increase NAD+.

Intermittent fasting: Periods of caloric restriction activate sirtuins, which depend on NAD+.

Quality sleep: Restorative sleep reduces oxidative stress and preserves NAD+ reserves.

Stress management: Chronic stress elevates NAD+ consumption; mindfulness and recovery practices help conserve it.

Avoid excess alcohol: Alcohol metabolism depletes NAD+, so moderation is key.

Related Article: Healing Peptides in Focus: BPC-157 vs TB-500 for Injury Recovery

Dietary Strategies

Niacin-rich foods: Chicken, tuna, salmon, turkey, and mushrooms provide vitamin B3, a precursor to NAD+.

Tryptophan sources: Eggs, dairy, and nuts support NAD+ synthesis via the kynurenine pathway.

Polyphenols: Resveratrol (found in grapes and red wine) activates sirtuins, indirectly supporting NAD+.

Ketogenic diet: Promotes fat metabolism and enhances NAD+/NADH ratio.

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Supplementation

Nicotinamide Riboside (NR): A direct precursor shown to raise NAD+ levels in humans.

Nicotinamide Mononucleotide (NMN): Another precursor with strong evidence for boosting NAD+ and supporting anti-aging pathways.

NAD+ IV therapy: Direct infusion used by some athletes for rapid replenishment.

Co-factors like magnesium and B vitamins: Support enzymatic reactions that sustain NAD+ metabolism.

Advanced/Medical Options

CD38 inhibitors: Experimental compounds that reduce NAD+ breakdown.

PARP inhibitors: Limit excessive NAD+ consumption during DNA repair (still under research).

Hormonal optimization: Testosterone and growth hormone balance indirectly support NAD+ pathways in men over 40.

The Catch:

Energy & endurance: Higher NAD+ means more efficient ATP production.

Recovery & repair: Supports DNA repair and reduces inflammation after training.

Anti-aging resilience: Helps maintain muscle mass, cognitive clarity, and metabolic health.

NAD+ Delivery Methods

1. Intravenous (IV) NAD+ Therapy

  • Direct infusion of NAD+ into the bloodstream.
  • Used in clinics for rapid replenishment of cellular NAD+.
  • Often promoted for anti-aging, recovery, and cognitive clarity.
  • Sessions can last several hours, as NAD+ must be infused slowly to avoid side effects (like nausea or flushing).

Dosing: Typically ranges from 250 mg to 1000 mg per session, but exact protocols vary by clinic and medical supervision.

2. Intramuscular or Subcutaneous Injections

  • Less common than IV, but some practitioners use NAD+ injections for quicker delivery than oral supplements.
  • Provides a shorter, more concentrated boost compared to IV drip.
  • Still requires medical oversight, as NAD+ injections can be uncomfortable and must be dosed carefully.

Oral Supplementation

1. NAD+ Precursors (NMN & NR)

  • Nicotinamide Mononucleotide (NMN) and Nicotinamide Riboside (NR) are widely available as capsules or powders.
  • These compounds are converted into NAD+ inside cells.
  • Easier, safer, and more practical for long-term use compared to IV therapy.

Dosing: Common ranges are 250–500 mg daily, though some studies explore higher doses.

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2. NAD+ Capsules

  • Direct oral NAD+ supplements exist, but absorption is less efficient than precursors.
  • Most experts recommend NMN or NR instead, as they are better studied and more bioavailable.

Overall

In the pursuit of strength, endurance, and longevity, NAD+ emerges as more than just a biochemical cofactor—it is a cornerstone of vitality for athletes and men over 40. As natural levels decline with age, the consequences ripple through energy, recovery, and resilience. By embracing lifestyle strategies, nutrient-rich diets, and modern supplementation, bodybuilders can sustain performance while slowing the clock on cellular aging. Whether through daily NMN or NR, or targeted therapies under medical guidance, supporting NAD+ is an investment in both present power and future health—a path to staying strong, sharp, and ageless in the decades ahead.

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The Testosterone Trap: Why Bigger Levels Don’t Guarantee Bigger Muscles

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For decades, testosterone has been hailed as the ultimate muscle-building hormone. In gyms, locker rooms, and fitness forums, it’s often portrayed as the magic key to unlocking massive strength and sculpted physiques. The narrative seems simple: the higher your testosterone, the bigger your muscles. But reality is far more complex. While testosterone undeniably plays a crucial role in muscle development, it is not the sole determinant of size or strength.

The Testosterone Myth

Walk into any gym and you’ll hear it repeated like gospel: testosterone is the secret weapon for building massive muscles. It’s the hormone most often associated with masculinity, strength, and dominance, and in bodybuilding culture it has taken on almost mythical status. The assumption is straightforward—more testosterone equals more muscle. This belief has fueled countless supplement sales, training programs, and even dangerous shortcuts like anabolic steroid use.

Many bodybuilders with naturally high testosterone levels struggle to pack on mass, while others with average levels achieve impressive physiques through disciplined training and nutrition.

The truth is that muscle growth is a multifaceted process influenced by genetics, training methods, diet, recovery, and the interplay of several hormones. Testosterone contributes by enhancing protein synthesis, increasing red blood cell production, and supporting recovery, but these effects only set the stage. Without the right stimulus from progressive overload, sufficient calories, and proper rest, elevated testosterone alone cannot deliver dramatic gains.

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Moreover, individual differences in androgen receptor sensitivity mean that two athletes with identical testosterone levels may respond very differently. One might experience rapid hypertrophy, while the other sees modest changes. Add to this the roles of growth hormone, insulin, and cortisol, and the picture becomes even more nuanced.

This article explores the myth of testosterone as a standalone muscle-building solution. By unpacking the science behind hypertrophy, we’ll reveal why “more testosterone” doesn’t automatically translate into “more muscle.” For bodybuilders and fitness enthusiasts alike, understanding this trap is essential—not only to set realistic expectations but also to focus on the factors that truly drive growth.

The myth persists because testosterone is easy to measure and easy to market. It’s a tangible number that can be tested in blood work, and it provides a convenient explanation for why some people grow faster than others. Yet, this oversimplification ignores the complexity of human physiology. Muscle growth depends on multiple variables—genetics, training intensity, nutrition, sleep, and even psychological factors. Testosterone is just one piece of a much larger puzzle.

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Moreover, the body has built-in checks and balances. Simply increasing testosterone doesn’t mean the body will endlessly build muscle. Receptor sensitivity, hormonal balance, and recovery capacity all influence how effectively testosterone can be used. Without these aligned, the “testosterone advantage” quickly fades.

In short, the myth of testosterone as the sole driver of muscle growth is seductive but misleading. It reduces a complex biological process into a single number, when in reality, building muscle is about synergy between hormones, lifestyle, and training discipline.

Biological Factors

Receptor sensitivity matters: Testosterone works by binding to androgen receptors in muscle tissue. If someone has fewer receptors or less sensitive ones, even high testosterone won’t translate into massive growth.

Genetic ceiling: Muscle fiber type distribution (fast-twitch vs. slow-twitch), tendon insertions, and overall body structure set natural limits. Genetics can cap how much muscle you can build, regardless of hormone levels.

Lifestyle & Nutrition

Fuel availability: Muscles need protein, carbs, and overall calories to grow. Without proper nutrition, testosterone can’t do much.

Recovery & sleep: Testosterone supports repair, but growth happens during rest. Poor sleep or chronic stress blunts the effect.

Training Stimulus

Progressive overload: Muscles grow when challenged. High testosterone without consistent resistance training is like having a powerful engine but never stepping on the gas.

Training style: Endurance athletes may have decent testosterone but don’t train in a way that maximizes hypertrophy.

Hormonal Balance

Other hormones play a role: Growth hormone, IGF-1, cortisol, and insulin sensitivity all interact with testosterone. An imbalance can limit muscle growth.

Baseline vs. spikes: Natural fluctuations in testosterone (like post-workout boosts) don’t necessarily lead to dramatic changes unless paired with the right conditions.

Possible Alternatives to Testosterone to Build More Muscle

Bodybuilders don’t need to rely on testosterone alone — there are several safer, natural alternatives that can support muscle growth, strength, and recovery. These options focus on nutrition, supplementation, and training strategies rather than risky anabolic steroids.

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Natural & Legal Alternatives

  • Protein & Amino Acids (BCAAs, EAAs) Essential for muscle protein synthesis. Branched-chain amino acids (leucine, isoleucine, valine) are particularly effective in stimulating growth.
  • Creatine Monohydrate One of the most researched supplements. It increases ATP availability, boosting strength and power output, which indirectly supports hypertrophy
  • Beta-Alanine Helps buffer lactic acid, delaying fatigue during high-intensity training. This allows longer, harder workouts that stimulate muscle growth.
  • D-Bal Max (natural Dianabol alternative) A supplement designed to mimic the anabolic effects of Dianabol using natural ingredients like BCAAs and whey protein concentrate.
  • Trenorol (natural Trenbolone alternative) Supports nitrogen retention and red blood cell production, enhancing endurance and recovery.
  • Testo-Max (natural testosterone booster) Derived from tribulus terrestris and other herbal extracts, it helps optimize natural testosterone production without synthetic hormones.

Overall

While testosterone is often celebrated as the “muscle hormone,” it is far from a guarantee of massive gains. Muscle growth is a multifaceted process shaped by genetics, nutrition, training, recovery, and the interplay of multiple hormones. High testosterone may provide a favorable environment for hypertrophy, but without progressive overload, sufficient protein intake, and consistent rest, its potential remains untapped.

Moreover, individual differences in androgen receptor sensitivity and muscle fiber composition mean that two people with similar testosterone levels can experience very different outcomes.

For bodybuilders seeking alternatives, natural supplements like creatine, BCAAs, and beta-alanine, alongside legal anabolic-support formulas, can safely enhance performance and recovery. These options mimic some of testosterone’s anabolic effects without the risks associated with synthetic hormones.

Combined with disciplined training strategies — heavy compound lifts, structured progression, and adequate recovery — they create a sustainable path to growth.

Ultimately, building bigger muscles is less about chasing one hormone and more about orchestrating a balanced system.

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