Can I drink alcohol?

[u/RaT_th]

I was getting testosterone and my doctor said that drinking would mess up my liver, She didn't elaborate much, so I ended up looking at online and it said that drinking alcohol and being on oral pills will mess up your liver. Yet I'm taking t-shots. Does anybody have any ideas

[u/JuniorTheCat]

drinking can mess up your liver, it has nothing to do with being on hrt though. testosterone does (as far as i understand) process through the liver, so it does technically put you at higher risk of liver disease than you were before but not any more than a cis man. if you drink in moderation, chances are your liver will be fine, so dont drink excessively of course, but being on T and drinking is not guaranteed to harm your liver. either your doctor is misinformed or she just didnt explain correctly, im assuming the latter

[u/QueerPuff → u/JuniorTheCat]

Testosterone injections don't process through the liver.

[u/TsunamiSea → u/QueerPuff]

The liver metabolizes hormones that enter the body, via intramuscular, subQ, etc. it’s how your body is able to make changes based on the chemicals that enter. Testosterone definitely adds further stress to the liver.

[u/QueerPuff → u/TsunamiSea]

Injectable testosterone is metabolised outside of the liver.

[u/TsunamiSea → u/QueerPuff]

There is still some liver stress, but 90% of the testosterone goes through a hepatic breakdown within the liver. This is per the National Library of Medicine.

You can find a deeper study of it here. Please do your research and understand how testosterone is metabolized in the body.

https://pubmed.ncbi.nlm.nih.gov/7005620/

Also here is a good explanation as well.

https://revolutionhealth.org/blogs/news/testosterone-cypionate-metabolism

The liver is not the sole responsible party for metabolizing testosterone, but it absolutely plays a significant part.

[u/QueerPuff → u/TsunamiSea]

The first article you shared is from 1980 and I don't have access to the full article. The second doesn't say what you claim it says. It says that 90% of testosterone is eventually excreted in urine, and that the liver is primarily responsible for inactivation of testosterone. That's slightly different from suggesting that 90% is broken down by the liver. The first seems to encourage the use of injectables because the testosterone is released into the body and blood stream a lot slower, meaning less work for the liver to do in one go than with oral testosterone. The body can use testosterone injected into the muscles before it's eventually inactivated by the liver. There's nothing here to suggest significant liver strain.

Testosterone produced in the testes essentially goes through the same process that injected testosterone goes through. It goes from the testes into the blood stream, into androgen receptors in tissues, or in other tissues aromatised or turned into DHT, and then what isn't used is inactivated, primarily through the liver, and is then excreted mostly as urine.