View Full Version : Got Testosterone?
Thanks. This is what fired me up.
http://i859.photobucket.com/albums/ab160/usmcvet0331/Mobile%20Uploads/th_035B235E-3D0F-4A03-A3C8-F7D675E27937_zpscfdoyo3d.png (http://s859.photobucket.com/user/usmcvet0331/media/Mobile%20Uploads/035B235E-3D0F-4A03-A3C8-F7D675E27937_zpscfdoyo3d.png.html)
HCG - Remember to keep it in the fridge.
Flankenstein
04-01-16, 15:46
Thanks. This is what fired me up.
http://i859.photobucket.com/albums/ab160/usmcvet0331/Mobile%20Uploads/th_035B235E-3D0F-4A03-A3C8-F7D675E27937_zpscfdoyo3d.png (http://s859.photobucket.com/user/usmcvet0331/media/Mobile%20Uploads/035B235E-3D0F-4A03-A3C8-F7D675E27937_zpscfdoyo3d.png.html)
Copy. I have had Rx inserts say 30, 45, and 90. Most docs and experts concur that the reconstituted solution will not lose any potency until after 90 days. Bodybuilding community kind of over hyped how fragile hCG is IMO. But I know how you feel, when you read it on the actual Rx insert (think my pregnyl or novarel said 30 days) it can fire you up for sure.
HCG - Remember to keep it in the fridge.
Yep, that too. I used to geek out about this when traveling. Come to realize it won't lose any potency even days out of the fridge.
Thanks Guys. I keep it in the fridge.
They shipped me another vial of HCG at no cost. I got my 3 month labs back and I'm frustrated.
11-06-2015
testosterone, total 502
SEX HORMONE BINDING GLOBULIN 17.5
estradiol, serum 85 pg/mL
12-12-2015
They did not run T
estradiol, serum 54 pg/mL 0-40
I changed my weekly T to .5ML twice weekly in December.
Here are my 3-31-16 Labs.
http://i859.photobucket.com/albums/ab160/usmcvet0331/T_zpsgdyl8ybq.jpg (http://s859.photobucket.com/user/usmcvet0331/media/T_zpsgdyl8ybq.jpg.html)
I have a telephone consult on the 21st. In the mean time I'm planning to up my T a bit on my own to .7 twice weekly. I will also try taking the anti E medication twice weekly on the same day as the T instead of once weekly.
I changed my weekly T to .5ML twice weekly in December.
Here are my 3-31-16 Labs.
http://i859.photobucket.com/albums/ab160/usmcvet0331/T_zpsgdyl8ybq.jpg (http://s859.photobucket.com/user/usmcvet0331/media/T_zpsgdyl8ybq.jpg.html)
I have a telephone consult on the 21st. In the mean time I'm planning to up my T a bit on my own to .7 twice weekly. I will also try taking the anti E medication twice weekly on the same day as the T instead of once weekly.
Just to clarify. Saying you use .5ml doesn't mean much. As an example: 200mg/ml @ .5ml = 100mg of testosterone VS 100mg/ml @ .5ml = 50mg of testosterone, double the amount. Also, what day are you having blood pulled? On your trough day? Meaning, the day of your shot but prior to administering it, your lowest point.
I would ask to have your FT (free testosterone) drawn as well as utilizing the estradiol ultra-sensitive test (Quest Diagnostics) versus the standard assay. The "ultra-sensitive" is the the most accurate test and should be used with men due to lower estradiol levels than the typical female.
Are you having high estrogen symptoms? If so, what are they? I would take it really easy using an aromatase inhibitor. Another thought would be to lower your dosage and do your injections every other day (EOD) to have a smoother profile overall. Less introduction of higher dosages of testosterone should result in lower estradiol levels. But, you do have to inject EOD versus twice a week... Just a few thoughts, hope they help.
Just to clarify. Saying you use .5ml doesn't mean much. As an example: 200mg/ml @ .5ml = 100mg of testosterone VS 100mg/ml @ .5ml = 50mg of testosterone, double the amount. Also, what day are you having blood pulled? On your trough day? Meaning, the day of your shot but prior to administering it, your lowest point.
I would ask to have your FT (free testosterone) drawn as well as utilizing the estradiol ultra-sensitive test (Quest Diagnostics) versus the standard assay. The "ultra-sensitive" is the the most accurate test and should be used with men due to lower estradiol levels than the typical female.
Are you having high estrogen symptoms? If so, what are they? I would take it really easy using an aromatase inhibitor. Another thought would be to lower your dosage and do your injections every other day (EOD) to have a smoother profile overall. Less introduction of higher dosages of testosterone should result in lower estradiol levels. But, you do have to inject EOD versus twice a week... Just a few thoughts, hope they help.
I think 14.4 on the labs is the free T. I'll double check. I had it drawn at 1630 the night I was doing my second weekly shot so it should have been the low point. I had symptoms when the E was 85. Sensitive nipples. No other that I remember and nothing I notice now. Every other day is a good idea.
It's 200 mg/ml Testosterone Cypionate.
yugo308guy
04-07-16, 16:40
I thought I would go ahead and update my situation for everyone. I started originally at one of the Low T Centers, I stayed with that Dr for a total of six weeks. My first injection was right after Christmas last Dec. Original numbers were 113 Total T and 2.0 Free T. After six weeks I had another blood draw and my numbers were significantly improved. Total T went up to 631 with Free T at 15.9. That blood draw was at my lowest point, weekly injections just prior to my injection. After the six weeks my Estrogen jumped way up to 65 from an original of 34, so he put me on an E blocker.
Also after that last blood draw at 6 weeks, I was able to find a Urologist who would write me scripts for weekly injections to do myself. He almost seemed to defer to my knowledge on what I wanted to do. Not that he was not knowledgable, just that he thought I sounded like I knew what I wanted. I have been self injecting .7cc on a weekly basis since. My cost has decreased significantly because I am self injecting. I was paying the Low T center $47/week now I get my prescription for $10/month!
As for the results, I have mixed feelings about it. It is not magic, it won't fix every problem in your life. What I have noticed is a huge increase in sex drive, which was not a problem for me at all in the first place, but my wife is certainly happily surprised. Also, I am much more likely to get up off the couch and go do something after a long day at work. I have been working out consistently now since Christmas, but haven't seen much in the way of weight loss, mainly because I am still eating like crap. I love food, and until I get ahold of my nutrition, I can't expect to lose much, but I am in much better general condition.
They shipped me another vial of HCG at no cost. I got my 3 month labs back and I'm frustrated.
.
I can understand the frustration, but with some minor adjustments, you'll be GTG I'd say, so just some continued tweaking will likely do the trick to get TT up, E2 down, etc.
I thought I would go ahead and update my situation for everyone. I started originally at one of the Low T Centers, I stayed with that Dr for a total of six weeks. My first injection was right after Christmas last Dec. Original numbers were 113 Total T and 2.0 Free T. After six weeks I had another blood draw and my numbers were significantly improved. Total T went up to 631 with Free T at 15.9. That blood draw was at my lowest point, weekly injections just prior to my injection. After the six weeks my Estrogen jumped way up to 65 from an original of 34, so he put me on an E blocker.
Also after that last blood draw at 6 weeks, I was able to find a Urologist who would write me scripts for weekly injections to do myself. He almost seemed to defer to my knowledge on what I wanted to do. Not that he was not knowledgable, just that he thought I sounded like I knew what I wanted. I have been self injecting .7cc on a weekly basis since. My cost has decreased significantly because I am self injecting. I was paying the Low T center $47/week now I get my prescription for $10/month!
As for the results, I have mixed feelings about it. It is not magic, it won't fix every problem in your life. What I have noticed is a huge increase in sex drive, which was not a problem for me at all in the first place, but my wife is certainly happily surprised. Also, I am much more likely to get up off the couch and go do something after a long day at work. I have been working out consistently now since Christmas, but haven't seen much in the way of weight loss, mainly because I am still eating like crap. I love food, and until I get ahold of my nutrition, I can't expect to lose much, but I am in much better general condition.
From the positive benefits you're experiencing above, and reasons for less than impressive changes in body comp explained by your own accord, not sure why your feelings would be mixed. Anyone who claims/thinks it will be magic or fix every problem in your life is delusional. I'd say time you have been on TRT and levels achieved, you're right on target effect wise: mood, energy, libido, etc. My conclusion from the above is :neo:
yugo308guy
04-07-16, 18:11
From the positive benefits you're experiencing above, and reasons for less than impressive changes in body comp explained by your own accord, not sure why your feelings would be mixed. Anyone who claims/thinks it will be magic or fix every problem in your life is delusional. I'd say time you have been on TRT and levels achieved, you're right on target effect wise: mood, energy, libido, etc. My conclusion from the above is :neo:
Lol! Thanks for calling that out. You are dead on and I guess I needed an objective eye to put things into perspective for me.
When I said mixed feelings, it didn't really have anything to do with the TRT. I'm a bit disappointed in myself and my own dedication to some of the things I'd like to see progress with in my life. I guess that's where I was going with, "it's not magic". But you're right, I am much further along than I would be if I hadn't moved forward with the TRT. Thanks for bringing that to my attention.
After the six weeks my Estrogen jumped way up to 65 from an original of 34, so he put me on an E blocker.
Also after that last blood draw at 6 weeks, I was able to find a Urologist who would write me scripts for weekly injections to do myself. He almost seemed to defer to my knowledge on what I wanted to do. Not that he was not knowledgable, just that he thought I sounded like I knew what I wanted. I have been self injecting .7cc on a weekly basis since. My cost has decreased significantly because I am self injecting. I was paying the Low T center $47/week now I get my prescription for $10/month!
I would suggest taking a look at halving your weekly dosage, into 2 injections, once every 3.5 days. That should help bring down your estradiol levels and you might be able to stop the AI (aromatase inhibitor). Estrogen follows testosterone, so the larger amount of test will incur a greater increase in estrogen through aromatase. Smaller, more frequent dosages, will help even out your levels and you'll have less of a rollercoaster ride. Hopefully you could eliminate the AI that way, or possibly EOD, if you don't mind more frequent injections.
Same thing I mentioned above... .7cc doesn't really give anyone an idea of how much testosterone that is. How many milligrams of testosterone per week is a valuable number, a cc not so much.
Like Will mentioned... All the testosterone, steroids, etc. won't do shit unless you get off the couch and start the train moving in the right direction. Be well.
Lol! Thanks for calling that out. You are dead on and I guess I needed an objective eye to put things into perspective for me.
When I said mixed feelings, it didn't really have anything to do with the TRT. I'm a bit disappointed in myself and my own dedication to some of the things I'd like to see progress with in my life. I guess that's where I was going with, "it's not magic". But you're right, I am much further along than I would be if I hadn't moved forward with the TRT. Thanks for bringing that to my attention.
All good. One step at a time man, one step at a time. You'll notice subtle but steady improvements over time and with even some effort in the exercise/nutri area, body comp improvements seem to happen in the 4-6 month and on range.
yugo308guy
04-07-16, 18:55
I would suggest taking a look at halving your weekly dosage, into 2 injections, once every 3.5 days. That should help bring down your estradiol levels and you might be able to stop the AI (aromatase inhibitor). Estrogen follows testosterone, so the larger amount of test will incur a greater increase in estrogen through aromatase. Smaller, more frequent dosages, will help even out your levels and you'll have less of a rollercoaster ride. Hopefully you could eliminate the AI that way, or possibly EOD, if you don't mind more frequent injections.
Same thing I mentioned above... .7cc doesn't really give anyone an idea of how much testosterone that is. How many milligrams of testosterone per week is a valuable number, a cc not so much.
Like Will mentioned... All the testosterone, steroids, etc. won't do shit unless you get off the couch and start the train moving in the right direction. Be well.
Sorry 150mg/week.
Sorry 150mg/week.
You may want to try 75mg 2X a week. As an example: 75mg Friday @ 7pm and Tuesday 7am.
This will help provide a more constant level of testosterone throughout the week and you should see lower estrogen levels as well. Most stuff I've read recommends waiting at least 5 to 6 weeks after a change before getting new blood work. It takes patience and I'm not very patient so I get it when people don't want to wait that long. But, in order to really dial things in you should make a change, stick with it, get blood work, record how your feeling most importantly!, and move forward from there.
29g 1/2" is the way to go in my opinion. These are great, cheap and free shipping direct from the source: https://www.easytouchstore.com/easy-touch-u-100-1cc-insulin-syringe-29g-x-12
yugo308guy
04-07-16, 19:29
You may want to try 75mg 2X a week. As an example: 75mg Friday @ 7pm and Tuesday 7am.
This will help provide a more constant level of testosterone throughout the week and you should see lower estrogen levels as well. Most stuff I've read recommends waiting at least 5 to 6 weeks after a change before getting new blood work. It takes patience and I'm not very patient so I get it when people don't want to wait that long. But, in order to really dial things in you should make a change, stick with it, get blood work, record how your feeling most importantly!, and move forward from there.
29g 1/2" is the way to go in my opinion. These are great, cheap and free shipping direct from the source: https://www.easytouchstore.com/easy-touch-u-100-1cc-insulin-syringe-29g-x-12
What about the vials? My vials come with 200mg and I have been told that they are only to be pierced once, then the remainder thrown away. Would it be safe to reuse the vial for 2 injections?
What about the vials? My vials come with 200mg and I have been told that they are only to be pierced once, then the remainder thrown away. Would it be safe to reuse the vial for 2 injections?
Nothing to worry about. Swab the top with alcohol, as you normally would, and draw out of the same vial. Many people use a multi-use 2000mg vial (200mg/ml X 10ml). The cheapest way to buy test, that I know of, is to purchase it in a 10ml vial. I know that CVS and Walgreens sell them and I would suggest using a coupon from http://www.goodrx.com to get a really good price, usually about $50 to $60.
I can understand the frustration, but with some minor adjustments, you'll be GTG I'd say, so just some continued tweaking will likely do the trick to get TT up, E2 down, etc.
I hope so. A total T of 1000 may have been too high but man I felt awesome. I want to be closer to that range again. Energy, mood and sexual function was all much better.
What about the vials? My vials come with 200mg and I have been told that they are only to be pierced once, then the remainder thrown away. Would it be safe to reuse the vial for 2 injections?
I get them the same way. For $15 I get a three month supply of the littl bottles. Under my plan the larger bottles are much more expensive. Like Irish said swab the stopper with an alcohol wipe before each use.
Flankenstein
04-08-16, 01:06
What about the vials? My vials come with 200mg and I have been told that they are only to be pierced once, then the remainder thrown away. Would it be safe to reuse the vial for 2 injections?
I have had 50ml and 100ml vials (cough.. jugs) many many times and drew everytime with an 18g... You have nothing to worry about.
Swab the stopper.
Don't go nuts with large gauge needles or you might rip a piece of the stopper out and get a floater.
Pretty much, don't be an idiot and you will be A-OK.
Just had my follow up phone consultation with Defy. This is a synopsis of the changes.
"Here are the changes we discussed for your current TRT medications:
1. Increase to Testosterone Cypionate 200mg/ml 0.4ml three times weekly (M/W/F)
2. Increase to HCG 400iu three times weekly (M/W/F)
3. Increase to Anastrozole 0.5mg/DIM 200mg three times weekly (M/W/F)
4. Cont. DHEA 25mg/Pregnenolone 50mg one before bed
We do labs again in 90 days for the Testosterone Free/Total and Estradiol and the FULL labs again in 6 months."
The question was asked if my T may have expired. I said no and double checked. My old stuff is good until 07/2017. I have three left. The stuff compounded by Tri-Coast Pharmacy is in 5ml vials with an expiration of 5/10/16. It was prescribed on 01/04/16. I call and asked why it expired so quickly when my other T had a medication expiration of over a year.
I understand my script expires after my refills but the med should last longer. Smells like BS and seems all about money. The only thing I can think is the bottles are pretty much single or two use in the 1ml size and the larger bottles are multiple use and there is a concern about the seal and sterility. Some if the things I read online indicate the shelf life is more like ten years.
1. Increase to Testosterone Cypionate 200mg/ml 0.4ml three times weekly (M/W/F)
2. Increase to HCG 400iu three times weekly (M/W/F)
3. Increase to Anastrozole 0.5mg/DIM 200mg three times weekly (M/W/F)
4. Cont. DHEA 25mg/Pregnenolone 50mg one before bed
280mg of testosterone per week? That's a hefty dosage.
Are you taking .5mg Anastrozole 3X a week? From my research, that's a really big dosage, if you are.
280mg of testosterone per week? That's a hefty dosage.
Are you taking .5mg Anastrozole 3X a week? From my research, that's a really big dosage, if you are.
Not yet. I'm supposed to start tomorrow. They want my E around 20. I'll keep an eye on how I feel.
Flankenstein
04-21-16, 17:07
280mg of testosterone per week? That's a hefty dosage.
Are you taking .5mg Anastrozole 3X a week? From my research, that's a really big dosage, if you are.
I am on 250mg Test Cyp/wk 1,000iu hCG/wk and 1.25mg letro twice a month (recently switched from .5mg arimidex 2x/wk)
I am on 250mg Test Cyp/wk 1,000iu hCG/wk and 1.25mg letro twice a month (recently switched from .5mg arimidex 2x/wk)
What are your TT, FT, and E2 levels on such high doses? The T dose is well above replacement I'd expect for labs.
Flankenstein
04-21-16, 18:07
What are your TT, FT, and E2 levels on such high doses? The T dose is well above replacement I'd expect for labs.
Uncertain. Will know shortly. My last labs I was on 225mg/wk.
http://i49.photobucket.com/albums/f291/cutt29/10.2-Lab.png
Uncertain. Will know shortly. My last labs I was on 225mg/wk.
With those labs, why would you up in dose? I'm confused. Those labs indicate, as I expected, a lower dose if TRT etc is the actual goal. If TRT is not the goal, than drive on. I didn't see them in that lab, but with T that high and E2 that low, how's your total cholesterol and LDL/HDL? I don't see a doc with any knowledge of this topic having you go from 225mg/wk to 250mg/wk.
Flankenstein
04-21-16, 18:14
Will- Have you heard of letro dosing at 2x/mo? Seems a little wonky to me for a drug with a short half life.
New doc seems to think that letro 2x/mo is a better course of action than arimidex, don't recall his reasons and I plan to ask him again and press him harder. He seemed to believe that both arimidex and aromasin had more negatives associated with them than letro. Everything else he spoke of was on point and his practice is respected so I gave him the benefit of the doubt during my initial consult/appointment.
I am plenty familiar with EOD or E3D letro dosing on high dosages of aromatising anabolics but using it twice a month as part of HRT is a foreign concept to me.
Flankenstein
04-21-16, 18:16
With those labs, why would you up in dose? I'm confused. Those labs indicate, as I expected, a lower dose if TRT etc is the actual goal. If TRT is not the goal, than drive on.
Those labs were not the reason for any switch.
In fact, those labs were a bit of an anomaly... Most labs on 225mg had me in the 800-1000 range.
Will- Have you heard of letro dosing at 2x/mo? Seems a little wonky to me for a drug with a short half life.
New doc seems to think that letro 2x/mo is a better course of action than arimidex, don't recall his reasons and I plan to ask him again and press him harder. He seemed to believe that both arimidex and aromasin had more negatives associated with them than letro. Everything else he spoke of was on point and his practice is respected so I gave him the benefit of the doubt during my initial consult/appointment.
I am plenty familiar with EOD or E3D letro dosing on high dosages of aromatising anabolics but using it twice a month as part of HRT is a foreign concept to me.
I'd have to dig a bit. I don't have much experience with letro and have not heard of that dosing schedule. Labs would indicate however that your E2 is lower than it should be.
Those labs were not the reason for any switch.
In fact, those labs were a bit of an anomaly... Most labs on 225mg had me in the 800-1000 range.
At 225mg/wk your TT was exactly what I expected to see and would be surprised to see that dose with TT in the 800-1000.
Not impossible, but very rare to see a dose above 200mg/week result in TT below 1000ng/dl etc.
Flankenstein
04-21-16, 18:47
I'd have to dig a bit. I don't have much experience with letro and have not heard of that dosing schedule. Labs would indicate however that your E2 is lower than it should be.
At 225mg/wk your TT was exactly what I expected to see and would be surprised to see that dose with TT in the 800-1000.
Not impossible, but very rare to see a dose above 200mg/week result in TT below 1000ng/dl etc.
I can go through my emails, screen shot, and post if need be. 800-1000...maybe 1100, is where I normally am. Labs taken on day 6 of a 7 day injection schedule. I have absolutely zero qualms with being in the 1400s though. In fact, I prefer it.
Uncertain. Will know shortly. My last labs I was on 225mg/wk.
Will's said pretty much everything I would have. I would add, and highly recommend, that you lower your hematocrit, now! Normally you'd want to see it be lower than 52% and anything above that is cause for action. The fastest way of accomplishing that would be either by donating blood or by lowering your testosterone dosage dramatically. High hematocrit is no joke and will lead to polycythemia. Thickening of your blood, stroke, heart attack, clotting events, and a bunch of nasty stuff.
Flankenstein
04-21-16, 18:53
Will's said pretty much everything I would have. I would add, and highly recommend, that you lower your hematocrit, now! Normally you'd want to see it be lower than 52% and anything above that is cause for action. The fastest way of accomplishing that would be either by donating blood or by lowering your testosterone dosage dramatically. High hematocrit is no joke and will lead to polycythemia. Thickening of your blood, stroke, and a bunch of nasty stuff.
Have donated blood since then but your info is not 100% accurate... There is a difference between polycythemia and erythrocytosis. I also live in the mountains at extrmley high elevation.
Have donated blood since then but your info is not 100% accurate... There is a difference between polycythemia and erythrocytosis. I also live in the mountains at extrmley high elevation.
Im open to being educated. What's not accurate about what I stated? Please explain further.
Guys is there any concern my T will be no good after 6 months? What I've read says no the life is measured in years not months.
The_crawfish
04-27-16, 17:10
As long as it's stored in a cool, dark place it will be fine for years.
Guys is there any concern my T will be no good after 6 months? What I've read says no the life is measured in years not months.
As long as it's stored in a cool, dark place it will be fine for years.
^^ That.
Thanks guys. That's what I thought. The pharmacist pissed me off !
Thread bump with some new intel of interest:
Long-term Testosterone May Decrease Cardiovascular Risk
SAN DIEGO — Long-term testosterone replacement therapy is associated with a decreased — not increased — risk for cardiovascular disease in men, according to a large population-based cohort study.
This finding "answers the controversy" fueled by recent warnings from the US Food and Drug Administration (FDA) suggesting that the opposite is true, said senior investigator Robert Nam, MD, from the Sunnybrook Health Sciences Centre in Toronto.
The study was published online May 7 in Lancet Diabetes & Endocrinology to coincide with its presentation here at the American Urological Association 2016 Annual Meeting.
On the basis of this study, "we can conclude that long-term testosterone is safe," Dr Nam told Medscape Medical News.
"We need to do further study, but with our large sample size and long follow-up, these data provide some powerful findings," he explained. "Physicians still need to individualize their recommendations to patients, but it certainly helps to address some of the controversy around testosterone."
The FDA recently required testosterone products to carry a warning about possible cardiovascular risk, as reported by Medscape Medical News. But that ruling was made on the basis of studies with a short duration of treatment, short follow-up, and no dose–response analysis, said Dr Nam.
"We weren't convinced that long-term testosterone had a detrimental effect because all the science says otherwise. That's why we wanted to look at it in a larger population with a longer duration of use," he explained.
Cont:
http://www.medscape.com/viewarticle/863125
Source:
http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2816%2900112-1/fulltext
yugo308guy
05-14-16, 13:52
Ok, so I had a bit of a teachable moment this go'round. I up'd my dose to 100mg 2x a week and just got my blood results back after this last 6 weeks. My total T was at 1500, and Free T at 48. Oops! My hematocrit was also pretty high at 53.2%.
We decided to drop my dosage down to 75mg 2x a week and check the results again in 6 weeks.
I guess I'm a bit suprised that with my number that high, I really haven't noticed a difference in the way I feel. About the only thing I have noticed is a bit of anxiety pretty consistently.
Self injections are going fine, no big deal at all. Bought the syringes online at the above referenced site, thanks for the reco. One concern I read about with these needles though is, they are 28ga 1/2" needles. I'm not hugely obese, but I am certainly not skinny. Do I need to be concerned that the needle is not long enough to get deeply enough into the muscle for best absorption?
Flankenstein
05-15-16, 17:06
Ok, so I had a bit of a teachable moment this go'round. I up'd my dose to 100mg 2x a week and just got my blood results back after this last 6 weeks. My total T was at 1500, and Free T at 48. Oops! My hematocrit was also pretty high at 53.2%.
We decided to drop my dosage down to 75mg 2x a week and check the results again in 6 weeks.
I guess I'm a bit suprised that with my number that high, I really haven't noticed a difference in the way I feel. About the only thing I have noticed is a bit of anxiety pretty consistently.
Self injections are going fine, no big deal at all. Bought the syringes online at the above referenced site, thanks for the reco. One concern I read about with these needles though is, they are 28ga 1/2" needles. I'm not hugely obese, but I am certainly not skinny. Do I need to be concerned that the needle is not long enough to get deeply enough into the muscle for best absorption?
Where are you injecting? I use a 25g 1" for all locations. If you are a little over weight and shooting glutes, I'd prob go for 1.5". Hard to really say without knowing your bf or where you're injecting.
yugo308guy
05-15-16, 17:16
Where are you injecting? I use a 25g 1" for all locations. If you are a little over weight and shooting glutes, I'd prob go for 1.5". Hard to really say without knowing your bf or where you're injecting.
Glutes.
Ok, so I had a bit of a teachable moment this go'round. I up'd my dose to 100mg 2x a week and just got my blood results back after this last 6 weeks. My total T was at 1500, and Free T at 48. Oops! My hematocrit was also pretty high at 53.2%.
We decided to drop my dosage down to 75mg 2x a week and check the results again in 6 weeks.
I guess I'm a bit suprised that with my number that high, I really haven't noticed a difference in the way I feel. About the only thing I have noticed is a bit of anxiety pretty consistently.
Self injections are going fine, no big deal at all. Bought the syringes online at the above referenced site, thanks for the reco. One concern I read about with these needles though is, they are 28ga 1/2" needles. I'm not hugely obese, but I am certainly not skinny. Do I need to be concerned that the needle is not long enough to get deeply enough into the muscle for best absorption?
Sub Q or IM both appear effective, but best to choose one or the other to avoid unpredictable levels. Without knowing your BF% and such, hard to say if you're getting IM, but most men, unless obese, are pretty lean in their thigh or shoulder. You can find sub Q instructions on line and or discuss with your doc and you may need to re test to find how sub Q impacts levels. Most not aware sub Q is fine for TRT and I posted the studies here a while ago. You'd have to be pretty lean for a glute injection to be IM with such a small needle.
Where are you injecting? I use a 25g 1" for all locations. If you are a little over weight and shooting glutes, I'd prob go for 1.5". Hard to really say without knowing your bf or where you're injecting.
I recommend going shorter and thinner vs larger and longer when ever possible and one can use very small 28-30g 1/2". It's a tad extra work, but totally worth it in terms of scar tissue, pain, etc over years of injections.
yugo308guy
05-15-16, 18:47
Sub Q or IM both appear effective, but best to choose one or the other to avoid unpredictable levels. Without knowing your BF% and such, hard to say if you're getting IM, but most men, unless obese, are pretty lean in their thigh or shoulder. You can find sub Q instructions on line and or discuss with your doc and you may need to re test to find how sub Q impacts levels. Most not aware sub Q is fine for TRT and I posted the studies here a while ago. You'd have to be pretty lean for a glute injection to be IM with such a small needle.
I recommend going shorter and thinner vs larger and longer when ever possible and one can use very small 28-30g 1/2". It's a tad extra work, but totally worth it in terms of scar tissue, pain, etc over years of injections.
Subcutaneous or intra-muscular?
Flankenstein
05-15-16, 19:04
I recommend going shorter and thinner vs larger and longer when ever possible and one can use very small 28-30g 1/2". It's a tad extra work, but totally worth it in terms of scar tissue, pain, etc over years of injections.
I went shorter and thinner for a while. After plenty of experimentation I personally prefer 1" 25g in the glutes, rotate sides each week. Some scar tissue, not much, I can live with it.
Glutes.
Lower outer quad with a 29g works great.
My local PA referred me to the local endocrinologist. I was hopeful this would be a productive appointment. It was not. She told me to drop the HCG and ANASTROZOLE/DIM 0.5MG/200MG. She actually recoiled when I told her I was taking HCG & Anastrozole/Dim an mentioned osteoporosis.
Well my free and total T went up a little. They did not test for E, I am betting that went up, my SHBG went down. I'm not feeling as well as I did six months ago. I told the doc I felt great when I was over 800. She said the goal is to get a patient to the mid range not the high end of the spectrum.
6-13-2016
hemoglobin, blood 16.4 g/dL 13.7-17.5
hematocrit, blood 47.6 % 36.0-52.0
testosterone, total 548 ng/dL 241-827
SEX HORMONE BINDING GLOBULIN 14.5 17.3-65.8
Free T 16.9 ng/dl 5.0-21.0
3-31-2016
testosterone, total 512 ng/dL 241-827
SEX HORMONE BINDING GLOBULIN 18.3 17.3-65.8
Free T 14.4 ng/dl 5.0-21.0
estradiol, serum 63 pg/mL 0-40
Subcutaneous or intra-muscular?
Either is fine as long as you're consistent with which you choose.
I went shorter and thinner for a while. After plenty of experimentation I personally prefer 1" 25g in the glutes, rotate sides each week. Some scar tissue, not much, I can live with it.
How long have you been doing it? If you have "some" scar tissue now, 5, 10, 20 years you may be problematic.
My local PA referred me to the local endocrinologist. I was hopeful this would be a productive appointment. It was not.
I have met a doc in ME who seems GTG. If you're willing to make the trip, he may be a solid option. If he can get you all squared away, I'd say worth the drive. He has offices in FL and ME. Feel free to tell him I sent you. See:
http://agemanagementcenter.com/dr-bedecs-anti-aging-doctor/
Flankenstein
06-16-16, 15:30
How long have you been doing it? If you have "some" scar tissue now, 5, 10, 20 years you may be problematic.
10 years.
10 years.
If it's working for you over 10 years, drive on. Thin and small as possible is what I tend to recommend, but many use what you use.
Any tips for getting my crit down without bleeding?
I have met a doc in ME who seems GTG. If you're willing to make the trip, he may be a solid option. If he can get you all squared away, I'd say worth the drive. He has offices in FL and ME. Feel free to tell him I sent you. See:
http://agemanagementcenter.com/dr-bedecs-anti-aging-doctor/
Thanks Will I will reach out. The over the phone doc isn't doing it for me. They're legit but seem more interested in the business end of things. Not that that's a bad thing just not working great for me.
Thanks Will I will reach out. The over the phone doc isn't doing it for me. They're legit but seem more interested in the business end of things. Not that that's a bad thing just not working great for me.
I don't know him that well, but my discussion on the phone suggested a switched on doc and I may look into his FL office.
Any tips for getting my crit down without bleeding?
Dose, type, and schedule? Blood work for TT, FT, E2, etc?
I worked with a guy who had low test levels. He was 47. He was constantly having sex with this chic after work, enjoyed lifting weights, and was pretty darn fit for 47, and not in a scrawny/skinny way, but with decent muscle-mass. Honestly, if I am him when I'm 47, I'd be cool with it. NONE of the symptoms one associates with low test, but his test was so low it hardly registered, so to speak when his lab-work was done. Just a singular datapoint, but you may have little to no symptoms, apparently.
Any tips for getting my crit down without bleeding?
Are you hydrated?
Do you have sleep apnea?
There could be a number of reasons your Hct is elevated that may warrant further investigation
I worked with a guy who had low test levels. He was 47. He was constantly having sex with this chic after work, enjoyed lifting weights, and was pretty darn fit for 47, and not in a scrawny/skinny way, but with decent muscle-mass. Honestly, if I am him when I'm 47, I'd be cool with it. NONE of the symptoms one associates with low test, but his test was so low it hardly registered, so to speak when his lab-work was done. Just a singular datapoint, but you may have little to no symptoms, apparently.
That's why symptoms have to be viewed with blood work. Many docs don't. We are more than blood work and HRT/TRT doc worth a damn will track symptoms and subjective responses.
That's why symptoms have to be viewed with blood work. Many docs don't. We are more than blood work and HRT/TRT doc worth a damn will track symptoms and subjective responses.
Agreed. Typically, men lose 1% of their test. production per year, after 30, at least, per my books.
She said the goal is to get a patient to the mid range not the high end of the spectrum...
Did you ask why? Anyone running blood work and not obtaining your e2 levels should automatically be suspect. I'd drop her in a heartbeat.
Did you ask why? Anyone running blood work and not obtaining your e2 levels should automatically be suspect. I'd drop her in a heartbeat.
I'm no endocrinologist, but higher test levels are linked to a host of disorder and disease.
I'm no endocrinologist, but higher test levels are linked to a host of disorder and disease.
Supraphysiological levels over long periods of time, yes. Please reference which disorders and diseases you're referring to along with what you consider "higher test levels" so we can continue the conversation. I'm genuinely curious.
Most people are reading and referencing old, antiquated myths, and not the most current research, science, and modern medicine, and the benefits of having higher test levels.
Stuck at work so I may not be able to respond til later. I appreciate the discourse.
I'm no endocrinologist, but higher test levels are linked to a host of disorder and disease.
I'm not aware of any such modern studies. Data suggests T levels in the higher normal physiological range (above 500ng/dl) is correlated to most benefits. I have posted a number of them here. It's astounding how many medical professionals (who should at least take time to be up on the lit if making medical decisions on that very topic) and even text books, etc will make such blanket statements without and data to support it. There's a general hormaphobia in this country among many who should know better. Two, clinical experience and symptology also strongly indicates levels in the upper normal range superior, and that's not even covering what is often totally ignored, such as E2...
More data is needed here, but what does exist, does not generally support being focused on keeping levels in the middle of the range. It's more about the practioners personal comfort levels than any data driven decision.
Supraphysiological levels over long periods of time, yes. Please reference which disorders and diseases you're referring to along with what you consider "higher test levels" so we can continue the conversation. I'm genuinely curious.
Most people are reading and referencing old, antiquated myths, and not the most current research, science, and modern medicine, and the benefits of having higher test levels.
Stuck at work so I may not be able to respond til later. I appreciate the discourse.
http://www.usatoday.com/story/news/nation/2013/11/05/testosterone-heart-attacks/3448543/
http://www.health.harvard.edu/heart-health/testosterone-and-the-heart
http://www.ncbi.nlm.nih.gov/pubmed/2029601
http://med.stanford.edu/news/all-news/2013/12/in-men-high-testosterone-can-mean-weakened-immune-response-study-finds.html
Like I said, I am not an endocrinologist, but have read and seen numerous studies which link high testosterone levels in animals and humans to many negative outcomes. You would have to find someone who has delved further into it to give you an answer of "what levels begin to exhibit these problems..."
http://www.usatoday.com/story/news/nation/2013/11/05/testosterone-heart-attacks/3448543/
http://www.health.harvard.edu/heart-health/testosterone-and-the-heart
http://www.ncbi.nlm.nih.gov/pubmed/2029601
http://med.stanford.edu/news/all-news/2013/12/in-men-high-testosterone-can-mean-weakened-immune-response-study-finds.html
Like I said, I am not an endocrinologist, but have read and seen numerous studies which link high testosterone levels in animals and humans to many negative outcomes. You would have to find someone who has delved further into it to give you an answer of "what levels begin to exhibit these problems..."
One study is from 1991 about testosterone and aggression. Simply put, antiquated, out dated, and disproven. The same thing goes with the heart problems. The latest studies have disproven those findings as junk and to be disregarded. I'm off the grid for the weekend but I'll post up the latest and greatest come Monday if Will or someone else doesn't post them.
One study is from 1991 about testosterone and aggression. Simply put, antiquated, out dated, and disproven. The same thing goes with the heart problems. The latest studies have disproven those findings as junk and to be disregarded. I'm off the grid for the weekend but I'll post up the latest and greatest come Monday if Will or someone else doesn't post them.
Thanks! As I said, that is not my area of expertise, and I would be happy to learn about current/accurate data on this issue. Thanks again!
http://www.usatoday.com/story/news/nation/2013/11/05/testosterone-heart-attacks/3448543/
http://www.health.harvard.edu/heart-health/testosterone-and-the-heart
http://www.ncbi.nlm.nih.gov/pubmed/2029601
http://med.stanford.edu/news/all-news/2013/12/in-men-high-testosterone-can-mean-weakened-immune-response-study-finds.html
Like I said, I am not an endocrinologist, but have read and seen numerous studies which link high testosterone levels in animals and humans to many negative outcomes. You would have to find someone who has delved further into it to give you an answer of "what levels begin to exhibit these problems..."
What you posted above is actually a good example of what I am talking about. See also:
http://www.brinkzone.com/anti-aging-and-hrt/testosterone-treatment-and-heart-attack-risk-new-study-shows-testosterone-treatment-can-actually-be-beneficial/
Anyway, you can ignore a large portion of what you read out there sadly.
An important thread bump. None of it's news per se for those who follow the data and or have extensive clinical experience, but the source is important here and summarizes the various issues surrounding testosterone deficiency (TD) well:
From the recent Mayo Clinic Proceedings report via Abraham Morgentaler - Director of Men's Health Boston and an Associate Clinical Professor of Urology at Beth Israel Deaconess Medical Center and Harvard Medical School.MD and chairman of the consensus conference:
After examining the best available scientific evidence, Morgentaler and colleagues—who included experts with specialties in urology, endocrinology, diabetes, internal medicine, and basic science research—agreed on the following:
TD is a well-established, clinically significant medical condition that negatively affects male sexuality, reproduction, general health and quality of life.
Symptoms and signs of TD occur as a result of low levels of testosterone and may benefit from treatment regardless of whether there is an identified underlying origin.
TD is a global public health concern.
Testosterone therapy for men with TD is effective, rational, and evidence-based.
There is no testosterone concentration threshold that reliably distinguishes those who will respond to treatment from those who will not.
There is no scientific basis for any age-specific recommendations against the use of testosterone therapy in adult males.
The evidence does not support increased risks of cardiovascular events with testosterone therapy.
The evidence does not support increased risk of prostate cancer with testosterone therapy.
The evidence supports a major research initiative to explore possible benefits of testosterone therapy for cardiometabolic disease, including diabetes.
Cont:
http://medicalxpress.com/news/2016-06-experts-strong-stance-testosterone-deficiency.html
Heads up I went from using Nipro 23 ga to a Exel 23 ga.
The Exel must be sharper I can hardly feel it going in to my mid
thigh . The nipro seem to sting more .
Flankenstein
06-23-16, 14:36
BD all the way for me.
yugo308guy
06-23-16, 21:10
Heads up I went from using Nipro 23 ga to a Exel 23 ga.
The Exel must be sharper I can hardly feel it going in to my mid
thigh . The nipro seem to sting more .
Can you post a link to where you purchased?
New article via BZ that's useful for both those on TRT/HRT and clinicians looking to better understand it:
"Testosterone Deficiency and Treatment – the FACTS (http://www.brinkzone.com/anti-aging-and-hrt/testosterone-deficiency-and-treatment-the-facts/)" Monica Mollica
Testosterone deficiency and treatment is a very misunderstood and controversial topic, both among scientists, regulatory agencies (such as the FDA and EMA), doctors and the popular media.
October 1, 2015, an international expert consensus conference about testosterone deficiency and its treatment was held in Prague, sponsored by King’s College London and the International Society for the Study of the Aging Male (ISSAM). The impetus for this meeting was to address the widespread misinformation and confusion about testosterone deficiency and testosterone therapy.[1]
The ultimate goal of this consensus conference was to document what is true or untrue about testosterone deficiency and testosterone therapy, to the best degree possible based on existing scientific and clinical evidence.
There were 18 experts from 11 countries on 4 continents. Specialties included urology, endocrinology, internal medicine, diabetology, and basic science research. Experts were invited on the basis of extensive clinical experience with testosterone deficiency and its treatment and/or research experience.
The final consensus on several key issues related to testosterone therapy was published in the form of 9 resolutions – i.e. facts – coupled with expert comments [2], which I summarize here….
Cont: HERE (http://www.brinkzone.com/anti-aging-and-hrt/testosterone-deficiency-and-treatment-the-facts/)
Thanks Will I will reach out. The over the phone doc isn't doing it for me. They're legit but seem more interested in the business end of things. Not that that's a bad thing just not working great for me.
Just got a call back from the doctors office. I can not afford him. The initial consultation sheet is $795 and there is monthly fee of $225 that includes all medication needed, T, HCG, DHEA, E Blocker and supplies.
I've been taking my E blocker for two weeks now, after the first few days it working. In the past I never took more than a pill a week, it make me feel like crap. I will need to confirm with blood work in a few weeks but things are working better.
Just got a call back from the doctors office. I can not afford him. The initial consultation sheet is $795 and there is monthly fee of $225 that includes all medication needed, T, HCG, DHEA, E Blocker and supplies.
I've been taking my E blocker for two weeks now, after the first few days it working. In the past I never took more than a pill a week, it make me feel like crap. I will need to confirm with blood work in a few weeks but things are working better.
Rgr rgr. Being all squared away, and a doc you don't have to fight with, and all your meds covered for $225 per month actually seems a good deal to me, so you might wanna make that happen if/when you can. Unfortunately, most of the forward thinking docs who "get it" are cash only as the insurance companies fight them tooth and nail and make sure it's just not worth it to take ins. Good old insurance companies, who who'd rather pay for the far more expensive diseases associated with low T and other hormones not optimized than the dead cheap (comparatively) treatment of TRT/HRT.
Will I agree it's a fair price. I don't blame them asking for cash. I expected it. I have to make some home repairs causing water damage and my extra cash is going there for now. The deck need to come off so I can repair a rotten sill plate, floor joists a door and floor. Even doing the demo myself it's still going to eat up my savings. Recently divorced and making it work but with three kids on one salary I do not have the $695 right now.
Dose, type, and schedule? Blood work for TT, FT, E2, etc?
I'll request a copy next time labs are drawn. Crit is down to 44.6, so I think the elevation was from the T. I get all of mine from the needle thanks to a tumor that stops FSH and several other goodies.
turnburglar
07-19-16, 14:29
Hey Will,
Sorry I haven't been able to read through the entire thread: if this question has already been asked. I saw in your original post that 600mg/week is a safe does for a male with healthy T levels. My question is this: "are there any benefits to a male with healthy T levels, taking a T supplement: for healing from physical injuries?"
I'm in my mid twenties, 8%BF and juice often, and am in the process of converting to a mostly vegan diet. I lift 3-4 days a week. I got my L5/S1 punched pretty hard by steel doing GWOT things and haven't felt right since. The VA docs did a MRI and concluded that I have a bulge in the disk, and have tried cortisone injections, PT, and chiropractic, but none of that has helped me long term. For pain relief the best things I have found has been actually weight lifting and heating up a sock filled with oatmeal.
Hey Will,
Sorry I haven't been able to read through the entire thread: if this question has already been asked. I saw in your original post that 600mg/week is a safe does for a male with healthy T levels. My question is this: "are there any benefits to a male with healthy T levels, taking a T supplement: for healing from physical injuries?"
Absolutely not a TRT dose. That's well into athletic/bbing doses and not a dose I'd ever recommend to a man with healthy T levels. You may be taking something out of context. OTC T "boosters" are a waste of $ as a rule. I cover them HERE (http://www.brinkzone.com/articles/the-facts-on-testosterone-boosting-supplements/) with some updates on the main BZ site if you look at the topic sections on the site. For some levity I made this:
https://www.youtube.com/watch?v=9XynJxCYg7Y
I'm in my mid twenties, 8%BF and juice often, and am in the process of converting to a mostly vegan diet. I lift 3-4 days a week. I got my L5/S1 punched pretty hard by steel doing GWOT things and haven't felt right since. The VA docs did a MRI and concluded that I have a bulge in the disk, and have tried cortisone injections, PT, and chiropractic, but none of that has helped me long term. For pain relief the best things I have found has been actually weight lifting and heating up a sock filled with oatmeal.
I have posted a fair amount here on back related stuff and possible use of hormones for connective tissue related issues here you'll turn up on a search. Also Look under the "Injuries" under topics on the main site for addition discussions.
Good luck!
The_crawfish
07-20-16, 09:50
I was looking for where will recommended 600mg/wk on TRT...knew I wouldn't be able to find that!! ����
I was looking for where will recommended 600mg/wk on TRT...knew I wouldn't be able to find that!! ����
There was a study that gave men 600mg per week and didn't find overt toxicity in the time period of the study, and I may have mentioned that here, but it's way above any TRT/HRT dose that's for sure.
Mr. Goodtimes
07-20-16, 20:47
There was a study that gave men 600mg per week and didn't find overt toxicity in the time period of the study, and I may have mentioned that here, but it's way above any TRT/HRT dose that's for sure.
Out of curiosity, how long was the study? 600mg/wk is a hefty dose and I would be interested in how long this is sustainable for? 600mg/wk for life would be awesome.
Sent from my iPhone using Tapatalk
Out of curiosity, how long was the study? 600mg/wk is a hefty dose and I would be interested in how long this is sustainable for? 600mg/wk for life would be awesome.
If memory serves, I think 12 weeks, but I'd have to look.
Well, the VA took me off T the end of March to see if my body would reset itself and in 6+ weeks take labs and then see a VA Endocrinologist. Up to this point I was getting 200mg of T every 2 weeks & my last T prior to stopping the IM's was TESTOSTERONE 386.51 ng/dL (range of test 241-827)
Lab work the Endocrinologist ordered in July was TESTOSTERONE 175.54 Low ng/dL 241-827, TESTOSTERONE, FREE 4.6 PG/ML, FERRITIN 253.2 ng/mL 8.0-388.0, IRON 97 ug/dL 50.0-175.0, PROLACTIN 9.0 ng/mL 2.5-17.4, TIBC 279 ug/dL 250-450, LUTEINIZING HORMONE 3.4 mIU/mL and FSH 3.8 mIU/mL 2-18, HCT 49.1 % 39.4-51.8 (live at 6k feet asl) and HGB 16.4 g/dL 13.1-17.8
Saw the Endocrinologist as well as a resident Endocrinologist last week and was told I'm fat (no shit, trying to eat healthy and smaller portions) and have sleep apena & can't tolerate CPAP/BiPap (well documented on home oxygen at night due to not tolerating the blower motor) taking 5/325 percocet for pain management due to L4/5/S1 Fusion 14 April 16 and that the narcotic lowers T, that my lab values are not really very low & that giving me IM of T would make sleep apena worse.
They do not want to start me on any T and said if/when I go to T it should be a gel as that is better for sleep apena even if it does not raise your levels like the shot would. Plus according to the VA my T is not low enough to do IM's now and the VA requires a 2nd low T to support the 1st low T since they treat lab valuse and not the person or the symptoms (I have all the classical signs of low T from no sex drive to mood swings, lack of energy, depression on top of my PTSD) and that since the last low T I had was in Sept of 15 (TESTOSTERONE 122.88 Low ng/dL 241-827) they wanted a current 2nd test as the body could jump start itself and my hormonal system could be working better and possibly bring it up higher.
Was told to wait till Nov, have labs drawn again and then see the Endocrinologist for a follow up.
Now I know the VA treats numbers, that's all they really care about and a pharmacist can over rule the Endocrinologist if the numbers do not match up with what the MD/DO says unless they have lots and lots of documentation and justification and that's very very rare the Doctor goes against the pharmacist.
My question is, is it better to wait till Nov and see what the lab results say or try and get a 2nd consult with a non VAMC associated Endocrinologist and see what they have to say?
Well, the VA took me off T the end of March to see if my body would reset itself and in 6+ weeks take labs and then see a VA Endocrinologist. Up to this point I was getting 200mg of T every 2 weeks & my last T prior to stopping the IM's was TESTOSTERONE 386.51 ng/dL (range of test 241-827)
Lab work the Endocrinologist ordered in July was TESTOSTERONE 175.54 Low ng/dL 241-827, TESTOSTERONE, FREE 4.6 PG/ML, FERRITIN 253.2 ng/mL 8.0-388.0, IRON 97 ug/dL 50.0-175.0, PROLACTIN 9.0 ng/mL 2.5-17.4, TIBC 279 ug/dL 250-450, LUTEINIZING HORMONE 3.4 mIU/mL and FSH 3.8 mIU/mL 2-18, HCT 49.1 % 39.4-51.8 (live at 6k feet asl) and HGB 16.4 g/dL 13.1-17.8
Saw the Endocrinologist as well as a resident Endocrinologist last week and was told I'm fat (no shit, trying to eat healthy and smaller portions) and have sleep apena & can't tolerate CPAP/BiPap (well documented on home oxygen at night due to not tolerating the blower motor) taking 5/325 percocet for pain management due to L4/5/S1 Fusion 14 April 16 and that the narcotic lowers T, that my lab values are not really very low & that giving me IM of T would make sleep apena worse.
They do not want to start me on any T and said if/when I go to T it should be a gel as that is better for sleep apena even if it does not raise your levels like the shot would. Plus according to the VA my T is not low enough to do IM's now and the VA requires a 2nd low T to support the 1st low T since they treat lab valuse and not the person or the symptoms (I have all the classical signs of low T from no sex drive to mood swings, lack of energy, depression on top of my PTSD) and that since the last low T I had was in Sept of 15 (TESTOSTERONE 122.88 Low ng/dL 241-827) they wanted a current 2nd test as the body could jump start itself and my hormonal system could be working better and possibly bring it up higher.
Was told to wait till Nov, have labs drawn again and then see the Endocrinologist for a follow up.
Now I know the VA treats numbers, that's all they really care about and a pharmacist can over rule the Endocrinologist if the numbers do not match up with what the MD/DO says unless they have lots and lots of documentation and justification and that's very very rare the Doctor goes against the pharmacist.
My question is, is it better to wait till Nov and see what the lab results say or try and get a 2nd consult with a non VAMC associated Endocrinologist and see what they have to say?
I'm not clear how anyone can really answer that Q but you. What do you wanna do? Obviously there are docs with far more experience and knowledge than who you're working with. Two, too many variables to answer such a Q, such as age, length of time on TRT, exercise, diet, bodyfat, etc. Long term goals, other tests and pre existing medical issues and so forth.
If you don't like the direction the docs are going, discuss with them and or seek alternative treatment options. It's a long thread, but obviously worth reading as it's full of studies, links, advice, etc, that would arm you with an intel dump to know what you want/need and it's only your long term well being at stake man.
Whether your own system rebounds depends on a number of factors, such what caused the low T in the first place, length of time on TRT, and so forth. Low T sucks, and is a negative for your health.
I'm not clear how anyone can really answer that Q but you. What do you wanna do? Obviously there are docs with far more experience and knowledge than who you're working with. Two, too many variables to answer such a Q, such as age, length of time on TRT, exercise, diet, bodyfat, etc. Long term goals, other tests and pre existing medical issues and so forth.
If you don't like the direction the docs are going, discuss with them and or seek alternative treatment options. It's a long thread, but obviously worth reading as it's full of studies, links, advice, etc, that would arm you with an intel dump to know what you want/need and it's only your long term well being at stake man.
Whether your own system rebounds depends on a number of factors, such what caused the low T in the first place, length of time on TRT, and so forth. Low T sucks, and is a negative for your health.
I'm 54, went on the patch about 5 1/3 years ago, them gel & then the shot for about 4 years as patch/gel were not bringing my T up very much. Since going on T have had 3 back surgeries and the last one was in Apr & it was a 2 level fusion. in PT now and trying to exercise more, but limited due to pain levels and not being able to take NSAID's thanks to the VA pushing them instead of surgery....
If I had to guess I'd say that my low T is directly related to military service, lack of sleep, poor diet, lots of working out/PT and almost zero recovery time & really poor sleep habits/lack of sleep. Not wanting the world handed to me, just help me help myself, the wife and I are having problems with me not having any sex drive, my piss poor attitude, getting depressed and saying to hell with it along with mood swings and blowing up at the drop of the hat.
I've given up pain meds, have not taken any narcs since seeing the doc & it hurts, always hurting at a 6 or 7 but can deal with that to a large extent if it helps the T and such.
Really don't know what I "want" other than to loose the weight, feel somewhat better, stop the mood swings and it would be nice to have a libido of some kind...
Oh, this is the Doc I saw....
http://www.cudoctors.com/Find_A_Doctor/Profile/20135
Well, the VA took me off T the end of March to see if my body would reset itself and in 6+ weeks take labs and then see a VA Endocrinologist...
Reset itself? You've smoked your own testosterone production via exogenous testosterone. If you wanted to attempt a restart of your own natural production I would suggest looking at Clomid for a start. I'm in a jam for time but can expand on this later if you want... Your testicles aren't going to just magically start up production again and whatever wingnut is suggesting that is a clueless twit.
I'm 54, went on the patch about 5 1/3 years ago, them gel & then the shot for about 4 years as patch/gel were not bringing my T up very much. Since going on T have had 3 back surgeries and the last one was in Apr & it was a 2 level fusion. in PT now and trying to exercise more, but limited due to pain levels and not being able to take NSAID's thanks to the VA pushing them instead of surgery....
If I had to guess I'd say that my low T is directly related to military service, lack of sleep, poor diet, lots of working out/PT and almost zero recovery time & really poor sleep habits/lack of sleep. Not wanting the world handed to me, just help me help myself, the wife and I are having problems with me not having any sex drive, my piss poor attitude, getting depressed and saying to hell with it along with mood swings and blowing up at the drop of the hat.
I've given up pain meds, have not taken any narcs since seeing the doc & it hurts, always hurting at a 6 or 7 but can deal with that to a large extent if it helps the T and such.
Really don't know what I "want" other than to loose the weight, feel somewhat better, stop the mood swings and it would be nice to have a libido of some kind...
Oh, this is the Doc I saw....
Considering age, length of time you were on TRT, and the other factors you mention, (1) It's doubtful your levels will rebound to where you - vs the doc - will want them in my opinion and (2) I'm unaware of a legit reason you shouldn't be on TRT, with obvious caveats I don't know your medical history, etc.
There are meds that can help reboot the HPTA, but few docs are aware of them and how to employ them for those uses and cold turkey all they tend to know.
Did they offer a medical reason you shouldn't be on TRT? If not, then say make it clear if they can't give a legit medical reason (as we already know low T associated with a variety of negatives for a man...) than ask firmly but politely why they will not put you back on. "Just cuz" is not an answer BTW, yet it's not uncommon sadly.
It's not impossible with weight loss, exercise, improved diet, stress management (a very underrated cause of low T) etc, there may be some solid rebound.
I'd read this thread also. You'll see lots of intel on topicals vs IM, or sub Q, dosing schedule (yours is typical and sub par) and so forth.
If you can do it via another doc willing to work with you, if it were me, I'd seek another doc if this one unable to supply a medically based reason at your age, etc you should not be on TRT. Be warned, you may have to pay out of pocket and it's difficult to find a doc who "gets" it with TRT/HRT as countless will tell you.
Reset itself? You've smoked your own testosterone production via exogenous testosterone. If you wanted to attempt a restart of your own natural production I would suggest looking at Clomid for a start. I'm in a jam for time but can expand on this later if you want... Your testicles aren't going to just magically start up production again and whatever wingnut is suggesting that is a clueless twit.
I've been told that it's possible now by 2 different Endocrinologist's & that's why they want me to stop the injections and then wait, the 1st one said 3 months the 2nd one said 6 months.
I've asked a 3rd Endocrinologist I knew at one point if that was true and she said yes it's possible, but did not go into details.
Reset itself? You've smoked your own testosterone production via exogenous testosterone. If you wanted to attempt a restart of your own natural production I would suggest looking at Clomid for a start. I'm in a jam for time but can expand on this later if you want... Your testicles aren't going to just magically start up production again and whatever wingnut is suggesting that is a clueless twit.
That's not completely true, but factors such as length of suppression, age, etc are essential factors. Young healthy men given T can and do see a rebound but it can take a long time and as you point out, meds such as Clomid and others can greatly shorten that refractory period if used correctly. I have known plenty of athletes who were on various AAS and did rebound given enough time. I also know some who were on doses and lengths of time they can't and are TRT for life even as youngish guys. Each case is unique and no black/white answer exist. I agree from what he's telling us, a rebound not vert likely and more importantly, why shouldn't he be on TRT? I have backed a number of docs into a corner on these discussions and they usually ended up with the medical equivalent of "just cuz"
The problem is, I know the data far better than they do as a rule and have the sci/med background to talk the lingo, so "just cuz" as in "just cuz I'm a medical doctor you shouldn't question me" does not work for me.
There's great docs out there, you just have to find them.
Considering age, length of time you were on TRT, and the other factors you mention, (1) It's doubtful your levels will rebound to where you - vs the doc - will want them in my opinion and (2) I'm unaware of a legit reason you shouldn't be on TRT, with obvious caveats I don't know your medical history, etc.
There are meds that can help reboot the HPTA, but few docs are aware of them and how to employ them for those uses and cold turkey all they tend to know.
Did they offer a medical reason you shouldn't be on TRT? If not, then say make it clear if they can't give a legit medical reason (as we already know low T associated with a variety of negatives for a man...) than ask firmly but politely why they will not put you back on. "Just cuz" is not an answer BTW, yet it's not uncommon sadly.
It's not impossible with weight loss, exercise, improved diet, stress management (a very underrated cause of low T) etc, there may be some solid rebound.
I'd read this thread also. You'll see lots of intel on topicals vs IM, or sub Q, dosing schedule (yours is typical and sub par) and so forth.
If you can do it via another doc willing to work with you, if it were me, I'd seek another doc if this one unable to supply a medically based reason at your age, etc you should not be on TRT. Be warned, you may have to pay out of pocket and it's difficult to find a doc who "gets" it with TRT/HRT as countless will tell you.
From what I understand they would not put me on T right now for 2 "reasons" the untreated sleep apena and that my numbers were not low enough to justify it & I needed a 2nd level to validate the 1st low due to Veterans Health Administration regulations for dosing testosterone.
Thus the blood work in Nov and the return to the Endocrinologist
The VA does not treat the person, the VA treats the numbers is how it came across, but then again this is socialized medicine at it's finest.
I've got private health insurance and can ask for a referral if I can find a good quality Doctor that understands TRT/HRT in the Denver Colorado/Front Range region.
I've been told that it's possible now by 2 different Endocrinologist's & that's why they want me to stop the injections and then wait, the 1st one said 3 months the 2nd one said 6 months.
I've asked a 3rd Endocrinologist I knew at one point if that was true and she said yes it's possible, but did not go into details.
Anything is possible. Probable is the issue here and why? I have published several reviews and position papers by some of the most prestigious medical groups who conclude there's no real downsides to TRT (increased risk of prostate cancer, etc etc, all debunked) and the benefits far outweigh the risks. So the Q for me is, what benefit does a guy in his mid 50s get who has been on TRT for years benefit from attempting this reboot? You may want to track down the last one I posted a few pages back, print it, and hand it to them as docs only have so much time in the day to keep up with info.
Some times the person wants to get off, some times there's a medical reason (which can usually be fixed, but moving on) but in your case, what is the medical benefits to you by going off? There is none I'm aware of, but you need to ask them why. If they cant supply a satisfactory response the why of it, then you may need to seek another doc.
From what I understand they would not put me on T right now for 2 "reasons" the untreated sleep apena
And that may be a legit reason. Losing weight more than anything you can do would likely help but the sleep apena and T connection is spurious at best.
and that my numbers were not low enough to justify it
But you were on TRT, hence they shouldn't be low so that does not quite add up.
& I needed a 2nd level to validate the 1st low due to Veterans Health Administration regulations for dosing testosterone.
Thus the blood work in Nov and the return to the Endocrinologist
The VA does not treat the person, the VA treats the numbers is how it came across, but then again this is socialized medicine at it's finest.
I've got private health insurance and can ask for a referral if I can find a good quality Doctor that understands TRT/HRT in the Denver Colorado/Front Range region.
I would ask around and get a referral from someone being treated who is happy vs just jumping doc to doc. Just like car mechanics and painters, etc, referrals by satisfied customers saves time and frustration.
Yep, I need to loose weight, no question and am trying.
The VA operates on numbers and since stopping the injections my one testosterone level check has not be stupid low and the VA requires 2 low testosterone tests prior to TRT. Guess I need to start sucking down lots of tofu, spearmint tea and other foods that help drop T levels so the "good doctors" get the numbers they need :rolleyes: :rolleyes: :rolleyes:
Have been asking around about Docs who are great when it comes to HRT but have not found anybody yet.
And yes, I'm going back thru this thread and printing out information to take with me to help edjumacate the doctors and see if it does any good.
BTW:
If you're a man on TRT, there's a new free app that records subjective symptoms and tracks them called TRT Analyzer that needs testers. Here's the details:
Greenville, August 31, 2016: Sypolt Systems and ExcelMale.com today announced the immediate availability of a new Android and iOS app for men on Testosterone Replacement Therapy. The app allows users to enter treatment protocols and daily assessments which record how they are feeling while on a specific treatment protocol. The results are then displayed in graphs so that users and whoever they wish to share the data with can better understand important areas in quality of life for a given protocol.
http://trtdata.com/
Interesting. (http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0162480)
[Researchers say there are no benefits of testosterone treatments for men Researchers say there are no benefits of testosterone treatments for men]
Huo S, Scialli AR, McGarvey S, et al. Treatment of Men for “Low Testosterone”: A Systematic Review. PLoS ONE 2016;11(9):e0162480. Treatment of Men for “Low Testosterone”: A Systematic Review
Testosterone products are recommended by some prescribers in response to a diagnosis or presumption of “low testosterone” (low-T) for cardiovascular health, sexual function, muscle weakness or wasting, mood and behavior, and cognition.
We performed a systematic review of 156 eligible randomized controlled trials in which testosterone was compared to placebo for one or more of these conditions. We included studies in bibliographic databases between January 1, 1950 and April 9, 2016, and excluded studies involving bodybuilding, contraceptive effectiveness, or treatment of any condition in women or children. Studies with multiple relevant endpoints were included in all relevant tables.
Testosterone supplementation did not show consistent benefit for cardiovascular risk, sexual function, mood and behavior, or cognition. Studies that examined clinical cardiovascular endpoints have not favored testosterone therapy over placebo.
Testosterone is ineffective in treating erectile dysfunction and controlled trials did not show a consistent effect on libido.
Testosterone supplementation consistently increased muscle strength but did not have beneficial effects on physical function.
Most studies on mood-related endpoints found no beneficial effect of testosterone treatment on personality, psychological well-being, or mood.
The prescription of testosterone supplementation for low-T for cardiovascular health, sexual function, physical function, mood, or cognitive function is without support from randomized clinical trials.
Flankenstein
09-22-16, 11:41
No effects on libido or mood? LOL... Ok.
No effects on libido or mood? LOL... Ok.
Agreed. That one is just goofy. I didn't look in depth at the review, but science works on the bulk of the data and preponderance of evidence, and the data strongly supports the benefits outweigh the negatives by a wide margin, much of which I have posted here in this thread.
No effects on libido or mood? LOL... Ok.
Agreed. That one is just goofy. I didn't look in depth at the review, but science works on the bulk of the data and preponderance of evidence, and the data strongly supports the benefits outweigh the negatives by a wide margin, much of which I have posted here in this thread.
I don't disagree with either one of you. I just thought it was interesting and plan on reading the whole thing shortly.
I don't disagree with either one of you. I just thought it was interesting and plan on reading the whole thing shortly.
The problem with meta analysis is depending on the inclusion and exclusion criteria and other factors, they can say what you want them to say (if bias creeps in) or simply don't reflect the bulk of the data well and give an inaccurate finding. I'm not saying that's the case here, but it does seem to be counter to various data I have posted here and read over time. I'd have to get into the nuts and bolts of that review to see where/how they might have missed the mark, but my motivation to put the effort in is low.
I used a new needle yesterday. BD's thin wall 28G 5/8" it worked great.
I used a new needle yesterday. BD's thin wall 28G 5/8" it worked great.
No fuss no muss eh?
All:
Met with Dr. Michael Bedecs today at Age Management Center (Jupiter FL office) and had by far the most extensive and thorough personal health workup I have had to date with extensive lab work done. Dr. Bedecs is a very switched on doctor and one I plan to work with in the near future. Stay tuned for further developments that could be of value to anyone who has been looking for that doc who "gets it" on all levels. I can say that about a handful of docs I have worked with to date...Stay tuned! ;)
No fuss no muss eh?
Yes. Honestly I am not sure I noticed much difference but It felt good to know this much smaller needle worked so well. The big ones caused me so much pain in the past.
Thanks Will!
All:
Met with Dr. Michael Bedecs today at Age Management Center (Jupiter FL office) and had by far the most extensive and thorough personal health workup I have had to date with extensive lab work done. Dr. Bedecs is a very switched on doctor and one I plan to work with in the near future. Stay tuned for further developments that could be of value to anyone who has been looking for that doc who "gets it" on all levels. I can say that about a handful of docs I have worked with to date...Stay tuned! ;)
That's good news.
Yes. Honestly I am not sure I noticed much difference but It felt good to know this much smaller needle worked so well. The big ones caused me so much pain in the past.
Thanks Will!
Unlike "other" areas of life, smaller is better with needles and TRT as a rule.
That's good news.
Stay tuned for more intel, but It looks like a go that we will be working together directly shortly.
i see this is an old thread and maybe no one is following it anymore. Any how, here is my two cents.
got blood work done a few months ago. t level was 600 ng per dl. low t is less than 241 according to the test reference range. so im good, right? nevertheless My doc (a former pro athlete) asked if I wanted to try some testosterone, explained the results I should expect and detailed his extensive use. The guy is in phenomenal shape,and gave a solid sales pitch, so I said sure. He prescribed 300mg of testosterone cypionate every week and anastrazole to combat the shut down of my natural t production.
So far Ive gained about 10lbs(im skinny so this is good) joint pain has subsided greatly. I need less sleep and I run the youngsters at the gym(late teens early 20's)into the ground sparing and doing mitt work. yesterday the kid (very athletic, out weighs me by 30lbs and has 8" reach advantage)I was sparring with(in round 3) was struggling to keep up when his girlfriend showed up to watch. I closed in on him and wrapped his arms up for a second, i quietly said that i was going to slow down so he didnt look bad. he smiled and nodded his head. it was a very good feeling!
Needless to say, I fully endorse testosterone supplementation!
Mr. Goodtimes
10-19-16, 03:56
i see this is an old thread and maybe no one is following it anymore. Any how, here is my two cents.
got blood work done a few months ago. t level was 600 ng per dl. low t is less than 241 according to the test reference range. so im good, right? nevertheless My doc (a former pro athlete) asked if I wanted to try some testosterone, explained the results I should expect and detailed his extensive use. The guy is in phenomenal shape,and gave a solid sales pitch, so I said sure. He prescribed 300mg of testosterone cypionate every week and anastrazole to combat the shut down of my natural t production.
So far Ive gained about 10lbs(im skinny so this is good) joint pain has subsided greatly. I need less sleep and I run the youngsters at the gym(late teens early 20's)into the ground sparing and doing mitt work. yesterday the kid (very athletic, out weighs me by 30lbs and has 8" reach advantage)I was sparring with(in round 3) was struggling to keep up when his girlfriend showed up to watch. I closed in on him and wrapped his arms up for a second, i quietly said that i was going to slow down so he didnt look bad. he smiled and nodded his head. it was a very good feeling!
Needless to say, I fully endorse testosterone supplementation!
Don't let this come across as me being a dick, just pointing out some facts here. For one, you need to do some serious research on steroid use and TRT. It looks as though you seriously lack understanding in how the body works in regards to hormones and how steroids work.
First off....Out of curiosity, how old are you? Why did you get your t levels checked? Were you symptomatic or A symptomatic? If you were symptomatic, what were the symptoms?
At 600 you would be considered borderline low ish depending on your age, however other numbers matter as well. What was you're free t? What was your E2? Was your LH good?
Secondly, no offense but you're Doctor is a complete ****ing moron if he thinks that Anastrazole is going to stop, or even slow the shut down of your natural testosterone production. Anastrazole (Arimidex) is prescribed to keep E2 in check and prevent the nasty sides associated with high estrogen.
Arimidex is an aromatase inhibitor, meaning it binds to the aromatase enzyme, rendering it inactive and thus preventing the Testosterone from aromatizing into estrogen.
Introducing exogenous testosterone into your system WILL shut you down, even at very small doses.
What's your Arimidex dose? Be careful with Arimidex as its very easy to bottom out your estrogen and that's not a good place to be. Side effects of Low E2 are nearly identical in many regards to high E2 so it can be difficult or impossible to know without blood work. You'll feel really awesome as you fall through the sweet spot but then you'll feel like absolute hell when you bottom out. To make it even more complicated, some people are Arimidex over responders and others are under responders. A general starting point is 1mg anastrozole a week for people using 100mg wk Test cyp. Arimidex has a short half life (around 48 hrs) and should thus be taken frequently. Most dose every other day. You'll need blood work to know for sure. Most people feel best with E2 in the low 20's, but there are exceptions.
I dissolve my Arimidex in vodka and use a 1cc insulin syringe (with needle removed) to dose it. I dilute the pills at .5mg/ML and dose accordingly to the amount of test I'm on.
Are you staying on Test for life? Because that's what TRT is, it's for life. While it's pretty sweet that your doc prescribed you 300mg a wk, that's not an TRT dose, that's a mild steroid dose. 200mg a week is considered a pretty hefty TRT dose, so 300 is pretty generous. That will put you well into super physiological levels.
Your nuts will shut down and adex isn't going to do shit to stop it. The only way to maintain function of the testes while on testosterone is with HCG. As 500iu/wk has been shown to work with out desensitizing the LH receptors in the testes.
If you aren't planning on staying on Test for life I would at a minimum get you're Doctor to prescribe you some Clomid or Nolvadex to help with bringing back you're natural t levels after you discontinue use.
If you're running 300mg a week I would be pinning my self three times a week with 100mg a pin.
I hope some of this information helped. For more insight, the TRT section at T-Nation is a great resource.
Sent from my iPhone using Tapatalk
Ah, yeah...lot of info. If you saw my doc you wouldnt doubt he knows what he is talking about. LOL
Im 40. no symptoms, just regular blood work. The normal reference range for total Testosterone on the lab sheet was 241-814. So, Im not anywhere near low. I remember when the UFC tested John Jones, his level was 800, and he ended up testing positive for PHD's the next time he was tested. which makes sense cause doc asked if i was already taking testosterone.(not sure why i feel the need to defend my natural testosterone level...)
I remember the dock using the phrase life enhancement several times. So, I guess that is our goal for treatment.
I will not stay on it permanently. I will discontinue use for a while and then restart when I feel like im returning to normal.
you definitely know your stuff ! cause the things you said to take after im done with the testosterone script is exactly what the doc recommended. He did tell me to find them for sale on line because it would cost one tenth of what the pharmacy would charge.
do you know a good source for those items?
It definitely wouldn't hurt for me to learn more
Thanks for the consult brother!
Don't let this come across as me being a dick, just pointing out some facts here. For one, you need to do some serious research on steroid use and TRT. It looks as though you seriously lack understanding in how the body works in regards to hormones and how steroids work.
First off....Out of curiosity, how old are you? Why did you get your t levels checked? Were you symptomatic or A symptomatic? If you were symptomatic, what were the symptoms?
At 600 you would be considered borderline low ish depending on your age, however other numbers matter as well. What was you're free t? What was your E2? Was your LH good?
Secondly, no offense but you're Doctor is a complete ****ing moron if he thinks that Anastrazole is going to stop, or even slow the shut down of your natural testosterone production. Anastrazole (Arimidex) is prescribed to keep E2 in check and prevent the nasty sides associated with high estrogen.
Arimidex is an aromatase inhibitor, meaning it binds to the aromatase enzyme, rendering it inactive and thus preventing the Testosterone from aromatizing into estrogen.
Introducing exogenous testosterone into your system WILL shut you down, even at very small doses.
What's your Arimidex dose? Be careful with Arimidex as its very easy to bottom out your estrogen and that's not a good place to be. Side effects of Low E2 are nearly identical in many regards to high E2 so it can be difficult or impossible to know without blood work. You'll feel really awesome as you fall through the sweet spot but then you'll feel like absolute hell when you bottom out. To make it even more complicated, some people are Arimidex over responders and others are under responders. A general starting point is 1mg anastrozole a week for people using 100mg wk Test cyp. Arimidex has a short half life (around 48 hrs) and should thus be taken frequently. Most dose every other day. You'll need blood work to know for sure. Most people feel best with E2 in the low 20's, but there are exceptions.
I dissolve my Arimidex in vodka and use a 1cc insulin syringe (with needle removed) to dose it. I dilute the pills at .5mg/ML and dose accordingly to the amount of test I'm on.
Are you staying on Test for life? Because that's what TRT is, it's for life. While it's pretty sweet that your doc prescribed you 300mg a wk, that's not an TRT dose, that's a mild steroid dose. 200mg a week is considered a pretty hefty TRT dose, so 300 is pretty generous. That will put you well into super physiological levels.
Your nuts will shut down and adex isn't going to do shit to stop it. The only way to maintain function of the testes while on testosterone is with HCG. As 500iu/wk has been shown to work with out desensitizing the LH receptors in the testes.
If you aren't planning on staying on Test for life I would at a minimum get you're Doctor to prescribe you some Clomid or Nolvadex to help with bringing back you're natural t levels after you discontinue use.
If you're running 300mg a week I would be pinning my self three times a week with 100mg a pin.
I hope some of this information helped. For more insight, the TRT section at T-Nation is a great resource.
Sent from my iPhone using Tapatalk
Ah, yeah...lot of info. If you saw my doc you wouldnt doubt he knows what he is talking about. LOL
Im 40. no symptoms, just regular blood work. The normal reference range for total Testosterone on the lab sheet was 241-814. So, Im not anywhere near low. I remember when the UFC tested John Jones, his level was 800, and he ended up testing positive for PHD's the next time he was tested. which makes sense cause doc asked if i was already taking testosterone.(not sure why i feel the need to defend my natural testosterone level...)
I remember the dock using the phrase life enhancement several times. So, I guess that is our goal for treatment.
I will not stay on it permanently. I will discontinue use for a while and then restart when I feel like im returning to normal.
you definitely know your stuff ! cause the things you said to take after im done with the testosterone script is exactly what the doc recommended. He did tell me to find them for sale on line because it would cost one tenth of what the pharmacy would charge.
do you know a good source for those items?
It definitely wouldn't hurt for me to learn more
Thanks for the consult brother!
What Mr. Goodtimes told you is correct. If you want to learn more, read this thread, it's nothing but learnin' op on the topic.
What Mr. Goodtimes told you is correct. If you want to learn more, read this thread, it's nothing but learnin' op on the topic.
im on it!
My recent visit to Age Management Center and Dr. Bedecs
Finding a good doctor to work with can be challenging for people, finding a doctor who is both competent and willing to assist people with their hormones is like finding the proverbial needle in a haystack. Make that a haystack the size of Jupiter…Ok, a slight exaggeration but for many who have spent years, if not decades, of their life looking for such a doctor, that’s exactly how it feels for them. I have spent much of my professional life attempting to assist people in understanding this topic and directing them as best I could to the resources they needed, via my articles, videos, etc, often fighting an uphill battle against ignorance and dogma. Enter stage left, Dr. Michael Bedecs of Age Management Center. Cont:
http://www.brinkzone.com/articles/age-management-center/
Thought this was interesting. As mentioned, I find low T in vets at younger ages than would be expected, even when the "usual suspects" accounted for. Various possibilities exist. One is TBI.
Low testosterone in a young combat veteran with dual diagnosis and suicidal behavior: a case study
International Journal of Adolescent Medicine and Health. Volume 27, Issue 2, Pages 235–237, ISSN (Online) 2191-0278, ISSN (Print) 0334-0139, DOI: https://doi.org/10.1515/ijamh-2015-5018, December 2014
Corresponding author: Drew D. Kiraly, MD, PhD, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Box 1230, One Gustave L Levy Place, New York, NY 10029, USA; and James J. Peters Veterans Administration Medical Center, New York, NY, USA, E-mail: (email)
Abstract
Suicide and suicidal behaviors amongst combat veterans is an important public health issue. Exposure to military combat predisposes patients to increased levels of major depression, post-traumatic stress disorder (PTSD), substance abuse, and chronic pain – all of which are important risk factors for suicide. Here, we present a case study of a young combat veteran who presented with an impulsive suicide attempt that had a high potential for lethality in the context of depression, PTSD, and substance use. On routine admission laboratory work, his serum level of testosterone was seen to be low. Given the important role that testosterone plays in the regulation of mood and behavior, we posit that it is a potentially important marker for suicide risk in an already at-risk population.
Enter stage left, Dr. Michael Bedecs of Age Management Center...
He sells a shot that'll make your dong bigger?!?! Sign me up! :)
He sells a shot that'll make your dong bigger?!?! Sign me up! :)
Bigger, no, but shwing on demand, yes. Never used it as that's never been an issue for me, but for some men, returns to them an aspect of life they'd lost.
Bigger, no, but shwing on demand, yes. Never used it as that's never been an issue for me, but for some men, returns to them an aspect of life they'd lost.
It sounds like "bigger" (http://agemanagementcenter.com/anti-aging-therapy-men/priapus-shot/) to me. Mostly just trying to lighten the mood. :)
If you are unable to achieve and/or maintain a satisfactory erection or your penis is a less than desirable size, you know the impact it can have on your sex life and intimate relationships.
Creating optimal penis health and size has a number of components to consider. One must have adequate desire and sexual energy (often testosterone related), intact nerve supply and optimal blood flow. Penis size is usually a genetic matter and many men feel they would like to achieve more length and girth. Fortunately there are medications on the market now that cause vasodilation (open the blood vessels for more flow) which are often a help– but these pills don’t always work. The pills can do a great job of increasing the blood flow to the penis, but whatever caused the decrease blood flow continues when the pill wears off. Also, the side effects of these pills can be serious: stroke, heart attack, and headache.
Fortunately, the revolutionary introduction of PRP (Platelet Rich Plasma) Therapy for penis rejuvenation can help men with enhancement of erection, sensitivity and penis size,otherwise known as the penis shots. This simple, relatively painless office based procedure called the Priapus Shot was pioneered by Dr. Charles Runels. It incorporates the harvesting and injection of one’s own plasma enriched growth factors or PRP into specific areas of the penis.
It is important to know that that not everyone will necessarily achieve the same results or satisfaction with the penis shots; however for many the result is an increase in the length, girth and sensitivity of the penis and the treatment results for those men are impressive. Also, results are not instantaneous. It takes several weeks to achieve the full effects and there are a couple things one must do daily to increase the rate of success. All of which will be discussed during your private consultation.
It sounds like "bigger" (http://agemanagementcenter.com/anti-aging-therapy-men/priapus-shot/) to me. Mostly just trying to lighten the mood. :)
EDIT: See Correct in #873,
You sorta have to read between the lines on that one. If you're not getting full shwing due to what ever reason, you'll obviously see "an increase in the length, girth" if you're at full attention. It's not going to increase size beyond what one can achieve under normal circumstances. Having an erection like you were 25 again when you're say 65, is " an increase in the length, girth " from what you've been experiencing.
You sorta have to read between the lines on that one. If you're not getting full shwing due to what ever reason, you'll obviously see "an increase in the length, girth" if you're at full attention. It's not going to increase size beyond what one can achieve under normal circumstances. Having an erection like you were 25 again when you're say 65, is " an increase in the length, girth " from what you've been experiencing.
Ohhh... I'm a little slow sometimes.
Ohhh... I'm a little slow sometimes.
EDIT: See Correct in #873,
Nah, that's how it reads. I just know physiology well enough, and the mechanism of action of that drug, to know what the real T is of it. Many man have difficulty getting their full shwing on due to various reasons and it works wonders for that.
Oddly enough I believe that Runels guy also does PRP shots for women, to improve sensitivity...
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Oddly enough I believe that Runels guy also does PRP shots for women, to improve sensitivity...
Interesting. Would have to look into that one. End of the day, our parts are more similar than different in terms of what impacts sensitivity, etc. so makes some sense.
Search string is "the O shot".
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Search string is "the O shot"...
Learned something new today. :)
Ohhh... I'm a little slow sometimes.
Actually, I'm slower and goofed here. You were referring to PRP (Platelet Rich Plasma) injections. I see claims of increased " an increase in the length, girth " as you said. I'm aware of no hard data to support those claims at this time. There's a lot of PRP related procedures out there these days, some of which may have utility, some not, all need more study in my view.
I had thought what you were referring to was Trimix, which is an injectable three-drug prescribed medication containing alprostadil, papaverine, and phentolamine. Trimix et al has published studies to support its use.
Sorry about the confusion
Search string is "the O shot".
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Learned something new today. :)
Indeed. Essential the same thing you were talking about, which is the PRP therapy for women:
"The procedure uses the patients’ drawn blood to stimulate vaginal and clitoral rejuvenation, according to Eterna M.D. Medical Rejuvenation Center. Platelets extracted from the blood, or platelet-rich plasma (PRP), are then placed in a syringe and injected into an area near the clitoris and an area just inside the vagina — the “o-spot.” Those platelets then stimulate the growth of new cells in the injected areas, making those areas more sensitive to the touch. Wood says the O-Shot improves orgasm, libido, and arousal."
Again, no hard data, and I remain skeptical the effect is greater than placebo. Or, it may work, but likely via another mechanism than claimed above.
Actually, I'm slower and goofed here. You were referring to PRP (Platelet Rich Plasma) injections. I see claims of increased " an increase in the length, girth " as you said. I'm aware of no hard data to support those claims at this time. There's a lot of PRP related procedures out there these days, some of which may have utility, some not, all need more study in my view.
I had thought what you were referring to was Trimix, which is an injectable three-drug prescribed medication containing alprostadil, papaverine, and phentolamine. Trimix et al has published studies to support its use.
Sorry about the confusion
All good brother.
The FDA in its infinite wisdom is now adding a new warning that bad things can happen when people abuse testosterone. This cutting edge revelation is our tax $ at work. It would be difficult to find something safer to "abuse" than testosterone, and improved mood, libido, strength, is "addictive" no doubt, but the FDA feels it necessary to add this new warning... I will say, doses above physiological replacement are not recommended and technically not TRT, so it's a moot point really. Some of these comments strike of an amazing level of ignorance of the topic.
FDA Adds New Warnings to All Testosterone Product Labels
The US Food and Drug Administration (FDA) has approved class-wide labeling changes for all prescription testosterone products, the agency announced today.
New safety information from published literature and case reports on the risks associated with abuse and dependence of testosterone and other anabolic androgenic steroids (AAS) will be added to all product labels, the FDA says.
Testosterone and other AAS, which have a schedule III classification by the Controlled Substances Act, may be abused by adults and adolescents, including athletes and body builders.
"Abuse of testosterone, usually at doses higher than those typically prescribed and usually in conjunction with other AAS, is associated with serious safety risks affecting the heart, brain, liver, mental health, and endocrine system," the FDA notes.
Reported serious adverse outcomes include myocardial infarction, heart failure, stroke, depression, hostility, aggression, liver toxicity, and male infertility. People abusing high doses of testosterone have also reported withdrawal symptoms, such as depression, fatigue, irritability, loss of appetite, decreased libido, and insomnia, the agency says.
The new warning will alert prescribers to the abuse potential of testosterone and the serious health risks, especially those related to heart and mental health, that have been linked to testosterone and AAS abuse, they note.
Cont:
http://www.medscape.com/viewarticle/870932
I feel so much safer now. I don't know how I managed to live this long without the mighty FDA's help.
They need to worry less about testosterone "abuse" and more about these so-called antidepressants and other drugs that leave you totally mentally jacked up.
They damn near act like testosterone is heroin or meth or something.
Flankenstein
12-28-16, 17:18
Lmao. I'd venture to guess that 99.9% of male FDA employees need TRT... and/or lobotomies.
Will - Let's talk aromatase inhibitors, relating to TRT. Effectiveness, safety, side effects, etc. Most of the time I see people recommend Arimidex (Anastrozole) and I wanted to learn more. So, after a bit of research, I thought I'd shoot a doctor friend an email and get his thoughts on Letrozole VS Anastrozole. One of the primary concerns with using Letro as an AI is erectile dysfunction, which I mentioned in my correspondence to him, and his reply was...
"I see the concerns reading the ED from the letrozole, however, I am more concerned with the increase in side effects including ischemic heart disease, Heart attack, and acute blood clots in the lungs, legs, and eyes that come at a much higher rate with arimidex than it does with letrozole."
Anyhow, let's start there. Hopefully we can all learn something.
At what dosages do the neg sides show up, using Adex? DH takes half a tab weekly, so only 0.5mg.
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Will - Let's talk aromatase inhibitors, relating to TRT. Effectiveness, safety, side effects, etc. Most of the time I see people recommend Arimidex (Anastrozole) and I wanted to learn more. So, after a bit of research, I thought I'd shoot a doctor friend an email and get his thoughts on Letrozole VS Anastrozole. One of the primary concerns with using Letro as an AI is erectile dysfunction, which I mentioned in my correspondence to him, and his reply was...
"I see the concerns reading the ED from the letrozole, however, I am more concerned with the increase in side effects including ischemic heart disease, Heart attack, and acute blood clots in the lungs, legs, and eyes that come at a much higher rate with arimidex than it does with letrozole."
Anyhow, let's start there. Hopefully we can all learn something.
Not totally clear where he's coming from on that, but some macro Qs/comments arise from the use of either drug, both being in the AI class of drugs. It's essential to use an AI only if indicated to control excessive conversion of T -> E2, vs simply suppress E2 (estradiol). Men need E2, for HDL, mood, etc. Some people simply add in an AI without any legit reason or blood work to indicate a need for it under some impression it makes the TRT "work" better, and that's simply not the case and bad science. The loss of libido or ED will be a result of overly suppressing E2 or overly elevated levels, vs keeping in the range wanted, generally 20-29 pg/mL. Either AI can do that, but letrozole seems to be trickier to dose correctly, perhaps more associated with ED. I'm not aware of anything unique about letrozole per se to ED. Some feel once correctly dosed, letrozole has a lower side effect profile. Most men don't need either of those drugs, and with a loss of some bodyfat, adjustment in TRT dose, etc can be managed fine.
The above side effects listed via his response are again due to improper management of E2 levels vs the drug itself per se as far as I know. I'm not aware of any head to head studies that find increased rates of "... ischemic heart disease, Heart attack, and acute blood clots in the lungs, legs, and eyes that come at a much higher rate with arimidex than it does with letrozole" in men on TRT to control E2. Maybe inquire as to where/what his source is for that statement.
At what dosages do the neg sides show up, using Adex? DH takes half a tab weekly, so only 0.5mg.
See comments above. At what ever dose, which is highly variable person to person, where E2 is overly suppressed, do side effects tend to appear. AIs are used to control E2, not suppress it to below "normal" levels, which can happen easily with AIs.
My interest is in lowering E2 into the "accepted range", <30 pg/mL, when body fat isn't an issue. I'm pretty well versed on estradiol and the good and bad for both suppressed and elevated levels. I'm in the camp that if you had to choose your poison I'd definitely rather be higher than 30, rather than under 20, due to bone loss issues.
The above side effects listed via his response are again due to improper management of E2 levels vs the drug itself per se as far as I know. I'm not aware of any head to head studies that find increased rates of "... ischemic heart disease, Heart attack, and acute blood clots in the lungs, legs, and eyes that come at a much higher rate with arimidex than it does with letrozole" in men on TRT to control E2. Maybe inquire as to where/what his source is for that statement.
He stated the "official drug profiles" and is sending me a copy in the mail. I'll check them out and give you source when I receive them. Worse comes to worse I can scan them and email them to you too.
My interest is in lowering E2 into the "accepted range", <30 pg/mL, when body fat isn't an issue. I'm pretty well versed on estradiol and the good and bad for both suppressed and elevated levels. I'm in the camp that if you had to choose your poison I'd definitely rather be higher than 30, rather than under 20, due to bone loss issues.
He stated the "official drug profiles" and is sending me a copy in the mail. I'll check them out and give you source when I receive them. Worse comes to worse I can scan them and email them to you too.
Those will be online some place. Data will generally be on women with breast cancer and of minimal value to how it's used in TRT in men.
Please see latest TRT/HRT related news regarding yours truly here:
https://www.m4carbine.net/showthread.php?193999-Age-Management-Center-and-BrinkZone-team-up
Hot off the presses. Not only did this study not find and increase in cardiovascular events, it found a reduction is cardiovascular events with men on TRT. This was a big study and published in the most prestigious of med journals:
Association of Testosterone Replacement With Cardiovascular
Outcomes Among Men With Androgen Deficiency
JAMAInternal Medicine
Key Points
Question What are the cardiovascular risks of testosterone
replacement therapy (TRT) in men with androgen deficiency?
Findings When use in androgen-deficient men with documented
low morning testosterone levels, TRT was not associated with an
increased risk of cardiovascular outcomes. During long-term
follow-up the risk of cardiovascular outcomes was lower in
testosterone-treated men.
Meaning These findings support the use of TRT in
androgen-deficient men.
Full paper:
http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2604140
Will, that's good to see this study got published.
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This may have already been covered and I just missed it, what is the optimal level, and yeah I realize that is subjective per person, for T count?
Male 48 years of age..heavy lifting (weights) wanting to continue. Doc I see seems a little confused, says range should be 400-600, somehow I would think higher would be better as long as Estradiol is under control, right?
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This may have already been covered and I just missed it, what is the optimal level, and yeah I realize that is subjective per person, for T count?
Male 48 years of age..heavy lifting (weights) wanting to continue. Doc I see seems a little confused, says range should be 400-600, somehow I would think higher would be better as long as Estradiol is under control, right?
For some reason, many docs shoot for middle of the range, which is 400-600. There's no data to support that however. Two, optimal includes favorable free T levels and estradiol (E2), and perhaps DHT. One can have high total but low free and so forth, so only tracking total T gives a very incomplete picture. Finally, humans are more than a lab number, so factoring in how you feel is also taken into account by a competent practitioner in my view.
It's a long thread, but well worth taking the time to read through it, and perhaps give you info you can supply the doc with. Many studies published in the thread.
Dave Williams
03-02-17, 05:53
+1 Will.....I emphasized to my Doc that I FEEL great around 1000 and I want it there all the time.
Will, that's good to see this study got published.
Agreed! It's an important finding to be sure.
A new study showing benefits of T in dieting men who often suffer low T and the symptoms of low T (eg, low mood, ED, etc), in this study, greatly improved via TRT.
Symptomatic response to testosterone treatment in dieting obese men with low testosterone levels in a randomized, placebo-controlled clinical trial
International Journal of Obesity (28 December 2016) | doi:10.1038/ijo.2016.242
Abstract
Background:
Obese men commonly have reductions in circulating testosterone and report symptoms consistent with androgen deficiency. We hypothesized that testosterone treatment improves constitutional and sexual symptoms over and above the effects of weight loss alone.
Methods:
We conducted a pre-specified analysis of a randomized double-blind, placebo-controlled trial at a tertiary referral center. About 100 obese men (body mass index (BMI)greater than or equal to30 kg m−2) with a repeated total testosterone level less than or equal to12 nmol l−1 and a median age of 53 years (interquartile range 47–60) receiving 10 weeks of a very-low-energy diet (VLED) followed by 46 weeks of weight maintenance were randomly assigned at baseline to 56 weeks of intramuscular testosterone undecanoate (n=49, cases) or matching placebo (n=51, controls). Pre-specified outcomes were the between-group differences in Aging Male Symptoms scale (AMS) and international index of erectile function (IIEF-5) questionnaires.
Results:
Eighty-two men completed the study. At study end, cases showed significant symptomatic improvement in AMS score, compared with controls, and improvement was more marked in men with more severe baseline symptoms (mean adjusted difference (MAD) per unit of change in AMS score −0.34 (95% confidence interval (CI) −0.65, −0.02), P=0.04). This corresponds to improvements of 11% and 20% from baseline scores of 40 and 60, respectively, with higher scores denoting more severe symptoms. Men with erectile dysfunction (IIEF-5less than or equal to20) had improved erectile function with testosterone treatment. Cases and controls lost the same weight after VLED (testosterone −12.0 kg; placebo −13.5 kg, P=0.40) and maintained this at study end (testosterone −11.4 kg; placebo −10.9 kg, P=0.80). The improvement in AMS following VLED was not different between the groups (−0.05 (95% CI −0.28, 0.17), P=0.65).
Conclusions:
In otherwise healthy obese men with mild to moderate symptoms and modest reductions in testosterone levels, testosterone treatment improved androgen deficiency symptoms over and above the improvement associated with weight loss alone, and more severely symptomatic men achieved a greater benefit.
http://www.nature.com/ijo/journal/v41/n3/full/ijo2016242a.html?WT.ec_id=IJO-201703
This new study applies mostly to vets, but PTSD caused by exposure to stressors not unique to soldiers:
Dual-hormone stress reactivity predicts downstream war-zone stress-evoked PTSD
Highlights
•We tested the singular and interactive effects of cortisol (CR) and testosterone (TR) reactivity as moderators of PTSD emergence in theater.
•Blunted cortisol and testosterone stress reactivity at pre-deployment prospectively predicted PTSD symptom emergence in the war-zone.
•This hormonal reactivity profile appears to confer increased risk for PTSD by potentiating the pathogenic effects of war-zone stressors.
•Findings underscore the utility of assessing both HPA and HPG stress reactivity and may inform early detection of at risk soldiers for PTSD.
Abstract
Background
The crucial role of the hypothalamic-pituitary-adrenal axis (HPA) in stress-related homeostasis suggests dysregulated HPA involvement in the pathogenesis of post-traumatic stress disorder (PTSD), yet most studies examining linkages between HPA axis measures and PTSD have yielded null findings. One untested explanation for this inconsistency is a failure to account for simultaneous adrenal and gonadal influence. Here we tested the singular and interactive effects of cortisol (CR) and testosterone (TR) reactivity as moderators of war-zone stress evoked PTSD emergence in the war-zone.
Methods
U.S. soldiers (N = 120) scheduled for deployment to Iraq completed pre-deployment measures of CR and TR stress reactivity to a CO2 inhalation challenge. Once deployed, monthly assessments of exposure to traumatic war-zone stressors and PTSD symptoms were collected via a web-based assessment system.
Results
Cortisol hypo-reactivity potentiated the pathogenic impact of war-zone stressors only in soldiers for whom the CO2 challenge did not elevate testosterone, suggesting that the dual hormone stress reactivity profile of blunted cortisol and testosterone may confer increased risk for PTSD emergence by potentiating the pathogenic effects of war-zone stressors.
Conclusions
Findings underscore the utility of assessing both HPA and HPG stress reactivity when assessing PTSD vulnerability and may help inform efforts for enhanced soldier screening and inoculation to war-zone stressors.
http://www.psyneuen-journal.com/article/S0306-4530(16)30676-X/fulltext
Flankenstein
03-09-17, 17:11
Will - Let's talk aromatase inhibitors, relating to TRT. Effectiveness, safety, side effects, etc. Most of the time I see people recommend Arimidex (Anastrozole) and I wanted to learn more. So, after a bit of research, I thought I'd shoot a doctor friend an email and get his thoughts on Letrozole VS Anastrozole. One of the primary concerns with using Letro as an AI is erectile dysfunction, which I mentioned in my correspondence to him, and his reply was...
"I see the concerns reading the ED from the letrozole, however, I am more concerned with the increase in side effects including ischemic heart disease, Heart attack, and acute blood clots in the lungs, legs, and eyes that come at a much higher rate with arimidex than it does with letrozole."
Anyhow, let's start there. Hopefully we can all learn something.
Letro on TRT is a terrible (terrible!) idea. My doc persuaded me to go on 1.25mg 2x/mo. Against my better judgement, I agreed. E2 way too low and 2x/mo dosing is idiotic.
Adex is the way to go. Labs will dictate dose.
Letro on TRT is a terrible (terrible!) idea. My doc persuaded me to go on 1.25mg 2x/mo. Against my better judgement, I agreed. E2 way too low and 2x/mo dosing is idiotic.
Adex is the way to go. Labs will dictate dose.
Adex and letrozole are both non suicidal AI. So they work in the same manner. The only problem was the dosage. Letrozole is a little bit stronger than adex, but 1.25mg of adex would have had the same outcome. Depending on the dosing of the testosterone 2 × per month dosing may be fine. If the patient is only taking 2 shots of test per month the dosing should be fine.
Most trt patients have an e2 spike after injection, and only require an AI around injections. Dosing AI daily or every other day for trt dosages will usually result in e2 levels being far to low.
The best AI for most trt patients is actually aromasin. Its a suicidal aromatase inhibitor, and its much easier on the body than letro or adex. Most men shouldn't even require an AI with trt dosages, if they're not overweight.
Adex and letrozole are both non suicidal AI. So they work in the same manner. The only problem was the dosage. Letrozole is a little bit stronger than adex, but 1.25mg of adex would have had the same outcome. Depending on the dosing of the testosterone 2 × per month dosing may be fine. If the patient is only taking 2 shots of test per month the dosing should be fine.
Most trt patients have an e2 spike after injection, and only require an AI around injections. Dosing AI daily or every other day for trt dosages will usually result in e2 levels being far to low.
The best AI for most trt patients is actually aromasin. Its a suicidal aromatase inhibitor, and its much easier on the body than letro or adex. Most men shouldn't even require an AI with trt dosages, if they're not overweight.
A common though terrible dosing schedule. Improved dose schedule often see E2 issues fixed, and no AI needed at all.
A common though terrible dosing schedule. Improved dose schedule often see E2 issues fixed, and no AI needed at all.
Twice a month dosing is horrible, and I would rather not be on trt than have my shots scheduled that way. A lot of doctors dont know any better. If you need AI on trt dosages you're more than likely at an unhealthy bodyfat levels. I split my 200mg dose twice a week, but even at once a week I dont need an AI.
Twice a month dosing is horrible, and I would rather not be on trt than have my shots scheduled that way. A lot of doctors dont know any better. If you need AI on trt dosages you're more than likely at an unhealthy bodyfat levels. I split my 200mg dose twice a week, but even at once a week I dont need an AI.
Exactly, so when we see elevated E2, instead of jumping on an AI, best to look at dosing schedule, body fat levels, etc. first. Yes, vast majority of med practitioners are unaware, most don't even bother to test for E2 at all, but that's another topic. This thread will get anyone squared away with the essential basics, if they can find a doc willing to work with them.
Exactly, so when we see elevated E2, instead of jumping on an AI, best to look at dosing schedule, body fat levels, etc. first. Yes, vast majority of med practitioners are unaware, most don't even bother to test for E2 at all, but that's another topic. This thread will get anyone squared away with the essential basics, if they can find a doc willing to work with them.
Most doctors dont even really know about AI, or testing e2 is important. I got lucky and found a PA that is pretty well versed in trt, and will read any literature I bring him.
This is a great thread that can help people greatly. I haven't read through the whole thing, but do you cover hcg anywhere in the thread? I choose to only use it for a few months per year, rather than year round. I just wanted to read anything you might have posted about it.
I was also wondering if you know of anybody using aveed (testosterone Undecanoate). The dosing schedule is real nice, after the loading phase injections can be spaced 8-10 weeks apart. Theres not much info on aveed, Nebeido the UK version is easier to find info on.
Most doctors dont even really know about AI, or testing e2 is important. I got lucky and found a PA that is pretty well versed in trt, and will read any literature I bring him.
Rarer than winning the lottery.
This is a great thread that can help people greatly. I haven't read through the whole thing, but do you cover hcg anywhere in the thread? I choose to only use it for a few months per year, rather than year round. I just wanted to read anything you might have posted about it.
I'm pretty sure just about everything relevant covered, but it's a long thread. I have also posted a lot of useful links to studies and articles.
I was also wondering if you know of anybody using aveed (testosterone Undecanoate). The dosing schedule is real nice, after the loading phase injections can be spaced 8-10 weeks apart. Theres not much info on aveed, Nebeido the UK version is easier to find info on.
I'm not a big fan. Levels are not all that steady as they claim, dosing varies quite a bit for individuals just as it does for the other esters of T, it's harder to tweak dose, and the FDA refused to approve it due to injection area complications found. Pass.
If you need AI on trt dosages you're more than likely at an unhealthy bodyfat levels.
What are you basing that assumption on? When would a person "need" an AI?
yugo308guy
03-10-17, 15:50
Just an update on my personal situation. I too have found a Doc who is willing to work with me and listen to my thoughts. I just met with him last week again, and my numbers look great. I'm at about 860. I do take a half a tablet of Anastrasole once a week and my Estrogen is right on track. I am a bit overweight. technically, if you believe in the bullshit BMI, I am obese at about 32% body fat at 5'7" and 245lbs, but I certainly can't be measured accurately by that scale. I have lifted heavy for all my adult life and have always been very muscular. I have the body more of a power lifter, who's put on some extra fat. About 3 months ago, he did send me to have a blood withdrawal once, but since has not had any concerns.
I did have a bit of a PSA scare over the last 6 weeks. My number was only 1.8, but he was concerned with how rapidly it increased. It nearly doubled over the last 6 or 7 months, starting at .88 up to the 1.8, but over the last 6 weeks it dropped back down to 1.2. My 73 year old brother does have low grade prostate cancer, but is progressing well with no treatment. It is not growing. My father had it late in life as well. I am 52 years old.
What are you basing that assumption on? When would a person "need" an AI?
What I would base it on: When their levels of E2 exceed the target range and can't be controlled via losing some BF, more frequent injection schedule, etc. Then an AI makes sense and pretty much only then in my view. Some are far too quick to get on/prescribe an AI in my view, but opinions differ.
Just an update on my personal situation. I too have found a Doc who is willing to work with me and listen to my thoughts. I just met with him last week again, and my numbers look great. I'm at about 860. I do take a half a tablet of Anastrasole once a week and my Estrogen is right on track. I am a bit overweight. technically, if you believe in the bullshit BMI, I am obese at about 32% body fat at 5'7" and 245lbs, but I certainly can't be measured accurately by that scale. I have lifted heavy for all my adult life and have always been very muscular. I have the body more of a power lifter, who's put on some extra fat. About 3 months ago, he did send me to have a blood withdrawal once, but since has not had any concerns.
I did have a bit of a PSA scare over the last 6 weeks. My number was only 1.8, but he was concerned with how rapidly it increased. It nearly doubled over the last 6 or 7 months, starting at .88 up to the 1.8, but over the last 6 weeks it dropped back down to 1.2. My 73 year old brother does have low grade prostate cancer, but is progressing well with no treatment. It is not growing. My father had it late in life as well. I am 52 years old.
If you lost some BF, say to 15% (which is not lean not too difficult to achieve) you may be able to drop that AI. 860 is good, but without tracking free T, E2, and perhaps SHBG (depending the outcome of E2 and FT testing) then it's a small piece of a larger picture of hormonal status. Per ongoing discussion, small more frequent dosing may also reduce need for AI and results in superior subjective symptoms.
yugo308guy
03-10-17, 16:01
If you lost some BF, say to 15% (which is not lean not too difficult to achieve) you may be able to drop that AI. 860 is good, but without tracking free T, E2, and perhaps SHBG (depending the outcome of E2 and FT testing) then it's a small piece of a larger picture of hormonal status. Per ongoing discussion, small more frequent dosing may also reduce need for AI and results in superior subjective symptoms.
I am self injecting twice a week. About 400mg/month total. I definitely do need to lose some weight. No question. I forgot to ask him what my Free T was, I will follow up with a phone call next week to find out. What is SHBG?
I am self injecting twice a week. About 400mg/month total. I definitely do need to lose some weight. No question. I forgot to ask him what my Free T was, I will follow up with a phone call next week to find out. What is SHBG?
Sex hormone-binding globulin (SHBG) or sex steroid-binding globulin (SSBG). Generally looked at if the others are not GTG to possibly explain why someone may have a good TT but poor free T, etc. I'm surprised you get TT that high with 200mg per month.
yugo308guy
03-10-17, 16:13
Sex hormone-binding globulin (SHBG) or sex steroid-binding globulin (SSBG). Generally looked at if the others are not GTG to possibly explain why someone may have a good TT but poor free T, etc. I'm surprised you get TT that high with 200mg per month.
Sorry, I edited it. Was supposed to be 400.
Sorry, I edited it. Was supposed to be 400.
Makes much more sense, and even then, I'm surprised. Do you get tested the day the next injection is due and at the same time in the am? Over 800 at 100mg per week is still unusually high. Not a bad thing at all, just unusual. Most wish they could hit that level at that dose, which does not include the docs that for reasons not supported by science, seem to want to keep people 500 ish.
What are you basing that assumption on? When would a person "need" an AI?
On trt that doesnt put you above the reference range AI should rarely be needed. Its well known that high body fat causes the body to turn more testosterone into estrogen via the aromatase enzyme. If your at a healty body fat level and on a proper trt regiment AI shouldn't be needed at all. If you have high bodyfat you may need an AI regardless of dose or schedule.
Bloodwork would be the only determining factor on when an AI would be needed like will said. I would personally rather have slightly out of range e2 rather than use an AI.
yugo308guy
03-11-17, 07:50
Makes much more sense, and even then, I'm surprised. Do you get tested the day the next injection is due and at the same time in the am? Over 800 at 100mg per week is still unusually high. Not a bad thing at all, just unusual. Most wish they could hit that level at that dose, which does not include the docs that for reasons not supported by science, seem to want to keep people 500 ish.
I Inject on Tuesday evening, and get blood drawn on Thursday around 4:00pm.
A interesting study this. This was done in a mouse model, so keep that in mind. However, there are some studies that simply can't be done in humans and this one likely a human equivalent study:
Chronic depletion of gonadal testosterone leads to blood-brain barrier dysfunction and inflammation in male mice.
J Cereb Blood Flow Metab. 2016 Jan 1:271678X16683961
Abstract
A dysfunction in the blood-brain barrier (BBB) is associated with many neurological and metabolic disorders. Although sex steroid hormones have been shown to impact vascular tone, endothelial function, oxidative stress, and inflammatory responses, there are still no data on the role of testosterone in the regulation of BBB structure and function.
In this context, we investigated the effects of gonadal testosterone depletion on the integrity of capillary BBB and the surrounding parenchyma in male mice. Our results show increased BBB permeability for different tracers and endogenous immunoglobulins in chronically testosterone-depleted male mice.
These results were associated with disorganization of tight junction structures shown by electron tomography and a lower amount of tight junction proteins such as claudin-5 and ZO-1. BBB leakage was also accompanied by activation of astrocytes and microglia, and up-regulation of inflammatory molecules such as inducible nitric oxide synthase (iNOS), cyclooxygenase 2 (COX-2), interleukin 1 beta (IL-1β), and tumor necrosis factor (TNF).
Supplementation of castrated male mice with testosterone restored BBB selective permeability, tight junction integrity, and almost completely abrogated the inflammatory features. The present demonstration that testosterone transiently impacts cerebrovascular physiology in adult male mice should help gain new insights into neurological and metabolic diseases linked to hypogonadism in men of all ages.
https://www.ncbi.nlm.nih.gov/pubmed/28256950
Recent study not only did not find an association between CVD and TRT, it found a statically significant drop in those on TRT.
LONDON — Testosterone replacement therapy does not appear to increase the risk for cardiovascular disease or thromboembolic events in middle-aged men, but it does increase the risk for obstructive sleep apnea, results from a large cohort study suggest.
In fact, the risk for a cardiovascular event was lower in men taking supplemental testosterone than in those who were not, said lead investigator Julian Hanske, MD, from Ruhr University Bochum in Herne, Germany, who collaborated on the study during a fellowship at Brigham & Women's Hospital in Boston.
But physicians should know whether a patient suffers from obstructive sleep apnea before prescribing testosterone, Dr Hanske said here at the European Association of Urology 2017 Congress.
Cohort studies of the cardiovascular and thromboembolic consequences of supplemental testosterone have generally relied on sources such as the Surveillance, Epidemiology, and End Results Medicare database, which is limited to an older population, he told Medscape Medical News.
To get a better handle on the relative risks associated with testosterone replacement therapy in a younger population, Dr Hanske and his team searched the TRICARE American military insurance database, which covers all retired and active-duty military personnel and their dependents.
Cont:
http://www.medscape.com/viewarticle/877786
Source: European Association of Urology (EAU) 2017 Congress: Abstract 256. Presented March 25, 2017.
inguinal hernias may be hormonal, at least in older men. A most interesting finding. Needs additional data for sure but if correct, yet another reason to track and balance hormones as we age:
The Endocrine Society.Public Release: 3-Apr-2017
Hormones are behind hernias of the groin in elderly men, study suggests
"Researchers have identified an apparent cause of inguinal hernia, or groin hernia, in older men: altered sex hormone levels that weaken and scar muscle tissue in the lower abdomen. "We have discovered that both increased estrogen action and decreased testosterone action leads to inguinal hernia formation," said Hong Zhao, MD. As men age, their estrogen levels increase and their testosterone levels drop. The researchers found that their mouse model mimics the increased estrogen formation in the tissue and the decreasing blood testosterone levels seen in elderly men. Furthermore, when they looked at the rodents' muscle tissue from the lower abdomen, they found tissue atrophy (weakening) and fibrosis (scarring), comparable to that observed in human muscle tissue specimens from patients who had undergone inguinal hernia operations."
Cont:
https://www.eurekalert.org/pub_releases/2017-04/tes-hab040117.php
interesting finding here, TRT delay progression of chronic kidney disease:
Testosterone replacement therapy (TRT) may delay progression of chronic kidney disease (CKD) and lower the risk of death in men with hypogonadism, new findings presented at the National Kidney Foundation's 2017 Spring Clinical Meetings suggest.
Archana Goel, MD, of the Veterans Administration Medical Center in Kansas City, Missouri, and colleagues analyzed data from a large cohort of veterans diagnosed with low total testosterone (TT). The investigators divided patients into 2 groups: those treated and who had normalization of TT (38,708 men) and those who were not treated (9755 men) and continued to have low TT. The treated and untreated groups had follow-up times of 6.1 and 5.1 years, respectively.
The groups did not differ significantly in the number of days until patients had a 30% or greater increase in serum creatinine or doubling of serum creatinine from baseline, the investigators reported in a poster presentation. The treated group, however, showed a significant delay in the progression of CKD as measured by days to serum creatinine increases of 1.5 or higher and 3.0 mg/dL or higher. TRT delayed the time to end-stage renal disease (ESRD), as defined by a serum creatinine level greater than 6.0 mg/dL) by 284 days and time to death by 328 days. Compared with the untreated men, the treated men had a 24% decreased risk of ESRD and 25% decreased risk of death.
Dr Goel's group concluded that “TRT does not associate with significant disadvantages at earlier stages of CKD, but rather a significant decrease and delay in all-cause mortality and delay in progression toward ESRD.”
Cont:
http://www.renalandurologynews.com/nkf-2017-spring-meeting/chronic-kidney-disease-progression-delayed-with-testosterone-therapy/article/651738/?DCMP=EMC-RUN_TodaysUpdate_20170422&cpn&NID&hmSubId=VNmBBvKiCFI1&spMailingID=17064706&spUserID=MTE3Mzk5MDYzODAyS0&spJobID=1001805288&spReportId=MTAwMTgwNTI4OAS2
I'm gonna go have my bloodwork done, but I sorta doubt it's low.. my only symptoms are constantly being tired and being small and weak, but I guess that's just who I am.
I'm gonna go have my bloodwork done, but I sorta doubt it's low.. my only symptoms are constantly being tired and being small and weak, but I guess that's just who I am.
It may be involved, but only way to know is you test it. It's either something to address, or something to rule out.
inguinal hernias may be hormonal, at least in older men. A most interesting finding. Needs additional data for sure but if correct, yet another reason to track and balance hormones as we age:
The Endocrine Society.Public Release: 3-Apr-2017
Hormones are behind hernias of the groin in elderly men, study suggests
"Researchers have identified an apparent cause of inguinal hernia, or groin hernia, in older men: altered sex hormone levels that weaken and scar muscle tissue in the lower abdomen. "We have discovered that both increased estrogen action and decreased testosterone action leads to inguinal hernia formation," said Hong Zhao, MD. As men age, their estrogen levels increase and their testosterone levels drop. The researchers found that their mouse model mimics the increased estrogen formation in the tissue and the decreasing blood testosterone levels seen in elderly men. Furthermore, when they looked at the rodents' muscle tissue from the lower abdomen, they found tissue atrophy (weakening) and fibrosis (scarring), comparable to that observed in human muscle tissue specimens from patients who had undergone inguinal hernia operations."
Cont:
https://www.eurekalert.org/pub_releases/2017-04/tes-hab040117.php
Another rat study from "the lab" addressing a problem that we're not even sure exists.
Are you aware of ANY studies that associate inguinal hernia with testosterone levels in humans?
Another rat study from "the lab" addressing a problem that we're not even sure exists.
Not sure I follow that one. is inguinal hernias not a thing?
Are you aware of ANY studies that associate inguinal hernia with testosterone levels in humans?
Not that I'm aware of. Proof of concept often starts in animal models and moves to RCTs and or correlational human data. Per above, I was very clear it should be taken with a grain O salt at this time, but interesting I thought. The study is highly suggested but far from conclusive. Comes under interesting but needs more data ;)
Not sure I follow that one. is inguinal hernias not a thing?
Inguinal hernia in rats is not a thing.
Not that I'm aware of. Proof of concept often starts in animal models and moves to RCTs and or correlational human data. Per above, I was very clear it should be taken with a grain O salt at this time, but interesting I thought. The study is highly suggested but far from conclusive. Comes under interesting but needs more data ;)
Incidental rat observations in the lab more often results in a clinical dead end when trying to apply to humans, however. Don't interpret any of this to mean that I'm pooh-poohing the problem...I'm pooh-poohing the drawing of any conclusions without any correlative data in humans. It would be an exceptionally easy thing to study. So easy that I think that the fact that it hasn't been studied is telling.
.
Inguinal hernia in rats is not a thing.
Rgr rgr. From how you said it, thought you meant in humans. I'm not a rat anatomist but it appears the equivalent is a Scrotal Hernia if I read correctly. A potentially interesting area of investigation that merits follow up. An interesting write up with more background. Apparently, as with so many discoveries, found during a different investigation:
http://www.news-medical.net/news/20170403/Researchers-find-link-between-hormones-and-inguinal-hernias-in-older-men.aspx
Source study:
https://plan.core-apps.com/tristar_endo17/abstract/f7e437ee5c2d999047a03154444733b4
No, I'm very clear on the extent and impact of inguinal hernia in older males. I diagnose them and fix them at least a couple of times a week.
Scrotal hernia and indirect inguinal hernia are the same thing.
No, I'm very clear on the extent and impact of inguinal hernia in older males. I diagnose them and fix them at least a couple of times a week.
Scrotal hernia and indirect inguinal hernia are the same thing.
Thanx for clarification. Apparently rats can suffer a Scrotal hernia. Whether causes/mechanisms in rats are human equivalent needs to be studied further no doubt.
Thanx for clarification. Apparently rats can suffer a Scrotal hernia. Whether causes/mechanisms in rats are human equivalent needs to be studied further no doubt.
The anatomy is similar. Scrotal/indirect inguinal hernia in humans is the same thing as scrotal/indirect inguinal hernia in rats. Scrotal hernia is just a more extensive version of indirect inguinal hernia. The difference is that it's hard to get a rat to turn its head and cough, consequently it's only diagnosed when it's clinically advanced that far with a visible bulge. In humans, they complain of pain earlier so it's diagnosed earlier.
The anatomy is similar. Scrotal/indirect inguinal hernia in humans is the same thing as scrotal/indirect inguinal hernia in rats. Scrotal hernia is just a more extensive version of indirect inguinal hernia. The difference is that it's hard to get a rat to turn its head and cough, consequently it's only diagnosed when it's clinically advanced that far with a visible bulge. In humans, they complain of pain earlier so it's diagnosed earlier.
Supported by the researchers experience:
" One day the investigators noticed that the male mice, used for breeding, could not walk and had a swollen lower abdomen. They initially thought the swelling was a tumor but later realized it was an extremely large groin hernia."
An interesting and unexpected finding about T. Will an asmtha attack be treated with a shot of T in the future? More data needed for sure:
Science News
Testosterone explains why women more prone to asthma
Summary:
An international research team has revealed for the first time that testosterone protects males against developing asthma, helping to explain why females are two times more likely to develop asthma than males after puberty. The study showed that testosterone suppresses the production of a type of immune cell that triggers allergic asthma. The finding may lead to new, more targeted asthma treatments.
Cont:
https://www.sciencedaily.com/releases/2017/05/170508112433.htm
Source:
Sophie Laffont, Eve Blanquart, Magali Savignac, Claire Cénac, Gilles Laverny, Daniel Metzger, Jean-Philippe Girard, Gabrielle T. Belz, Lucette Pelletier, Cyril Seillet, Jean-Charles Guéry. Androgen signaling negatively controls group 2 innate lymphoid cells. The Journal of Experimental Medicine, 2017; jem.20161807
More reasons docs need to stop relying on total T as the only metric of hormonal status and why competent TRT/HRT docs will look at and adjust am array of hormones knowing it's essential to getting the best effects for the people with work with:
AUA 2017: Calculated Free T and T:E Ratio but not Total Testosterone and Estradiol Predict Low Libido
Boston, MA (UroToday.com) Libido is thought to be influenced by hormonal milieu, particularly testosterone. The knowledge about the role of estradiol in male sexual function has been found to be more important than originally thought. The estradiol cut-off point of 5 ng/dL in hypogonadal men is thought to directly affect libido. Dr. Gupta presented a study assessing the impact of sex hormones on libido specifically in a cardiac patient population.
Cont:
https://www.urotoday.com/conference-highlights/aua-2017/aua-2017-sexual-function/95904-aua-2017-calculated-free-t-and-t-e-ratio-but-not-total-testosterone-and-estradiol-predict-low-libido.html
Large studies coming out suggesting TRT is protective:
Testosterone Replacement Therapy May Protect Against Stroke, Heart Attack in Hypogonadism
Testosterone replacement therapy (TRT) may exhibit a protective effect against myocardial infarction, stroke, and all-cause mortality in men with secondary hypogonadism. The findings were presented at the 26th Annual Scientific and Clinical Congress of the American Association for Clinical Endocrinologists (AACE), held May 3-7, 2017, in Austin, Texas.
Given that there has been growing concern that TRT may be associated with an increased risk for adverse cardiovascular outcomes or mortality, investigators led by Joyce George, MD, of the Cleveland Clinic in Ohio, conducted a retrospective cohort study using electronic health records from a large health care database to examine outcomes.
Records for men at least 40 years of age, with at least 2 testosterone levels <220 ng/dL (one obtained between 7 am and 10 am) were pulled from the database. Patients with primary hypogonadism, secondary hypogonadism related to overt hypothalamic pituitary pathology, HIV infection, metastatic cancer, a history of prostate cancer, prostate specific antigen >4 ng/mL, elevated hematocrit, or a history of previous thromboembolic disease were not included in the final cohort.
The study ultimately included 418 men (median age 53.8 years) exposed to TRT and 283 matched controls (median age 54.9 years; P =.02). At baseline, the prevalence of established cardiovascular disease was 9.8% vs 12.7%, respectively (P =.23). The treatment group was followed for a median of 3.8 years compared with 3.4 years for the control group.
The event composite outcome in the treatment group was 3.3% compared with 6.4% in the control group, with the investigators ultimately observing a reduction in the odds of the combined cardiovascular end point in the treatment group (hazard ratio [HR] 0.49; 95% CI, 0.24-0.99; P =.046).
While “the effect of TRT may vary considerably depending on the etiology of low testosterone, the patient's age, and whether or not they have established CV [cardiovascular] disease,” the results suggest TRT may protect some men with hypogonadism from cardiovascular events, the investigators concluded.
Cont:
http://www.endocrinologyadvisor.com/aace_2017/cardiovascular-benefits-in-testosterone-replacement-therapy/article/654941/
This thread has been life changing for me.
I just came across this website and the video is fresking outstanding! I will probably watch it a few more times. I'd like to get my local doc to watch it too.
DOSAGES FOR MEN
50mg Testosterone enanthate/cypionate injections every third day.
0.25mg Arimidex every third day.
500IU HCG every third day.
https://youtu.be/k7eu9RnZOvI
https://www.menshormonalhealth.com/testosterone-therapy.html
This thread has been life changing for me.
I just came across this website and the video is fresking outstanding! I will probably watch it a few more times. I'd like to get my local doc to watch it too.
DOSAGES FOR MEN
50mg Testosterone enanthate/cypionate injections every third day.
0.25mg Arimidex every third day.
500IU HCG every third day.
Few thoughts here. Smaller doses of T more often is the in thing these days, some doing very small doses (20mg) daily. Some feel better on such schedules, but frankly it shows a lack of understanding of the pharmacokinetics of those esters. Use of Arimidex without showing a need for it (via blood work showing elevated E2) is a waste of $ and can cause side effects, lower HDL, etc. Docs adding in Arimidex as part of standard protocol without doing so to address elevated E2 (as not all men experience elevated E2), are using bad medicine. Three, that dose of HCG higher than needed to maintain fertility and gonadal function and may lead to elevated E2.
Those who want to take their knowledge base on this topic, including docs you may be working with, should join the excelmale site and forums. I'd be happy to speak with your doc if needed.
Few thoughts here. Smaller doses of T more often is the in thing these days, some doing very small doses (20mg) daily. Some feel better on such schedules, but frankly it shows a lack of understanding of the pharmacokinetics of those esters. Use of Arimidex without showing a need for it (via blood work showing elevated E2) is a waste of $ and can cause side effects, lower HDL, etc. Docs adding in Arimidex as part of standard protocol without doing so to address elevated E2 (as not all men experience elevated E2), are using bad medicine. Three, that dose of HCG higher than needed to maintain fertility and gonadal function and may lead to elevated E2.
Those who want to take their knowledge base on this topic, including docs you may be working with, should join the excelmale site and forums. I'd be happy to speak with your doc if needed.
Thanks Will! I'll head over there now and sign up. I would hope blood work/results would be part of the protocol too.
Thanks Will! I'll head over there now and sign up. I would hope blood work/results would be part of the protocol too.
I'd sure as hell hope so, but not always the case and addition of Arimidex without indication it's needed without blood work not uncommon these days. Those jumping on the TRT/HRT train looking to make people think they have the magic ju ju protocols when they don't and or can potentially do as much harm as good using cookie cutter protocols.
DH is lucky. He got put on anastrozole for elevated e2(bloodwork confirmed). But in his case a very low dose keeps him where he needs to be and has not crashed him.
Sent from my SGH-M919 using Tapatalk
DH is lucky. He got put on anastrozole for elevated e2(bloodwork confirmed). But in his case a very low dose keeps him where he needs to be and has not crashed him.
Many do over dose and crash E2 levels after confirming elevated levels. Even among some in the medical community, E2 = bad in men and a "female" hormone to be suppressed. Worked with one guy who had a doc put him on 3mg per week of anastrozole which took him from elevated to almost non detectable. Talk about pan into the fire.
DH is on .5mg once a week.
Sent from my SM-T230NU using Tapatalk
DH is on .5mg once a week.
Sent from my SM-T230NU using Tapatalk
Always best to titrate up until until target levels achieved vs titrate down after crashing it.
Flankenstein
06-08-17, 15:57
Many do over dose and crash E2 levels after confirming elevated levels. Even among some in the medical community, E2 = bad in men and a "female" hormone to be suppressed. Worked with one guy who had a doc put him on 3mg per week of anastrozole which took him from elevated to almost non detectable. Talk about pan into the fire.
Yes, I saw a doc who thought (still thinks) letrozole was (is) the best AI for TRT....
I'd sure as hell hope so, but not always the case and addition of Arimidex without indication it's needed without blood work not uncommon these days. Those jumping on the TRT/HRT train looking to make people think they have the magic ju ju protocols when they don't and or can potentially do as much harm as good using cookie cutter protocols.
My estradoil, serum was 60 pf/ml The reference range they list is 0-40. I knew this was one of my issues. I have a call into my doc now.
Sex Hormone Binding Gloublin is 9.1
Total T was 586
Free T was 20.4
DH is lucky. He got put on anastrozole for elevated e2(bloodwork confirmed). But in his case a very low dose keeps him where he needs to be and has not crashed him.
Sent from my SGH-M919 using Tapatalk Who prescribes it for DH? Local Doc?
Will you in box is full. Can you PM me a way to get in touch with you for a possible consultation with my local Doc? I will figure out how to reach out VIA Skype.
My estradoil, serum was 60 pf/ml The reference range they list is 0-40. I knew this was one of my issues. I have a call into my doc now.
Sex Hormone Binding Gloublin is 9.1
Total T was 586
Free T was 20.4
Which estradiol test are you using? Males should be using the ultra sensitive test.
My estradoil, serum was 60 pf/ml The reference range they list is 0-40. I knew this was one of my issues. I have a call into my doc now.
Sex Hormone Binding Gloublin is 9.1
Total T was 586
Free T was 20.4
Who prescribes it for DH? Local Doc?
Will you in box is full. Can you PM me a way to get in touch with you for a possible consultation with my local Doc? I will figure out how to reach out VIA Skype.
Originally his endocrinologist . New PCP who does write his TRT script is unfamiliar with using a-dex, so on Friday we will get a new scrip from his new endo. His old endo moved out of state. 😢
Sent from my SM-T230NU using Tapatalk
Which estradiol test are you using? Males should be using the ultra sensitive test.
I don't know. I will call now and ask.
Originally his endocrinologist . New PCP who does write his TRT script is unfamiliar with using a-dex, so on Friday we will get a new scrip from his new endo. His old endo moved out of state. ��
Sent from my SM-T230NU using Tapatalk
I went to an Endo and she would not even talk about it. It was frustrating.
I met with a local Urologist yesterday. It was promising because he seemed open to suggestions. He said he wanted to pull me off the T and start me on HCG to try to restart my natural production of T. I am nervous about that. Is it possible to re boot straying on T and adding HCG? I'll go check out excel male later tonight but I have not had much in the way of response to any of my questions over there. I heard an add on the radio today for the North East Mens Clinic. http://northeastmensclinic.com/ I made an appointment. Anyone familiar with them? Looks like I may be canceling that appointment: http://www.startribune.com/midnight-trip-to-er-results-in-complaint-against-men-s-sexual-health-clinic/261394601/ Bummer. I'm going to call Defy Back. =)
Looks like I'm member of the low-T club now... total T was 252. Primary care doesn't think it's low as the labs normal range was 175-750. Working on getting a referral to endocrinologist.
Have most of the symptoms and haven't felt 'right's in a few years.
I met with a local Urologist yesterday. It was promising because he seemed open to suggestions. He said he wanted to pull me off the T and start me on HCG to try to restart my natural production of T. I am nervous about that. Is it possible to re boot straying on T and adding HCG?
Reboot no, keep the nads working yes. Can't reboot the HPTA with HCG alone regardless.
I'll go check out excel male later tonight but I have not had much in the way of response to any of my questions over there.
I saw responses to your thread. Just need to fill in the Qs asked etc and you'll find mods, etc give excellent advice
I heard an add on the radio today for the North East Mens Clinic. http://northeastmensclinic.com/ I made an appointment. Anyone familiar with them? Looks like I may be canceling that appointment: http://www.startribune.com/midnight-trip-to-er-results-in-complaint-against-men-s-sexual-health-clinic/261394601/ Bummer. I'm going to call Defy Back. =)
Don't know anything about them but most seem happy with Defy. They take insurance?
Looks like I'm member of the low-T club now... total T was 252. Primary care doesn't think it's low as the labs normal range was 175-750. Working on getting a referral to endocrinologist.
Have most of the symptoms and haven't felt 'right's in a few years.
You'll save yourself years of hassle and all manner of problems if you take the time to read through this thread.
You'll save yourself years of hassle and all manner of problems if you take the time to read through this thread.
Thanks Will, I've read some, plan to read through it all!
For those in the VA system dealing with the TRT/HRT issue. This study found there's a wide range of prescribing practices in the VA. Something to consider perhaps when/if searching for docs in the VA for assistance with that issue. Not surprisingly, younger docs far more likely to prescribe TRT than older docs, likely due to being much more current with the data on TRT/HRT:
Testosterone prescribing in VA varies by provider's age, experience, specialty and region
Providers in the Veterans Health Administration (VA) system vary in their testosterone prescribing practices, according to a study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism. This is the first study to examine provider and site predictors of testosterone prescribing in the VA.
There has been a large increase in testosterone prescribing in the United States over the past decade, and prescriptions increased substantially between 2009 and 2012. Some testosterone prescriptions have been made without appropriate baseline evaluation prompting the U.S. Food and Drug Administration to review labeling for testosterone products. However, the clinical context within which testosterone prescriptions occur is not well understood, and better understanding that context could help guide interventions to improve the appropriateness of testosterone prescribing
"Our study clearly shows that there is variation in both receipt of testosterone as well as guideline-concordant prescribing of testosterone in the VA," said study author, Guneet K. Jasuja, Ph.D., of Edith Nourse Rogers Memorial Veterans Hospital (Bedford VA Medical Center) in Bedford, Mass., and Boston University School of Public Health in Boston, Mass. "Provider's age, number of years in practice and geographic area are all associated with variations in testosterone prescribing practices."
In this study, researchers examined provider and site characteristics associated with an index dispensing of testosterone among patients receiving outpatient medications in the national VA system from October 1, 2007 to September 30, 2012. The study included 132,764 male patients who had at least one outpatient testosterone prescription and 550,151 male patients who did not receive testosterone, but did receive another medication.
Researchers found that providers ranging in age from 31 to 60 years, with less experience in the VA, and credentialed as medical doctors in endocrinology and urology were more likely to prescribe testosterone, compared to older providers, providers of longer VA tenure, and primary care providers. While they were more likely to prescribe testosterone, endocrinologists were also more likely to obtain an appropriate workup before prescribing, compared to primary care providers.
Sites located in the Northeast were more likely to appropriately check two low testosterone levels as well as two low morning testosterone levels. Patients who received care at VA's smaller community-based clinics (known as community-based outpatient clinics or CBOCs) were more likely to receive testosterone and less likely to have received appropriate testing in comparison with patients receiving care at the parent VA medical facility.
"Our findings highlight the opportunity to intervene at the provider and local level to improve testosterone prescribing practices," Jasuja said. "The VA and other healthcare systems can use these insights to promote targeted efforts that can help decrease inappropriate prescribing of testosterone, while ensuring that those patients who can benefit the most can still receive it."
https://www.sciencedaily.com/releases/2017/07/170718142942.htm
Source study:
Provider and Site-Level Determinants of Testosterone Prescribing in the Veterans Healthcare System. The Journal of Clinical Endocrinology & Metabolism, 2017; DOI:
Good thread bump:
Study: Long-term testosterone therapy improves urinary, sexual function and quality of life
(Boston) - A new study shows a significant improvement in both sexual and urinary function as well as quality of life for hypogonadal men who undergo long-term testosterone replacement therapy.
These findings appear in the Journal of Urology.
Testosterone is a steroid hormone involved in the regulation of sexual function, urinary health and metabolism as well as a number of other critical functions. For most men, testosterone concentration declines slowly with age and may not cause immediate major symptoms. However, some men may experience a host of signs and sumptoms constituting a clinical condition called Testosterone Deficiency (TD), or male hypogonadism, which is attributed to insufficient levels of testosterone. As a result, they experience symptoms as varied as erectile dysfunction, low energy, fatique, depressed mood and an increased risk of diabetes.
Cont:
https://www.eurekalert.org/pub_releases/2017-08/bumc-slt081517.php
Study:
http://www.jurology.com/article/S0022-5347(17)77145-5/fulltext
A new report appeared in the Asian Journal of Urology, "Testosterone Treatment and Cardiovascular Events in Prescription Database Studies," September 2017, concluded "T treatment was not associated with increased risks for thrombosis, MI, stroke, composite CV events, or mortality."
The paper reviewed retrospective/observational studies using prescription databases to the examine the association of testosterone treatment with the above-referenced morbidities. A literature search yielded eligible studies that were either retrospective cohort or case-control studies analyzing prescription or insurance claim databases. Fourteen studies were examined.
Summary of Results by Specific Outcomes
MI (Myocardial Infarction):
Several large MI-focused studies "found no increased risk for MI with T treatment. The largest of these was a well-designed study that included approximately 65,000 T-treated men an reported a 24% decreased risk for MI with T treatment."
Stroke
In three studies of stroke, "T treatment was not associated with an increased risk of stroke." The same study referenced in the MI results section (above) reported a 36% decreased risk for stroke with T treatment.
Composite CV Outcomes
Three studies reported conflicting results on the association of T treatment and composite CV outcomes. However, at least one of those studies was poorly designed.
Thrombosis
Four studies indicated that treatment with testosterone was not associated with an elevated risk for thrombosis. One study indicated an increased risk of such an event.
Mortality
No study found an overall increased mortality risk for men being treated with testosterone. The decreased mortality risk (all-cause mortality) ranged from 22%-66%.
Conclusion
The studies examined over 215,000 men being treated with testosterone. Most, by a substantial majority, showed that such treatment was not associated with cardiovascular disease/mortality. However, the author points out that - given the nature and limitations of retrospective, observational data - discussion and debate will likely continue until a large, prospective randomized, double-blind, placebo-controlled study is undertaken.
The abstract for this article is linked below. For a short time the full-text will also be available.
http://www.ajandrology.com/preprintarticle.asp?id=212903;type=0
Thanks to this thread I got tested. I'm 55 and discovered that I have both low T and low T4.
Starting Testosterone replacement and Thyroid support.
Looking forward to better quality of life all around.
Thanks Will for the knowledge you share here on a regular basis!
Eta: Testosterone 179, Free T4 0.75
Symptoms: weight gain, moodiness, loss of muscle mass/strength
I also have sleep apnea and will be starting overnight O2 therapy soon.
Thanks to this thread I got tested. I'm 55 and discovered that I have both low T and low T4.
Starting Testosterone replacement and Thyroid support.
Looking forward to better quality of life all around.
Thanks Will for the knowledge you share here on a regular basis!
I'm happy to assist. Report you low numbers, and report your treated numbers when you are re tested. Write down subjective symptoms, if any, while low (now) and keep track of them as each week passes until you're retested and see how/if they line up. Make sure doc you're working with is up to speed RE: the topics covered here for issues such as dose, dose schedules, etc all of which makes a huge difference and (sadly) few docs know that intel supplied in this lengthy thread, which is worth taking the time to read as an investment in your health and well being. If you simply go by what the doc tells you for dose, type, schedule etc, unless he/she is really up to speed (and as anyone here will tell you, that's a unicorn) you may end up no better, or worse than you began, so be informed. Word.
Stranger45
09-23-17, 10:57
What if your PSA numbers go up, is that a bad sign?
What if your PSA numbers go up, is that a bad sign?
Maybe. Maybe not. Depends on your total PSA level and what your urologist finds when he does the rectal exam.
Maybe. Maybe not. Depends on your total PSA level and what your urologist finds when he does the rectal exam.
Also, my understanding if the velocity of change in those numbers, if they change at all, the most relevant variable.
Also, my understanding if the velocity of change in those numbers, if they change at all, the most relevant variable.
Importance of velocity of change is highly debated. Many or most urologists believe it to be secondary to the actual PSA level and results of DRE. Increasingly fewer urologists would biopsy solely on the basis of PSA velocity.
Importance of velocity of change is highly debated. Many or most urologists believe it to be secondary to the actual PSA level and results of DRE. Increasingly fewer urologists would biopsy solely on the basis of PSA velocity.
Of course there's an ongoing debate over total PSA vs free, and the ratio there of and the strength of either in predicting PC. Regardless, we know PSA far from a perfect test and just a tool in the tool box among diagnostic tools for PC. Most recent paper I found would support what you're saying in terms of actually improving the screening and clinical management:
http://www.sciencedirect.com/science/article/pii/S1078143914001525
There's really no clinical debate. The bullshit over PSA is based on the possibility that a rising or elevated PSA might cause some unnecessary prostate biopsies. When it comes to cancer, I would rather overdiagnose than underdiagnose, and overtreat rather than undertreat. They're worried about spending money, urologists are worried about people dying of prostate cancer.
Cause and effect is unclear here, but men with low T and not treated, have an increased risk of developing autoimmune diseases;
Clin Rheumatol. 2016 Dec;35(12):2983-2987. Epub 2016 Jun 20.
Hypogonadism and the risk of rheumatic autoimmune disease.
Baillargeon et al
Abstract
Testosterone deficiency has been linked with autoimmune disease and an increase in inflammatory markers, such as C-reactive protein (CRP), tumor necrosis factor, and interleukin-6 (IL-6). However, no large-scale longitudinal studies have examined this association. We examined whether untreated hypogonadism was associated with an increased risk of rheumatic autoimmune disease in a large nationally representative cohort. Using one of the nation's largest commercial insurance databases, we conducted a retrospective cohort study in which we identified 123,460 men diagnosed with hypogonadism between January 1, 2002 and December 31, 2014 and with no prior history of rheumatic autoimmune disease. We matched this cohort to 370,380 men without hypogonadism, at a 1 to 3 ratio, on age and index/diagnosis date. All patients were followed until December 31, 2014 or until they lost insurance coverage or were diagnosed with a rheumatic autoimmune disease. Cox proportional hazards regression was used to calculate adjusted hazard ratios (aHRs). Untreated hypogonadism was associated with an increased risk of developing any rheumatic autoimmune disease (HR = 1.33, 95 % CI = 1.28, 1.38), rheumatoid arthritis (HR = 1.31, 95 % CI = 1.22, 1.44), and lupus (HR = 1.58, 95 % CI = 1.28, 1.94). These findings persisted using latency periods of 1 and 2 years. Hypogonadism was not associated with the control outcome, epilepsy (HR = 1.04, 95 % CI = 0.96, 1.15). Patients diagnosed with hypogonadism who were not treated with testosterone had an increased risk of developing any rheumatic autoimmune disease, rheumatoid arthritis, and lupus. Future research should further examine this association, with particular attention to underlying mechanisms.
Cause and effect is unclear here, but men with low T and not treated, have an increased risk of developing autoimmune diseases;
Clin Rheumatol. 2016 Dec;35(12):2983-2987. Epub 2016 Jun 20.
Hypogonadism and the risk of rheumatic autoimmune disease.
Baillargeon et al
Abstract
Testosterone deficiency has been linked with autoimmune disease and an increase in inflammatory markers, such as C-reactive protein (CRP), tumor necrosis factor, and interleukin-6 (IL-6). However, no large-scale longitudinal studies have examined this association. We examined whether untreated hypogonadism was associated with an increased risk of rheumatic autoimmune disease in a large nationally representative cohort. Using one of the nation's largest commercial insurance databases, we conducted a retrospective cohort study in which we identified 123,460 men diagnosed with hypogonadism between January 1, 2002 and December 31, 2014 and with no prior history of rheumatic autoimmune disease. We matched this cohort to 370,380 men without hypogonadism, at a 1 to 3 ratio, on age and index/diagnosis date. All patients were followed until December 31, 2014 or until they lost insurance coverage or were diagnosed with a rheumatic autoimmune disease. Cox proportional hazards regression was used to calculate adjusted hazard ratios (aHRs). Untreated hypogonadism was associated with an increased risk of developing any rheumatic autoimmune disease (HR = 1.33, 95 % CI = 1.28, 1.38), rheumatoid arthritis (HR = 1.31, 95 % CI = 1.22, 1.44), and lupus (HR = 1.58, 95 % CI = 1.28, 1.94). These findings persisted using latency periods of 1 and 2 years. Hypogonadism was not associated with the control outcome, epilepsy (HR = 1.04, 95 % CI = 0.96, 1.15). Patients diagnosed with hypogonadism who were not treated with testosterone had an increased risk of developing any rheumatic autoimmune disease, rheumatoid arthritis, and lupus. Future research should further examine this association, with particular attention to underlying mechanisms.
I suspect that might have cause and effect mixed up. But interesting.
Just got my numbers back:
T - 314
Free T - 9.2
E2 - 16.7
Should I consider supplemental T?
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I’m happy to see my doctor has a new reference range for total T of 229-902. I tried rebooting my natural T taking Let resolution 2.5 a day and CMP . Anastrolole.125 daily. I stopped taking T on July 5th. I’m down to 27 and I can't hack it anymore I'm going to restart now!
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Just got my numbers back:
T - 314
Free T - 9.2
E2 - 16.7
Should I consider supplemental T?
Can't be answered by a simple set of numbers per se. Subjective symptoms, variables (e.g., age, bodyfat, meds, exercise, diet, etc, etc) that may explain the low "normal" levels, and so forth. You'd do yourself a huge favor by getting up to speed by reading this thread, and deciding after that. It's an intel dump, but worth it being your well being and TRT being a life time commitment as a rule.
Can't be answered by a simple set of numbers per se. Subjective symptoms, variables (e.g., age, bodyfat, meds, exercise, diet, etc, etc) that may explain the low "normal" levels, and so forth. You'd do yourself a huge favor by getting up to speed by reading this thread, and deciding after that. It's an intel dump, but worth it being your well being and TRT being a life time commitment as a rule.
Ok. Didn't realize it was more complicated. Will bookmark the thread to deep dive when time permits.
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Ok. Didn't realize it was more complicated. Will bookmark the thread to deep dive when time permits.
There's few things less complicated in human physiology than hormones, putting hormones into your body without being informed, is a very bad idea. Yes, some - who should know better either due to ignorance, greed, or both - will treat it as a simple matter, but that's a road paved with problems.
Dr. Bullseye
10-19-17, 17:05
Im 21... is there any chance of me having low test levels?
Is your name Anderson Cooper?
Ha! F You! =). I've been a mess the past month. It was 41 last month! 110 two months ago. My E is finally good! My job of 21 years is going away on January 1st. I have a bunch of applications out there. I've been very emotional the last three weeks. I've had insomnia. That's no fun. I went to the VA yesterday to establish my health care. I loose mine in a few months. I met with my new Doc and asked about Alpha-Stim. http://www.alpha-stim.com/2015/02/vets-va-seek-alternative-treatments-of-ptsd-and-chronic-pain/
He said he'd look into it. I'd heard from Dakota Meyer on FRI and a bunch of Google searches that it's an option at the VA. I don't want to take news for it. I heard it's only been approved for pain. I have that covered too. A
I started Crossfit three weeks ago. I'm going to stick with it for at least six months and then reevaluate it. I like most of it so far.
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Oops I thought you called me Anderson Cooper. If you think your T is low have it checked.
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Im 21... is there any chance of me having low test levels?
In the absence of some underlying pathology, it's unlikely. Testosterone levels generally peak around age 21, begin to decline about 1% per year after age 30. Just ask your doctor to check it.
Mr. Goodtimes
10-20-17, 09:18
Is your name Anderson Cooper?
In the absence of some underlying pathology, it's unlikely. Testosterone levels generally peak around age 21, begin to decline about 1% per year after age 30. Just ask your doctor to check it.
Holy ****ing necro quote... that original post is 7 years old. To answer the question, though, no I did not have low t at the time. I got tested and my levels were in the 1400 range. Last year, however, I did come up low on multiple blood panels over several months. My diet has always been healthy and I live as healthy a lifestyle as a firefighter can (screwed up sleep patterns) and thus made a decision to go on TRT.
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Dr. Bullseye
10-20-17, 20:40
Bad joke on my part. No, i am not calling you Anderson Cooper. I was pointing out that his program, Estrogen 360, lacks it.
I'm 70. I am taking a T supplement now. There seem to be three reasons for doing this. 1. Sexual drive. 2. Muscle building. 3. Energy. I am concerned with the latter. Some days I just feel like all the wind has been taken out of my sails. I don't feel like doing anything. I just want to sit there. I want my energy back. But there is a bit more. You have head the term "grumpy old man"? Well, I think this is a lack of testosterone too. What I am saying it low T causes bad attitude. Testosterone supplements, like you find at health food stores, do help with this. Even taking a zinc pill helps. Taking an iron pill helps with the energy too.
There is something else. Different suppliments seem to effect you in different ways. When I was 32 and lifting weights I reached a sticking point on the bench press. Someone suggested testosterone, but for me no steroids, so I found something called Muscle Mix. It was a small bottle of herbs in alcohol, administered through an eye dropper. You put 7 drops under your tongue and held it for 30 seconds. Wow, what a difference. Broke right through that sticking point. There may be supplements for sexual problems also. They could all be separate problems, influenced by different supplements---I don't know.
Bad joke on my part. No, i am not calling you Anderson Cooper. I was pointing out that his program, Estrogen 360, lacks it.
I'm 70. I am taking a T supplement now. There seem to be three reasons for doing this. 1. Sexual drive. 2. Muscle building. 3. Energy. I am concerned with the latter. Some days I just feel like all the wind has been taken out of my sails. I don't feel like doing anything. I just want to sit there. I want my energy back. But there is a bit more. You have head the term "grumpy old man"? Well, I think this is a lack of testosterone too. What I am saying it low T causes bad attitude. Testosterone supplements, like you find at health food stores, do help with this. Even taking a zinc pill helps. Taking an iron pill helps with the energy too.
There is something else. Different suppliments seem to effect you in different ways. When I was 32 and lifting weights I reached a sticking point on the bench press. Someone suggested testosterone, but for me no steroids, so I found something called Muscle Mix. It was a small bottle of herbs in alcohol, administered through an eye dropper. You put 7 drops under your tongue and held it for 30 seconds. Wow, what a difference. Broke right through that sticking point. There may be supplements for sexual problems also. They could all be separate problems, influenced by different supplements---I don't know.
No, they do not. Many tested to date, all failed when put to objective testing. Only way to know your T is not up to snuff is to get tested. This thread is focused on legit TRT/HRT. In terms of "T booster" type supplement, I cover them HERE. (http://www.brinkzone.com/articles/the-facts-on-testosterone-boosting-supplements/)
Today is day three for me back on T. I'm starting to feel better. I also slept better last night.
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Correlation does = causation, but if the reverse was found, the media and other anti T knobs would be all over it. Be that as it may...
Testosterone decline associated with increased mortality risk
Men experiencing a pronounced, age-related decline in testosterone level are more likely to die of any cause during a 15-year period vs. men who have testosterone levels in the 10th to 90th percentile, according to findings reported in the European Journal of Endocrinology.
https://www.healio.com/endocrinology/reproduction-androgen-disorders/news/in-the-journals/%7Bb9ffabec-a385-4c19-b01b-4981f05e01d1%7D/testosterone-decline-associated-with-increased-mortality-risk
Yet more research showing TRT does not increase risk of MI:
Conclusion
"This large, retrospective, real-world observational study showed no significant association between TT use and acute MI when comparing TT-treated with untreated hypogonadal men overall, by age, or by prior CVD; the suggested association between injectable TT and acute MI deserves further investigation."
Source:
http://www.jsm.jsexmed.org/article/S1743-6095(17)31427-3/abstract
Don Robison
10-29-17, 21:16
I've been on TRT since August, turned 50 in September. Total test was in the low normal range, but free test taken at 7:30a.m. was only 2.8. Just finishing my third month of 300mg a week along with an estrogen blocker and HCG. Haven't felt this good in 15 years. Better focus, better sleep, down just just one cup of coffee in the morning and water the rest of the day. Previously my normal caffeine intake was 10-12 cups of coffee a day and 4-6 diet cokes just to keep me going. Within 5-6 days I noticed I didn't have a taste for the soda anymore. I've dropped two pant sizes, but only about 10 pounds which I'm cool with. A benefit I wasn't expecting is that a lot 50-60% of my arthritis joint pain has diminished.
I've been on TRT since August, turned 50 in September. Total test was in the low normal range, but free test taken at 7:30a.m. was only 2.8. Just finishing my third month of 300mg a week along with an estrogen blocker and HCG. Haven't felt this good in 15 years. Better focus, better sleep, down just just one cup of coffee in the morning and water the rest of the day. Previously my normal caffeine intake was 10-12 cups of coffee a day and 4-6 diet cokes just to keep me going. Within 5-6 days I noticed I didn't have a taste for the soda anymore. I've dropped two pant sizes, but only about 10 pounds which I'm cool with. A benefit I wasn't expecting is that a lot 50-60% of my arthritis joint pain has diminished.
What's your labs look like? That's a very high weekly dose.
Don Robison
10-30-17, 07:46
What's your labs look like? That's a very high weekly dose.So far everything looks good other than a cholesterol spike. The testosterone decreased my hdl which increased my ldl plus I got sloppy on my diet for about six weeks. I've been borderline on cholesterol for a few years and controlling it with diet since I didn't like how the meds made me feel.
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So far everything looks good other than a cholesterol spike. The testosterone decreased my hdl which increased my ldl plus I got sloppy on my diet for about six weeks. I've been borderline on cholesterol for a few years and controlling it with diet since I didn't like how the meds made me feel.
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That does not tell me much. What is your TT, FT, E2, etc with those doses? Who recommended 300mg weekly?
Don Robison
10-30-17, 08:25
That does not tell me much. What is your TT, FT, E2, etc with those doses? Who recommended 300mg weekly?I'll post it when I get my next blood work done. This last was just done by my family doc as part of an annual physical and he didn't check the things my endochrinologist is monitoring. My endocrinologist is writing the scripts. I feel great so I have no reason to doubt his reasoning behind it. Unless something changes drastically for the worse in my blood work I'm going to run with it.
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I'll post it when I get my next blood work done. This last was just done by my family doc as part of an annual physical and he didn't check the things my endochrinologist is monitoring. My endocrinologist is writing the scripts. I feel great so I have no reason to doubt his reasoning behind it. Unless something changes drastically for the worse in my blood work I'm going to run with it.
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I don't expect health related labs to be out of whack per, but I guarantee your total T (assuming you're in the US using typical esters of T) and free T, will be well above TRT ranges. I'm surprised you found an endo who started you off on that dose. Typical dose (though not what I'd recommend...) might be 300mg every 2 weeks.
Good luck.
Don Robison
10-30-17, 08:42
I don't expect health related labs to be out of whack per, but I guarantee your total T (assuming you're in the US using typical esters of T) and free T, will be well above TRT ranges. I'm surprised you found an endo who started you off on that dose. Typical dose (though not what I'd recommend...) might be 300mg every 2 weeks.
Good luck.Yeah, I'm expecting free T to be up around 9 and total to be around 1000-1100 just based on the average increases from the few studies I've read done on 300mg vs 600mg of test per week. Definitely at the top of the scale and if they are over he said he'll back them down.
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Yeah, I'm expecting free T to be up around 9 and total to be around 1000-1100 just based on the average increases from the few studies I've read done on 300mg vs 600mg of test per week. Definitely at the top of the scale and if they are over he said he'll back them down.
I'd expect higher at 300mg per week. 200mg per week, maybe.
Thanks to Will and this thread I started to suspect I may have low T. Talked to my doctor about it, he didn't think that I had any issues, but I was able to get him to order me a hormone panel.
Test came back at 67 ng/dl, @32 years of age.
Doctor now wants to do another test in a few weeks to confirm those numbers. Is waiting and retesting after a few weeks a normal practice?
If this has already been covered I apologize, I am working my way through this thread but haven't come across an answer yet.
Thanks to Will and this thread I started to suspect I may have low T. Talked to my doctor about it, he didn't think that I had any issues, but I was able to get him to order me a hormone panel.
Test came back at 67 ng/dl, @32 years of age.
Doctor now wants to do another test in a few weeks to confirm those numbers. Is waiting and retesting after a few weeks a normal practice?
If this has already been covered I apologize, I am working my way through this thread but haven't come across an answer yet.
Wow, that's lowest I have ever seen in a (seemingly) healthy man under 40. A retest is in order per docs recs, as it could be lab error, etc, but while already drawing blood, seeing a number that low, I'd want to see free T, E2, LH, and FSH, at the very least on the re test. If total T, and free T, and or E2, etc come back out whack, that gives a far better clinical picture and more intel as to where the issue stems from (primary vs secondary) and how to move forward.
I assume you had it done due to experiencing subjective symptoms of low T?
Wow, that's lowest I have ever seen in a (seemingly) healthy man under 40. A retest is in order per docs recs, as it could be lab error, etc, but while already drawing blood, seeing a number that low, I'd want to see free T, E2, LH, and FSH, at the very least on the re test. If total T, and free T, and or E2, etc come back out whack, that gives a far better clinical picture and more intel as to where the issue stems from (primary vs secondary) and how to move forward.
I assume you had it done due to experiencing subjective symptoms of low T?
I did have the test done for that reason, though I have been having the symptoms since my senior year of college, it wasn't until I started reading this thread that I thought I may be suffering from low T.
I eat healthy and lift 3-4 times a week, do a little bit of spinning for cardio, and have a very active job/lifestyle.
I actually had a number of the tests you mention done with the hormone test per doctors orders, though the only numbers that the doctor mentioned being outside of normal were the testosterone numbers and cholesterol.
Can low T be genetic? Males on one side of my family generally experience what I did, being quite healthy and fit until their early 20's, then going all Fun House Mirror over a few months time even though they (we) lead a very healthy/active lifestyle at the time.
I did have the test done for that reason, though I have been having the symptoms since my senior year of college, it wasn't until I started reading this thread that I thought I may be suffering from low T.
I eat healthy and lift 3-4 times a week, do a little bit of spinning for cardio, and have a very active job/lifestyle.
I actually had a number of the tests you mention done with the hormone test per doctors orders, though the only numbers that the doctor mentioned being outside of normal were the testosterone numbers and cholesterol.
Can low T be genetic? Males on one side of my family generally experience what I did, being quite healthy and fit until their early 20's, then going all Fun House Mirror over a few months time even though they (we) lead a very healthy/active lifestyle at the time.
Then what were the numbers for free T, E2, LH, and FSH? If those were not tested, then they should be at this point in my view. Always ask for a copy of your blood work, always. Depending on those numbers, at your age, and generally healthy life style, I'd want to rule out things like pituitary tumor*, meds, etc. You'd want to rule out all possible known causes before even considering some genetic related factor at this point. Some times, the cause just can't be determined.
* = The majority of which are noncancerous benign adenomas BTW.
Thank you for the input and advice sir, I will get a copy of the bloodwork when I see the doctor next, and inquire about those numbers and tests.
New paper further supports going the sub Q route for T administration. I don't see any reason to switch per se if one is getting the results they wanted from their current admin route, but worth noting sub Q is perfectly viable route:
Serum Testosterone Concentrations Remain Stable Between Injections in Patients Receiving Subcutaneous Testosterone
J Endo Soc. 2017;1(8):1095-1103.
Abstract and Introduction
Abstract
Purpose: Intramuscular (IM) testosterone is the most common modality for testosterone therapy of both male hypogonadism and female-to-male (FTM) gender transition. However, IM injections can be painful and often are not self-administered by the patient. The objective of this study was to further characterize subcutaneous (SC) administration of testosterone as an effective and safe alternative to IM injections by evaluating the pharmacodynamics of serum total and free testosterone concentrations between weekly testosterone injections.
Methods: Eleven FTM transgender patients already receiving weekly SC testosterone cypionate with documented therapeutic levels prior to enrollment had free and total serum testosterone levels measured at eight different time points during a 1-week dosing interval.
Results: Mean levels of total and free testosterone were stable and remained well within the normal range between injections. Overall mean ± standard deviation levels for the seven samples taken between injections were 627 ± 206 ng/dL (range, 205 to 1410) for total testosterone and 146 ± 51 pg/mL (range, 38 to 348) for free testosterone. No adverse effects were encountered.
Conclusions: The results of this study support use of SC testosterone to achieve therapeutic and stable serum testosterone levels for the purpose of gender transition. It is anticipated that these results can be extended to hypogonadal men. This route may be preferred over IM testosterone because it is relatively painless and easy to self-inject thus allowing for the convenience and economy of patient self-administration.
Full Paper:
https://www.medscape.com/viewarticle/886166?nlid=119016_1005&src=WNL_mdplsfeat_171114_mscpedit_urol&uac=38277HG&spon=15&impID=1483203&faf=1
Low T levels and obesity have been associated for a long time, but the relationship and mechanisms unclear. This may be at least one viable mechanism by which increased bodyfat levels = reduced T levels. In bold most interesting part of this paper I thought.
Endotoxin initiated inflammation reduces testosterone production in men of reproductive age.
Am J Physiol Endocrinol Metab. 2017 Nov
Abstract
Inflammation, both acute and chronic is associated with testosterone deficiency, raising the possibility of a direct causal link. One potential trigger for inflammation in obese men is the passage of intestinal bacteria into the circulation due to a breakdown in mucosal barrier integrity.
Recently we hypothesized that this endotoxin exposure may cause androgen deficiency in obese men. To test this hypothesis, we analysed the relationship between serum levels of lipopolysaccharide binding protein (LBP), an indirect measure of endotoxin exposure, against male reproductive hormones, inflammatory markers (CRP, IL-1β, IL-6, TNF-α) and adiposity in 75 men. Adiposity was positively correlated with endotoxin exposure (LBP) and inflammation (CRP, IL-6), while negatively correlated with testosterone.
Furthermore, endotoxemia (LBP) was negatively correlated with serum testosterone, but positively correlated with IL-6. Multivariate analysis revealed a significant negative correlation between serum IL-6 and free testosterone. In a second interventional study, low-dose endotoxin challenge in lean men produced a transient inflammatory response that was followed by a decline in serum testosterone, without changes in LH or FSH, providing further evidence that endotoxin-driven inflammation may results in impaired Leydig cell function.
https://www.ncbi.nlm.nih.gov/pubmed/29183872
Why we can't have nice things, TRT style. Kidding aside, this small study illustrates why the common schedule of 1 injection every 2wks with common esters used in the US is is sub optimal schedule for most men, and 1xwk a schedule that will result in steadier serum levels without swings above and below physiological levels, spikes in E2, etc. Now some will do small doses 2xw and or more as the "in" schedule, but frankly, I don't believe more than 1xw is required, and until I see convincing data otherwise, will continue to recommend 1xk schedules:
Hormone profiles after intramuscular injection of testosterone enanthate in patients with hypogonadism.
Endocr J. 2006 Jun;53(3):305-10. Epub 2006 May 19.
Abstract
To examine hormone levels after androgen replacement therapy (ART) in Japanese male patients with hypogonadism, nine Japanese male patients with hypogonadism (serum total testosterone (tT) or free testosterone (fT) levels of < or = 2.7 ng/mL or < or = 10 pg/mL, respectively; average age, 59 years) were enrolled. They were treated with 125 mg of testosterone enanthate by single intramuscular injection. Blood samples were collected on the morning of the day of treatment, pre-ART, as well as on days 1 to 7 and day 14 after administration. Serum levels of tT, fT, estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) were determined. On day 1 after administration, the mean serum levels of tT and fT were 7.62 ng/mL and 23.22 pg/mL, respectively. Serum levels of tT and fT on day 14 after administration were lower than their pre-ART values. One patient exhibited abnormally high serum tT and fT levels of 19.6 ng/mL and 44.4 pg/mL, respectively. Serum levels of LH and FSH began to decrease gradually on day 5 after administration. Serum levels of SHBG did not change throughout the observation period. Serum levels of E2 increased 1.7 times on day 1 after administration but returned to its pre-ART value by day 14 after administration. The dose of testosterone enanthate for male patients with hypogonadism requiring ART should be determined carefully because some patients exhibited high serum levels of androgen beyond the physiological range and gonadotropin was suppressed in all treated patients.
https://www.ncbi.nlm.nih.gov/pubmed/16710076
Here's a lengthy detailed review on the possible risks of TRT - for men and women - but for those who just want the take home: "The benefits of treatment of low testosterone levels with testosterone therapy in men and women substantially outweigh any risks, according to the current data."
Testosterone and Cardiovascular Health
http://www.mayoclinicproceedings.org/article/S0025-6196(17)30824-8/fulltext
Averageman
03-14-18, 11:16
This thread has taken on 100 pages now and I have benefited from it quite a bit.
I complained of a lack of energy and putting on weight that no amount of dieting seemed to take off four years ago. I went to my MD for a check up, had the blood work done and come to find out my Thyroid had pretty much just quit entirely.
75 MCG's of Levothyroxin daily helped a bit, but my blood work also showed low T. My Doctor (Female, I don't know it that makes a difference) was extremely resistant to prescribing HRT. After working with her for way too long about this, I got another Doctor.
Now I'm on Depo-Testosterone 200 mg/ml injections every other week.
I have also worked on my diet. I'm now doing an intermittent fast 16/8 and I've been eating very clean.
Broccoli, Kale, Spinach and mixed green leafy vegetables along with peppers, tomatoes and cucumbers etc. My main Carbs are from Brown Rice, Sweet Potatoes and Quinoa (yeah, I know also a protein). Meats are Fish, Chicken and lots of eggs. So, that's clean and it doesn't seem to be restrictive enough for me to need a lot of "cheat" meals.
After the first 25 pounds came off, I felt inspired to work out again. Now I am at the gym daily and have a total weight loss of 32 lbs. I feel much better, I can see and feel the difference every day. My blood pressure (as of 3/5/18) has lowered significantly. At one time my original Dr. wanted me on BP meds, it now has lowered to 104/73
The lessons I have learned are;
You have to educate yourself.
If your Doctor wont work with you find one that will.
Diet and exercise and experimentation with both are key.
You can read this stuff all day long, but if you dont get up and move, it's not going to happen.
This thread has taken on 100 pages now and I have benefited from it quite a bit.
I complained of a lack of energy and putting on weight that no amount of dieting seemed to take off four years ago. I went to my MD for a check up, had the blood work done and come to find out my Thyroid had pretty much just quit entirely.
75 MCG's of Levothyroxin daily helped a bit,
And did what for your thyroid levels via TSH/t4/t3?
but my blood work also showed low T. My Doctor (Female, I don't know it that makes a difference) was extremely resistant to prescribing HRT. After working with her for way too long about this, I got another Doctor.
Now I'm on Depo-Testosterone 200 mg/ml injections every other week.
Per this lengthy thread and study posted just recently above, sub par schedule, but a start at least. What were levels pre treatment? Full panel of just total T?
I have also worked on my diet. I'm now doing an intermittent fast 16/8 and I've been eating very clean.
Broccoli, Kale, Spinach and mixed green leafy vegetables along with peppers, tomatoes and cucumbers etc. My main Carbs are from Brown Rice, Sweet Potatoes and Quinoa (yeah, I know also a protein). Meats are Fish, Chicken and lots of eggs. So, that's clean and it doesn't seem to be restrictive enough for me to need a lot of "cheat" meals.
After the first 25 pounds came off, I felt inspired to work out again. Now I am at the gym daily and have a total weight loss of 32 lbs. I feel much better, I can see and feel the difference every day. My blood pressure (as of 3/5/18) has lowered significantly. At one time my original Dr. wanted me on BP meds, it now has lowered to 104/73
The lessons I have learned are;
You have to educate yourself.
If your Doctor wont work with you find one that will.
Diet and exercise and experimentation with both are key.
You can read this stuff all day long, but if you dont get up and move, it's not going to happen.
Excellent AAR's of truth ;)
Averageman
03-14-18, 11:36
Will;
Because of a work schedule I was in a rush and didn't see the last results. I went in for the blood work, got my prescription and got on my flight. I didn't get to see the Doctor because of scheduling issues, so I didn't get the T results as I wanted. Now that I'm back in town after a month and a half out on the road, I will make an appointment and discuss this topic further.
I need to make a point of getting copies of this stuff to bring home to study and compare.
The big Ah Ha moment for me was discovering the link between Testosterone and Thyroid. My understanding now is that for some people, treating one without the other may be lead to less than desirable results, such as I experienced.
From what I remember the original Thyroid results were that I was not producing at all. My Thyroid had essentially "died". My T results were in the bottom of the Low/Average for my age group. That's rather vague, but I will get the numbers ASAP.
Thanks.
Will;
Because of a work schedule I was in a rush and didn't see the last results. I went in for the blood work, got my prescription and got on my flight. I didn't get to see the Doctor because of scheduling issues, so I didn't get the T results as I wanted. Now that I'm back in town after a month and a half out on the road, I will make an appointment and discuss this topic further.
I need to make a point of getting copies of this stuff to bring home to study and compare.
The big Ah Ha moment for me was discovering the link between Testosterone and Thyroid. My understanding now is that for some people, treating one without the other may be lead to less than desirable results, such as I experienced.
From what I remember the original Thyroid results were that I was not producing at all. My Thyroid had essentially "died". My T results were in the bottom of the Low/Average for my age group. That's rather vague, but I will get the numbers ASAP.
Thanks.
Once things settle down, I'd recommend you have discussion with doc as to optimize treatment based on the intel in this thread. Good luck :cool:
I went to see my doc at the VA today. I’ve had muscle spasms and bad back pain for two weeks. After an exam he ordered ordered X-Rays. He called me as I was driving home to tell me I have compression fractures in the thorasic area of my spine. Maybey I can get them to prescribe anastrozole now.
I went to see my doc at the VA today. I’ve had muscle spasms and bad back pain for two weeks. After an exam he ordered ordered X-Rays. He called me as I was driving home to tell me I have compression fractures in the thorasic area of my spine. Maybey I can get them to prescribe anastrozole now.
Due to the fractures? I don't think they will see the two as connected.
Due to the fractures? I don't think they will see the two as connected.
I am certainly not an expert. I was trying to read up on osteoporosis. I have hypogonadism, caused by chemo in 2004. I've been on T since then. I've had hairy cell leukemia twice and chemo twice. Last night I read low t and an increase in estrogen are risk factors for men getting osteoporosis. I read an article last night that I can not find. I mentioned the importance of controlling estradoil to help prevent osteoporosis.
I am certainly not an expert. I was trying to read up on osteoporosis. I have hypogonadism, caused by chemo in 2004. I've been on T since then. I've had hairy cell leukemia twice and chemo twice. Last night I read low t and an increase in estrogen are risk factors for men getting osteoporosis. I read an article last night that I can not find. I mentioned the importance of controlling estradoil to help prevent osteoporosis.
Hmmm, well, no reason not to print that out or email to docs as a reason you need to manage high E2 levels. #1 way to lower E2, is to lose weight. What's your BMI and or Bf% these days?
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