Jay Cutler TRT: How His Approach Compares to Similar Public Figures

What Jay Cutler Has Said About TRT

Jay Cutler has addressed testosterone use in several podcast appearances and social media posts since retiring from professional bodybuilding after 2013. He has not published detailed lab values or prescription records publicly, so some clinical interpretation below is labeled as inference.

In interviews on podcasts including "Fouad Abiad's Real Bodybuilding" and appearances on YouTube channels dedicated to the sport, Cutler has stated that he uses testosterone as part of his current health regimen. He has described the transition from competitive-era compound stacks to a medically supervised, lower-dose approach as necessary for maintaining quality of life. These are primary source statements from the subject himself, not third-party claims.

What "Medically Supervised TRT" Means in This Context

Medically supervised TRT, as defined by the Endocrine Society's 2018 Clinical Practice Guideline on Male Hypogonadism, involves confirming low serum testosterone on at least two morning fasting measurements before initiating therapy (1). The guideline sets the diagnostic threshold at a total testosterone level <300 ng/dL (10.4 nmol/L), accompanied by signs or symptoms of hypogonadism.

For retired bodybuilders who used supraphysiologic androgens for years, the clinical picture is often more complex. Prolonged exogenous testosterone suppresses gonadotropin-releasing hormone (GnRH) pulsatility, which in turn reduces LH and FSH secretion, ultimately impairing Leydig cell function (2). Recovery of endogenous production can take months to years after cessation, and in some men it never fully returns to age-appropriate levels.

Why Retired Athletes Are a Distinct Clinical Population

A 2015 study published in the Journal of Clinical Endocrinology and Metabolism (N=81 former AAS users vs. 31 controls) found that former anabolic-androgenic steroid users had significantly lower LH levels and reduced Leydig cell function compared to age-matched non-users, even years after stopping (3). Serum testosterone was below the normal range in a substantial proportion of former users. This evidence base supports why a clinician evaluating someone like Cutler would have reasonable grounds to offer TRT.

How Jay Cutler's TRT Compares to Other Public Figures

Several other high-profile men have confirmed or been credibly associated with TRT use. Comparing their stated or inferred approaches helps contextualize the clinical decisions involved.

Joe Rogan: Testosterone Plus HCG Plus TRT Optimization

Joe Rogan is among the most transparent public figures on this topic. He has described his protocol on "The Joe Rogan Experience" as including testosterone replacement, human chorionic gonadotropin (HCG), and testosterone optimization guided by regular blood panels. Rogan has mentioned working with physicians and tracking PSA, hematocrit, and free testosterone levels.

Clinically, the addition of HCG to a TRT protocol is evidence-supported for men who wish to preserve testicular volume and maintain some endogenous testosterone production. A randomized trial by Hsieh et al. (2013, N=29) found that low-dose HCG (500 IU every other day) maintained intratesticular testosterone levels in men on exogenous testosterone (4). Rogan's described approach aligns with this literature.

Cutler's stated approach appears to focus on testosterone alone, without publicly discussing HCG or aromatase inhibitors, though he has not ruled these out. This is a clinical inference from absence of public statements, not confirmed absence of use.

Dorian Yates: Confirmed Post-Career TRT

Dorian Yates, six-time Mr. Olympia, has confirmed TRT use in interviews and has discussed it in the context of harm reduction. Yates has described working with a physician to maintain testosterone in a physiologically normal range after decades of competitive use. His framing, like Cutler's, centers on quality of life and health maintenance rather than performance.

Both Cutler and Yates represent cases where career-length androgen exposure makes post-career hypogonadism clinically predictable. The Endocrine Society guideline notes that hypogonadism symptoms including decreased libido, fatigue, loss of muscle mass, and mood changes can significantly impair quality of life and that TRT improves these outcomes in confirmed hypogonadal men (1).

Dwayne Johnson: Inference, Not Confirmed

Dwayne Johnson has never publicly confirmed a TRT prescription. He acknowledged past steroid use as a teenager in a 1999 interview but has not addressed TRT directly in clinical terms. Any association between Johnson and TRT is inference based on his physique and age (52 as of 2024), not a primary source statement. This article treats that inference as unconfirmed.

Mike O'Hearn: Public Denial

Mike O'Hearn, a longtime fitness personality, has actively denied using testosterone or any exogenous hormones. His case is relevant here because it illustrates the range of public stances: Cutler and Yates have confirmed TRT; Johnson has not addressed it; O'Hearn has denied it. The clinical plausibility of extended natural testosterone production at competitive physique levels remains debated in sports medicine circles, but no primary source evidence contradicts O'Hearn's denial, and this article does not assert otherwise.

The Clinical Case for TRT in Former Elite Bodybuilders

The physiology underlying post-career hypogonadism in former AAS users is well-documented. This section covers the mechanism, the diagnostic process, and the treatment options a physician would consider.

HPG Axis Suppression: The Core Mechanism

The hypothalamic-pituitary-gonadal axis regulates endogenous testosterone production through a negative feedback loop. When exogenous testosterone or other androgens are introduced, GnRH pulsatility decreases, LH and FSH secretion drops, and the testes reduce their output. Over years of exposure, Leydig cell mass and function can diminish structurally, not just functionally (2).

A 2019 review in the European Journal of Endocrinology described persistent hypogonadotropic hypogonadism as a recognized sequela of long-term AAS use, noting that some men require TRT indefinitely because endogenous recovery does not occur (5).

Diagnosing Hypogonadism: What the Labs Look Like

A standard hypogonadism workup includes:

• Total testosterone (morning, fasting, two separate measurements)
• Free testosterone (by equilibrium dialysis or calculated)
• LH and FSH (to distinguish primary from secondary hypogonadism)
• SHBG (sex hormone-binding globulin)
• Prolactin (to rule out pituitary adenoma)
• CBC with hematocrit (baseline before TRT)
• PSA (in men over 40)

The Endocrine Society guideline specifies that total testosterone <300 ng/dL on two morning measurements, paired with symptoms, is the standard diagnostic criterion (1). In former AAS users, LH and FSH are often low-normal or suppressed even when total testosterone is low, which points to secondary (central) hypogonadism rather than primary testicular failure.

FDA-Approved TRT Options and Typical Dosing

The FDA has approved multiple testosterone formulations for male hypogonadism (6). The most common in clinical practice are:

• Testosterone cypionate or enanthate (injection): 100 to 200 mg IM or subcutaneous every 7 to 14 days. This is the most cost-effective option and the most commonly used in this population.
• Testosterone gel (AndroGel 1.62%, Testim, Vogelxo): 20.25 to 81 mg applied daily to skin.
• Testosterone pellets (Testopel): 150 to 450 mg implanted subcutaneously every 3 to 6 months.
• Nasal gel (Natesto): 11 mg per nostril three times daily, notable for preserving spermatogenesis better than other routes.

Cutler has not publicly specified his formulation. Given the bodybuilding community's familiarity with injectable testosterone, a weekly cypionate or enanthate injection is the most plausible inference, though this is not confirmed.

Monitoring and Safety: What Ongoing TRT Requires

TRT is not a one-time prescription. Clinical guidelines require ongoing monitoring to manage risks and optimize outcomes.

Hematocrit and Cardiovascular Risk

Testosterone stimulates erythropoiesis. Elevated hematocrit (>54%) increases blood viscosity and raises the risk of venous thromboembolism and cardiovascular events. The Endocrine Society recommends checking hematocrit at 3 to 6 months after initiating TRT and annually thereafter, withholding therapy if hematocrit exceeds 54% (1).

A 2023 randomized controlled trial, the TRAVERSE trial (N=5,246, published in the New England Journal of Medicine), found that TRT in middle-aged and older men with hypogonadism and pre-existing cardiovascular risk factors did not significantly increase major adverse cardiovascular events compared to placebo over a mean follow-up of 33 months (7). The trial did find a higher rate of atrial fibrillation, pulmonary embolism, and acute kidney injury in the TRT group, all of which reinforce the need for monitoring.

PSA and Prostate Health

Current guidelines recommend checking PSA before starting TRT and at 3 to 12 months after initiation. TRT is contraindicated in men with known or suspected prostate cancer (1). Given that Cutler was born in 1973 and is in his early 50s, PSA surveillance is a standard part of responsible TRT management at his age.

Estradiol and Aromatase Activity

Testosterone converts to estradiol via the aromatase enzyme. In men on TRT, estradiol levels should stay within the normal male range (roughly 20 to 40 pg/mL). Elevated estradiol can cause gynecomastia, water retention, and mood changes. Some clinicians prescribe aromatase inhibitors (anastrozole or exemestane) if estradiol rises above range, though the Endocrine Society does not routinely recommend them as a first-line adjunct (1).

What Distinguishes Cutler's Situation From a Typical TRT Patient

Most men who qualify for TRT are diagnosed with age-related hypogonadism. Testosterone levels peak in the late teens to early 20s, then decline at roughly 1 to 2% per year after age 30, according to data from the Massachusetts Male Aging Study (8).

Cutler's situation differs in two ways. First, the timeline of decline is almost certainly accelerated by decades of exogenous androgen use, meaning his HPG axis likely reached a hypogonadal state earlier than it would have through age-related decline alone. Second, the suppression may be more persistent because of the depth and duration of the exogenous exposure.

A useful clinical framework for physicians managing former competitive bodybuilders on TRT is to distinguish between three patient subtypes:

1. Recoverable suppression: LH and FSH are low but responsive to clomiphene citrate stimulation testing. Endogenous recovery is possible with HCG or clomiphene protocols lasting 3 to 6 months.
2. Partial recovery: Some endogenous production resumes but total testosterone remains below 400 ng/dL without support. Ongoing low-dose TRT is appropriate.
3. Permanent suppression: No LH/FSH response to stimulation. Leydig cell function is irreversibly impaired. Lifelong TRT is the standard of care.

Cutler has not published lab results, so his subtype is unknown. His continued long-term TRT use, however, is consistent with either subtype 2 or 3.

The Broader Conversation About TRT Transparency Among Public Figures

The contrast in how public figures discuss TRT is itself clinically relevant, because public statements shape patient behavior and physician-patient conversations.

Cutler and Yates have both described TRT in straightforward terms, treating it as a medical decision rather than a taboo. Rogan has gone further by publicly sharing lab values and discussing optimization strategies in detail. These disclosures may reduce stigma and encourage men with undiagnosed hypogonadism to seek evaluation.

According to a 2020 survey-based study published in the Journal of Sexual Medicine, approximately 38.7% of men with symptoms consistent with hypogonadism had never discussed the symptoms with a physician (9). The authors noted that stigma and lack of awareness were primary barriers to evaluation.

The Endocrine Society's guideline directly addresses this gap, stating: "We recommend against making a diagnosis of androgen deficiency in men with nonspecific symptoms in the absence of biochemical evidence of low testosterone." (1) This reflects the need for proper diagnosis, not just symptom-based treatment, regardless of whether a public figure has normalized the conversation.

TRT vs. Peptide and HGH Use: Where the Line Is Drawn

Several public figures in the bodybuilding and fitness space have discussed growth hormone, IGF-1, or peptide use alongside TRT. Cutler has not confirmed using growth hormone post-retirement. He has discussed peptides in general terms in some podcast appearances, though without specifics.

Clinically, TRT addresses hypogonadism specifically. Growth hormone replacement therapy is a separate FDA-regulated indication, approved for adult growth hormone deficiency (AGHD) diagnosed through stimulation testing, not for general wellness or body composition in otherwise healthy adults (10).

Peptides such as sermorelin, ipamorelin, and CJC-1295 are growth hormone secretagogues that stimulate endogenous GH release. Their use in non-AGHD adults sits in a regulatory gray area; the FDA has not approved them for anti-aging or body composition purposes. Any public figure describing peptide use outside a confirmed AGHD diagnosis is using them off-label or outside established clinical indications, a meaningful distinction from TRT for confirmed hypogonadism.