A Very Frank Talk with a Gay Non-Doctor Who's Devoted His Life to Testosterone/Steroid Education

Houston's Nelson Vergel says that testosterone and steroids saved his life when he was wasting from AIDS in the 1990s. He's since become an expert and advisor to countless men on the topic.

Nelson Vergel, looking very buff at 65.

Hey there, Caftaners! And a special greeting to the many of you who've subscribed recently at either the free or the paid (no paywall) rate. I think we may have bumpy years ahead in terms of LGBTQ rights, healthcare and maintaining our mental health and solidarity amid these challenges, and I really want you to stay here with me as I continue to try to bring you "news you can use" as well as fun interviews with various notable gay men (usually!) over age 60. (In fact, I just lined up a really sexy one for early December.)

So in that vein, I want to set up this new interview with a personal story I find a bit embarrassing because, well, it reveals my vanity and internal body fascism—but oh well, I like to be honest! So, I've written here before about how I love working out and maintaining muscle in my fifties, both for vanity/self-esteem and because it, along with a bit of running, just makes me feel better mentally and physically on a daily basis.

Me (on the right) with my fab friend Fabio at the beach here in NYC a few months ago. Do you love my seductively untied Speedo string?

But earlier this year I became a bit obsessed with getting a little bit bigger—not like 'roid-freak huge but maybe, say 20 percent more muscle mass. Yes, I admit it, I wanted to be that jacked muscle daddy. Sue me!

So, in my journalistic way, I embarked on a journey of research, reading everything I could about testosterone and steroids. Finally, I broached this with Ted, the nurse practitioner who until recently was my primary care provider. He tested my testosterone and found it in the normal range (perhaps not surprising for someone who keeps off excess weight, eats right, exercises a lot and gets enough sleep...all those things will boost testosterone naturally). 

But despite this, I still wanted to go on testosterone—and told as much to Ted, who said that he'd rather I do that under his supervision than not. So he prescribed me "T." And I duly watched the how-to-inject video he pointed me to and took this journey all the way to the pharmacy, where my T was all packaged up and waiting for me.

And that's when I reversed course. Why, I finally asked myself with a jolt of clarity—when I had perfectly healthy natural T levels and a decently muscled body—was I going to go on external T that would immediately shut down my own natural T production, very possibly shrink my balls and—worst of all—plunge me into a potentially months-long mood and energy crash should I decide to go off it for whatever reason? Never mind the risk of high blood pressure (which can be mitigated...read on.)

I decided instead to just keep pushing myself weights-wise at the gym, take creatine, eat a lot of lean protein like chicken and fish, and to check my T levels yearly, keeping the T therapy option in reserve if my levels ever dropped below 500. And I'm happy with that choice. 

I tell you this story, then, to let you know that I am not some partisan booster of T when I introduce you to Nelson Vergel, 65, of Houston. Nelson and I have know each other a very long time, since we met in the early 2000s when I was a writer for the HIV magazine Poz and he was an HIV treatment advocate with a specialty in muscle mass, the loss of which was a huge issue for people with HIV before the advent of effective HIV-suppressing meds in the late 1990s. (In fact, here is the 2004 story I wrote about treatment activism during which I first got to know Nelson.)

Nelson was wasting from AIDS in the early 1990s when he discovered the use of anabolic steroids (in his case, testosterone plus Nandrolone) via other gay men with HIV/AIDS. He claims that the muscle mass he was able to regain from their use was what kept him alive until the advent of effective HIV medications a few years later. But since then, he's not only stayed on them but has devoted his life to learning about their proper (and improper) use and educating other men—both with and without HIV, gay and straight—about their use. He has consolidated all the information on his website, ExcelMale, which can also help you find a testosterone-prescribing doctor near you—and can connect you to affordable key blood tests that don't have to go through your insurance (which often won't cover either T therapy, or its related regular blood tests, if your baseline T level is above 350). 

Here is a video he made that packs a lot of detailed information about T therapy into one 3-minute video:

Now let me be clear: This is not medical advice or recommendation or an endorsement of Nelson’s services. Take it for what it is: an interesting and potentially useful talk with a non-MD treatment advocate who's gone down this road himself and is well connected to researchers, research and providers on this topic. I wanted to interview Nelson because I know that the question "To Go Or Not To Go On Testosterone After Age X?" is a big one for a lot of middle-age and older gay men. As I just shared, I've grappled with it myself! 

If you want to know what the medical establishment says about testosterone use (I’ll keep other steroids out of this for a moment), the short version is that it comes with both benefits (improved energy, libido, muscle mass and mood) and risks (increased red blood cell count, which can increase the risk of clotting) depending on one’s individual circumstances—the most important of which is likely whether you actually have low T. (Interestingly, recent studies have bucked the longtime assumption that T use increases one’s risk of heart attack or stroke.) Here are “testosterone 101s” from some of the most reputable medical sites on the Web: Harvard Health, The Mayo Clinic, Boston’s venerable LGBTQ-serving Fenway Health, Cedars-Sinai in L.A. and a 2024 guide from the American Urological Association. If you’re considering going on T, read them all and compare them against Nelson’s thoughts.

If I offer only one piece of hard advice here, it's to not start going down this road without looping in your doctor or health provider. Your provider may well refuse to prescribe for you, particularly if your T levels are 500+, in which case, if you're still dead set on T therapy, you still have options for going about it carefully and properly. But if you're exploring this, start with your doctor—please!

I also offer this interview in the spirit of the legacy of HIV treatment activism, which realized a long time ago that sometimes the best options and solutions came up out of the community (and that can include certain community-minded doctors, like the late, great Dr. Joseph Sonnabend, whom I wrote about shortly after his 2021 death) and not out of formal medical practice or research. As a longtime health writer for whom formal data is the gold standard, I also think there is nothing wrong with absorbing health and wellness info from "the community" as long as you do your homework, be skeptical and thorough, and do not cut your doctor or health provider out of the equation.

So here is my friend Nelson Vergel, who was diagnosed with HIV in 1985 and lives in Houston with his husband of 28 years, Tim, and their schnauzer, Cora.

Nelson and Tim.

Nelson, thank you so much for talking to me today. Can you share your version of how you became so immersed in anabolic steroid therapy? 

I started my HIV activism back in the early 90s, back when we had no Internet. I was scared shitless about wasting syndrome from AIDS. My friends were dying and my boyfriend, the one for whom I moved from Venezuela to the States in 1984, was losing weight fast.

Nelson (left) with that boyfriend, Calvin, who later died of AIDS.

Then I was diagnosed with HIV and started losing weight. But I was a chemical engineer and had been hired by Shell Oil to work in L.A., where I went to HIV support groups, one of which was led by Marianne Williamson. That's where I met two HIV+ guys who were all pumped up. I asked them what they were doing and they said testosterone and nandrolone. 

I said, "That's bad for you," and they said, "Queen, you're going to die anyway!" So they took me to their place and gave me a shot of Sustanon, which is a mix of four different kinds of testosterone. And then everything changed. My energy improved and I started gaining weight and people at work stopped saying that I didn't look so good, which had made me afraid they were going to find out I had HIV. I continued to inject myself with Sustanon weekly and gained about 35 pounds in four or five months, after getting down as low as 142 pounds.

Did you have side effects?

None whatsoever. That's when I realized, oh my God, I need to tell everyone about this, people who were dying and losing weight and afraid of being stigmatized because of their appearance. So, with my own money, I put together a program and started lecturing, mostly at HIV support groups at different nonprofits. Then I got a fax machine and a pharmaceutical rep gave me a list of HIV doctors' fax numbers throughout the U.S., which made me even more efficient. And doctors started prescribing testosterone because, with their AIDS patients, there was nothing to lose. Then in 1999 I published a book, Built To Survive: A Comprehensive Guide to the Use of Anabolic Steroids, Nutrition and Exercise Therapy for HIV Therapy.

And the book spread like wildfire.

Do you think the testosterone played a role in keeping you alive until effective HIV treatment emerged in 1996 and beyond?

I'm 100% sure I'd have died before 1996 if I hadn't gone on T, because T increases muscle protein synthesis. At that time, after 12 to 14 weeks of T therapy, most people were regaining at least 5 to 10 percent of the weight they'd lost. But eventually guys who were not HIV+ started reaching out asking for my help too.

Are you still on it?

I've been on a very low dose of only testosterone for the past decade now—two weekly injections of 50mg. After 20 years on both testosterone and nandrolone, I started having problems with blood pressure, which is one of the side effects, so I went off the nandrolone and lowered my dose of testosterone.

At this point, I share with Nelson my story about nearly going on T but deciding not to for as long as my own T was in the normal range. So my question is, would you recommend T therapy to someone whose natural T is in the normal range but wants T therapy anyway?

For a person whose natural T is in the normal range, no, I wouldn't recommend it, unless that person has real issues with body-image, self-esteem, low libido, depression—and also unless you do all the research and studying you have to do and you have access to blood testing, which you can do in this country without seeing a doctor. And get it prescribed from a doctor, not a dealer at the gym.