I think that’s a bit of an overstatement, because it depends on the task, and rodent studies aren’t the best predictors of athletic performance, which is what I’m referring to. I’m not talking about castrated rats learning to walk a maze or press a lever.
DHT-related compounds are routinely used in the performance world because they’re known by coaches and athletes to improve coordination and reduce hesitancy, i.e. they improve reaction time, so skill mastery comes more easily. We don’t have the kind of RCTs that show this (anti-doping rules make this infeasible), but we do have thousands of case studies and a general knowledge base from that world. There are places where these things are discussed, but that is typically done rather discretely because coaches don’t want to get their athletes in trouble. Still, this is common practice and it’s common because everybody in that world knows that it works. We’re talking a few decades of trial and error at this point.
I don’t know why one would think there would surely be RCTs, or relevant RCTs for compounds that fell out of favor long ago and that were designed for different purposes. The implied premise there is shaky (and I didn’t make claims about dementia). We’re talking about far off-label use, and pharmacology moved on to more sophisticated and specific drugs. There were a couple early studies on mesterolone, but they were small and inconclusive. Existing studies of DHT in men aren’t helpful because they don’t represent how one would actually use it in practice, which would be with a testosterone base.
We’re left, again, with thousands of case studies and also modern clinical practice. When men on TRT have libido problems, the solution is often to add in scrotal cream that increases DHT. When men on underground forums discuss DHT-derivatives, particularly drostanolone and mesterolone, and to some extent oxandrolone, the message is clear: near instantaneous mood and libido boosting across the board, nice calm feelings, better performance in the gym, often a correction of mild ED. Everybody reporting these things is already injecting testosterone.
Anybody can test this. Take 50mg of Proviron and see how you feel 4 hours later. Take a moderate dose of Masteron for a month and see what happens to your coordination when executing compound movements or playing your favorite sport. DHT is actually harder to come by, so reports are less frequent.
If RCTs are done well, they’re great, but we have a large body of evidence as it is, and the effects are so obvious that I don’t know why we would need RCTs for this - just try the compounds. I mean, nobody needs RCTs to know that heroin or meth work, either.
