@juliandecina_'s TRT claims need more context

What did @juliandecina_ actually say?

The creator shared a blood work review while on what he calls a "cruise" — a bodybuilding term for running a maintenance dose of testosterone between heavier cycles. He reports liver enzymes, cholesterol, glucose, electrolytes, TSH, and an Epstein-Barr virus antibody result, saying "everything looks good" across the board. He flags low HDL as a concern and plans to address it with fish oil and extra virgin olive oil. He also mentions a positive Epstein-Barr result, linking it to fatigue flare-ups.

This is a relatively transparent blood work review from someone who is openly using performance-enhancing testosterone. He is not claiming everything is perfect and he does flag the HDL issue, which is more self-aware than most TRT content on this platform. That said, several of his interpretations are either incomplete or slightly off, and one claim about HDL function needs a correction.

Does the science back this up?

Partially. The connection between supraphysiologic or even high-normal testosterone and suppressed HDL is well-documented, so his low HDL is not surprising. Fish oil has modest but real evidence behind it for HDL and triglycerides, though the effect size is small.

A 2022 meta-analysis by Bernasconi et al. in Mayo Clinic Proceedings found omega-3 supplementation reduced cardiovascular events, particularly at higher doses, but improvements in HDL were modest and inconsistent across trials. Extra virgin olive oil has stronger cardiovascular evidence overall, largely through LDL particle quality and inflammation rather than direct HDL elevation. The idea that creatine supplementation elevates serum creatinine is accurate and clinically well-supported. Papadimitriou et al. (2019, Journal of the International Society of Sports Nutrition) confirmed that creatine users routinely show creatinine elevations that can falsely suggest reduced kidney function without actual renal impairment. His TSH being in range is reassuring but a single TSH does not rule out thyroid dysfunction. His framing of Epstein-Barr virus (EBV) as a cause of fatigue flare-ups is generally consistent with what the literature shows for EBV reactivation, though the mechanism is not fully settled.

What did they get wrong (or right)?

The biggest factual error is his description of HDL. He says "my HDL is pretty low which helps combat your ADL" and that "HDL helps fight off the bad cholesterol." He means LDL, not ADL. ADL stands for activities of daily living and has nothing to do with cholesterol. This is a verbal slip, but it is worth correcting because the underlying concept is also oversimplified.

HDL does not simply "fight off" LDL. HDL's cardioprotective role is primarily through reverse cholesterol transport, moving excess cholesterol from peripheral tissues back to the liver for excretion. Raising HDL pharmacologically has not consistently reduced cardiovascular risk in trials, which complicates the simple "higher HDL is always better" narrative. His instinct to improve HDL through diet is reasonable, but the mechanism he describes is not quite right. On the positive side, flagging creatinine in the context of high creatine intake and protein diet is genuinely useful context that many people miss when reading their own labs. That is a credit to him.

What should you actually know?

If you are on testosterone therapy and reviewing your own blood work, cholesterol is one of the most important panels to watch. Exogenous testosterone, particularly injectable esters, consistently suppresses HDL. A 2016 review by Corona et al. in the Journal of Sexual Medicine found that testosterone therapy was associated with reductions in HDL across multiple formulations, with injectable forms showing stronger effects than transdermal. This is a real cardiovascular risk consideration, not a minor footnote.

Creatinine interpretation in athletes and supplement users genuinely does require context. Reporting a creatinine value without flagging creatine use or muscle mass can lead to unnecessary follow-up or misdiagnosis of kidney dysfunction. The Epstein-Barr point is clinically real. Most adults carry latent EBV, and reactivation can contribute to fatigue, though it is often hard to distinguish from other causes. A positive EBV antibody result on its own does not confirm active reactivation. That typically requires a more specific panel including IgM or early antigen markers.

• Low HDL on testosterone is common and worth monitoring, not just supplementing around
• Fish oil at standard doses has limited HDL-raising effects
• Creatine use and high protein diets elevate creatinine without harming kidneys
• EBV antibody positivity is not the same as active EBV disease
• HDL's role is reverse cholesterol transport, not simply blocking LDL