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Latest video from Will on the T subject: http://youtu.be/lqurpeMP16w
Will, I have to say from (obviously long) experience that the T is too thick for an insulin syringe/needle setup.
And I'm telling you that's incorrect. As outlined, it requires a draw needle, and some prep, but as I have said repeatedly, it's easy to do. I didn't pull the idea from my you know what. Read this thread for more intel on that topic.
At least the Cypionate is.
The only two T esters currently offered in the US for TRT are cypionate and enanthate and both work fine.
We currently use 21G needles that are 1 1/2" long. Yeah, harpoon is right! However, it needs to get deep into the muscle for a proper IM injection (my wife is an RN and knows all about that kind of stuff). Not saying your advice is incorrect at all but this is what I've personally found to be the case.
Not disrespect intended to your wife, but I'm betting researching TRT/HRT is not her area of expertise and focus per se. IM can be achieved with much smaller and shorter needles and it's actually a moot issue (see above), just as I have outlined and explained in this thread and the "Low T at 26" thread where studies supplied.
Latest video from Will on the T subject: http://youtu.be/lqurpeMP16w
Dang, that was fast Irish! :dance3:
Dang, that was fast Irish! :dance3:
I'm "subscribed" so I get an email when you upload a new video. :)
http://www.endocrinology.org/policy/docs/12-10_HypogonadismAndAgeing.pdf
http://www.endocrinology.org/policy/docs/12-10_HypogonadismAndAgeing.pdf
Assuming that's for me, the circadian rhythm of T peaks at 7-9 am, hence the general rec to do it in the am when T levels are at their highest. However, as long as the person does it at the same time within that circadian rhythm, it's going to be approx the same number. Thus, if you did it at 1PM, and need to do it a second time, it's best to do it at 1pm the following time. If you did test #1 at 8am, and test number #2 at 2pm, it would be less accurate, but would not invalidate the testing in terms the difference between them per se. But, that is also contingent on what the results are of say test #1 (1) and other variables such as the if testing free T, E2, prolactin, SHBGs, etc which can have their own circadian rhythm and are part of the clinical picture. We are not as far off on recs as it may seem, I just stop short on saying doing a TT test after the 7-9 am window invalidates the test.
(1) The differences in the peak and trough is approx 30% so if that person comes back borderline say, then the test time becomes more important, but as i said, it's not going to be 600ng/dl at 8am and 200ng/dl at 3pm, at least not without some specific issue to that person.
I hope that clarifies my initial comment and request for citation.
Not saying that I'm the end all when it comes to giving IM's...however, the Testosterone Cypionate I get is pre mixed with cottonseed oil and it's thick, to thick for a insulin needle to effectively inject IM...not to mention trying to push 300mg through such a needle, that will take way to long to inject the T and can cause other problems in the muscle......
Never reuse your draw needle, once used it is no longer sterile & thus can cause problems like cellulitis. I draw with either a 18 or a 20 ga (whatever I grab) & once the T is drawn into the 3cc syringe the draw needle is safety caped and will be disposed of.
For me a 1" 22ga needle works best pushing the thick T deep enough into the muscle tissue, any deeper and I tend to bleed more & can push some of the T back out the injection site.
Here again for me, my thighs for whatever reason do not accept the 300mg of T very well, they both tend to get very sore and warm to the touch for 2-4 days. Thus I've been getting the IM's in the buttox as that does not react like the thigh does.
I've talked to quite a few RN's who give testosterone IM's. (I work in a VA hospital and a large percentage of prior military have low T) and they almost all say the 22ga is the smallest they use, (1 RN will use a 25ga only in the thigh) some go with a 1" others do the 1.5 inch needle. The RN who instructed me has been giving T IM's for over 20 years and she said she has tried all different combinations of needle sizes & lengths and she prefers the 22 ga 1.5 needle as the most effective delivery system.
http://i859.photobucket.com/albums/ab160/usmcvet0331/20140206_211453_zps2mmhtwis.jpg (http://s859.photobucket.com/user/usmcvet0331/media/20140206_211453_zps2mmhtwis.jpg.html)
http://i859.photobucket.com/albums/ab160/usmcvet0331/20140206_211522_zpsnztcb30l.jpg (http://s859.photobucket.com/user/usmcvet0331/media/20140206_211522_zpsnztcb30l.jpg.html)
Okay the last photo I posted was of some samples from my doc. I am using a 25G 5/8" long needle to inject and 18G 1" long needle to draw.
Will is right. I was scared shitless of using the big needle to inject. I did it once at the doctors office in front of the nurse. I tried it again two weeks later at home, I literally tried all day! I couldn't do it. I was using an 18G needle, can't remember the length. Pushing 2ML. It freaking hurt like hell! On ML in the 25G 5/8" needle to inject 1ML a week. It is just a tiny prick so to speak. =) The 30G was too small for me. But it works for others well.
I ordered my needles online. All they would sell me w/o a script locally were disposable diabetic/heroin needles. I was pissed! I showed them my T and the script and explained I was just trying for a more comfortable injection. I ordered online, it was cheaper and quick. I was never asked for a script.
My problems cam about mentally, not physically...having to understand and accept that I'll be getting T shots the rest of my life...was very hard to admit and adjust to accepting that & still have a few problems wrapping my head around that...
I can imagine the "prick" of a 18ga...they are almost garden hoses...wonder how much the total volume injected pertains to things, I've been told 400mg is the max one can inject at a single site..when I went from 200mg to 300 there was a noticeable increase in discomfort from the extra 100mg. Never felt the "prick" of the insulin needle, but was unreal trying to inject 300mg...and the muscle really started to protest as slow as it was going in...had to switch out needles...
Will have to ask about the 25ga 5/8's, wonder if it has to do with muscle mass or what as I was told not to use anything shorter than 1inch or it would not get the T into the muscle properly...
Nice thing about the VA is they will give you all your needles/syringes & sharps container...but you only get 1 month worth of T per order & max of 6 as it's a CIII drug before the provider has to enter a new scrip, but this way I get my T tested every 6 months & can track it on https://www.myhealth.va.gov
My last T was 499.73 ng/dL getting 300mg every 2 weeks up from 320.24 ng/dL @ 200ml every 2 & the lab values range is 14-827 so I'm happy & the results are quite remarkable....
And I'm telling you that's incorrect. As outlined, it requires a draw needle, and some prep, but as I have said repeatedly, it's easy to do. I didn't pull the idea from my you know what. Read this thread for more intel on that topic.
The only two T esters currently offered in the US for TRT are cypionate and enanthate and both work fine.
Not disrespect intended to your wife, but I'm betting researching TRT/HRT is not her area of expertise and focus per se. IM can be achieved with much smaller and shorter needles and it's actually a moot issue (see above), just as I have outlined and explained in this thread and the "Low T at 26" thread where studies supplied.
I've not encountered any issues with the way I've done it so unless I have a problem I doubt I'll change, just deal with the "harpooning" I guess. Rotating injection sites weekly has thus far worked out. My only concern with larger gauge needles (and that would go for just about any IM injection I guess) is the meds oozing out before the hole closes. For that reason I try to lay still for a few minutes to allow that to happen. I've thought about applying direct pressure (not hard pressure, just a finger) but don't want to "squeeze" it out either. Going a few gauges smaller might help. Might look into it when my current supply runs out.
Not saying that I'm the end all when it comes to giving IM's...however, the Testosterone Cypionate I get is pre mixed with cottonseed oil and it's thick, to thick for a insulin needle to effectively inject IM...not to mention trying to push 300mg through such a needle, that will take way to long to inject the T and can cause other problems in the muscle......
Never reuse your draw needle, once used it is no longer sterile & thus can cause problems like cellulitis. I draw with either a 18 or a 20 ga (whatever I grab) & once the T is drawn into the 3cc syringe the draw needle is safety caped and will be disposed of.
For me a 1" 22ga needle works best pushing the thick T deep enough into the muscle tissue, any deeper and I tend to bleed more & can push some of the T back out the injection site.
Here again for me, my thighs for whatever reason do not accept the 300mg of T very well, they both tend to get very sore and warm to the touch for 2-4 days. Thus I've been getting the IM's in the buttox as that does not react like the thigh does.
I've talked to quite a few RN's who give testosterone IM's. (I work in a VA hospital and a large percentage of prior military have low T) and they almost all say the 22ga is the smallest they use, (1 RN will use a 25ga only in the thigh) some go with a 1" others do the 1.5 inch needle. The RN who instructed me has been giving T IM's for over 20 years and she said she has tried all different combinations of needle sizes & lengths and she prefers the 22 ga 1.5 needle as the most effective delivery system.
I use a 21 gauge that is 1 1/2" long. Maybe the 1" you're talking about might be better for the bleeding and the possibility of bringing T back out with it, as well as going to a slightly smaller gauge. Hmmm.....
http://i859.photobucket.com/albums/ab160/usmcvet0331/20140206_211453_zps2mmhtwis.jpg (http://s859.photobucket.com/user/usmcvet0331/media/20140206_211453_zps2mmhtwis.jpg.html)
http://i859.photobucket.com/albums/ab160/usmcvet0331/20140206_211522_zpsnztcb30l.jpg (http://s859.photobucket.com/user/usmcvet0331/media/20140206_211522_zpsnztcb30l.jpg.html)
Okay the last photo I posted was of some samples from my doc. I am using a 25G 5/8" long needle to inject and 18G 1" long needle to draw.
Will is right. I was scared shitless of using the big needle to inject. I did it once at the doctors office in front of the nurse. I tried it again two weeks later at home, I literally tried all day! I couldn't do it. I was using an 18G needle, can't remember the length. Pushing 2ML. It freaking hurt like hell! On ML in the 25G 5/8" needle to inject 1ML a week. It is just a tiny prick so to speak. =) The 30G was too small for me. But it works for others well.
I ordered my needles online. All they would sell me w/o a script locally were disposable diabetic/heroin needles. I was pissed! I showed them my T and the script and explained I was just trying for a more comfortable injection. I ordered online, it was cheaper and quick. I was never asked for a script.
Wow, you're ordered 1ml per week, huh? Where does that keep your T levels?
I've not encountered any issues with the way I've done it so unless I have a problem I doubt I'll change, just deal with the "harpooning" I guess. Rotating injection sites weekly has thus far worked out. My only concern with larger gauge needles (and that would go for just about any IM injection I guess) is the meds oozing out before the hole closes. For that reason I try to lay still for a few minutes to allow that to happen. I've thought about applying direct pressure (not hard pressure, just a finger) but don't want to "squeeze" it out either. Going a few gauges smaller might help. Might look into it when my current supply runs out.
All good. I'm just making you aware on the options that exist.
Wow, you're ordered 1ml per week, huh? Where does that keep your T levels?
If you read the rest of this thread, you'll see discussion on why smaller weekly doses are superior to larger doses every 2-3 weeks.
Not saying that I'm the end all when it comes to giving IM's...however, the Testosterone Cypionate I get is pre mixed with cottonseed oil and it's thick, to thick for a insulin needle to effectively inject IM...not to mention trying to push 300mg through such a needle, that will take way to long to inject the T and can cause other problems in the muscle......
Never reuse your draw needle, once used it is no longer sterile & thus can cause problems like cellulitis. I draw with either a 18 or a 20 ga (whatever I grab) & once the T is drawn into the 3cc syringe the draw needle is safety caped and will be disposed of.
For me a 1" 22ga needle works best pushing the thick T deep enough into the muscle tissue, any deeper and I tend to bleed more & can push some of the T back out the injection site.
Here again for me, my thighs for whatever reason do not accept the 300mg of T very well, they both tend to get very sore and warm to the touch for 2-4 days. Thus I've been getting the IM's in the buttox as that does not react like the thigh does.
I've talked to quite a few RN's who give testosterone IM's. (I work in a VA hospital and a large percentage of prior military have low T) and they almost all say the 22ga is the smallest they use, (1 RN will use a 25ga only in the thigh) some go with a 1" others do the 1.5 inch needle. The RN who instructed me has been giving T IM's for over 20 years and she said she has tried all different combinations of needle sizes & lengths and she prefers the 22 ga 1.5 needle as the most effective delivery system.
Ugh. I give up...
Wow, you're ordered 1ml per week, huh? Where does that keep your T levels?
Well..... I don't know! I tried last week to get in for a test but I was taking the T every Wednesday and they wanted me to come in mid week! I switched this morning to Friday's so I can make a Wednesday appointment. I wanted to be tested a week after but the doc is right that would be my lowest. I will say I feel great and things are very steady. I went into the Doc back in 2004 following my first round of Chemo. I had no desire and couldn't get it up. It really sucked at 32. A quick blood test confirmed I have hypogonadism. So I started with Androgel, worked great for a while then not so much, then patches, they SUCKED! then the shot. I was getting a shot for close to two years. I have been giving them to myself for months now. I need to call today to make an appointment to get my levels tested. SO when I say level I'm just talking about feeling like a man. Libido and sexual function is very good again, not crazy just back to normal. It was non existent for a few months and while the patches did not work.
Ugh. I give up...
Well I know it works. The doc's, nurses and PA's all said much the same. BUT they also respected me and what I brought to them and they let me make the changes to weekly and I had their blessing for smaller needles, just did that on my own online.
Well..... I don't know! I tried last week to get in for a test but I was taking the T every Wednesday and they wanted me to come in mid week! I switched this morning to Friday's so I can make a Wednesday appointment. I wanted to be tested a week after but the doc is right that would be my lowest. .
Which is SOP for testing, the day before your next shot. That's standard protocol. Mid week of a weekly dosing schedule makes little sense, but what ever. As long as they continue to treat you and help you, all good.
I just want to say thank you Will.
I was thinking about this thread and the Low T @ 26 thread.
They've really helped me. It's been life changing. I hope it helps those of you who need it as much as it has helped me!
I've had Hairy Cell Leukemia twice, in 2004 and again in 2010. I figure I am due again in two years. ****ing Oil Fires! These are not the best photos but we were outside the Albragan Oil Fields. Day could look like night and night like day depending on the direction of the wind. It often rained oil!
23385233862338723388
I just want to say thank you Will.
I was thinking about this thread and the Low T @ 26 thread.
They've really helped me. It's been life changing. I hope it helps those of you who need it as much as it has helped me!
I've had Hairy Cell Leukemia twice, in 2004 and again in 2010. I figure I am due again in two years. ****ing Oil Fires! These are not the best photos but we were outside the Albragan Oil Fields. Day could look like night and night like day depending on the direction of the wind. It often rained oil!
23385233862338723388
I'm very happy the info has helped you, and you have done an excellent job of listening, reading, and putting the info into practice to your benefit. I just supplied the info, you did the work sir. I always give priority to mil and LE where ever possible. Thank you for your service and sacrifices made.
RE Leukemia, give a read of the Life Extension Protocols:
http://www.lef.org/protocols/cancer/leukemia_01.htm
Update: This morning was my first shot. Put the bottle in my hand while taking it to the Dr's office so it would warm up. Handed the nurse my 25 GA needle, she just looked at it, walked out and walked back in with a 21 Gauge. 1ML In the hip, didn't hurt one bit; just like a normal shot except it took about 10 seconds to get all the fluid in. Left hip. That was easy-peasy.
Told her about the secret of warming the bottle and syringe/using really small needle/SC...she wasn't having anything to do with it; she wanted it IM. She told me she'd swap the 25's I have for 21's she has. Don't hurt any yet, I could live with it as long as I didn't have to do it myself, and my wife does as good a job as this nurse did. Key for me is not to tense the muscle. Afterwards walked out and am now back to work; we'll see if I'm sore tomorrow or not.
I asked her if she did a lot of this, she said yes. I asked her if she saw people have good results, she said yes, so I am hopeful.
Also, she talked to the Urologist this AM, and the schedule has changed a little. He wants me to get another shot in THREE weeks (2/28), and ONE week after that (3/7)(in the AM as I'm leaving town later that day) is when they want to retest my blood and adjust from there.
Will see if I feel any different (and share) as the next week progresses...
Told her about the secret of warming the bottle and syringe/using really small needle/SC...she wasn't having anything to do with it;
That's why you do it yourself which saves time, $$$, and aggravation
she wanted it IM.
Not sound like an A-hole, but for the 9,273,018,04 time in this thread, done correctly it is IM.
Anyway, good luck.
It's funny: sometimes I barely feel it, others it stings like a bitch![/QUOTE]
Sometimes if there is alcohol left on the skin and then you get the shot the alcohol will burn where the needle went in.
Not sound like an A-hole, but for the 9,273,018,04 time in this thread, done correctly it is IM.
Yes I understand you've said IM is the standard. I was referring to the posts that you talk about using a insulin needle and the study that seemed to point that SC seemed to have the same effect as IM. I may have misunderstood, but I didn't see how an insulin needle could give an IM injection. Then again, I am an amateur at this subject, so please forgive any misunderstanding.
Yes I understand you've said IM is the standard. I was referring to the posts that you talk about using a insulin needle and the study that seemed to point that SC seemed to have the same effect as IM. I may have misunderstood, but I didn't see how an insulin needle could give an IM injection.
But, done in the leaner areas, such as shoulder and outer thigh, unless the person is quite obese, will be IM. Short needles like that are never used in the typical injection site such as the buttocks where a 21g 1.5" would be used.
Then again, I am an amateur at this subject, so please forgive any misunderstanding.
All good. My comment was more an annoyance with the nurse than you really. But, I was not there, and perhaps (giving her the benefit of the doubt) decided you required the 21g 1.5" was what was needed for you to be IM. However, 98% of the time, it's done because that's how it's always been done, and for no other reason.
However, 98% of the time, it's done because that's how it's always been done, and for no other reason.
Having worked in the medical field for almost 24 years I can vouch for that being the gospel truth (at least for more "mundane" things like injections; *some* outside the box thinking does occur but mainly not until new technology emerges).
But, done in the leaner areas, such as shoulder and outer thigh, unless the person is quite obese, will be IM. Short needles like that are never used in the typical injection site such as the buttocks where a 21g 1.5" would be used.
All good. My comment was more an annoyance with the nurse than you really. But, I was not there, and perhaps (giving her the benefit of the doubt) decided you required the 21g 1.5" was what was needed for you to be IM. However, 98% of the time, it's done because that's how it's always been done, and for no other reason.
Made an appointment for next Wednesday a.m. To get blood work. I'm not getting IM at all. We will see what my levels are but I'm feeling good.
Glad the shot went well!
I stopped going to the doc because of cost and time.
I agree they do it one way because that is how they're trained to do it. That makes sense. My PA was willing to work with me. Got my T today in the mail, it only took a day. But they're 2ML bottles so I will need to use them twice. The compounding place locally will not take insurance so at $5 a month this way was a no brainer. I will ask for 1ML bottles next time. It will be convenient for travel. I hope TSAndoesnt give me any shit. They didn't with my Androgel 4-5 years ago. I've never flown with needles before but as long as I have my script I should be good to go.
I will read that article thanks Will.
If you read the rest of this thread, you'll see discussion on why smaller weekly doses are superior to larger doses every 2-3 weeks.
Roger that. That's why I went to 1/2cc per week instead of 1cc every 2 weeks. I also see where he suffers from leukemia and of course that coupled with the chemo may deplete his T (what was it, 32 at one point he said?) to an umpteenth degree.
But, done in the leaner areas, such as shoulder and outer thigh, unless the person is quite obese, will be IM. Short needles like that are never used in the typical injection site such as the buttocks where a 21g 1.5" would be used.
All good. My comment was more an annoyance with the nurse than you really. But, I was not there, and perhaps (giving her the benefit of the doubt) decided you required the 21g 1.5" was what was needed for you to be IM. However, 98% of the time, it's done because that's how it's always been done, and for no other reason.
Sooo, to be clear, I'm reading what you've said above as - if you use shoulder or thigh and aren't obese, with a insulin needle it WILL be an IM shot because the short needle will reach the muscle, whereas because it was in the hip it would take the longer one...thanks.
Made an appointment for next Wednesday a.m. To get blood work. I'm not getting IM at all. We will see what my levels are but I'm feeling good.
Glad the shot went well!
I stopped going to the doc because of cost and time.
I agree they do it one way because that is how they're trained to do it. That makes sense. My PA was willing to work with me. Got my T today in the mail, it only took a day. But they're 2ML bottles so I will need to use them twice. The compounding place locally will not take insurance so at $5 a month this way was a no brainer. I will ask for 1ML bottles next time. It will be convenient for travel. I hope TSAndoesnt give me any shit. They didn't with my Androgel 4-5 years ago. I've never flown with needles before but as long as I have my script I should be good to go.
I will read that article thanks Will.
What most people get is multi use 10ML bottle, and you want the 200mg/ml not the typical 100mg/ML as it goes further and allows less volume needed in the shot. I don't know anyone using 1ml or 2ml type stuff like that. 10Ml is the norm.
Roger that. That's why I went to 1/2cc per week instead of 1cc every 2 weeks. I also see where he suffers from leukemia and of course that coupled with the chemo may deplete his T (what was it, 32 at one point he said?) to an umpteenth degree.
1/2 CC (and that's assuming it's the 200mg/ml) will be enough for most men to them in the lower -middle range, with some individual responses. Dose needs to be adjusted to labs and symptoms, and hopefully (but unlikely) estradiol is also being tracked, a topic I have barely even mentioned as I try to just get these gents squared away on the essentials....If it's 50mg (1/2 CC of 100mg/ml) it's way under dosed and serum levels will be sub par. That's one of the many problems man face with this stuff, and it's a constant uphill battle unless they get that very rare doc who really knows what he/she is doing. I do some consulting work in that arena for docs.
Sooo, to be clear, I'm reading what you've said above as - if you use shoulder or thigh and aren't obese, with a insulin needle it WILL be an IM shot because the short needle will reach the muscle, whereas because it was in the hip it would take the longer one...thanks.
Yup, you have it covered. That's the basics, and more interestingly, recent studies suggest subQ is just as good, so it's a moot issue to boot! Yes, IM is the standard, but I think that's going to change quickly.
Sooo....for some of you who have started this....when did you start to feel different?
This is first morning after my first shot. Could just be PSYOPS, but it seemed that I didn't feel as exhausted and was easier to get up. Zero soreness btw...
Sooo....for some of you who have started this....when did you start to feel different?
This is first morning after my first shot. Could just be PSYOPS, but it seemed that I didn't feel as exhausted and was easier to get up. Zero soreness btw...
Depends on a few factors, but most report psychological improvements as soon as a week or two, and physical changes in a few months give or take.
Heavy Metal
02-08-14, 23:06
Been 6 weeks Will.
I feel much better and my Bench Press has gone up by 20lbs on my SRM after being plateau'd for over two years.
It's like I am making early gains again! I am also throwing off some old injuries. My Tendons are recovering much better now.
So far, so good!
Heavy Metal
02-08-14, 23:07
Depends on a few factors, but most report psychological improvements as soon as a week or two, and physical changes in a few months give or take.
Took me about two weeks to start feeling it. The biggie was the shot stopped hurting like an SOB!
See my post above this one too.
Took me about two weeks to start feeling it. The biggie was the shot stopped hurting like an SOB!
.
As discussed at length it this thread, that can be remedied easily enough using much small needles.
Interstingly enough, I was a little sore on day 2 and today (day 3) but no biggie.
Does anybody have any good info on foods or supplements that help block estrogen production for men on t treatment?
Interstingly enough, I was a little sore on day 2 and today (day 3) but no biggie.
My pain was so bad that it was almost a constant distraction. Not huge pain just uncomfortable and distracting. It felt like a Charley Horse.
Does anybody have any good info on foods or supplements that help block estrogen production for men on t treatment?
Have you been tested and shown to have elevated estradiol? Although some supps may help, I have seen nothing that's reliable per se. There are medications that can be used as indicated for elevated estradiol. Losing body fat can help reduce levels, adjusting the TRT dose and or schedule (read through thread fully on that...) , regular exercise and other strategies can help.
My pain was so bad that it was almost a constant distraction. Not huge pain just uncomfortable and distracting. It felt like a Charley Horse.
See above, post # 287...
Might I recommend (albeit, from a noob at this)...I saw previously where someone said they had their shot, then went to bed...IMHO this would not be the best way to keep from being sore..usually movement seems to help the muscle from getting sore.
Have you been tested and shown to have elevated estradiol? Although some supps may help, I have seen nothing that's reliable per se. There are medications that can be used as indicated for elevated estradiol. Losing body fat can help reduce levels, adjusting the TRT dose and or schedule (read through thread fully on that...) , regular exercise and other strategies can help. Not been tested since starting t injection. Want to eat different foods if that will help keep estradiol in check now that he up my t injection to 1ml a week. Body fat don't have much 14% last November. Exercise i like but it eats my t levels up so i have to be careful not to over do it or my recovery will be real slow and i don't do a lot heavy weights mine is more endurance type exercise. Other strategies not sure what you mean by that.
Have you been tested and shown to have elevated estradiol? Although some supps may help, I have seen nothing that's reliable per se. There are medications that can be used as indicated for elevated estradiol. Losing body fat can help reduce levels, adjusting the TRT dose and or schedule (read through thread fully on that...) , regular exercise and other strategies can help.
Why someone would take T supplementation and NOT exercise, thereby taking full advantage of it's benefits, is beyond me!
Not sure if current research shows different results but I avoid soy and soy products (soy protein) which is used in many processed foods esp. protein and granola bars. My understanding is soy contains phytoestrogens which are similar to estrogen and act on receptors in the body
Saw my Dr. yesterday and my problem is actually my hypothalamus causing my problem, not my gonads. Put me on a pill that I can't rememeber the name of right now and said that should regulate it and get me producing on my own. No more gels or shots, so yay I guess...
Not been tested since starting t injection. Want to eat different foods if that will help keep estradiol in check now that he up my t injection to 1ml a week. Body fat don't have much 14% last November. Exercise i like but it eats my t levels up so i have to be careful not to over do it or my recovery will be real slow and i don't do a lot heavy weights mine is more endurance type exercise. Other strategies not sure what you mean by that.
Not sure what that means exactly, but you may need to adjust your dose if it's lower than desired. Without knowing your estrogen (estradiol) levels, there's no way to know if that's something you need to address. Foods known to contain compounds that may improve estrogen metabolism, such as Indole-3-Carbinol found in Cruciferous vegetables, can be eaten, but I'm not aware of any studies that looked them specific to estrogen in men on TRT. See:
http://lpi.oregonstate.edu/infocenter/phytochemicals/i3c/
There's a number of "anti estrogenic" compounds in foods.
[QUOTE=WillBrink;1853907]Not sure what that means exactly.
It was something i said when i was fatigue all the time the last 4 years i would lay around and rest up for weeks to get my energy back. When i started feeling better i would go exercise and feel great during the work out but then the next day i would be done no energy for weeks again. Its a lot better now since i started taking t shots but i still have to be careful with my work outs. That's why my doc double my t dosage last week to 1ml a week. Last December my estradiol level was 14 so that's my starting number before i started taking t shots.
I see my Dr this friday and I am going to ask about me doing the injections myself .since I have been reading this and seeing so many of you doing it yourself I am sure I can too.Although I am still having troubles understanding this subject this thread has helped me as I read it over and over again .I have noticed the injections are helping me so i will keep reading and listening to what others say .and again thank you Will for being so understanding with us and trying to break it down into simple terms
Not sure what that means exactly.
It was something i said when i was fatigue all the time the last 4 years i would lay around and rest up for weeks to get my energy back. When i started feeling better i would go exercise and feel great during the work out but then the next day i would be done no energy for weeks again. Its a lot better now since i started taking t shots but i still have to be careful with my work outs. That's why my doc double my t dosage last week to 1ml a week. Last December my estradiol level was 14 so that's my starting number before i started taking t shots.
That raises more Qs than it answers, but not likely to get hashed out on a 'net forum, so all good.
Have had a couple very eye opening chat with my Doc and RN & pulled op these threads as reference material. Seems the Doc's hands are tied by policy's and procedures on how to order testosterone & the injections by the VA...while the Doc might want to deviate from the protocols that in itself is a nightmare & requires lots and lots and lots more detailed documentation and referral's to specialists who also try the same things the original Doc did.
They also do not have access to order the multi use vials of T, only the single dose ones tons of paperwork and justification.....the military base nearby who's pharmacy we go to when I don't use the VA also does not carry the multi dose vial....
Welcome to socialized medicine.....
So, off the record at home (if it happens at the VA they must chart it and must follow orders) .....will be going to a weekly IM of 150mg (200mg/ML) in the thigh or buttox using different needles.....think I'll go slow & start with a 25ga 1 inch....
As far as pain, the 300mg in the thigh was the very worst, injection was more uncomfortable than normal as was pushing that much fluid...however, the next 2-3 days sucked ass. Hurt like a mother ****er & I'm on other NSAID's & narcs (as needed and I try to not take them at all) for other pain issues. Took at least 3 days to walk out & I'm on my feet at least 7 hours out of a 8 hour shift....when it's in the buttox it might be a tad sore...but never really hurts or get's warm to the touch the size of a palm and 1/2.
Have had a couple very eye opening chat with my Doc and RN & pulled op these threads as reference material. Seems the Doc's hands are tied by policy's and procedures on how to order testosterone & the injections by the VA...while the Doc might want to deviate from the protocols that in itself is a nightmare & requires lots and lots and lots more detailed documentation and referral's to specialists who also try the same things the original Doc did.
They also do not have access to order the multi use vials of T, only the single dose ones tons of paperwork and justification.....the military base nearby who's pharmacy we go to when I don't use the VA also does not carry the multi dose vial....
Welcome to socialized medicine.....
I don't know enough about the VA to comment one way or another on that. Maybe others here dealing with similar can comment/advise. Assuming there's not a big cost difference to you getting single vs multi use, it's mostly a PITA logistics issue for you. No insurance, a 10CC multi use vial usually runs approx $100-$150 and $10-$15 with insurance co pay. How does that jibe with what you will be paying?
So, off the record at home (if it happens at the VA they must chart it and must follow orders) .....will be going to a weekly IM of 150mg (200mg/ML) in the thigh or buttox using different needles.....think I'll go slow & start with a 25ga 1 inch....
As far as pain, the 300mg in the thigh was the very worst, injection was more uncomfortable than normal as was pushing that much fluid...however, the next 2-3 days sucked ass. Hurt like a mother ****er & I'm on other NSAID's & narcs (as needed and I try to not take them at all) for other pain issues. Took at least 3 days to walk out & I'm on my feet at least 7 hours out of a 8 hour shift....when it's in the buttox it might be a tad sore...but never really hurts or get's warm to the touch the size of a palm and 1/2.
Was that the doc or you doing that? That volume of oil is a buttocks shot only as a rule, and using a large needle (18-22g, 1.5") can be dangerous unless you're medically trained to do it. Not advised. Why a med professional would choose the thigh over glute to inject that much oil, I don't know if it wad the doc/nurse.
Small needle (25g 1") or even smaller (as discussed in this thread) and smaller volume delivered will vastly improve post injection pain.
They also do not have access to order the multi use vials of T, only the single dose ones tons of paperwork and justification.....the military base nearby who's pharmacy we go to when I don't use the VA also does not carry the multi dose vial....
Are you aware that the VA can order prescriptions and have them mailed directly to your house? It might be possible to have them order the "right one" and have it sent directly to you. Not sure if they'd do it with T but I can't see why they wouldn't.
Are you aware that the VA can order prescriptions and have them mailed directly to your house? It might be possible to have them order the "right one" and have it sent directly to you. Not sure if they'd do it with T but I can't see why they wouldn't.
I wanted the Multi Dose bottle but the price was $280 and would not be covered by insurance. I got three months for a fifteen dollar copay and it is much easier to take the small bottle on a trip.
I don't know enough about the VA to comment one way or another on that. Maybe others here dealing with similar can comment/advise. Assuming there's not a big cost difference to you getting single vs multi use, it's mostly a PITA logistics issue for you. No insurance, a 10CC multi use vial usually runs approx $100-$150 and $10-$15 with insurance co pay. How does that jibe with what you will be paying?
I really don't know the cost of a multi vial....have not looked into it, there the mail order way to get meds, that's how I got the patch, but it SUCKS and is not user friendly at all with a Schedule III med....and I could try going to Wally World if they have it or another local pharmacy with a scrip....however, the ease and convenience of using the VA's pharmacy & dealing with single use vials is worth it. My Co-Pay is $8 a month....can live with that also as with the VA's on line system it gives me a HUGE flexibility and access to all steps in the process. Once really great feature is I can pull up all the treatment notes in my records from any provider RN or almost anybody else.
Are you aware that the VA can order prescriptions and have them mailed directly to your house? It might be possible to have them order the "right one" and have it sent directly to you. Not sure if they'd do it with T but I can't see why they wouldn't.
Yep, the meds by mail program is the one they use where the provider puts the orders in and then depending on what the provider ordered you pick em up at the pharmacy & the renewals come by mail, or you can get em directly by mail without going to the VA's pharmacy....and this formulary is the same as the VA's in house & they do not have the multi dose testosterone cypionate from what I was told.
Tricare also has a Pharmacy program...called express scrips...this is the one that SUCKS HAIRY GOAT BALLS and is NOT user friendly....I've used it in the past & won't ever use it again unless it's the only way on the planet to get something....just looked on line & it appears testosterone cypionate is single dose vial.
Was that the doc or you doing that? That volume of oil is a buttocks shot only as a rule, and using a large needle (18-22g, 1.5") can be dangerous unless you're medically trained to do it. Not advised. Why a med professional would choose the thigh over glute to inject that much oil, I don't know if it wad the doc/nurse.
Small needle (25g 1") or even smaller (as discussed in this thread) and smaller volume delivered will vastly improve post injection pain.
Was the RN doing that...and from talking to several RN's they all give that same size IM in the same location, seems the majority of PT's prefer the 300mg in the thigh over the buttox for some reason. 400 mg is the max they can give in a single IM & then that is pushing the limit and it also depends on the size of the person receiving the IM if they can tolerate that much fluid was what I was told. But with all the T injections they do most of them all want em in the thigh & I'm the strange one going for the butt....
Needle size has never bothered me, & it seems I'm a believer in the go big or stay home idea...when I spent a couple days in the hospital last year seems even doped up so high I did not know my own name I was not happy till I had a "green" IV in me, they started out with a blue one, then pink, but till the green one went in I was not happy & upon seeing the green I really calmed down (this with aprox 20mg Valium & 10 of Dilaudid, on board along with a HUGE dose of decadron) so going smaller for me is all about reducing the chances of scar tissue.....
Was the RN doing that...and from talking to several RN's they all give that same size IM in the same location, seems the majority of PT's prefer the 300mg in the thigh over the buttox for some reason. 400 mg is the max they can give in a single IM & then that is pushing the limit and it also depends on the size of the person receiving the IM if they can tolerate that much fluid was what I was told. But with all the T injections they do most of them all want em in the thigh & I'm the strange one going for the butt....
Needle size has never bothered me, & it seems I'm a believer in the go big or stay home idea...when I spent a couple days in the hospital last year seems even doped up so high I did not know my own name I was not happy till I had a "green" IV in me, they started out with a blue one, then pink, but till the green one went in I was not happy & upon seeing the green I really calmed down (this with aprox 20mg Valium & 10 of Dilaudid, on board along with a HUGE dose of decadron) so going smaller for me is all about reducing the chances of scar tissue.....
Makes no sense to me, and not SOP for any docs I know who deal with TRT/HRT. You might inquire why they prefer that location for such a large IM injection. I suspect the answer will be something less than compelling.
I know it isn't the question you asked, but testing your testosterone level in the afternoon invalidates the test.
An interesting added variable to the 8am rule:
Validity of Midday Total Testosterone Levels in Older Men with Erectile Dysfunction
INTRODUCTION: Based on studies demonstrating the circadian rhythmicity of testosterone levels, the optimal time of day to draw total testosterone (TT) in men has classically been reported as between 8 and 11 AM. However, further studies have demonstrated that the circadian rhythmicity of testosterone levels becomes blunted with age.
METHODS: Charts of 2,569 men presenting with erectile dysfunction (ED), were retrospectively reviewed for TT and draw times and were compared by age group. Men were grouped to: less than 40, and then by 5 year groupings. TT was analyzed for variability over the most common draw time hours (7 AM - 2 PM).
RESULTS: The mean TT for 7-9 AM versus 9 AM-2 PM were both clinically and statistically different only for men in the age groups of < 40 and 40-44, with mean TT differences of 207 ng/dL [95% CI 98-315 p = 0.0004], and 149 ng/dL [95% CI 36-262 p = 0.01] respectively. All other groupings did not demonstrate both a clinically and statistically significant difference between those time periods.
CONCLUSION: A TT level in men with ED who are younger than 45 years should be drawn as close to 7 AM as possible as a statistically and a clinically relevant drop in testosterone levels will occur over the course of the day. Men older than age 45 years with ED can have their TT drawn at any time before 2 PM without fear of misleading results.
Welliver RC, Jr., Wiser HJ, Brannigan RE, Feia K, Monga M, Kohler TS. Validity of Midday Total Testosterone Levels in Older Men with Erectile Dysfunction. J Urol. http://www.sciencedirect.com/science/article/pii/S0022534714001153
wilson1911
02-13-14, 10:32
If you pin in the leg, about 2 mils is all you are wanting to do. The exception to this is a larger person. The buttox can handle 3 mils easier, and with less care. When you pin the thigh, you need to be careful of hitting a vein or nerve ending. Always pull back to check you did not hit something. If you are going for a thigh pin, it is good to walk it out on a treadmill for about 20 mins, this will help with any injection site pain. I use 23g 1.5 to pin everywhere. I started using the 25g, but unless you warm the bottle up with warm water, its still a bit of effort to get it in since the needle is so small.
There are several sites that will show yo how to pin on the net. Its good to have a bit of a rotation so there will not be any scar tissue buildup also. If you are pinning more than 3 mils a week, you must start your rotation and not stray from it.
The worst thing you can do is pin, and then go sit and watch tv. It is much better to walk it out or workout. I prefer to pin in the am so I have a chance to break up the oil a bit during the day.
If you pin in the leg, about 2 mils is all you are wanting to do. The exception to this is a larger person. The buttox can handle 3 mils easier, and with less care. When you pin the thigh, you need to be careful of hitting a vein or nerve ending. Always pull back to check you did not hit something. If you are going for a thigh pin, it is good to walk it out on a treadmill for about 20 mins, this will help with any injection site pain. I use 23g 1.5 to pin everywhere. I started using the 25g, but unless you warm the bottle up with warm water, its still a bit of effort to get it in since the needle is so small.
There are several sites that will show yo how to pin on the net. Its good to have a bit of a rotation so there will not be any scar tissue buildup also. If you are pinning more than 3 mils a week, you must start your rotation and not stray from it.
The worst thing you can do is pin, and then go sit and watch tv. It is much better to walk it out or workout. I prefer to pin in the am so I have a chance to break up the oil a bit during the day.
Anyone using 3MLs per week of any currently offered T ester used for TRT/HRT in the US, will be well above TRT/physiological levels. If it's a TRT/HRT goal (the focus and intent of the thread), you'll see that dose every 2-3 weeks. It's a less than optimal dose pattern (as covered in this thread) but that's what you'll see if it's TRT/HRT as the goal.
wilson1911
02-13-14, 11:18
I wasn't trying to stray from the intent of the thread, but it seemed like some were wanting to know the limits of injections sites. I am currently on 1 mil a week, and prefer this method over the over schedules.
I wasn't trying to stray from the intent of the thread, but it seemed like some were wanting to know the limits of injections sites. I am currently on 1 mil a week, and prefer this method over the over schedules.
Rgr rgr. I just didn't want anyone to think 3ML per week (which would be 300-600mg depending on the T) of T was "normal" or common in term of TRT/HRT.
Now the bbers and other athletes out there, that's a different matter...
talked to My Dr and he signed off on me injecting Myself .I had to get the single use viles as that is all the pharmacy had i got 3 month supply ,But was given the 22 ga Needles ( it is like a damn harpoon) and had to inject myself in front of my DR to prove i could do it .
It was a butt shot ,I asked about using smaller needles and using the thigh as ya'll have been talking about but he told me as thick as this is he would rather me put it where they do .I agreed just to get him to give me the thumbs up . I have been getting 1cc every 2 weeks .and it has helped me and any words of advice would be greatly appreciated .
should I up the dose ? do smaller amounts weekly as I have read? what advice do you have Will ? thank you for helping me
Cost was only 15 dollars a Vile
talked to My Dr and he signed off on me injecting Myself .I had to get the single use viles as that is all the pharmacy had i got 3 month supply ,But was given the 22 ga Needles ( it is like a damn harpoon) and had to inject myself in front of my DR to prove i could do it .
It was a butt shot ,I asked about using smaller needles and using the thigh as ya'll have been talking about but he told me as thick as this is he would rather me put it where they do
That topic has been discussed at length in this thread and other referenced ("Lot T at 26") so I'd refer to those for more info on the use of smaller needles as needed.
I agreed just to get him to give me the thumbs up . I have been getting 1cc every 2 weeks .and it has helped me and any words of advice would be greatly appreciated .
should I up the dose ? do smaller amounts weekly as I have read? what advice do you have Will ? thank you for helping me
Per this thread and other referenced, smaller doses given more often will result in steadier blood levels with less spikes and drops, generally leading to improved effects with noticeable improvements in symptoms. Dose is decided on lab work to see what dose you require to get to the levels you and your doc want and you feel best. The dose you are currently on is on the low end and one would expect low "normal" levels within the standard ranges. Data and clinical experience suggests ranges in the higher "normal" range is superior all around. Posted some studies on that here a while back.
I cannot recommend you raise the dose on your own accord without lab work and doc being in the loop.
Got my labs back last week. My T is at 300nd. My Doc reitterated whats been said here, "normal" being 250-1100 which is a stupid wide margin. Additionally since I've had massive fatigue, trouble losing weight, untethered sleep patterns etc she has no problem treating my low T as a symptomatic treatment rather than clinical.
Unfortunately, or not, but Dr won't sign off on T yet because my thyroid is, as she described it, passive ie not functioning. . So we are treating to the Thyroid for 2 months, retest, regauge and at that time if my symptoms don't improve we'll commence w TRT.
On the plus side for a fat guy in his 30's my blood pressure, sugars and cholesterol are money! Like do good Dr wanted a second test just to ensure there weren't errors.
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Got my labs back last week. My T is at 300nd. My Doc reitterated whats been said here, "normal" being 250-1100 which is a stupid wide margin. Additionally since I've had massive fatigue, trouble losing weight, untethered sleep patterns etc she has no problem treating my low T as a symptomatic treatment rather than clinical.
Unfortunately, or not, but Dr won't sign off on T yet because my thyroid is, as she described it, passive ie not functioning. . So we are treating to the Thyroid for 2 months, retest, regauge and at that time if my symptoms don't improve we'll commence w TRT.
On the plus side for a fat guy in his 30's my blood pressure, sugars and cholesterol are money! Like do good Dr wanted a second test just to ensure there weren't errors.
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This does not seem an unreasonable approach by your doc to me, and you should notice big improvements in the symptoms you listed going from the hypo to normal thyroid levels. Now, if after your thyroid is corrected, X months go by, and you're still feeling poorly and T levels are still bottom of "normal" than you take it from there and likely get additional testing done.
Agreed - I'm certainly holistically minded that if I can correct the thyroid I want to. If that came across bemoaning or lamenting it was unintentional.
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Went with 150mg in the left thigh via 25ga 1 inch........heated vial up prior to drawing and heated syringe up also...did not notice any difference between the 22ga and the 25ga as far as stab...however, the 25ga took forever to inject, seems like it goes in almost 3 times as fast with the 22 vs the 25.......my thigh was quivering bad by the time it was all in....started to hurt the next day and even walking it out on day 2 it still hurts....no more thigh IM's for me, they just do not like or tollerate it very well.
As far as thigh vs buttox, I've been told that "most" people like the thigh better....no idea why that is...
Went with 150mg in the left thigh via 25ga 1 inch........heated vial up prior to drawing and heated syringe up also...did not notice any difference between the 22ga and the 25ga as far as stab...however, the 25ga took forever to inject, seems like it goes in almost 3 times as fast with the 22 vs the 25.......my thigh was quivering bad by the time it was all in....started to hurt the next day and even walking it out on day 2 it still hurts....no more thigh IM's for me, they just do not like or tollerate it very well.
As far as thigh vs buttox, I've been told that "most" people like the thigh better....no idea why that is...
This post is not clear to me. Did you go from a 22g in the hip/glute to a 25g in the thigh, or have you been doing a 22g to the thigh and switched to a 25g? If the former, then apples/oranges kinda deal. Location of thigh shot is much less margin for things that don't like being stuck with a needle and hurt the following day(s). Any concerns or Qs, discuss with your doc. Some useful info:
Clinical Practice - IM injections: How’s your technique?
Good injection technique can mean the difference between less pain and injury. Angela Cocoman and John Murray explain
The administration of intramuscular injections is a common nursing intervention in clinical practice.1 This article aims to, raise awareness in relation to the injection sites used for intramuscular injection and, to highlight best practice in relation to IM injection administration.
The importance of good injection technique cannot be understated. It should not be forgotten that among potential complications of IM injection are abscess, cellulites, tissue necrosis, granuloma, muscle fibrosis, contractures, haematoma and injury to blood vessels, bones and peripheral nerves.2 Although IM injection is a commonplace nursing practice, there is a dearth of guidelines for nursing staff in this area.3,4 It has been outlined that there are no working policies or procedures on administering injections to which nursing staff can refer.3 Furthermore, the technique and preparation by certain staff may not be substantiated by evidence.4
Sites of the thigh (Rectus femoris and Vastus lateralis)
The uptake of drugs from the thigh region is slower than from the arm but faster than from the buttock, thus facilitating better drug serum concentrations than is possible with the gluteal muscles.5
Cont:
http://www.inmo.ie/MagazineArticle/PrintArticle/5676
Gents, this is an interesting study. Although the findings may only apply to this narrow group, it seems to jibe well with the known effects of estrogen on CVD risk factors such as HDL I'd expect. Having not read the full study, not sure if they also examine the association between alterations in CVD risk factors with AI and increased risk of CAD.
I'm not sure if any other studies have looked at Ais and risk of CAD, but it appears to point to the fact that there's potentially negative outcomes to both too much or too little estradiol for men and women, which other studies generally support. Why did I post this: There's often a tendency in my experience that many men are under the impression the lower the estrogen = better, and that does not appear to be the case. They often use AIs minus blood work showing any need for it which increase their risk of CAD and other negatives best avoided.
This may be one of the firsts studies I'm aware of that examined AI use increased CAD risk, albeit in a very specific population.
Association of Aromatase Inhibitors With Coronary Heart Disease in Women With Early Breast Cancer
As compared to tamoxifen aromatase inhibitors (AIs) may increase the risk of heart disease. Here we explored the association between the use of AIs and coronary artery disease (CAD) in a population-based observational study. In a small and heterogeneous population of 74 women with early breast cancer who received adjuvant hormonal therapy and subsequently underwent cardiac angiography, AIs significantly increased the hazard for CAD (HR 3.23, 95% confidence intervals [CI] 1.26–8.25, p = .01) compared to tamoxifen. Our results suggest that therapy with AIs may increase the risk for CAD.
Source: http://informahealthcare.com/doi/abs/10.3109/07357907.2014.880452
Good article here for those interested in the impact of TRT on fertility and possible ways to treat/avoid infertility due to TRT:
Testosterone Replacement Therapy (TRT) and Fertility – how to get the best of both worlds – part 1 By BrinkZone.com author Monica Mollica
The prevalence of testosterone deficiency (aka hypogonadism or Late Onset Hypogonadism), defined as total testosterone (TT) at or below 300 ng/dl is close to 40% in men aged 45 years and older presenting to primary care offices in the US.1 Year 2006 is was estimated that more than 13.8 million men over 45 years of age visiting a primary care doctor in the United States have symptomatic androgen deficiency.1
A large international web survey using the Aging Males’ Symptoms (AMS) questionnaire showed the prevalence of symptomatic testosterone deficiency to be 80% in men aged 16–89 (mean 52 years).2 It is notable that in the survey 40% of respondent were at younger ages when ‘Late Onset Hypogonadism’ is generally not believed to be occurring.2 The surprisingly high prevalence of raised scores indicative of testosterone deficiency in the younger age groups may be due to the increasing prevalence of conditions in these age groups known to reduce testosterone levels, such as obesity 3-7 and chronic work stress. 8-10 Stress-induced cortisol elevation, by increasing SHBG, lowers the free active fraction of testosterone and thereby reduces its action.11
This large and rising prevalence of testosterone deficiency is gaining recognition among doctors and patients alike. However, while testosterone replacement therapy (TRT) confers great benefits to men with sup-optimal testosterone levels, it also comes with some side-effects which are especially relevant for men who wish to have a family…Many testosterone users and even clinicians 12 are unaware that testosterone supplementation suppresses the hypothalamic-pituitary-gonadal (HPG) axis and may result in infertility…
CONT:
http://www.brinkzone.com/mens-health/testosterone-replacement-therapy-trt-and-fertility-how-to-get-the-best-of-both-worlds-part-1/
In part I BrinkZone author Monica M covered issues related to the effect of TRT (Testosterone Replacement Therapy) on male fertility linked above. In Part II, she outlines options for men to increase endogenous testosterone production by non-TRT means, and ways to speed up spermatogenesis for those who chose to go the TRT route...
Testosterone Replacement Therapy (TRT) and Fertility Part II (http://www.brinkzone.com/mens-health/trt-and-fertility-how-to-get-the-best-of-both-worlds-part-2/)
Well, today was shot number 2, three weeks after shot #1.
In those three weeks, what I have noticed the most is that I can actually get out of bed in the morning without feeling like I'm already dead, and in the afternoons I seem to be able to keep up better. Oh, I don't think I've argued with my wife in the last 3 weeks, either.
In one week I have to return for a blood test; we will see how it goes then.
In part I BrinkZone author Monica M covered issues related to the effect of TRT (Testosterone Replacement Therapy) on male fertility linked above. In Part II, she outlines options for men to increase endogenous testosterone production by non-TRT means, and ways to speed up spermatogenesis for those who chose to go the TRT route...
Testosterone Replacement Therapy (TRT) and Fertility Part II (http://www.brinkzone.com/mens-health/trt-and-fertility-how-to-get-the-best-of-both-worlds-part-2/)
Hey, I don't have kids and at 48 sure as HELL ain't looking too! If I shoot blanks all the better! :sarcastic:
BTW Will, these adds I see on TV now for some law firm about HRT......stroke, heart attack, death (no shit given the first two). What gives? Is there now enough "evidence" for them to win in court? I was doing cardio and had my MP3 player on so couldn't hear sound but I swear I didn't see injectable Test listed.
Ok, so now I can feel the difference the morning after my second shot. I've been awake since about 5:30 ready to get up (that NEVER happens)
Hey, I don't have kids and at 48 sure as HELL ain't looking too! If I shoot blanks all the better! :sarcastic:
BTW Will, these adds I see on TV now for some law firm about HRT......stroke, heart attack, death (no shit given the first two). What gives? Is there now enough "evidence" for them to win in court? I was doing cardio and had my MP3 player on so couldn't hear sound but I swear I didn't see injectable Test listed.
Ambulance chasers don't need much accepted conclusive evidence to play their game, but the recent few studies that suggested an increased risk of cardio vascular risks was covered in this thread a few pages back.
Note: There's no free lunch in human biology. Nadda, zip, none. Risk/benefit is a concept many are unable or unwilling to accept, especially in the US.
Ironworker46
03-01-14, 22:05
Is anyone taking Testapel? I use to get shots bi-weekly in the arm, which wasn't too bad. Now I get 14 to 16 pellets of Testapel placed high on my hip, every 4 months. I know it cost the insurance more, but it hives me more stable results and not the roller coaster ride the shots give me. It also saves me countless hours going to the doctor.
For those interested, a lengthy response/discussion regarding some recent studies getting (too much...) media attention on possible dangers of TRT therapy. Although the article I posted in this thread covered the main issues, there's some good points made in the LEF response and it's not as heavy on the science as the article on my site (http://www.brinkzone.com/mens-health/comment-on-study-increased-risk-of-heart-attack-following-testosterone-therapy/) done by Monica M. My personal take is, there may still be something to this, and their may be a subset of men who experience and increased risk of cardiac events with TRT, and I'd like to see more well conducted studies examining that issue, but these recent studies don't answer that and fail to address some glaring mistakes made that very well might explain their results, per comments below and linked in text:
Life Extension Magazine
Life Extension Magazine March 2014
Response To Media Reports Associating Testosterone Treatment With Greater Heart Attack Risk (http://www.lef.org/magazine/mag2014/mar2014_Response-To-Media-Reports-Associating-Testosterone-Treatment-With-Greater-Heart-Attack-Risk_01.htm)
For those interested, a lengthy response/discussion regarding some recent studies getting (too much...) media attention on possible dangers of TRT therapy. Although the article I posted in this thread covered the main issues, there's some good points made in the LEF response and it's not as heavy on the science as the article on my site (http://www.brinkzone.com/mens-health/comment-on-study-increased-risk-of-heart-attack-following-testosterone-therapy/) done by Monica M. My personal take is, there may still be something to this, and their may be a subset of men who experience and increased risk of cardiac events with TRT, and I'd like to see more well conducted studies examining that issue, but these recent studies don't answer that and fail to address some glaring mistakes made that very well might explain their results, per comments below and linked in text:
Life Extension Magazine
Life Extension Magazine March 2014
Response To Media Reports Associating Testosterone Treatment With Greater Heart Attack Risk (http://www.lef.org/magazine/mag2014/mar2014_Response-To-Media-Reports-Associating-Testosterone-Treatment-With-Greater-Heart-Attack-Risk_01.htm)
If you don't mind, what is that Cliff's Notes subset? I've been on injectables for almost 5 years now, do cardio and weights religiously, and am still alive. I do have hypertension but it is well controlled with meds.
BTW, I saw that commercial for the law firm today that I mentioned a few posts back; it did NOT include injectables.
If you don't mind, what is that Cliff's Notes subset? I've been on injectables for almost 5 years now, do cardio and weights religiously, and am still alive. I do have hypertension but it is well controlled with meds.
BTW, I saw that commercial for the law firm today that I mentioned a few posts back; it did NOT include injectables.
I think the cliffs more or less exist in this thread if you give it a read and I wouldn't know how to cliff it anyway. I'd say your health and well being worth the time to read up fully on the issue - via various links supplied - than my writing up cliffs on on the topic.
Only cliff I can give is: My stance remains the same; the data overwhelmingly suggests the benefits outweigh the risks by a wide margin, but there's no free lunch in human biology.
Aveed is a long acting IM T that's been around for a long time in most other countries under the name Nebido. It's finally gotten FDA approval for the US market:
U.S. FDA APPROVES AVEED™ (TESTOSTERONE UNDECANOATE) INJECTABLE TESTOSTERONE REPLACEMENT THERAPY FOR MEN LIVING WITH HYPOGONADISM, OR LOW-T
AVEED offers distinct dosing schedule to increase testosterone levels in hypogonadal men, and underscores Endo’s strategy and commitment to addressing health issues facing men
Dublin, Ireland, March 6, 2014 / PRNewswire / — Endo International plc (NASDAQ: ENDP) (TSX: ENL) announced today that its operating company Endo Pharmaceuticals Inc. received U.S. Food and Drug Administration (FDA) approval of AVEED™ (testosterone undecanoate) injection for the treatment of adult men with hypogonadism (commonly known as Low-T) that is associated with a deficiency or absence of the male hormone testosterone. AVEED is a new prescription medicine indicated to produce serum testosterone levels in the normal range by administration of a single 3-mL (750 mg) intramuscular injection given once at initiation of therapy, at 4 weeks, and then every 10 weeks thereafter. It is expected to be available in early March.
"Today's FDA approval of AVEED is a significant milestone for Endo. AVEED expands our branded portfolio of men's health products and highlights our passion and commitment to providing high quality therapies that improve patient care," said Rajiv De Silva, president and chief executive officer of Endo. "With AVEED, Endo can now offer men living with hypogonadism different treatment options to raise testosterone levels. We are focused on getting AVEED to market to ensure that appropriate patients have access to it."
Cont:
http://www.multivu.com/mnr/65167-u-s-fda-approves-endo-aveed-for-men-with-hypogonadism-low-t
And interesting look at the impact of "Low T" in terms of costs:
The 20-year public health impact and direct cost of testosterone deficiency in U.S. men
By author Monica Mollica
Recent evidence strongly suggests that testosterone deficiency is a predisposing factor for various chronic illnesses, including cardiovascular disease, diabetes and osteoporosis.1-3 Testosterone deficiency has also been implicated as a modifiable disease risk factor for various chronic diseases in otherwise well patients.4-7
Cardiovascular disease, diabetes and osteoporosis-related fractures consume a significant portion of the $2.3 trillion in annual U.S. health expenditures. The economic impact of diabetes is estimated at $503 billion, $152 billion for cardiovascular disease, and $6 billion for osteoporosis-related fractures.8-10
Thus, the total burden of these diseases is over $660 billion, representing approximately 29% of all U.S. health care expenditures in 2008. Since testosterone deficiency is a potentially modifiable risk factor for these and other medical conditions, it may be responsible for substantial financial and quality-of-life burden on the U.S. health care system.11
A study was conducted to specifically quantify the U.S. health care (or should I say sick care) cost burden imposed by consequences of testosterone deficiency …12
- See more at: http://www.brinkzone.com/mens-health/the-20-year-public-health-impact-and-direct-cost-of-testosterone-deficiency-in-us-men/#sthash.pBNafJ2e.dpuf
Cont HERE (http://www.brinkzone.com/mens-health/the-20-year-public-health-impact-and-direct-cost-of-testosterone-deficiency-in-us-men/)
UPDATE: One week after my second shot, My blood test results came back at 560. That's the highest I've ever been tested at for 5 years. My Urologist thinks that's a good result for me, so we are going to stick with 1/shot every 3 weeks for awhile. THANK YOU Will for helping me get off the pot about this.
UPDATE: One week after my second shot, My blood test results came back at 560. That's the highest I've ever been tested at for 5 years. My Urologist thinks that's a good result for me, so we are going to stick with 1/shot every 3 weeks for awhile. THANK YOU Will for helping me get off the pot about this.
560 at the end 3 weeks? That schedule is still sub par, but at least you appear to be heading in the right direction and should be feeling better at least.
560 at the end 3 weeks? That schedule is still sub par, but at least you appear to be heading in the right direction and should be feeling better at least.
Clarify, Test at 560 was ONE WEEK after Shot #2. Schedule going forward is 1 shot every 3 weeks. Yes I wish he'd go to 1 every 2 weeks, but it's certainly an improvement. And I'll be working him to up it.
Yes, I can now at least wake up in the mornings without starting out feeling dead. Nurse says it's her experience that it takes 4-5 doses before you really start to feel it. I'm still waiting/hoping for an epiphany :)
Clarify, Test at 560 was ONE WEEK after Shot #2. Schedule going forward is 1 shot every 3 weeks. Yes I wish he'd go to 1 every 2 weeks, but it's certainly an improvement. And I'll be working him to up it.
Yes, I can now at least wake up in the mornings without starting out feeling dead. Nurse says it's her experience that it takes 4-5 doses before you really start to feel it. I'm still waiting/hoping for an epiphany :)
Well then, both the testing and dosing schedule, sub par in my view. But, an improvement and something to work from at least. If you were to take the test the day before the shot due (the standard protocol) you'd find T levels low on that every 3d week schedule by middle/end of week 2. On that schedule, here's how you will feel: Great week one, and by around end of week 2, so so, and by week 3, well, you let me know.
No, not a mind reader, just simple understanding of pharmacokinetics (a fancy way of saying how the drug behaves in the system more or less) of these compounds which anyone can look up and figure out frankly. But, there are often other considerations of what's more the optimal dose vs. some practical considerations, so not trying to beat down the approach of this doc per se.
Well then, both the testing and dosing schedule, sub par in my view. But, an improvement and something to work from at least. If you were to take the test the day before the shot due (the standard protocol) you'd find T levels low on that every 3d week schedule by middle/end of week 2. On that schedule, here's how you will feel: Great week one, and by around end of week 2, so so, and by week 3, well, you let me know.
No, not a mind reader, just simple understanding of pharmacokinetics (a fancy way of saying how the drug behaves in the system more or less) of these compounds which anyone can look up and figure out frankly. But, there are often other considerations of what's more the optimal dose vs. some practical considerations, so not trying to beat down the approach of this doc per se.
Is there a medical quote about the test day before due that defines it as standard protocol somewhere I might be able to print and take with me to see him? This Dr. is at least willing to talk w/me about it.
What I gather from reading this thread is that if you tested the day before, that result will be the LOWEST number you could have, the day or two after the shot the HIGHEST, and some kind of curve throughout the period. So, if 560 was my number at the end of week one, theoretically it might be 800 on day one, 400 end of week two and 200 at day before (week three) - but I also read that at about 10 days is when it really drops off. I wonder if anyone has ever done testing every day over the period to see where it really drops at...because THAT's when you need to be getting the next shot...I am assuming that while he might not want me at 200, he is not comfortable with it being 800 the day after the shot, either...
Goal is to get him to same dose every 2 weeks instead of 3 - and I am probably going to have to do current protocol for a few months then try and convince him. In the meantime, it is still a huge improvement over ineffective Androgel...thanks Will
Is there a medical quote about the test day before due that defines it as standard protocol somewhere I might be able to print and take with me to see him? This Dr. is at least willing to talk w/me about it.
It's as SOC/SOP as it gets in TRT/HRT and I'd be astounded a board certified urologist wouldn't know that. It's more likely he/she does know that, but has their own reasons for the testing schedule. I can dig something up but I'd just ask why the testing is not done the day before the next shot per usual. Although not "cutting edge" per se, probably find it on the Endocrine Society reports:
https://www.endocrine.org/
What I gather from reading this thread is that if you tested the day before, that result will be the LOWEST number you could have, the day or two after the shot the HIGHEST, and some kind of curve throughout the period. So, if 560 was my number at the end of week one, theoretically it might be 800 on day one, 400 end of week two and 200 at day before (week three) -
And that's the problem in a nut shell, hence why those in the know, be they experienced TRT/HRT docs, or just wise guys like me, know smaller weekly doses avoid all that leading too improved effects and reduced side effects. Per what I have been saying all through this thread. The half life of these T compounds is very well known and established.
but I also read that at about 10 days is when it really drops off. I wonder if anyone has ever done testing every day over the period to see where it really drops at...because THAT's when you need to be getting the next shot...I am assuming that while he might not want me at 200, he is not comfortable with it being 800 the day after the shot, either...
Indeed, and again, old news to those who have researched this topic and you're starting to hone in on the having a true "ah ha!" moment I think. We know exactly when the levels start to drop off, and why smaller weekly shots work better: very small changes in serum levels due to correct dosing schedule because the next shot comes right around that drop off time. Hence, no big spikes, no big drops in T levels. Again, report back around week 3 on that schedule as to how you feel compared to week 1 and and two...
Goal is to get him to same dose every 2 weeks instead of 3 - and I am probably going to have to do current protocol for a few months then try and convince him. In the meantime, it is still a huge improvement over ineffective Androgel...thanks Will
Well if you're able to give your own shots, why would he care if you did it every week? Obviously, using far smaller doses for reasons outlined. Now, if you have go get the shot at his place, either because you wont do it and or he does not allow you to do it yourself (another topic....) then that is the major practical issue of which I mentioned vs optimal schedule.
As you can see in this thread, lots of people have docs who have no issues with them doing it themselves which saves all sorts of time and $$$, etc.
Ahh, I think the light just blinked "on"....
Nurse asked me if I wanted her to give me the shot, or me give it to myself.....If I self-administer, then I can split the dose, and VIOLA....
I originally asked her to do it, but I'm going to change my mind at the next shot....If I'm on 1 dose every 3 weeks, then splitting it in two would be every 10 days rather than 1 once week, or would you stick to weekly? At least until I can get him to maybe move it up a little...
Ahh, I think the light just blinked "on"....
Nurse asked me if I wanted her to give me the shot, or me give it to myself.....If I self-administer, then I can split the dose, and VIOLA....
I originally asked her to do it, but I'm going to change my mind at the next shot....If I'm on 1 dose every 3 weeks, then splitting it in two would be every 10 days rather than 1 once week, or would you stick to weekly? At least until I can get him to maybe move it up a little...
Qs like this put me in an awkward position. Once every 10 days will be far superior than 2 weeks, much less 3 as you will only be a day or so past when levels start to drop. But, I can not advise to go alter the dose schedule the doc has set up. It's not a good idea to advise someone over the 'net to alter or counter what their doc has prescribed without the docs knowledge, as that can lead to obvious problems, even if seemingly a minor change. It's best to keep your doc in the loop of any changes made, so i'd recommend discussing with him an interest in changes in dosing schedules being you plan to do it yourself.
Qs like this put me in an awkward position. Once every 10 days will be far superior than 2 weeks, much less 3 as you will only be a day or so past when levels start to drop. But, I can not advise to go alter the dose schedule the doc has set up. It's not a good idea to advise someone over the 'net to alter or counter what their doc has prescribed without the docs knowledge, as that can lead to obvious problems, even if seemingly a minor change. It's best to keep your doc in the loop of any changes made, so i'd recommend discussing with him an interest in changes in dosing schedules being you plan to do it yourself.
totally understand and maybe I should have phrased the question differently. Thank you for trying to give your opinion.
It's much more accepted now then it was just a few years ago, but yes, can be a real PITA to get doc to do it. Also depends on what part of the country you live in. Some areas are easier/tougher then others.
PS, I do NOT recommend 1000mg per week for anyone which is WAY above HRT/TRT levels. Just an FYI.
typo. woops
Thurs the 13th is day 1 week 4 of getting 150 IM every week instead of 300 every 2 weeks.
Have gone back to using a 22 ga needle, it just works better for me.
So far I've noticed no real spiks for a high or a low....sexual interest and activity is lower on the weekly shot vs 2 week, have noticed on the 2 week schedual a peak high and slow taper off..but now the weekly shot does not have that high. just a lower sex drive and not as active. Mrs rampy has noticed the lower sex drive and has made mention of it a few times....and not in a good way.
Mood swings were never a problem till the lows...and on the weekly shot I'm a little more stable, but at the same time depression seems easier to slip into...
Had a real problem with acne, lots and lots of zits from the 2 week dose, they are really going away, not nearly as bad in any way shaope or form...
Don't seem to have the same energy level on the 1 week shot, just more blah....harder to get up and going in the AM even the day after the shot..
Not scheduled for blood work for a couple more months..will see how things go.....
Thurs the 13th is day 1 week 4 of getting 150 IM every week instead of 300 every 2 weeks.
Have gone back to using a 22 ga needle, it just works better for me.
So far I've noticed no real spiks for a high or a low....sexual interest and activity is lower on the weekly shot vs 2 week, have noticed on the 2 week schedual a peak high and slow taper off..but now the weekly shot does not have that high. just a lower sex drive and not as active. Mrs rampy has noticed the lower sex drive and has made mention of it a few times....and not in a good way.
Mood swings were never a problem till the lows...and on the weekly shot I'm a little more stable, but at the same time depression seems easier to slip into...
Had a real problem with acne, lots and lots of zits from the 2 week dose, they are really going away, not nearly as bad in any way shaope or form...
Don't seem to have the same energy level on the 1 week shot, just more blah....harder to get up and going in the AM even the day after the shot..
Not scheduled for blood work for a couple more months..will see how things go.....
From your subjective symptoms, I'd guess you're being under dosed. 150mg weekly IM is usually adequate to get into the middle of the range, but for some it's not, and or, some simply feel better at the upper end. Again, many docs don't look for the optimal dose, but the adequate dose. Current studies suggest (which I posted in this thread) that major benefits are seen at 550ng/dl and above. My guess is you're hovering right around that number at that dose, but there's a real difference between 450ng/dl and 800ng/dl in how you feel, etc, and is will within physiological range. Hence dosing should be based on both objective and subjective measures as we are more than just a lab number.
Also, this also starts to get complex. Do you get E2 (estradiol) tested also? Overly high or low levels can also impact mood, and is not routinely tested by most docs doing TRT/HRT.
Finally, it mat be unrelated to your T levels, so if dose and schedule are correct, looking at other possible causes is warranted as there's many possible causes of such symptoms and we are far more complex than any single hormone, if even T is a mighty important one.
Diet, sleep patterns, other meds, other hormones (e.g., thyroid. etc) may be involved.
Regulars here know I have a specific focus and interest in testosterone replacement therapy/Hormone replacement therapy (TRT/HRT) via this thread and others as well as many articles on my site via myself or other authors.
I do some consulting work in that arena, including for some medical professionals in the US. It's been an area of research for me for 20+ years, well before the current "Low T" interest which is the marketing name some pharma company invented as “hypogonadism” does not role of your tongue I guess.
And as some of you know, I spend a fair amount of time in Panama. Something I have been investigating in Panama is the idea of a location that would focus on TRT/HRT and allied/overlapping concerns; life style, fitness/health, etc. The idea just dawned on me a few months ago after speaking with a number of docs here and seeing how much interest there is.
Although I find some men being well served by the doctors they work with, I find the majority of them fail to get what they really need, and with vets, it seems even worse in this particular area. It’s often frustrating, verging on heart breaking, to see how some suffer when there’s simply no need for it.
Panama has top quality medical facilities, an economy growing at a rate that’s the envy of any nation, low crime, the and Panama City is a first world city, which is why it’s become such a popular destination for such a wide variety of people in business (it’s the second largest banking center in the world), retirement, and vacations.
All the details have yet to be worked out, but I will have a medical doctor on staff, have specialists on referral, access to a full lab for blood work, and offer packages that will result in getting squared away (and for some, it’s been years of trying to make that happen and the frustration is palpable) and a vacation to boot, that will still cost less – all in – than doing it in the US. I will offer special pricing to Mil and LE as it’s the least I can do for those of the thin green and blue line, which for me, is not a metaphor.
I’m calling it Life Performance Center Panama currently.
As mentioned, in the planning fact finding stages, but all the pieces of it – should I decide to move forward – are there so it could come together fairly quick if it happens.
I’ll post updates regardless and am happy to answer Qs anyone has.
BTW, “Medical Tourism” is one of the fastest growing industries in the world and Panama becoming a key player to that. My sister was quoted 5k+ for some crowns and root canal. Panama it cost her $1,400, she had a weeks vacation, and still ahead by several thousand. Her dentist was an oral surgeon who graduated from a US medical school who practiced in NYC for years and his son going to BU medical in Boston currently. As we all know, costs in the US are completely out of control, hence the huge growth in medical tourism.
PS, this is the only location I have mentioned this possible development outside of friends, as it’s the only place I feel able to do so honestly.
As mentioned above, Aveed was just approved by the FDA.
Effects of 6-year Long-Term Testosterone Replacement Therapy (TRT) in Patients with ‘‘Diabesity’’ (http://www.brinkzone.com/mens-health/effects-of-6-year-long-term-testosterone-replacement-therapy-trt-in-patients-with-diabesity/#sthash.OR5uIeVd.dpuf)
March 6th 2014 FDA approved Aveed for treatment of male hypogonadism, aka testosterone deficiency.1 Aveed is a long-acting form of injectable testosterone called testosterone undecanoate. In Europe, testosterone undecanoate (under the name Nebido) has a long successful TRT track record for treatment of testosterone deficiency and its consequences (especially obesity, the metabolic syndrome and diabetes).2-16
In contrast to shorter acting forms of testosterone (e.g. cypionate), testosterone undecanoate only needs to be injected every 6 to 12 weeks, and thereby offers practical benefits to patients. (Comment: for Nebido, the initial interval is 6 weeks, followed by intervals of 10-14 weeks; for Aveed, the initial interval is 4 weeks, followed by 10-week intervals).
Five days after the FDA approval a notable and impressive 6-year long TRT study was published, confirming the health benefits of TRT that have previously been found in shorter term studies…44
Background
The term “diabesity” was coined in the early 1970s to describe the occurrence of obesity and diabetes in the same individual.17 Excessive amounts of body fat, especially abdominal (visceral) fat accumulation, is a well documented strong risk factor for insulin resistance and development of type-2 diabetes and cardiovascular disease.18-26
More and more studies are showing that testosterone deficiency contributes to development of obesity (both general and abdominal), insulin resistance, metabolic syndrome, type-2 diabetes and muscle loss. 27-32 In line with this, a growing number of intervention studies have demonstrated that TRT improves these outcomes.2, 34, 28, 33-43
Several recent 5-year long-term studies reported that TRT results in marked and significant weight (fat) loss, reduction in waist circumference and BMI, as well as improvements in blood cholesterol parameters and reductions in fasting glucose, HbA1c, CRP (in inflammatory marker) and liver enzymes
CONT:
http://www.brinkzone.com/mens-health/effects-of-6-year-long-term-testosterone-replacement-therapy-trt-in-patients-with-diabesity/#sthash.OR5uIeVd.dpuf
30 cal slut
03-25-14, 05:52
If it hasn't been mentioned on this thread before ...
Don't rely on your primary care physician to get treatment. If your PCP does a testosterone blood test, and you score on the low end of the "normal" range, you likely will still be low. Your PCP might blow that off.
If your health plan allows you to, consult a specialist - namely a male endocrinologist.
Any doc worth his salt will draw blood for several hormonal tests and do a physical exam on the boys. Maybe even an MRI of the pituitary gland.
Day 1. See how it goes. :cool:
If it hasn't been mentioned on this thread before ...
Don't rely on your primary care physician to get treatment. If your PCP does a testosterone blood test, and you score on the low end of the "normal" range, you likely will still be low. Your PCP might blow that off.
If your health plan allows you to, consult a specialist - namely a male endocrinologist.
Any doc worth his salt will draw blood for several hormonal tests and do a physical exam on the boys. Maybe even an MRI of the pituitary gland.
Day 1. See how it goes. :cool:
I don't think that's bad general advice, but I have known some solid GPs/PCPs who know their stuff on the TRT/HRT and many a specialist without a clue. You'd think endocrinologist would be a no brainer, but you'd be amazed there at the conversations I have had... I find urologists often best informed there and most willing to help.
If one can find an endocrinologist who specializes in male TRT/HRT, great, all the better.
And today (the next day); I can tell a difference in my energy levels...
Got a call from my RN after having blood drawn yesterday to check my T....was getting 150mg a week IM....due a shot today....not happening..seems my T is something like 1469 (don't remember exactly how high) but it's way way high and has thrown other levels out of whack raising em (again, do not remember exactly what all else was off, but it was several differernt ones) ...was told the Doc wanted to go to one (1) IM a month...asked to get my T checked in a couple weeks again & see how it is doing, so no IM this week or next at a minimum. Not sure what the dossage will be either, will have to wait && see the results of the next blood draw....
No idea why it shot up so high, been trying to do the Palio diet (about 80% compliant) and working out cardio more....
Heavy Metal
04-10-14, 19:56
Got my T checked after 14 weeks on. Was at 586 mid-way between my weekly shots. Shooting for 600.
Close enough.
Heavy Metal
04-10-14, 19:58
150MG? That's almost nothing! I take 500MG per week.
Got a call from my RN after having blood drawn yesterday to check my T....was getting 150mg a week IM....due a shot today....not happening..seems my T is something like 1469 (don't remember exactly how high) but it's way way high and has thrown other levels out of whack raising em (again, do not remember exactly what all else was off, but it was several differernt ones) ...was told the Doc wanted to go to one (1) IM a month...asked to get my T checked in a couple weeks again & see how it is doing, so no IM this week or next at a minimum. Not sure what the dossage will be either, will have to wait && see the results of the next blood draw....
No idea why it shot up so high, been trying to do the Palio diet (about 80% compliant) and working out cardio more....
1469, damn, i would be lifting like a madman!
seriously, would like to know what doc thinks may cause your high level. Curious to know, Did you have any other labs (? estrogen). did you notice any other side effects physical or emotional ?
Got a call from my RN after having blood drawn yesterday to check my T....was getting 150mg a week IM....due a shot today....not happening..seems my T is something like 1469 (don't remember exactly how high) but it's way way high and has thrown other levels out of whack raising em (again, do not remember exactly what all else was off, but it was several differernt ones) ...was told the Doc wanted to go to one (1) IM a month...asked to get my T checked in a couple weeks again & see how it is doing, so no IM this week or next at a minimum. Not sure what the dossage will be either, will have to wait && see the results of the next blood draw....
No idea why it shot up so high, been trying to do the Palio diet (about 80% compliant) and working out cardio more....
Likely simply a mistake of the lab. Was the test taken the day before your next shop was due?
150MG? That's almost nothing! I take 500MG per week.
500mg per week of enanthate or cypionate (the two esters of T used in the US for TRT in the US) is well above physiological replacement dose and would result in T level well above the physiological range for men, so 586 does not make sense. You found a doc that wrote a script for 500mg per week? at typical 100mg/ml, that's 5 Mls you're injecting per week. You sure on that dose?
Yes, taken the day before my next IM...
Nope, not a lab mistake, it's time for my annual physical and they drew lots of labs...my red blood cell count was up, white count was up, hematocrit was elevated and I had a couple other lab results that corallate to a elevated T level.
I even asked if the lab screwed up & they had checked & was told no.
Likely simply a mistake of the lab. Was the test taken the day before your next shop was due?
Have not noticed any change in sex drive (have lower back injury that is a large part of this) and no physical or emotional changes I can tell or the wife and kids can tell. I do have very bad mood swings and explode at the drop of a hat when low....but nothing to suggest my T was this high.
1469, damn, i would be lifting like a madman!
seriously, would like to know what doc thinks may cause your high level. Curious to know, Did you have any other labs (? estrogen). did you notice any other side effects physical or emotional ?
Yes, taken the day before my next IM...
Nope, not a lab mistake, it's time for my annual physical and they drew lots of labs...my red blood cell count was up, white count was up, hematocrit was elevated and I had a couple other lab results that corallate to a elevated T level.
I even asked if the lab screwed up & they had checked & was told no.
Those results do not indicate if it was or was not a simple lab issue BTW. If I were the doc (and I'm not, nor do I play one on TV, etc, etc), I'd have you re tested. I have seen that type of thing before, and 9 out of 10 times, on re test, was normal. However, if the test came back similar, I'd suspect other causes and do a full workup. You don't get those levels from those doses taken the day before a dose period, unless some other variable is involved, such as other meds, medical issues, etc.
Heavy Metal
04-11-14, 16:44
I may be off an zero. I am injecting a 0.5CC. 1/2 a Diabetic needle.
I may be off an zero. I am injecting a 0.5CC. 1/2 a Diabetic needle.
That's what I suspected and was leading you toward. If that's .5CC of 200mg/ml, then your numbers make sense. If that's .5CC of 100mg/ML, giving you a mere 50mg per week, I'm surprised you're able to get 500+ TT levels even mid week, but if taken the day before your shot due, I'll bet $$$ you'll be low end.
Heavy Metal
04-11-14, 18:13
That's what is is, a half CC and I took the shot on Saturday night and the blood draw was on a Thursday. I was actually a day past mid-week. I was taking my weekly shot on Saturday but I now do it on Sunday.
Lab results were checked & verified & re ran....same results..
After talking to my Doc and a Endocrinologist who was/is on the same page as my doc...stopped the IM of T......had another T taken & waiting the results...having some mood issues/anger problems again & so the T levels were drawn...I'm alo been doing Palio for about a week now...zero sodey, sugqar & such...have a 99% compliance with Palio in the last week....
Those results do not indicate if it was or was not a simple lab issue BTW. If I were the doc (and I'm not, nor do I play one on TV, etc, etc), I'd have you re tested. I have seen that type of thing before, and 9 out of 10 times, on re test, was normal. However, if the test came back similar, I'd suspect other causes and do a full workup. You don't get those levels from those doses taken the day before a dose period, unless some other variable is involved, such as other meds, medical issues, etc.
I am so freakin confused....help me out here, Will.
After finally getting on the shot schedule (1 ever three weeks, which I know you aren't that excited about), after the 2nd shot I got tested by my Urologist, I tested the morning of the third week at over 500. So that's the schedule I've been on for the last 2-3 months.
Last week, I happened to have a appointment with my regular doctor (who had previously been testing me and 2 yrs worth of androgel with no luck), on the SAME DAY I was scheduled for my next shot (week 3) with my Urologist. So, for giggles, I asked my regular doctor to test me that morning, and afterwards went to my urologist and got my shot (no test). Test results from my GP Doctor came back at 148.8. I did not also get test from Urologist same day. I wish I had.
This makes no sense to me. Testing the last day on the same dosing schedule, with that kind of difference? I know different tests give differing results, but this is not what I would have expected. Brings into doubt EVERYTHING both doctors are doing.....
I am so freakin confused....help me out here, Will.
After finally getting on the shot schedule (1 ever three weeks, which I know you aren't that excited about), after the 2nd shot I got tested by my Urologist, I tested the morning of the third week at over 500. So that's the schedule I've been on for the last 2-3 months.
Last week, I happened to have a appointment with my regular doctor (who had previously been testing me and 2 yrs worth of androgel with no luck), on the SAME DAY I was scheduled for my next shot (week 3) with my Urologist. So, for giggles, I asked my regular doctor to test me that morning, and afterwards went to my urologist and got my shot (no test). Test results from my GP Doctor came back at 148.8. I did not also get test from Urologist same day. I wish I had.
This makes no sense to me. Testing the last day on the same dosing schedule, with that kind of difference? I know different tests give differing results, but this is not what I would have expected. Brings into doubt EVERYTHING both doctors are doing.....
The second test value is more what I'd expect to see on such a dose and schedule. Over 500ng/dl after 3 weeks on that dose is what would not make sense or be expected. Could simply be a lab error or other factors. Although you wouldn't expect to see that wide a difference between an am vs pm test (typical difference is approx 30%), make sure to get tested same time to reduce possible variables, use the same lab next time you get tested. I'm betting the results will be closer to the second test vs first.
Both were AM tests same time of day on the third-week (shot day). Have forwarded new low result from GP Dr. to my Urologist for his review (and for me to ask, how could this be).
My problem is going to be that my Urologist who is now responsible for treating this, is the one that is getting the really high result...I can understand testing lab differences as discussed previously, but that large a difference is unexpected and causes doubt in EITHER results, or the treatment.
I'm going to use this to try and get Urologist to go to bi-weekly instead of tri-weekly (more in line with what you've previously discussed)....
Both were AM tests same time of day on the third-week (shot day). Have forwarded new low result from GP Dr. to my Urologist for his review (and for me to ask, how could this be).
My problem is going to be that my Urologist who is now responsible for treating this, is the one that is getting the really high result...I can understand testing lab differences as discussed previously, but that large a difference is unexpected and causes doubt in EITHER results, or the treatment.
I'm going to use this to try and get Urologist to go to bi-weekly instead of tri-weekly (more in line with what you've previously discussed)....
That second result may work in your favor then in terms of dose schedule to get steadier levels. Bi weekly is not great, but it's a big improvement to every 3 weeks...Having over 500 at week three, hard to blame him for thinking the dose schedule was working fine. However, knowing the half life/pharmacokinetics of the drug, it would have gotten a "WTF?" from me or anyone really experienced with TRT and would have it re tested with possible additional tests (which he may have already done) to see what, if anything was out of spec to expected. Free T, LH, FSH, prolactin, estradiol, etc. are all part of the clinical "big picture" to know what's going on and if something else needs to be addressed.
Just got my latest results, T is 814. The nurse said it was a little high and they might want to lower my dose. I laughed and said Noooooo! :o I feel really good at this level and it's working great Sub Q. I told here the size of the needle I was using, she was very surprised. Thanks Will!
Just got my latest results, T is 814. The nurse said it was a little high and they might want to lower my dose. I laughed and said Noooooo! :o I feel really good at this level and it's working great Sub Q. I told here the size of the needle I was using, she was very surprised. Thanks Will!
Congrats. No, that's not too high and is high "normal" where you optimally want to be as long as other labs are good. No surprise you're feeling good. On the needle size, buddy wanted to do that and his doc informs him it's not possible. Although a well meaning and intentioned doc who is doing right by my friend, he was convinced for some odd reason (and the first time I have heard either) it was not possible to use such a small needle. I literally ended going with him to the office to show this doc it's not only possible, but common among those who know how it works. Too his credit, he said he'd now be recommending the method to other patients if they were open to it. So, good on him for at least not rejecting totally as some do.
Just got my latest results, T is 814. The nurse said it was a little high and they might want to lower my dose. I laughed and said Noooooo! :o I feel really good at this level and it's working great Sub Q. I told here the size of the needle I was using, she was very surprised. Thanks Will!
LUCKY....
A better question is, "Got Toblerone?"
I have a doctors appointment today, pretty sure I tore my rotator cuff again. Not sure if it will come up with my PA. It is good to hear folks are listening. The nurse asked me how I got the T to go through the 27G needle. I laughed and told her I tried a 30G needle, I know some of you have had success, I could not get it to go, I also was not warming it up yet at that point.
I have a doctors appointment today, pretty sure I tore my rotator cuff again. Not sure if it will come up with my PA. It is good to hear folks are listening. The nurse asked me how I got the T to go through the 27G needle. I laughed and told her I tried a 30G needle, I know some of you have had success, I could not get it to go, I also was not warming it up yet at that point.
30 is just slow, but doable. There's also 29g. 27g is quite small, so if it's GTG for you, all good. Essentially no pain and no scar tissue etc.
30 cal slut
05-29-14, 11:25
Holy crap. I just got an earful from a doc friend of mine (college buddy who I just re-connected with at lunch).
He's a practicing urologist at a large hospital in a large northeastern city.
I asked him what he thought about testosterone replacement therapy. He read me the riot act.
Man, I would not go near that stuff with a 10 foot pole.
Most people who are taking it don't really NEED it. If your testicles are the size of peas (literally speaking) and your total testosterone is in the 20's, then, yes, you need the stuff to function.
However, if you're in the normal range, even at the lower end of normal, that's enough.
Guys don't realize that they are eventually going to be 100% dependent on that stuff - your nuts (his words, lol) over time are going to stop producing T altogether and they'll shrink. Then you'll REALLY need TRT.
T is an anabolic steroid and you're gonna have to deal with all sorts of bad things, like acne, stretch marks, and markedly increased risk for stroke and heart attack, in addition to the hormone dependency.
We don't really have good data from a large group of users over a long period of time that shows that T is SAFE.
We thought we had women's hormones figured out a decade ago - in hindsight, we were wrong. We're in the same boat with TRT now ... don't take any chances.
I didn't know guys could have testicles the size of peas. Some water shot out of my nose after that revelation.
Anyways, here's what he had say about alternatives:
You know, sometimes we should expect to slow down as we get older. That's a fact of life. Accept it.
Instead of injecting ourselves with dangerous hormones, we should do things to improve the quality of our life, like:
1) Get more sleep
2) Get more exercise
3) Form more meaningful relationships in our lives.
#1 and #2 I kinda agree with.
WTH does #3 mean? lmao.
Good convo.
Holy crap. I just got an earful from a doc friend of mine (college buddy who I just re-connected with at lunch).
He's a practicing urologist at a large hospital in a large northeastern city.
I asked him what he thought about testosterone replacement therapy. He read me the riot act.
I didn't know guys could have testicles the size of peas. Some water shot out of my nose after that revelation.
Anyways, here's what he had say about alternatives:
#1 and #2 I kinda agree with.
WTH does #3 mean? lmao.
Good convo.
Some of his points are correct/legit, some are completely off base/not supported by the data and tells me he's not well read on the modern literature. I'd read through this thread for more info if interested in the topic. Is there a specific comment of his you want to address or the above just FYI?
30 cal slut
05-29-14, 12:18
Will,
I'm just passing along what I heard. I wanted to post this right away while the memory of the convo was fresh.
If you look at this from the POV of SHTF, the dependency warning is interesting.
What happens if you can't get testosterone post SHTF?
Will,
I'm just passing along what I heard. I wanted to post this right away while the memory of the convo was fresh.
If you look at this from the POV of SHTF, the dependency warning is interesting.
What happens if you can't get testosterone post SHTF?
The same thing that happens with other meds you need to stay healthy when the SHTF, you either stock pile enough to last, or you run out. Does anyone not take X med they need because they may not have it if SHTF?
The dependency warning illogical: men need T to function properly on many levels, so if you're not making adequate amounts you need replacement. Does any doc tell people they should not take thyroid meds when diagnosed hypo thyroid because they may become dependent? That's illogical highly unscientific thinking and double standard many have, including some medical professionals who should know better.
Yes, replacement is generally for life.
Men who have normal production of T who add T, is another issue totally and I think he was alluding to it, but I don't agree with his assessment of that topic (from your paraphrase) and the data solidly on my side in that position.
Now who should do TRT/HRT and who should not, is open for debate and for sure, many jumping on TRT/HRT who likely don't need it and unaware of some of the potential long term complications of such choices. But, two totally different issues there.
30 cal slut
05-29-14, 15:17
Will, good to know. I was just surprised at the forcefulness of the doc.
Will, good to know. I was just surprised at the forcefulness of the doc.
I'm not. I see it all the time on various topics. Docs are human beings like the rest of us, some times with strong bias about something, some times that bias is not accurate to what the studies/data/clinical experience actually reflects, some times it does. Yes, you'd hope and expect that bias would be based on the modern supportable studies/data, or at least extensive clinical experience if counter the studies, but that's not always the case.
Just human nature regardless of education level.
Want to sniff your T? FDA just approved a nasal version. Seems like an inconvenient way to get your T, and the brain specific comments are a possible concern, but here ya go:
Trimel Pharmaceuticals Corporation announced today (May 28.2014) that the United States Food and Drug Administration (FDA) has approved Natesto (testosterone), formerly CompleoTRT, the first and only testosterone nasal gel for replacement therapy in adult males for conditions associated with a deficiency or absence of endogenous testosterone. Natesto is self-administered via a nasal applicator thereby minimizing the risk of secondary exposure to testosterone of women or children.
The product is self-administered into the nostrils via a metered-dose pump applicator. One pump actuation delivers 5.5 mg of testosterone, and the recommended dose is 11 mg (2 pump actuations, 1 in each nostril), 3 times daily (total 33 mg/day).
Bradley D. Anawalt, MD, chief of medicine at the University of Washington Medical Center, Seattle, and chair of the Hormone Health Network for the Endocrine Society, pointed to a theoretic concern, that brain testosterone levels will be much higher with intranasal testosterone gel than with other testosterone treatments. A study published in 2009 using mice showed brain levels of testosterone that were about twice as high in mice who received intranasal testosterone gel than in mice receiving intravenous testosterone. "What this finding means and whether it applies to men is unknown," he told Medscape Medical News.
Im sure to raise some debate with this statement but Its been my experience doctors opinions are sometimes based on latest research they have encountered, studies from biased pharmaceutical co. or other financialy motivated co. attempting to ultimately influence patient care. Why cure a disease (not that T is a cure) or condition when you can manage the primary disease and related comorbities over a lifetime=$$$$$. A surgeon will advise surgery even if medical management is possible. Why prescribe T when they can run a million tests and search for a problem to solve. I am fortunate to have a great relationship with my primary. I always advise people to get second and third opinions and ultimately make an informed decision based on research rather than a MD recomendation.
Heavy Metal
06-01-14, 11:02
Will, SHTF, can you go off this stuff in descending doses and return to pre-therapy levels? Will your body start making it again on its own? Just curious.
Im sure to raise some debate with this statement but Its been my experience doctors opinions are sometimes based on latest research they have encountered, studies from biased pharmaceutical co. or other financialy motivated co. attempting to ultimately influence patient care. Why cure a disease (not that T is a cure) or condition when you can manage the primary disease and related comorbities over a lifetime=$$$$$. A surgeon will advise surgery even if medical management is possible. Why prescribe T when they can run a million tests and search for a problem to solve. I am fortunate to have a great relationship with my primary. I always advise people to get second and third opinions and ultimately make an informed decision based on research rather than a MD recomendation.
Is that a general FYI/opinion statement or specific to this thread topic? If the latter, I'm not clear how it applies per se.
Will, SHTF, can you go off this stuff in descending doses and return to pre-therapy levels? Will your body start making it again on its own? Just curious.
That's actually difficult to answer. As you know, the nature of SHTF scenarios tends to include little to no warning, so the taper of dose method may not apply I'm thinking, but I'll do my best. Maybe I should write a "TRT for SHTF scenarios" guide? I bet that would be a big seller with the survivalists on TRT :cool:
In most cases, it's likely given time, yes, levels would return to pre treatment, but there's a lot of variables in there, such as why the person was on TRT (maybe they had their nads removed due to cancer for example), dose, duration of dose (longer you're on, longer time it takes to get production restored if at all), and if you have the meds known to help re start production assuming all your stuff (med name HPTA) is able to do do it.
Probably, best thing to do is store the meds* known to help restart a shut down HPTA and start those on SHTF.
Going off TRT, and then experiencing real symptoms of low T, takes a while, so another variable is, are we talking a week or so of SHTF or end of the world kinda SHTF? If the latter, well, those who needed their TRT and don't have it will be in far better shape then all sorts people (such as diabetics, etc) who will be dropping left and right. You won't diet from low T, but you'll feel like shit and it will increase your risk of various diseases, which may be a moot issue in a true SHTF scenario.
So, Store enough meds for X period of time (recommended for all meds you take/need) for a realistic SHTF time period, keep meds on hand that can re start the T production if it goes longer than expected SHTF, you'll have far bigger things to worry about (like food, water, gangs, etc) if it goes beyond that.
* = another topic for another day.
My comment is in reply to statements made by ( members refering to ) doctors to stay away from T because of the latest research they heard or read. Its also applies to healthcare i general, IMO. Managment of disease or condition is huge buisness. It seems crazy to think that taking medication to manage a deficiency would cause such harm to your health, talking physiological levels not supra-bodybuilding doses that is. Its like saying insulin would cause harm for a diabetic or levothyroxine would harm a hypothyroid pt. It would make sense to say sub therapeutic levels would cause health issues that normal levels IMO. It would benefit the healthcare industry to maintain a sick individual than a healthy one.
Heavy Metal
06-01-14, 11:51
Will, I stay a bottle ahead and one bottle will do 20 weeks. So, at a minimum, I have 20 weeks to gradually wean myself off and possibly 40.
Heavy Metal
06-01-14, 11:55
My comment is in reply to statements made by ( members refering to ) doctors to stay away from T because of the latest research they heard or read.
Once you look at this latest research, it does not apply to most of us. The problem was the blood thickening effect killing old men with already damaged hearts which couldn't pump it.
So, from that, to draw a conclusion that T replacement is always bad is idiotic and absurd.
If you are able to and pay out of pocket, and get refills on your T scripts, go back and get new updated script with a refill, and use different pharmacies. I did that and have my year supply jic.
The connection between testosterone and prostate cancer has been a confusing one, and often paradoxical. The latest article by BrinkZone.com author science writer Monica Mollica may explain why and is a must read on the topic:
Testosterone and Prostate Cancer – Bye Androgen Hypothesis, Welcome Saturation Model (http://www.brinkzone.com/mens-health/testosterone-and-prostate-cancer-bye-androgen-hypothesis-welcome-saturation-model/)
Summary/take home for those who don't wanna read the science jargon:
"The long-held belief that prostate cancer risk is related to high testosterone levels, aka the Androgen Hypothesis, is not supported by clinical data. The Saturation Model and paradigm change that it brings to old inaccurate reasoning is that testosterone has a finite ability to stimulate prostate cancer growth.
The saturation model explains the paradoxical observations that prostate tissue is sensitive to changes in testosterone levels at low concentrations, but becomes insensitive to changes in testosterone levels at higher levels. Men with high testosterone levels are not at increased risk of developing prostate cancer, low testosterone levels provide no protection against the development of prostate cancer, and some men with untreated prostate cancer have received testosterone therapy without evidence of prostate cancer progression.Current evidence shows that maximal testosterone-stimulated prostate cancer growth is achieved at low sub-optimal testosterone levels."
Holy crap. I just got an earful from a doc friend of mine (college buddy who I just re-connected with at lunch).
He's a practicing urologist at a large hospital in a large northeastern city.
I asked him what he thought about testosterone replacement therapy. He read me the riot act.
I didn't know guys could have testicles the size of peas. Some water shot out of my nose after that revelation.
Anyways, here's what he had say about alternatives:
#1 and #2 I kinda agree with.
WTH does #3 mean? lmao.
Good convo.
Interesting. I am not taking T for a little help I am taking it because w/o it I'm not making much T at all. I do not need it to live but it makes living more pleasant. With my T shots I have normal sexual function, I am interested and I can get it up. Chemo knocked out my T production. I am not taking it for an edge or to feel a little better. For me it is mainly about sexual function. With out it Cialis helped. Now with my T in a good spot I don't need Cialis. The T is waaaaay more affordable too.
Interesting. I am not taking T for a little help I am taking it because w/o it I'm not making much T at all. I do not need it to live but it makes living more pleasant. With my T shots I have normal sexual function, I am interested and I can get it up. Chemo knocked out my T production. I am not taking it for an edge or to feel a little better. For me it is mainly about sexual function. With out it Cialis helped. Now with my T in a good spot I don't need Cialis. The T is waaaaay more affordable too.
Not directed at this doc per, but it's all too common for men to go see a doc because they are tired, depressed, no libido, only to have the doc prescribe an SSRI and Cialis without even bothering to check T levels. That's improving with all the "Low T" commercials and growing TRT/HRT industry no doubt (driving men who may not need T to go get T, but that's another issue...) but it's still common for guys to be given SSRIs, Cialis, Viagra vs having their T and other hormones tested and adjusted if indicated via labs and symptoms.
I was diagnosed with low-T at like 38, but stopped the gel when I found out my wife was pregnant (to fearful to get any on her accidentally and come out with bearded daughters).
At 41, a year ago, I went on a Patch (Androgen? Androderm?) and my levels went from 180 to about 375. NOTE: the patches still felt 75-90% full after 24hrs, so I'd leave them on usually--sometimes having three or four on at once.
NOW the doctor wants to do monthly or "maybe bi-weekly" injections at the office or self-administered, but I'd PERSONALLY rather do weekly shots personally administered: I worry too much about the idea of spiking and crashing (getting angry and/or humping trees for a few days, then crying at commercials before my next injection).
I'm going in for a "baseline" test again tomorrow--I've been off the patch for about a month now (I was supposed to get the test after being off a week, but I've been too busy to get in for testing).
--
For me, I don't know if the low energy and extra belly fat are causing the low-T or vice versa. But something's gotta give, because I can't get through the day without a nap, and I'm not losing weight even though I'm eating way less...and the idea of doing anything strenuous like working out just makes me want to take another nap.
I was diagnosed with low-T at like 38, but stopped the gel when I found out my wife was pregnant (to fearful to get any on her accidentally and come out with bearded daughters).
At 41, a year ago, I went on a Patch (Androgen? Androderm?) and my levels went from 180 to about 375. NOTE: the patches still felt 75-90% full after 24hrs, so I'd leave them on usually--sometimes having three or four on at once.
NOW the doctor wants to do monthly or "maybe bi-weekly" injections at the office or self-administered, but I'd PERSONALLY rather do weekly shots personally administered: I worry too much about the idea of spiking and crashing (getting angry and/or humping trees for a few days, then crying at commercials before my next injection).
I'm going in for a "baseline" test again tomorrow--I've been off the patch for about a month now (I was supposed to get the test after being off a week, but I've been too busy to get in for testing).
--
For me, I don't know if the low energy and extra belly fat are causing the low-T or vice versa. But something's gotta give, because I can't get through the day without a nap, and I'm not losing weight even though I'm eating way less...and the idea of doing anything strenuous like working out just makes me want to take another nap.
If you read this thread and other linked in it ("Low T at 26" I recall the name) you'll find intel as to why the weekly IM is optimal using common T esters used in the US, as well other info germane to your situation.
Good luck
Yeah, I don't think the doctor would object to weekly IF I pushed it--he just seemed to imply that bi-weekly was what HE wanted me to do (with no explaining why...perhaps he just thinks it's more convenient).
There was some studies suggesting possible association between TRT and heart attacks. They were criticized for various methodology flaws, but still got media traction. Recent studies, as with many prior studies, find either no connection, or a reduced rate of CVD. The latest:
Testosterone therapy does not increase heart attack risk, study shows
Testosterone prescriptions for older men in the United States have increased more than three-fold over the past decade. Recent studies linking testosterone use with increased risk of heart attack and stroke have caused widespread concern among patients and their families. A new US-based study of more than 25,000 older men shows that testosterone therapy does not increase men's risk for heart attack.
The study, conducted by researchers at the University of Texas Medical Branch at Galveston, examined 25,420 Medicare beneficiaries 66 years or older treated with testosterone for up to eight years. It appears in the July 2 issue of the Annals of Pharmacotherapy.
"Our investigation was motivated by a growing concern, in the U.S. and internationally, that testosterone therapy increases men's risk for cardiovascular disease, specifically heart attack and stroke," said Jacques Baillargeon, UTMB associate professor of epidemiology in the Department of Preventive Medicine and Community Health and lead author of the study. "This concern has increased in the last few years based on the results of a clinical trial and two observational studies," he said. "It is important to note, however, that there is a large body of evidence that is consistent with our finding of no increased risk of heart attack associated with testosterone use."
MORE:
http://www.sciencedaily.com/releases/2014/07/140702102427.htm
For the science minded, the actual study:
Risk of Myocardial Infarction in Older Men Receiving Testosterone Therapy (http://aop.sagepub.com/content/early/2014/07/09/1060028014539918.full)
Heavy Metal
07-10-14, 09:08
My total cholesterol went down 23 points this year. I credit the T.
Sent from my iPhone using Tapatalk (http://tapatalk.com/m?id=1)
Will, I had an appointment with my Urologist yesterday (unrelated to T). While there I went ahead and discussed it with him. He also gives shots; I had originally assumed my regular doctor would have referred me to him instead of my urologist to start with. He asked a lot of questions and looked at my old test results. He talked chemestry more than medicine IMHO.
He said (paraphrasing), that my hemocrit (Red Blood Cell count) was high, which to him meant I was getting too much T, and it just looked to him that it was in my blood but my body wasn't absorbing it - and THAT was the real issue. He asked about some other testing related to absorption (didn't get the name) and I told him I didn't know and that I'd has some testing inconsistencies that didn't make sense (same day same time big differences in numbers). He also drew blood (24 hours after a shot this time) and wants me to come back in a month after he reviewed those results and my history.
My concern of course is that I've got several Dr's now looking into it, and when the step on each others toes I'm gonna have them all refuse to treat me.
Heavy Metal
07-10-14, 09:55
How can your red blood count go up if your body isn't absorbing it? That makes no sense.
Just in case anyone has forgotten the female side in this T discussion:
Low testosterone levels predict all-cause mortality and cardiovascular events in women (http://www.agelessforever.net/anti-aging-news-blog/low-testosterone-levels-predict-all-cause-mortality-and-cardiovascular-events-in-women)
A study in a large primary care patient population shows that low baseline testosterone in women aged 43-72 years is associated with increased all-cause mortality and cardiovascular events. This association was found to be largely independent of traditional risk factors, and supports the notion that the hormonal status in middle age and older women might impact morality outcomes.
The objective of the study was to determine whether baseline testosterone levels in women are associated with future overall or cardiovascular morbidity and mortality.
Methods and Study Design:
Prospective cohort study with a 4.5-year follow-up period.
From a representative sample of German primary care practices, 2914 female patients between 18 and 75 years were analyzed for the main outcome measures: cardiovascular risk factors, cardiovascular diseases, and all-cause mortality.
Results:
At baseline, the study population was aged 57.96 +/- 14.37 years with a mean body mass index (BMI) of 26.71 +/- 5.17 kg/m2.
No predictive value of total testosterone for incident cardiovascular risk factors or cardiovascular diseases was observed.
However, women with the lowest total testosterone levels, 16 ng/dl or below, had a higher risk to die of any cause or to develop a cardiovascular event within the follow-up period compared to women with higher total testosterone levels of 29-143 ng/dl.
More specifically, compared to women with the lowest total testosterone levels, higher levels (29-143 ng/dl vs. 16 ng/dl) was associated with a 38-51% lower risk of all-cause mortality and a 46% lower risk of cardiovascular events.
Conclusions:
Low baseline testosterone in women is associated with increased all-cause mortality and incident CV events independent of traditional risk factors.
So Will, what is the recommended method for a woman to boost T levels into the female norm? Finding an md who would prescribe and develop dosing for IM T, seems near impossible. All I have ever had prescribed was compounded T cream, which is a low low dose and expensive.
So Will, what is the recommended method for a woman to boost T levels into the female norm? Finding an md who would prescribe and develop dosing for IM T, seems near impossible. All I have ever had prescribed was compounded T cream, which is a low low dose and expensive.
OTC, DHEA can work for women. My article on the topic below. Med wise, I have seen docs use a combo of estradiol, progest, and T, as a compounded cream, depending on the hormonal status of the women and based on blood work. What most docs don't know and or don't appreciate, it giving with estrogenic hormones for birth control, HRT, etc crashes their T, leading to various problems such loss of libido, low mood, weight gain, etc. More progressive docs, will add a small amount of T to their hormonal testing and treatments of women
DHEA, for women:
http://www.brinkzone.com/articles/dhea-the-most-underrated-supplement-for-women/#comment-19859
Docs have me on progesterone, limited estradiol(for hrt,) levothyroxine (for Hashimoto's thyroiditis), and T cream(4 days a week). That seems to work well as HRT for symptom relief, but the T levels on last blood work were like 22, even with cream. I wish there was a gel dosing for women. I don't want to bulk up, our any of the andro side effects, but the cream doesn't seem to do much.
Docs have me on progesterone, limited estradiol(for hrt,) levothyroxine (for Hashimoto's thyroiditis), and T cream(4 days a week). That seems to work well as HRT for symptom relief, but the T levels on last blood work were like 22, even with cream. I wish there was a gel dosing for women. I don't want to bulk up, our any of the andro side effects, but the cream doesn't seem to do much.
Why not simply go to 5 days per week of the T cream and see if that bumps your T up to the high normal for women? Or see if the doc will increase the concentration of T in the cream? How are your DHEA levels?
At 5x/wk I run out of the cream too soon. They really limit how much you can receive as a woman. Thanks for the reminder on the DHEA though. I used to take it, and ran out, and forgot to reorder.
What has honestly helped most in feeling better, has been getting on the thyro meds. Hashimoto's sucks. I was just diagnosed officially with it last month based on antibody tests. If I am really unlucky, I will turn into an adult type 1 diabetic (autoimmune)...joy. Luckily I have a really good endocrinologist.
At 5x/wk I run out of the cream too soon. They really limit how much you can receive as a woman. Thanks for the reminder on the DHEA though. I used to take it, and ran out, and forgot to reorder.
What has honestly helped most in feeling better, has been getting on the thyro meds. Hashimoto's sucks. I was just diagnosed officially with it last month based on antibody tests. If I am really unlucky, I will turn into an adult type 1 diabetic (autoimmune)...joy. Luckily I have a really good endocrinologist.
Being a compounded product, can't they just increase the concentration of the T for you? Dose should be dictated by response via blood work and subjective symptoms, not arbitrary 4X per week etc.
Hypo thyroid sucks donkey nads, regardless of cause. I do have some limited but useful thyroid related info i posted on M4C a while back and on my site:
http://www.brinkzone.com/general-health/useful-info-for-those-on-thyroid-or-ssris/
Being a compounded product, can't they just increase the concentration of the T for you? Dose should be dictated by response via blood work and subjective symptoms, not arbitrary 4X per week etc.
Hypo thyroid sucks donkey nads, regardless of cause. I do have some limited but useful thyroid related info i posted on M4C a while back and on my site:
http://www.brinkzone.com/general-health/useful-info-for-those-on-thyroid-or-ssris/
It's sort of odd in my case, as the HRT & T is prescribed by the OBGyn, not the Endocrinologist (who doesn't do sex-hormone therapy). I don't see the OBGyn very often, usually just once a year, so getting dosages modded is more problematic. The thyro is done by the Endo. We just started on levo about 3mo ago, and have increased dosage to 4x/wk, .025Mg. It will be increased gradually, based on how I am feeling (better than before levo!), and bloodwork results. The Hashimoto's means I will eventually have no thyroid left that works...I am going to talk with the Endo in Sept about possibly adding a small amount of T3 into the mix. I think they will be amenable to that.
At 5x/wk I run out of the cream too soon. They really limit how much you can receive as a woman. Thanks for the reminder on the DHEA though. I used to take it, and ran out, and forgot to reorder.
What has honestly helped most in feeling better, has been getting on the thyro meds. Hashimoto's sucks. I was just diagnosed officially with it last month based on antibody tests. If I am really unlucky, I will turn into an adult type 1 diabetic (autoimmune)...joy. Luckily I have a really good endocrinologist.
My 13 year old daughter has Hashimotos....but hers is still burning itself out...
How can your red blood count go up if your body isn't absorbing it? That makes no sense.
I assume it's in my blood but not in my other parts...
Heavy Metal
07-11-14, 15:29
Blood doesn't make blood.
Sent from my iPhone using Tapatalk (http://tapatalk.com/m?id=1)
I assume it's in my blood but not in my other parts...
I recommend you get clarification on that from the doc as it's not adding up.
30 cal slut
07-21-14, 08:48
Thought you'd all would be interested in a key upcoming date to keep an eye on .
September 17, 2014: FDA’s Drug Safety and Risk Management Advisory Committee meeting jointly with the Bone, Reproductive, and Urologic Drugs Advisory Committee
Topic: Review of testosterone replacement therapy
Background:
http://www.fda.gov/Drugs/DrugSafety/ucm383904.htm?utm_source=rss&utm_medium=rss&utm_campaign=fda-evaluating-risk-of-stroke-heart-attack-and-death-with-fda-approved-testosterone-products
http://www.fda.gov/Drugs/DrugSafety/ucm383904.htm?utm_source=rss&utm_medium=rss&utm_campaign=fda-evaluating-risk-of-stroke-heart-attack-and-death-with-fda-approved-testosterone-products
Safety Announcement
[01-31-2014] The U.S. Food and Drug Administration (FDA) is investigating the risk of stroke, heart attack, and death in men taking FDA-approved testosterone products. We have been monitoring this risk and decided to reassess this safety issue based on the recent publication of two separate studies that each suggested an increased risk of cardiovascular events among groups of men prescribed testosterone therapy. We are providing this alert while we continue to evaluate the information from these studies and other available data, and will communicate our final conclusions and recommendations when the evaluation is complete.
At this time, FDA has not concluded that FDA-approved testosterone treatment increases the risk of stroke, heart attack, or death. Patients should not stop taking prescribed testosterone products without first discussing any questions or concerns with their health care professionals. Health care professionals should consider whether the benefits of FDA-approved testosterone treatment is likely to exceed the potential risks of treatment. The prescribing information in the drug labels of FDA-approved testosterone products should be followed.
Testosterone is a hormone essential to the development of male growth and masculine characteristics. Testosterone products are FDA-approved only for use in men who lack or have low testosterone levels in conjunction with an associated medical condition. Examples of these conditions include failure of the testicles to produce testosterone because of reasons such as genetic problems or chemotherapy. Other examples include problems with brain structures, called the hypothalamus and pituitary, that control the production of testosterone by the testicles.
None of the FDA-approved testosterone products are approved for use in men with low testosterone levels who lack an associated medical condition. FDA-approved testosterone formulations include the topical gel, transdermal patch, buccal system (applied to upper gum or inner cheek), and injection.
The first publication that prompted FDA to reassess the cardiovascular safety of testosterone therapy was an observational study of older men in the U.S. Veteran Affairs health system published in the Journal of the American Medical Association (JAMA) in November 2013.1 The men included in this study had low serum testosterone and were undergoing imaging of the blood vessels of the heart, called coronary angiography, to assess for coronary artery disease. Some of the men received testosterone treatment while others did not. On average, the men who entered the study were about 60 years old, and many had underlying cardiovascular disease. This study suggested a 30 percent increased risk of stroke, heart attack, and death in the group that had been prescribed testosterone therapy.
A second observational study reported an increased risk of heart attack in older men, as well as in younger men with pre-existing heart disease, who filled a prescription for testosterone therapy.2 The study reported a two-fold increase in the risk of heart attack among men aged 65 years and older in the first 90 days following the first prescription. Among younger men less than 65 years old with a pre-existing history of heart disease, the study reported a two- to three-fold increased risk of heart attack in the first 90 days following a first prescription. Younger men without a history of heart disease who filled a prescription for testosterone, however, did not have an increased risk of heart attack.
We urge health care professionals and patients to report side effects involving prescription testosterone products to the FDA MedWatch program, using the information in the "Contact FDA" box at the bottom of the page.
Thought you'd all would be interested in a key upcoming date to keep an eye on .
September 17, 2014: FDA’s Drug Safety and Risk Management Advisory Committee meeting jointly with the Bone, Reproductive, and Urologic Drugs Advisory Committee
Topic: Review of testosterone replacement therapy
Background:
http://www.fda.gov/Drugs/DrugSafety/ucm383904.htm?utm_source=rss&utm_medium=rss&utm_campaign=fda-evaluating-risk-of-stroke-heart-attack-and-death-with-fda-approved-testosterone-products
On paper, I don't think it's unreasonable for the FDA to take an enhanced look at TRT due to these studies and the current "Low T" push by pharma. Although the vast majority of data to date shows either no increased risk of heart attack, or even a decreased risk, with TRT (see OP for example), it would be irresponsible for the FDA to simply ignore those studies, which do have a number of flaws to them. As always, there's no free lunch in human biology. Risk/benefit applies, and the data strongly supports the benefits of TRT in those that have low T, far exceeds the risks. Nothing, not air, nor water, is risk free.
More info that T is a hormone that has protective effects in women also:
NEW YORK (Reuters Health) – The incidence of breast cancer in women prescribed testosterone implant treatment for symptoms of androgen deficiency is lower than in several comparison groups, according to a prospective study.
“This hormone therapy should be further investigated for the prevention and treatment of breast cancer,” the researchers suggest in their report in Maturitas online September 10.
The authors note that testosterone therapy is being prescribed increasingly for hormone deficiency in pre- and post-menopausal women, and there is evidence that androgens are breast protective.
To investigate the impact on breast cancer risk, Dr. Rebecca L. Glaser, with Wright State University Boonshoft School of Medicine in Dayton, Ohio and Dr. Constantine Dimitrakakis, at Athens University Medical School in Greece, initiated a 10-year prospective study beginning in 2008. The current report is an interim 5-year analysis of the findings.
So far, 1388 women have been accrued to the study. They were seen at the Millennium Wellness Center in Dayton, Ohio for a variety of symptoms of relative androgen deficiency, such as hot flashes, depressive mood, pre-menstrual syndrome, menstrual or migraine headaches, sexual problems, and bone loss. They received subcutaneous pellet implants of testosterone or testosterone combined with anastrozole designed to last 3 months.
The interim analysis includes 1268 participants who received more than one implant. There have been 8 cases of invasive breast cancer in this group, which translates to an incidence of 142 cases per 100,000 person-years. Among women who were consistently adherent to implant therapy, the incidence equated to 73 cases per 100,000 person-years, according to the report.
The authors compare these rates of breast cancer to age-specific SEER incidence rates (293/100,000), incidence in the placebo arm of the Women’s Health Initiative (300/100,000) and in the Million Women Study (325/100,000).
Regarding side effect, Drs. Glaser and Dimitrakakis report no adverse events attributed to testosterone therapy other than expected androgenic effects, which were reversible with lowering the dose.
They conclude, “subcutaneous T (testosterone), and subsequently, T + A (testosterone + anastrozole), has a protective effect in the breast, and prevented cancer occurrence in some cases.”
Furthermore they suggest, “It is possible that continuous, subcutaneous T + A could help prevent breast cancer in high-risk women, and recurrences in breast cancer survivors.”
SOURCE: Reduced breast cancer incidence in women treated with subcutaneous testosterone, or testosterone with anastrozole
Maturitas 2013.
- See more at: http://www.thedoctorschannel.com/view/breast-cancer-risk-lower-in-women-on-testosterone-therapy-2/collection/reuters/#sthash.w1zwocwV.dpuf
Average T levels have been dropping for decades in all sexes, and why that is, remains unclear. I suspect it's no one cause, but this recent study suggests one possible cause:
Reduced Testosterone Tied To Phthalates
Men, women and children exposed to high levels of phthalates tended to have reduced levels of testosterone in their blood compared to those with lower chemical exposure, according to a new paper in the Endocrine Society's Journal of Clinical Endocrinology&Metabolism.
Testosterone is the main sex hormone in men. It contributes to a variety of functions in both sexes, including physical growth and strength, brain function, bone density and cardiovascular health. In the last 50 years, research has identified a trend of declining testosterone in men and a rise in related health conditions, including reduced semen quality in men and genital malformations in newborn boys.
Some animal and cellular studies have found that some phthalates block the effects of testosterone on the body's organs and tissues. Researchers set out to examine whether these chemicals, which are widely used in flexible PVC plastics and personal care products, had a similar effect in humans.
"We found evidence reduced levels of circulating testosterone were associated with increased phthalate exposure in several key populations, including boys ages 6-12, and men and women ages 40-60," said one of the study's authors, John D. Meeker, MS, ScD, of the University of Michigan School of Public Health in Ann Arbor, MI. "This may have important public health implications, since low testosterone levels in young boys can negatively impact reproductive development, and in middle age can impair sexual function, libido, energy, cognitive function and bone health in men and women."
The cross-sectional study examined phthalate exposure and testosterone levels in 2,208 people who participated in the U.S. National Health and Nutrition Examination Survey, 2011-2012. Researchers analyzed urine samples to measure concentrations of 13 substances left after the body metabolizes phthalates. Each participant's testosterone level was measured using a blood sample.
Researchers found an inverse relationship between phthalate exposure and testosterone levels at various life stages. In women ages 40-60, for example, increased phthalate concentrations were associated with a 10.8 to 24 percent decline in testosterone levels. Among boys ages 6-12, increased concentrations of metabolites of a phthalate called di-(2-ethylhexyl) phthalate, or DEHP, was linked to a 24 to 34.1 percent drop in testosterone levels.
"While the study's cross-sectional design limit the conclusions we can draw, our results support the hypothesis that environmental exposure to endocrine-disrupting chemicals such as phthalates could be contributing to the trend of declining testosterone and related disorders," Meeker said. "With mounting evidence for adverse health effects, individuals and policymakers alike may want to take steps to limit human exposure to the degree possible."
CONT:
http://www.science20.com/news_articles/reduced_testosterone_tied_to_phthalates-142625
For those interested in the actual study:
Meeker JD, Ferguson KK. Urinary Phthalate Metabolites Are Associated With Decreased Serum Testosterone in Men, Women, and Children From NHANES 2011-2012. J Clin Endocrinol Metab. http://press.endocrine.org/doi/abs/10.1210/jc.2014-2555
Context: There is evidence of declining trends in T levels among men in recent decades, as well as trends in related conditions at multiple life stages and in both sexes. There is also animal and limited human evidence that exposure to phthalates, chemicals found in plastics and personal care products, is associated with reduced androgen levels and associated disorders.
Objective: To explore relationships between urinary concentrations of 13 phthalate metabolites and serum total T levels among men, women, and children when adjusting for important confounders and stratifying by sex and age (6-12, 12-20, 20-40, 40-60, and 60-80 y).
Design: A cross-sectional study. Setting: US National Health and Nutrition Examination Survey, 2011-2012. Patients or Other Participants: US general population.
Interventions: None
Main Outcome Measures: Serum total T measured by isotope dilution-liquid chromatography-tandem mass spectrometry.
Results: Multiple phthalates were associated with significantly reduced T in both sexes and in differing age groups. In females, the strongest and most consistent inverse relationships were found among women ages 40-60 years. In boys 6-12 years old, an interquartile range increase in metabolites of di-2-ethylhexyl phthalate was associated with a 29% (95% confidence interval, 6, 47) reduction in T. In adult men, the only significant or suggestive inverse associations between phthalates (metabolites of di-2-ethylhexyl phthalate and dibutyl phthalate) and T were observed among men ages 40-60 years.
Conclusions: Because T plays an important role in all life stages for both sexes, future efforts should focus on better defining these relationships and their broader impacts.
Another "T Booster" supplement bites the dust:
TRIBULUS THE "T BOOSTER"...NOT
Recent study found: "Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total testosterone."
This is my shocked face....
Tribulus terrestris versus placebo in the treatment of erectile dysfunction: A prospective, randomized, double blind study.
Actas Urol Esp. 2014 May;38(4):244-8.
Abstract
OBJECTIVES:
To evaluate the possible effects of Tribulus terrestris herbal medicine in the erectile dysfunction treatment and to quantify its potential impact on serum testosterone levels.
DESIGN AND METHODS:
Prospective, randomized, double-blind and placebo-controlled study including thirty healthy men selected from 100 patients who presented themselves spontaneously complaining of erectile dysfunction, ≥ 40 years of age, nonsmokers, not undergoing treatment for prostate cancer or erectile dysfunction, no dyslipidemia, no phosphodiesterase inhibitor use, no hormonal manipulation and, if present hypertension and/or diabetes mellitus should be controlled. International Index of Erectile Function (IIEF-5) and serum testosterone were obtained before randomization and after 30 days of study. Patients were randomized into two groups of fifteen subjects each. The study group received 800 mg of Tribulus terrestris, divided into two doses per day for thirty days and the control group received placebo administered in the same way.
RESULTS:
The groups were statistically equivalent in all aspects evaluated. The mean (SD) age was 60 (9.4) and 62.9 (7.9), P = .36 for intervention and placebo groups, respectively. Before treatment, the intervention group showed mean IIEF-5 of 13.2 (5-21) and mean total testosterone 417.1 ng/dl (270.7-548.4 ng/dl); the placebo group showed mean IIEF-5 of 11.6 (6-21) and mean total testosterone 442.7 ng/dl (301-609.1 ng/dl). After treatment, the intervention group showed mean IIEF-5 of 15.3 (5-21) and mean total testosterone 409.3 ng/dl (216.9-760.8 ng/dl); the placebo group showed mean IIEF-5 of 13.7 (6-21) and mean total testosterone 466.3 ng/dl (264.3-934.3 ng/dl). The time factor caused statistically significant changes in both groups for IIEF-5 only (P = .0004), however, there was no difference between the two groups (P = .7914).
CONCLUSIONS:
At the dose and interval studied, Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total testosterone.
http://www.ncbi.nlm.nih.gov/pubmed/24630840
Testosterone Treatment and Heart Attack Risk – New study shows testosterone treatment can actually be beneficial (http://www.brinkzone.com/anti-aging-and-hrt/testosterone-treatment-and-heart-attack-risk-new-study-shows-testosterone-treatment-can-actually-be-beneficial/)
by Monica Mollica
Testosterone therapy has been in use for more than 70 years for the treatment of hypogonadism, also called testosterone deficiency.[1] In the past 30 years there has been a growing body of scientific research demonstrating that testosterone deficiency is associated with increased body weight/adiposity/waist circumference, insulin resistance, type 2 diabetes, hypertension, inflammation, atherosclerosis and cardiovascular disease, erectile dysfunction (ED) and increased risk of mortality [2, 3]. In line with the detrimental health outcomes seen with testosterone deficiency, testosterone therapy has been shown to confer beneficial effects on multiple risk factors and risk biomarkers related to these clinical conditions.[4]
Despite these well-documented health benefits, testosterone therapy is still controversial, in large part due to a few flawed studies about potential elevated heart attack (myocardial infarction) risk with testosterone therapy. On July 2, 2014, a new study was published, demonstrating that testosterone therapy is not associated with an increased risk of heart attack, and may actually confer protection against heart attack…[5]
KEY POINTS
* Testosterone deficiency is associated with increased body weight/adiposity/waist circumference, insulin resistance, type 2 diabetes, hypertension, inflammation, atherosclerosis and cardiovascular disease, erectile dysfunction (ED) and increased risk of mortality [2].
* Testosterone therapy beneficially impacts multiple risk factors and risk biomarkers related to highly prevalent clinical conditions that are associated with testosterone deficiency.[4]
* The most recent study reported reported below demonstrates that testosterone therapy does not increase risk of heart attack, and that it actually may protect against heart attack in high-risk population.[5] This is in line with a large body of research showing beneficial effects of testosterone therapy in hypogonadal men.[4]
* Three large meta-analyses specifically focusing on identifying potential adverse effects of testosterone treatment report no significant increases in cardiovascular risk.[6-8]
* A review of all testosterone trials up to 2012 found that testosterone therapy in patients with preexisting cardiovascular conditions, the effect on disease markers has typically been either neutral or beneficial, and does not increase the incidence of cardiovascular events.[9]
Cont HERE (http://www.brinkzone.com/anti-aging-and-hrt/testosterone-treatment-and-heart-attack-risk-new-study-shows-testosterone-treatment-can-actually-be-beneficial/)
30 cal slut
09-03-14, 08:56
FDA memorandum just out ahead of September 17 Adcom meeting.
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/ReproductiveHealthDrugsAdvisoryCommittee/UCM412536.pdf
There's focus on the benefits of testosterone replacement (TRT) in those who are deficient, but what are the adverse health effects of being deficient? This latest article from Monica M covers that topic.
Adverse health effects of testosterone deficiency, aka hypogonadism, in men
Testosterone deficiency, also known as hypogonadism, is a state with sub-optimal circulating levels of testosterone concomitant with clinical signs and symptoms attributed to low physiological testosterone levels.[1-3]
Sexual dysfunction is the most commonly recognized symptom of testosterone deficiency. However, testosterone also plays a broader role in men’s health. A growing body of evidence has established associations between low testosterone levels and multiple risk factors and diseases including the metabolic syndrome, obesity, type 2 diabetes, sarcopenia, frailty, mobility limitations, osteoporosis, cognitive impairment, depression, cardiovascular disease, and reduced longevity.[3-12]
In this article I provide an overview of the detrimental impact of testosterone deficiency on a wide range of health outcomes.[13]
KEY POINTS
Cont:
http://www.brinkzone.com/anti-aging-and-hrt/adverse-health-effects-of-testosterone-deficiency-aka-hypogonadism-in-men/
30 cal slut
09-22-14, 07:32
Better stock up while you can. Highlights from recent FDA Adcom meeting:
The FDA’s Drug Safety and Risk Management Advisory Committee – meeting jointly with the FDA’s Bone, Reproductive,
and Urologic Drugs Advisory Committee – expressed concern about the safety of testosterone-replacement therapies (gels,
injections, and pellets), voting 14-1 to recommend that the drugs should be restricted to men with a related medical
condition (e.g., tumor or genetic disorder).
The panel urged the Agency to exclude normal problems related to aging – low energy, loss of libido, or other lifestyle
reasons – from the approved indications for these drugs. The panel also said the evidence of cardiovascular risk was mixed
and recommended clinical trials in men with age-related low testosterone to settle the issue.
30 cal slut
09-22-14, 07:39
More here:
http://www.cleveland.com/healthfit/index.ssf/2014/09/testosterone_replacement_thera.html
Testosterone replacement therapy comes under scrutiny; FDA advisory panel rejects new drug
By Angela Townsend, The Plain Dealer
on September 19, 2014 at 11:00 AM, updated September 19, 2014 at 11:02 AM
Concerned about the increased risk of heart attack or stroke, an advisory committee for the Food and Drug Administration on Wednesday recommended that drugs designed to boost levels of testosterone in the body should be used only by men with specific medical conditions affecting the testicles (such as a tumor, genetic condition or side effects caused by chemotherapy), and not for those who are simply being treated for the "Low T" condition.
On Thursday, the same panel voted to reject a new oral drug called Rextoro, made by Illinois-based Clarus Therapeutics, the Wall Street Journal reported.
...
Its my body and my decision to supplement with T. I should have the right to do so with my doctors script and without FDA regulations. Why not go after medication like oxycontin that's abused and causes addiction related disease and death amount users/abusers instead ?
Its my body and my decision to supplement with T. I should have the right to do so with my doctors script and without FDA regulations. Why not go after medication like oxycontin that's abused and causes addiction related disease and death amount users/abusers instead ?
They are. All scheduled medications are under intense scrutiny and the subject of new regulations.
FDA's recommendations on testosterone are just recommendations. They may change the indications, but your doctor can always prescibe it as long as he's willing to accept the risk of you suing him.
FloridaWoodsman
09-22-14, 15:02
So many studies and so much confusion. The only thing for sure is that everybody dies from something. May as well make the most of the interim period.
So many studies and so much confusion.
Vast majority of studies all saying the same thing. There's really not as much confusion as bias, agenda, and ignorance. If you take some time to read this thread, you'll be far less confused over the (supposedly) conflicting studies.
The only thing for sure is that everybody dies from something. May as well make the most of the interim period.
There's a quality vs quantity issue to be sure, and that's even giving equal weight to those who worry TRT may potentially increase rates of some diseases.
A good balanced review here for both med/sci and non readers:
REVIEW: Testosterone deficiency and replacement: Myths and realities
Can Urol Assoc J 2014;8(7-8):S145-7.
Ethan D. Grober, MD, MEd, FRCSC
Assistant Professor, Division of Urology, University of Toronto; Urologist, Mount Sinai Hospital and Women’s College Hospital, Toronto, ON
Full paper down load HERE (http://journals.sfu.ca/cuaj/index.php/journal/article/view/2309/1830)
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Giving myself .6 every 10 days . (In thighs ) All good sex mood Energy .
I get blood tested every 6 mouths from my doc,
After posting in another forum that I had put on 30 lbs of lean muscle in six months with only a proper diet (including 2-3 protein shakes a day, cutting out refined sugar and most non-fibrous carbs) and a daily multi-vitamin, I was called a liar. I fought hard (I know, who cares what internet people think, but it was annoying me) telling them that the doctor's scales don't lie but no one believed me. So... I started some Google research and learned that I had grown muscle approximately 3-4 time faster than the average human male is supposed to be able to pack on without steroids. This intrigued me so I went to an endocrinologist who told me I was actually suffering from HYPERGONADISM! Screw the low-t, I was surging with testosterone! Now I'm actually considering therapies to lower my T for health reasons. My grandfather died of a heart attack and my dad has always had arms the size of barrels. Now I know why... apparently it's an inherited condition. I feel sorry for all you low-T guys, but with the fear of prostate cancer and all of the other horrible conditions that can result from too much test, I can honestly say that I'm not sure which condition is better to be afflicted by.
EDITED TO ADD: I'm 37 years old, have an alcoholic beverage maybe a dozen times a year, and eat what my fiancee cooks me. I also eat at least 6 boiled eggs a day (sans yolk) and lots of avocado - and have been doing so for quite some time. Maybe I should stop.
After posting in another forum that I had put on 30 lbs of lean muscle in six months with only a proper diet (including 2-3 protein shakes a day, cutting out refined sugar and most non-fibrous carbs) and a daily multi-vitamin, I was called a liar. I fought hard (I know, who cares what internet people think, but it was annoying me) telling them that the doctor's scales don't lie but no one believed me. So... I started some Google research and learned that I had grown muscle approximately 3-4 time faster than the average human male is supposed to be able to pack on without steroids. This intrigued me so I went to an endocrinologist who told me I was actually suffering from HYPERGONADISM! Screw the low-t, I was surging with testosterone! Now I'm actually considering therapies to lower my T for health reasons. My grandfather died of a heart attack and my dad has always had arms the size of barrels. Now I know why... apparently it's an inherited condition. I feel sorry for all you low-T guys, but with the fear of prostate cancer and all of the other horrible conditions that can result from too much test, I can honestly say that I'm not sure which condition is better to be afflicted by.
What were your lab numbers for that diagnosis? Were other tests done? As far as CVD and prostate cancer, etc, I recommend reading through this thread for more info on that.
What were your lab numbers for that diagnosis? Were other tests done? As far as CVD and prostate cancer, etc, I recommend reading through this thread for more info on that.
I have to find the papers but my ng/dL was something like 2200. The doc asked if I was using a testosterone supplement or steroids... Nope...
I have to find the papers but my ng/dL was something like 2200. The doc asked if I was using a testosterone supplement or steroids... Nope...
2200, wow! Are follow up studies planned to see where such high levels are coming from via the hypothalamic–pituitary–gonadal axis?
2200, wow! Are follow up studies planned to see where such high levels are coming from via the hypothalamic–pituitary–gonadal axis?
I have no insurance currently (self-employed, been meaning to get a policy) and further testing would have drained my bank account so I had to put it off. This was about 4 months ago that I got tested. I definitely plan on following up as I don't want to die young.
I have no insurance currently (self-employed, been meaning to get a policy) and further testing would have drained my bank account so I had to put it off. This was about 4 months ago that I got tested. I definitely plan on following up as I don't want to die young.
That's an issue for sure. A basic total T test is not expensive, but the testing to find out where the dysregulation is in the HPTA can be very expensive, be it to see why too low (far more common) or too high. In your case, likely worth it to find out. Good luck!
That's an issue for sure. A basic total T test is not expensive, but the testing to find out where the dysregulation is in the HPTA can be very expensive, be it to see why too low (far more common) or too high. In your case, likely worth it to find out. Good luck!
Add to my paranoia why don't you? :) I plan on following up soon. After the test I became a bit of a hypochondriac and became convinced that I had an enlarged prostate since I was urinating about every hour - then after a trip to the country with a limited water supply, I realized it's probably because I drink 2+ gallons of water and at least a pot of coffee every day. Thanks for the good luck wishes. I'll post here again after I have further testing done.
Add to my paranoia why don't you? :) I plan on following up soon. After the test I became a bit of a hypochondriac and became convinced that I had an enlarged prostate since I was urinating about every hour - then after a trip to the country with a limited water supply, I realized it's probably because I drink 2+ gallons of water and at least a pot of coffee every day. Thanks for the good luck wishes. I'll post here again after I have further testing done.
Paranoia wise, read the thread. Although you're well above "normal" physiological levels, connections between CVD, prostate cancer, etc is outdated model not supported by the data and I'd take T levels too high vs too low any day personally. If you're other health metrics & risk factors of those conditions you're concerned about are GTG: lipids, BP, PSA, BMI. etc. than you likely have little to be concerned over.
I wonder if a local medical or PA school would do some sptesting on you free of charge to get a chance to learn. I know the local dental hygiene school is always looking for young children somtheyncan do their competencies. It is harder to get parents to bring kids in to school for x Rays and cleanings.
Yet more data TRT does not appear to increase risk of prostate cancer. In fact, this long term study (17 years) not only finds no association, those on TRT had slightly lower rates of prostate cancer:
Incidence of Prostate Cancer in Hypogonadal Men Receiving Testosterone Therapy: Observations from Five Year-median Follow-up of Three Registries. (http://www.ncbi.nlm.nih.gov/pubmed/24980615)
J Urol. 2014 Jun 26. pii: S0022-5347(14)03885-3. doi: 10.1016/j.juro.2014.06.071.
Haider A1, Zitzmann M2, Doros G3, Isbarn H4, Hammerer P5, Yassin A6.
Author information
Abstract
BACKGROUND:
Although there is no evidence that testosterone (T) therapy increases risk of prostate cancer (PCa), there is a paucity of long-term data.
OBJECTIVE:
To determine whether incidence of PCa is increased in hypogonadal men receiving long-term T therapy.
DESIGN, SETTING, AND PARTICIPANTS:
In three parallel, prospective, ongoing, cumulative registry studies, 1,023 hypogonadal men received T therapy. Two study cohorts were treated by urologists (since 2004), one by an academic andrology centre (since 1996). Patients were treated when total testosterone was ≤12.1 nmol/L (350 ng/dL) and symptoms of hypogonadism present. Maximal follow-up was 17 years (1996 to 2013), median follow-up five years. Mean baseline patient age in the urological settings was 58 years, in the andrology setting 41 years.
INTERVENTION(S):
Patients received T undecanoate injections in 12-week-intervals. Pre-treatment examination of the prostate and monitoring during treatment were performed. Prostate biopsies were performed according to EAU Guidelines.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:
Numbers of positive and negative biopsies were assessed. Incidence of PCa and post-prostatectomy outcomes were studied.
RESULTS AND LIMITATIONS:
A total of 11 patients were diagnosed with PCa in the two urology settings with proportions of 2.3% and 1.5%, respectively. Incidence per 10,000 patient years was 54.4 and 30.7, respectively. No PCa was reported in the Andrology Centre. Limitations are inherent in the registry design without control group.
CONCLUSIONS:
T therapy in hypogonadal men does not increase the risk of PCa. If guidelines for T therapy are properly applied, T treatment is safe in hypogonadal men.
CONCLUSIONS:
T therapy in hypogonadal men does not increase the risk of PCa. If guidelines for T therapy are properly applied, T treatment is safe in hypogonadal men.
http://www.europeanurology.com/article/S0302-2838%2813%2900843-9/fulltext/a-new-era-of-testosterone-and-prostate-cancer-from-physiology-to-clinical-implications
I have no insurance currently (self-employed, been meaning to get a policy) and further testing would have drained my bank account so I had to put it off. This was about 4 months ago that I got tested. I definitely plan on following up as I don't want to die young.
Listen, I'm not your mother, I'm just some guy on the internet.
Not having health insurance is playing with fire.
Medical Bills are the NUMBER ONE reason for bankruptcy in the US. Something happens, it is very easy to spend several hundred thousand dollars. Bad things happen to young people too.
I hope you get things figured out. Good luck.
That being said, there is often cheaper ways to get healthcare if you ask around and compare prices, get prices on cash in advance, and do one test at a time.
http://www.europeanurology.com/article/S0302-2838%2813%2900843-9/fulltext/a-new-era-of-testosterone-and-prostate-cancer-from-physiology-to-clinical-implications
So much win...
Paranoia wise, read the thread. Although you're well above "normal" physiological levels, connections between CVD, prostate cancer, etc is outdated model not supported by the data and I'd take T levels too high vs too low any day personally. If you're other health metrics & risk factors of those conditions you're concerned about are GTG: lipids, BP, PSA, BMI. etc. than you likely have little to be concerned over.
I've been reading through the thread. I feel a lot better now. Thanks. I feel great and have no health issues that I'm aware of. I checked out your website too. I've been inspired to get back into a hardcore routine to try to reach my next plateau. I've been on a maintenance regimen for the past 1.5 years. I may as well take advantage of some of this spare testosterone.
I wonder if a local medical or PA school would do some sptesting on you free of charge to get a chance to learn. I know the local dental hygiene school is always looking for young children somtheyncan do their competencies. It is harder to get parents to bring kids in to school for x Rays and cleanings.
Something to look into, thanks.
Listen, I'm not your mother, I'm just some guy on the internet.
Not having health insurance is playing with fire.
Medical Bills are the NUMBER ONE reason for bankruptcy in the US. Something happens, it is very easy to spend several hundred thousand dollars. Bad things happen to young people too.
I hope you get things figured out. Good luck.
That being said, there is often cheaper ways to get healthcare if you ask around and compare prices, get prices on cash in advance, and do one test at a time.
Don't remind me. I know this and I think about it often. If anyone could recommend a good policy, I'll look into it. Thanks.
I've been reading through the thread. I feel a lot better now. Thanks. I feel great and have no health issues that I'm aware of. I checked out your website too. I've been inspired to get back into a hardcore routine to try to reach my next plateau. I've been on a maintenance regimen for the past 1.5 years. I may as well take advantage of some of this spare testosterone.
.
I would. :cool:
Need advice. I had to change my doctor. My new MD. refered me to an endocrinologist, who's a hot 30 yo blonde hair blue eyed beauty. She wanted to know why I was on T, and why I was taking IM vs patch. I told her T patches cost 10 times as much. I told her I was symptomatic, felt like I was wearing a suit of lead on all the time and my energy and desire was gone. My T was was in the low 300s also. I don't think she believe me or cared how I felt. I also mentioned that I want my T to be in the high 800-900 range. Her reply was well lets see if we can get you off T and get to back to making your own. She wants me off t for 3 weeks and follow up with her. My serum, random T was >1500, which was 2 days after my weekly 200mg injection of T-cypionate. Btw, I have been feeling like a young 20yo man, I'm 42, I've been happy and full of energy, I'm afraid to let this go to feel like I did before my T therapy. My primary was giving me script for T, not an endocrinologist. I wanted to ask her if she does the same with diabetic or anemic patients that take insulin or epogen, stop them completely after a year of therapy to see if the start producing endogenous hormones. On top of that, after I told her I shrunk, she wanted to see my junk, and she had to get another female to cover her butt. I've been off a week, what should I do? I work so hard in the gym and feel so good, I'm afraid to loose what I worked for.
For or against testosterone replacement therapy?
Cast your vote at N Engl Journal of Medicine and join the fight for the justice of testosterone and men's health!
Poll open through Dec 3, 2014.
http://www.nejm.org/doi/full/10.1056/NEJMclde1406595
Flankenstein
11-30-14, 23:39
FOR!!
FOR!!
Vote and vote often. Poll is on the right side of the page.
http://www.nejm.org/doi/full/10.1056/NEJMclde1406595
Need advice. I had to change my doctor. My new MD. refered me to an endocrinologist, who's a hot 30 yo blonde hair blue eyed beauty. She wanted to know why I was on T, and why I was taking IM vs patch. I told her T patches cost 10 times as much. I told her I was symptomatic, felt like I was wearing a suit of lead on all the time and my energy and desire was gone. My T was was in the low 300s also. I don't think she believe me or cared how I felt. I also mentioned that I want my T to be in the high 800-900 range. Her reply was well lets see if we can get you off T and get to back to making your own. She wants me off t for 3 weeks and follow up with her. My serum, random T was >1500, which was 2 days after my weekly 200mg injection of T-cypionate. Btw, I have been feeling like a young 20yo man, I'm 42, I've been happy and full of energy, I'm afraid to let this go to feel like I did before my T therapy. My primary was giving me script for T, not an endocrinologist. I wanted to ask her if she does the same with diabetic or anemic patients that take insulin or epogen, stop them completely after a year of therapy to see if the start producing endogenous hormones. On top of that, after I told her I shrunk, she wanted to see my junk, and she had to get another female to cover her butt. I've been off a week, what should I do? I work so hard in the gym and feel so good, I'm afraid to loose what I worked for.
This is exactly what my endocrinologist also wants and I've been putting him off...but mine is not a hot blonde, and I never got the dosage you are getting.
Need advice. I had to change my doctor. My new MD. refered me to an endocrinologist, who's a hot 30 yo blonde hair blue eyed beauty. She wanted to know why I was on T, and why I was taking IM vs patch. I told her T patches cost 10 times as much. I told her I was symptomatic, felt like I was wearing a suit of lead on all the time and my energy and desire was gone. My T was was in the low 300s also. I don't think she believe me or cared how I felt. I also mentioned that I want my T to be in the high 800-900 range. Her reply was well lets see if we can get you off T and get to back to making your own.
That's fine in theory, but how does she propose to re start your HPTA production? The correct use of specific meds such as HCG and Clomid and others using the right protocol can get some normal production to return to "normal." Few docs know of these protocols nor use them sadly. The usual route by many docs, is simple cold turkey route, which for many a man, is going to be a tough and long experience in the 6 months to a year experience if their system "re boots" at all. Those are the topics/Qs you need to discuss with the doc. Depending on her responses will help you decide your next move.
She wants me off t for 3 weeks and follow up with her. My serum, random T was >1500, which was 2 days after my weekly 200mg injection of T-cypionate.
The test is supposed to be done the day before your next shot and 200mg per week is going to be on the high end of physiological replacement, hence the 1500 (I assume ng/dl) number.
Btw, I have been feeling like a young 20yo man, I'm 42, I've been happy and full of energy, I'm afraid to let this go to feel like I did before my T therapy. My primary was giving me script for T, not an endocrinologist. I wanted to ask her if she does the same with diabetic or anemic patients that take insulin or epogen, stop them completely after a year of therapy to see if the start producing endogenous hormones. On top of that, after I told her I shrunk, she wanted to see my junk, and she had to get another female to cover her butt. I've been off a week, what should I do? I work so hard in the gym and feel so good, I'm afraid to loose what I worked for.
Why did you have to change docs?
A good bump for this thread.
From the proceedings of Mayo Clinic:
Testosterone Therapy and Cardiovascular Risk: Advances and Controversies
Abraham Morgentaler, MD e al
Published Online: January 26, 2015 (In press)
Abstract
Two recent studies raised new concerns regarding cardiovascular (CV) risks with testosterone (T) therapy. This article reviews those studies as well as the extensive literature on T and CV risks. A MEDLINE search was performed for the years 1940 to August 2014 using the following key words: testosterone, androgens, human, male, cardiovascular, stroke, cerebrovascular accident, myocardial infarction, heart attack, death, and mortality. The weight and direction of evidence was evaluated and level of evidence (LOE) assigned. Only 4 articles were identified that suggested increased CV risks with T prescriptions: 2 retrospective analyses with serious methodological limitations, 1 placebo-controlled trial with few major adverse cardiac events, and 1 meta-analysis that included questionable studies and events. In contrast, several dozen studies have reported a beneficial effect of normal T levels on CV risks and mortality. Mortality and incident coronary artery disease are inversely associated with serum T concentrations (LOE IIa), as is severity of coronary artery disease (LOE IIa). Testosterone therapy is associated with reduced obesity, fat mass, and waist circumference (LOE Ib) and also improves glycemic control (LOE IIa). Mortality was reduced with T therapy in 2 retrospective studies. Several RCTs in men with coronary artery disease or heart failure reported improved function in men who received T compared with placebo. The largest meta-analysis to date revealed no increase in CV risks in men who received T and reduced CV risk among those with metabolic disease. In summary, there is no convincing evidence of increased CV risks with T therapy. On the contrary, there appears to be a strong beneficial relationship between normal T and CV health that has not yet been widely appreciated.
http://www.mayoclinicproceedings.org/article/S0025-6196%2814%2900925-2/abstract
Flankenstein
01-27-15, 12:07
Nice to see stuff like this being published. Thanks for passing along Will!
Nice to see stuff like this being published. Thanks for passing along Will!
As you can see in this thread, there's quite a bit being published, and more all the time as TRT/HRT gets more acceptance and more data showing benefits.
Flankenstein
01-27-15, 15:48
As you can see in this thread, there's quite a bit being published, and more all the time as TRT/HRT gets more acceptance and more data showing benefits.
Yea, understood. I was saying the continued publication is a good thing. Seems like we are slowly moving in the right direction towards mainstream medical acceptance. We are still pretty far away IMO though.
Yea, understood. I was saying the continued publication is a good thing. Seems like we are slowly moving in the right direction towards mainstream medical acceptance. We are still pretty far away IMO though.
True, but if anyone had told me 10 years ago there would be commercials on TV every 10 minutes for "low T" I would have smacked them. Dogma, out dated info, and negative perceptions die hard, but "no lie lives forever"
It's still very frustrating considering.
Testosterone and Fat Loss – The Evidence
by Monica Mollica
It is well documented that obesity may cause hypogonadism, and that hypogonadism may cause obesity [1-4] This has generated debate about what condition comes first; obesity or hypogonadism? And what should be the first point of intervention?
In this article I will summarize data from several reviews on the associations of hypogonadism and obesity [1-4], and make the case that these conditions create a self-perpetuating vicious circle. Once a vicious circle has been established, it doesn’t matter where one intervenes; one can either treat the obese condition or treat hypogonadism first. The critical issue is to break the vicious circle as soon as possible before irreversible health damage arises.
Nevertheless, as I will explain here, treating hypogonadism first with testosterone replacement therapy may prove to be a more effective strategy because it to a large extent “automatically” takes care of the excess body fat and metabolic derangements. In addition, treating hypogonadism first also confers psychological benefits that will help obese men become and stay more physically active.
Key Points [1-4]
• Traditional obesity treatments with diet and exercise programs are notorious for failing in long-term maintenance of weight loss due to lack of adherence. Anti-obesity drugs have limited efficacy and may not be without adverse effects.
• In the prospective Massachusetts Male Aging Study (MMAS), non-obese men who became obese had a decline of testosterone levels comparable to that of 10 years of aging.
• Testosterone deficiency and obesity each contribute independently to a self-perpetuating vicious cycle.
• Long-term testosterone therapy in men with hypogonadism improves body composition, metabolic syndrome components and quality of life, and thereby can help break the vicious cycle.
• Treatment of hypogonadism with long-term testosterone therapy, with or without lifestyle modifications, effectively treats obesity by correcting testosterone deficiency; one physiological root cause of obesity.
• In contrast to the U-shaped curve for weight loss seen with traditional obesity treatments, which are characterized by weight loss and weight regain, treatment with testosterone therapy results in a continuous reduction in obesity parameters (waist circumference, weight and BMI) for >5 years, or until metabolic abnormalities return to healthy ranges.
• The significant effectiveness of testosterone therapy in combating obesity in hypogonadal men remains largely unknown to doctors. Educational efforts are therefore critical to bring research findings into clinical practice in order to improve patient care and health outcomes.
Cont:
http://www.brinkzone.com/anti-aging-and-hrt/testosterone-and-fat-loss-the-evidence/
Will-
I had my testosterone tested last week. The Doc said low was in the 300 high was 1100. I test in the 530s, they said on the lower end of the scale I am 29 and work mid shift 12 hours. Which could be affecting my levels. Is 500 low enough that I should look to another Doctor for a boost. Would prefer 700-850 but I don’t even know if that would affect muscle and energy.
I am sure this was covered somewhere in the 65 pages but I couldnt find anything. Any thoughts would be appreciated!
Will-
I had my testosterone tested last week. The Doc said low was in the 300 high was 1100. I test in the 530s, they said on the lower end of the scale I am 29 and work mid shift 12 hours. Which could be affecting my levels. Is 500 low enough that I should look to another Doctor for a boost. Would prefer 700-850 but I don’t even know if that would affect muscle and energy.
I am sure this was covered somewhere in the 65 pages but I couldnt find anything. Any thoughts would be appreciated!
It's unlikely you'll find a doc who will put you on TRT at those levels. Do you suffer from any classic subjective symptoms of low T levels*? How about free T? Other hormones? I'm not your doc, and don't play one on TV, and know nothing of your medical history and other essential info, but I'd suggest - after discussing with your doc - get re tested in a few months and or consider a more extensive panel done to get a larger picture of your hormonal status if you're having classic symptoms of hypo gonadism, which can be caused by various things (thyroid, etc) not related to testosterone.
* = which may or may not actually be connected to your T levels.
It's unlikely you'll find a doc who will put you on TRT at those levels. Do you suffer from any classic subjective symptoms of low T levels*? How about free T? Other hormones? I'm not your doc, and don't play one on TV, and know nothing of your medical history and other essential info, but I'd suggest - after discussing with your doc - get re tested in a few months and or consider a more extensive panel done to get a larger picture of your hormonal status if you're having classic symptoms of hypo gonadism, which can be caused by various things (thyroid, etc) not related to testosterone.
* = which may or may not actually be connected to your T levels.
I don't really think I suffer from any symptoms of low T or hypo gonadism. I really think that my lack of energy comes from my work schedule and family life, both cut into my sleep big time. I remember reading that you suggest people go get it checked if they had a concerns because you cannot correct it if you don't know where you stand. I got the test free thought work but the Doctor seem annoyed by my request for a T check and a lead level reading. The doctor is part of a county employee clinc gear toward avoiding health issues and lowering the county health insurance. While I know I am not low I am certainly not on the high end either.
Anyway thanks for your time. I will go get a second check this summer.
The Doc said low was in the 300 high was 1100. I test in the 530s, they said on the lower end of the scale I am 29...
This may help. According to the chart you're like a 65 year old dude in terms of test. Also, I've read several articles stating test has been going down 20% per generation. In other words your pops had 20% more than you and his had 20% more than him.
http://i682.photobucket.com/albums/vv186/Super_2nd_Chance/test1-1.jpg
Flankenstein
02-10-15, 22:53
I've read several articles stating test has been going down 20% per generation. In other words your pops had 20% more than you and his had 20% more than him.
Society definitely supports that theory!
Flankenstein
02-10-15, 23:00
Will-
I had my testosterone tested last week. The Doc said low was in the 300 high was 1100. I test in the 530s, they said on the lower end of the scale I am 29 and work mid shift 12 hours. Which could be affecting my levels. Is 500 low enough that I should look to another Doctor for a boost. Would prefer 700-850 but I don’t even know if that would affect muscle and energy.
I am sure this was covered somewhere in the 65 pages but I couldnt find anything. Any thoughts would be appreciated!
FWIW I get tested in my trough period (6-7 days after injection) and my doc wants to see me 700-850 then which likely has me at around 1100-1200 at my peak.
I'm 30 and am prescribed 225mg/week Test Cyp, 500iu/wk hCG, and .25mg Arimidex 2x/wk.
I don't really think I suffer from any symptoms of low T or hypo gonadism. I really think that my lack of energy comes from my work schedule and family life, both cut into my sleep big time. I remember reading that you suggest people go get it checked if they had a concerns because you cannot correct it if you don't know where you stand. I got the test free thought work but the Doctor seem annoyed by my request for a T check and a lead level reading. The doctor is part of a county employee clinc gear toward avoiding health issues and lowering the county health insurance. While I know I am not low I am certainly not on the high end either.
Anyway thanks for your time. I will go get a second check this summer.
Yes, a baseline is good to have and does no harm. Next time you get tested you'll have something to compare. I'd like to see levels higher in a guy your age, but shift work, lack of sleep, etc can be hard on T levels.
FWIW I get tested in my trough period (6-7 days after injection) and my doc wants to see me 700-850 then which likely has me at around 1100-1200 at my peak.
I'm 30 and am prescribed 225mg/week Test Cyp, 500iu/wk hCG, and .25mg Arimidex 2x/wk.
That's a surprisingly aggressive doc you have there. I'd expect levels toward the upper end of the range or above on those doses. Where does your estradiol test with that dose of Arimidex? What were you pre TRT levels?
This may help. According to the chart you're like a 65 year old dude in terms of test.. . .
http://i682.photobucket.com/albums/vv186/Super_2nd_Chance/test1-1.jpg
Those numbers do not support your statement. The standard deviations are quite large, and his numbers are quite normal for his age group. Granted your sample size is quite small. Still, very unlikely a doctor would start a young guy on supplementation on with those numbers.
Flankenstein
02-11-15, 10:54
That's a surprisingly aggressive doc you have there. I'd expect levels toward the upper end of the range or above on those doses. Where does your estradiol test with that dose of Arimidex? What were you pre TRT levels?
Yes, pretty aggressive. Pre TRT T was EXTREMELY Low. I tested 50-80 a few times and then mid to high 300s twice (ng/dl).
Estradiol was at 15.8 pg/ml last time I had labs done.
Yes, pretty aggressive. Pre TRT T was EXTREMELY Low. I tested 50-80 a few times and then mid to high 300s twice (ng/dl).
Was a workup ever done in an attempt to figure out why?
Estradiol was at 15.8 pg/ml last time I had labs done.
That's a tad low, but OK. Remember, low E2 is also not good for men or women. Some suppress E2 too much thinking E2 is "bad" for men, which is not the case. Per usual, too high or too low is a negative. Men need E2 just as women do.
Flankenstein
02-11-15, 11:36
Was a workup ever done in an attempt to figure out why?
Can discuss via PM if you want. Some things I don't want on the open forum.
That's a tad low, but OK. Remember, low E2 is also not good for men or women. Some suppress E2 too much thinking E2 is "bad" for men, which is not the case. Per usual, too high or too low is a negative. Men need E2 just as women do.
Copy that.
...his numbers are quite normal for his age group.
What is "normal"? I assume most men looking at TRT are shooting for optimal and not the levels of the normal fat**** pounding down twinkies and diet coke watching American Idol.
I was looking for a nicer way to write that but I'm drawing a blank currently. Please note, I'm not trying to come off as a dick.
What is "normal"? I assume most men looking at TRT are shooting for optimal and not the levels of the normal fat**** pounding down twinkies and diet coke watching American Idol.
.
That is the issue. The range is quite wide, and if a man is 301ng/dl in a range of 300-1100* he's considered "normal" by some docs. Some will treat, some will no, and smart docs will look at both subjective symptoms and other tests in addition to TT to decide vs a single number and ignoring symptomology. The data strongly suggests the major benefits of T are found above mid normal** showing "normal" and "optimal" two very different things.
* = different labs actually use different ranges, but that's a fairly typical range
** = studies posted within this thread
...if a man is 301ng/dl in a range of 300-1100* he's considered "normal" by some docs. Some will treat, some will no, and smart docs will look at both subjective symptoms and other tests in addition to TT to decide vs a single number and ignoring symptomology...
Absolutely. If this weren't the case you wouldn't have anti-aging and T clinic spots opening up everywhere. I've read too many cases of guys having the "symptoms" of low-T being ignored by their endo or urologist and simply focusing on the person being within the "normal" limits. Then dude goes to anti-aging clinic, they look at the big picture, he gets his scrip for T and hasn't felt better since he was 20 years old.
Absolutely. If this weren't the case you wouldn't have anti-aging and T clinic spots opening up everywhere. I've read too many cases of guys having the "symptoms" of low-T being ignored by their endo or urologist and simply focusing on the person being within the "normal" limits. Then dude goes to anti-aging clinic, they look at the big picture, he gets his scrip for T and hasn't felt better since he was 20 years old.
There's some truth to that, but a big caveat to it: there's good docs out there not associated with longevity clinics who "get it" and many a longevity clinic run by total scam artists who will throw a script at you for T, GH, and other hormones/meds without even testing the person. TRT/HRT is now big $$$, so it's essential to do your due diligence. Many of the clinics often fail to explain the downsides of TRT/HRT, especially for younger men, and or, fail to manage them well. It's amazing how many young guys for example who go on TRT and no one told them their sperm count would drop to nadda for example, then be wonder why they can't have kids, etc.
The benefits of TRT/HRT for those who need it FAR out weigh the negatives, but those negatives rarely discussed when there's $$$ to be made...
Completely agree with you. I just did my annual blood work and had the doc throw TT and free T on as well. Should've done E2 but I spaced it... I'm curious to see how much mine changes from year to year. But, I also know that there are a variety of factors from exercise, diet, stress, etc. that'll affect the outcome at a given date as well.
Completely agree with you. I just did my annual blood work and had the doc throw TT and free T on as well. Should've done E2 but I spaced it... I'm curious to see how much mine changes from year to year. But, I also know that there are a variety of factors from exercise, diet, stress, etc. that'll affect the outcome at a given date as well.
That's one reason it's recommended the person get at least 3 draws over time before TRT as levels will rise and fall due to a number of factors. The most dramatic I have personally seen was a young guy I worked with who went from under 100ng/dl to over 700ng/dl once he got his stuff corrected. He was an extreme case. That's not normal and surprised me. Normally, it's a few hundred ng/dl which can make a difference to be sure.
How long in between each test would you recommend. Several of the above mentioned factors could also be contributing to my lower levels. Mainly stress and lack of sleep.
How long in between each test would you recommend. Several of the above mentioned factors could also be contributing to my lower levels. Mainly stress and lack of sleep.
Did the doc recommend retesting at some point? It's not like you have bottom of the range levels.
No, I didn't even go into see her we talk in the phone. Like I said they don't really care. Anyway she said I should go to see a urologist, " if I wanted to."
No, I didn't even go into see her we talk in the phone. Like I said they don't really care. Anyway she said I should go to see a urologist, " if I wanted to."
If your levels were terrible, I'd agree. But, 8-12 weeks would make sense to re test if you want to see what your levels are, and free T and estradiol (E2) would give a more complete picture. Obviously, if little changes on your end for those factors you feel are contributing, it's likely you will see similar numbers.
Ok I will give it 8-12 then re test to see what is going on. Thanks for your time spent replying.
What is "normal"? I assume most men looking at TRT are shooting for optimal and not the levels of the normal fat**** pounding down twinkies and diet coke watching American Idol.
I was looking for a nicer way to write that but I'm drawing a blank currently. Please note, I'm not trying to come off as a dick.
It comes down to statistics. It is assumed that there are two different populations of people. One who would benefit from TRT, and one that doesn't.
Now a perfect test could tell one from the other with no cross over. In medicine, this example of perfect tests rarely exist.
The numbers you posted are trying to find what is "normal" ranges of testosterone. You will notice the standard deviation is quite large, over one hundred. In a bell curve, 67% of a population are within one standard deviation, and 95% are within 2 standard deviation. Saying that he has the same testosterone as a 65 y/o is not accurate. He is well within one standard deviation. Now if his numbers were over 2 standard deviations away from normal, you could say with at least 95% confidence that his level of testosterone is different than the rest of the group.
Now I freely admit that if you look at the group of people who would benefit from TRT and those that would not benefit from TRT are likely a statistical distribution that overlaps significantly. Therefore it is very likely that people with "normal" numbers of testosterone would benefit from TRT, and there are those with "low" of TRT that would not benefit.
The issue is complicated that the tests themselves are not perfect, and testosterone is a cyclical hormone. Further, its become a significant pharmasutical fad. LOTS of advertisement. Lots of companies making big bucks. Lots of phycisian who are more interested in seeing lots of happy, paying patient's than following evidence. Now once you start someone on supplimentation, you are stuck supplimenting them.
There are lots of quacks in the thyroid business as well, even though those are a lot more data and most of the test are pretty good.
I guess we are lucky here in this house. I have an outstanding endocrinologist to treat my Hashimoto's Disease (autoimmune thyroiditis), and my husband has a great LNP who understands his hypogonadism and is willing to work with us in treating him with t-cyp. Home injections, with the added benefit of using weekly injections at half the dose to keep his totals more stable.
I guess we are lucky here in this house. I have an outstanding endocrinologist to treat my Hashimoto's Disease (autoimmune thyroiditis), and my husband has a great LNP who understands his hypogonadism and is willing to work with us in treating him with t-cyp. Home injections, with the added benefit of using weekly injections at half the dose to keep his totals more stable.
Sounds like your docs are on the ball. What gauge needle does he use? You can use much smaller needles than typically used, which is covered in this thread a ways back. Using small needles does take a little extra prep, but well worth it if he's using typical 1-1/2" 21g harpoons that will create scar tissue over time, etc. Easiest is 1" 25g but you can even use 1/2" 29-30g insulin needles.
I'd have to go look for sure but I think it's the 21ga 1.5". We move injection sites regularly. With the smaller insulin needles, we'd run out of them, since he is an insulin dependent diabetic. We do warm the T-cyp prior to injection. He says it helps.
I'd have to go look for sure but I think it's the 21ga 1.5". We move injection sites regularly. With the smaller insulin needles, we'd run out of them, since he is an insulin dependent diabetic. We do warm the T-cyp prior to injection. He says it helps.
If he's OK with the 1.5 21g, all good. Needles that size get old fast week after week, year after year and can hurt like SOB if hit the wrong spot, etc. Just letting you know, much smaller needles can be used, such as the 1" 25g right down to 1/2" 30g as mentioned. Many docs are not aware of the use of insulin needles to deliver TRT and default to the harpoons as SOC.
Flankenstein
02-14-15, 11:26
I'd have to go look for sure but I think it's the 21ga 1.5". We move injection sites regularly. With the smaller insulin needles, we'd run out of them, since he is an insulin dependent diabetic. We do warm the T-cyp prior to injection. He says it helps.
OUCH..no thanks for me!
If he's OK with the 1.5 21g, all good. Needles that size get old fast week after week, year after year and can hurt like SOB if hit the wrong spot, etc. Just letting you know, much smaller needles can be used, such as the 1" 25g right down to 1/2" 30g as mentioned. Many docs are not aware of the use of insulin needles to deliver TRT and default to the harpoons as SOC.
As the recipient of said "harpoon" you are spot on, some sticks just hurt like anything. What gets weird however is when the bolus of T gets injected near a nerve bundle, can cause everything from the toes to the hip to ache. Appreciate the advice on the smaller needles, will have to go to those once the conex box of harpoons we were given with the first scrip runs out.
Semper Fi
As the recipient of said "harpoon" you are spot on, some sticks just hurt like anything. What gets weird however is when the bolus of T gets injected near a nerve bundle, can cause everything from the toes to the hip to ache. Appreciate the advice on the smaller needles, will have to go to those once the conex box of harpoons we were given with the first scrip runs out.
Semper Fi
Start with 1" 25G which will help, and if you read through this thread (giving you something to while waiting for script to run out...) you'll see extensive discussion on the use of 29-30g insulin needles. Personally, I'd buy a box cash out of pocket for the smaller needles than continue the harpoon route:
http://i23.photobucket.com/albums/b374/willbrink/DSC06064.jpg (http://s23.photobucket.com/user/willbrink/media/DSC06064.jpg.html)
http://i23.photobucket.com/albums/b374/willbrink/DSC06064.jpg (http://s23.photobucket.com/user/willbrink/media/DSC06064.jpg.html)
Oooh! I have one of those! That'll be perfect!
(just kidding!)
Just had the doc do total and free test blood work, mine came in at 524 (range 241 - 827), total test was 553 a year ago. Still waiting on the free numbers.
Just had the doc do total and free test blood work, mine came in at 524 (range 241 - 827), total test was 553 a year ago. Still waiting on the free numbers.
Free T came in at 76.2 or 7.62 for the conversion.
Free T came in at 76.2 or 7.62 for the conversion.
What's the range used for the lab for FT?*
What's the range used for the lab for FT?*
Quest Labs 46 - 224.
Looking at this chart that appears low... Not sure who made it, etc. http://elitemensguide.com/testosterone-levels-by-age/
Quest Labs 46 - 224.
Looking at this chart that appears low... Not sure who made it, etc. http://elitemensguide.com/testosterone-levels-by-age/
Low normal of that range it appears yes. On that chart, my position is, I don't want good T levels for my age, I want good T levels when it was at peak for any age. That is, those of healthy 20 something male, which would be in the higher end of the physiological range. The data supports that has having the greatest benefits it seems also. So, personally, I don't pay much attention to Testosterone Levels By Age charts as they have no real utility to me. Your mileage may vary.
I'm wondering if that's low enough to consider sticking myself in the butt every week for the rest of my life... My doc at the VA is a numbskull and laughed when I even mentioned getting a blood test done so he's basically useless as far as this goes.
I'm wondering if that's low enough to consider sticking myself in the butt every week for the rest of my life... My doc at the VA is a numbskull and laughed when I even mentioned getting a blood test done so he's basically useless as far as this goes.
On paper, no. Sleep, nutrition, exercise (too little or too much), micro nutrient deficiencies (e.g., zinc, etc), various meds, and other factors can effect T levels, FT, estradiol (E2) and those are usual suspects to address when levels are good but could be better. You also have to look at lab tests in the context of subjective symptoms. I always recommend a base line of T levels for men after 40 regardless, and now you have that.
Thought you guys might appreciate this info:
Now lets figure out which oil is best to use:
Flow Rate can be derived from Poiseuille's Law: Q = ∆p π R^4 / (8 η L)
where
Q is flow rate
∆p is the pressure differential on both sides
R is the radius of the needle
η is the viscosity of the fluid
L is the length of the needle
As you can see from the equation, pressure gradients when drawing are negligible due to the small cross sectional area of the needle acting as an effective choke. I ran an experiment with different gauge syringes and our Testosterone Cypionate in Sesame Oil.
Size of Needle 25G 27G 29G 31G
Amount drawn in 1 minute 2mL 0.8mL 0.32mL 0.07mL
As the results show the amount drawn becomes exponentially smaller with a smaller gauge needle. This is due to the Radius^4 variable in our equation.
So what else does Poiseuille's law teach us? When you have a small radius changing the viscosity won't cause a huge difference in flow rates. It's the radius value that dominates the equation, not the viscosity, pressure differential or length. From this we can determine that the carrier oil wouldn't make a measurable difference in draw time.
Thought you guys might appreciate this info:
Holy over thinking it Batman! Where did you get that? Above 25g, drawing up an ML or two takes a long time and becomes quite tedious. Hence, the "trick" is to use a large g needle (20-21g) as the draw needle, and a small g needle for the injection. For some, the "sweet spot" in terms of fairly easy draw is the 25g 1" and inject using one needle only, but for those who want to go as small as possible, 29-30g 1/2", the method mentioned works best.
I had one friend who's doctor told him it was physically "impossible" to use 30g for TRT. I went to his office and showed him said "trick" and that was the end of that. He offered that option to all future men on TRT and used it himself. Docs can be extremely smart people, but creative or out of the box thinkers, not so much in my experience.
Flankenstein
03-03-15, 18:07
Holy over thinking it Batman! Where did you get that? Above 25g, drawing up an ML or two takes a long time and becomes quite tedious. Hence, the "trick" is to use a large g needle (20-21g) as the draw needle, and a small g needle for the injection. For some, the "sweet spot" in terms of fairly easy draw is the 25g 1" and inject using one needle only, but for those who want to go as small as possible, 29-30g 1/2", the method mentioned works best.
I had one friend who's doctor told him it was physically "impossible" to use 30g for TRT. I went to his office and showed him said "trick" and that was the end of that. He offered that option to all future men on TRT and used it himself. Docs can be extremely smart people, but creative or out of the box thinkers, not so much in my experience.
LOL. Yea, way too much thinking. I use an 18g to draw and 25g 1" to inject regardless of location.
As I'm sure you are aware Will, some oils are thicker than others. Yes, x2 on the lack of outside the box thinking..
Holy over thinking it Batman! Where did you get that?
One of the TRT dork forums :) The argument was going back and forth about warming up the test prior to injection, etc. and somebody with a big brain basically said it doesn't matter due to the size of the hole, blahblahblah... I just thought it was interesting.
ETA - He also recommended 29g as being the best in his opinion.
LOL. Yea, way too much thinking. I use an 18g to draw and 25g 1" to inject regardless of location.
As I'm sure you are aware Will, some oils are thicker than others. Yes, x2 on the lack of outside the box thinking..
On those thicker oils, once loaded, run the body of the syringe under hot water for minute or so. That makes the push of the plunger easier if you're having any issues. Obviously, don't let the water hit the needle as the water is not sterile.
One of the TRT dork forums :) The argument was going back and forth about warming up the test prior to injection, etc. and somebody with a big brain basically said it doesn't matter due to the size of the hole, blahblahblah... I just thought it was interesting.
ETA - He also recommended 29g as being the best in his opinion.
Simply try it and you'll see heating the oil does have an effect. Basic rule is, increasing temp increases viscosity and flow rate and it's noticeable when pushing the plunger on a very small needle. He says "When you have a small radius changing the viscosity won't cause a huge difference in flow rates."
Huge no, noticeable, yes....I'm no oil engineer and have not applied Poiseuille's law to TRT I have to admit.
29g is a good choice yes.
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