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WillBrink
01-24-10, 11:05
Got Test? :cool:
by Will Brink

As hormone replacement therapy (HRT) has become much more common place, and there is a growing understanding that keeping men in the “healthy” range for testosterone (T) has various benefits, I wanted to briefly address the issue. For those who need a refresher on the basics of blood work, see my article “It’s in your blood (http://www.brinkzone.com/articles/its-in-your-blood/)."


To review the general issues of low T in men, according to one recent review by a Dr. Shabsigh and colleagues:

“Hypogonadism (low testosterone) is associated with central obesity; insulin resistance; low levels of high-density lipoprotein (HDL); high cholesterol levels; and high levels of low-density lipoprotein (LDL), triglycerides, fibrinogen, and plasminogen activator-1. Some observational studies show a correlation between low testosterone and cardiovascular disease (CVD), and others show no correlation. Interventional studies do not reveal a direct long-term relation between testosterone therapy and CVD. Short-term data suggest cardiovascular benefits of testosterone.”•

The above review also leaves out other known effects of low T, such as loss of libido, depression, loss of muscle mass and decreases performance, as well as other issues best avoided.

Most studies find clear health benefits for men with hypogonadism treated with HRT. However, some fears of long term side effects such as cardio vascular disease (CVD) and prostate cancer have been raised. These fears appear to be unfounded, with benefits to the cardio vascular system for men low in T.

So what of the risks of CVD or prostate cancer with HRT?

The jury is still out, but most data does not find an association between HRT and CVD or prostate cancer. For example, a retrospective analysis by researchers at Beth Israel Deaconess Medical Center published in The New England Journal of Medicine found no causal relationship between testosterone replacement and prostate cancer or heart disease risk. According to Dr. Abraham Morgentaler:

“We reviewed decades of research and found no compelling evidence that testosterone replacement therapy increases the incidence of prostate cancer or cardiovascular disease.”••

This review of 72 studies puts to rest-at least for me- that there is any risk of testosterone replacement therapy, at least where it concerns CVD or prostate cancer. Not everyone would agree with that opinion however and anyone considering HRT should get full blood workup done and talk with their doctor about it.

But what about healthy men with normal testosterone levels taking additional testosterone? That’s a little less clear at this time. Studies are conflicting whether or not adding additional testosterone to men with normal levels presents an increased risk. However, a study published in The New England Journal of Medicine (NEJM) – considered one of the most prestigious medical and scientific journals in the world – found healthy men given 600mg per week of testosterone enanthate did not suffer any side effects, negative changes in lipid profiles, and did not see a rise in prostate-specific antigens, or increased aggression. •••

But what if the person has already had a heart attack? Interestingly, one study suggests testosterone therapy may actually help after a heart attack, but it’s preliminary research done on animals. ••••

This is just a sample of the many studies published on the topic. Finally, what about the very high doses used by high level bodybuilders and other athletes? That’s petty much an unknown at this time. As with many hormones, below a certain levels, health issues arise and above a certain level, the same thing happens, though the health issues may or may not be the same. For example, very high levels or very low levels of T may present an increased risk for cardiovascular disease (CVD) but far more is known about too little vs. too much when it comes to testosterone and CVD or prostate issues, etc. At the very high doses used by some athletes it would not surprise me if there was an increased risk of CVD but data is scarce here. So what’s the take home?

• For men with low testosterone, studies are quite clear the benefit of HRT outweigh the risks by a long shot.

• In men with normal testosterone who take moderate doses (defined here as 600mg per week or less), there appears to be little risk, at least in the short term. Other side effects, such as acne, hair loss (if genetically susceptible) and others are still possible however and should not be ignored

• In bodybuilders and other athletes taking very high doses, say above 1000mg per week or more, the risks are unclear and not recommended without very close medical supervision, especially if other risk factors are involved, such as a family history of CVD, etc.

That pretty much sums up my thoughts on the issue.

Cites:

• Cardiovascular issues in hypogonadism and testosterone therapy.Am J Cardiol. 2005 Dec 26;96(12B):67M-72M.

••http://www.sciencedaily.com/releases…0129072631.htm

••• “The Effects Of Supraphysiologic Doses Of Testosterone On Muscle Size And Strength In Normal Men (vol.336, July, 96).

•••• Cardiovasc Res. 2003 Feb;57(2):370-8.

Effect of testosterone on post-myocardial infarction remodeling and function. Cardiovasc Res. 2003 Feb;57(2):370-8

Ga Shooter
01-24-10, 17:40
What about all those T-Boosters they sell in the mags? Do they have the same effect or are they just hype or dangerous?

JHC
01-24-10, 19:40
Great thread. The years will really take their toll if you are not on top of this.

One should consider working very hard to maintain their natural levels as high as possible for a long as possible as the years roll by.
- eat clean. I think the supplement ZMA is worth adding at bedtime.
- workout in a manner that supports maintaining as much muscle mass as you can. Pure high mileage marathon training can lower testosterone levels. Intense weight training, especially moving big weights in compound movements does reliably elevate T.
- and most exotic - and I've no intention of getting too detailed, but there are lessons to draw - some - but not all - conclusions from ancient Chinese Taoist health practices around sexual vitality. The book the Tao of Health, Sex and Longevity is worth a read. IMO it should not be take literally however. Read it, you'll see what I mean. The lessons there are to naturally kick in testosterone production. There have been modern studies that I think actually suggest these ancients were onto something. Google this: "German study finds daily erections increase testostrone" :D

I've been living this for well over a decade and at 52 I'm as strong as ever, and actually leaner than I was at 30.

JHC
01-24-10, 19:41
Ga shooter, high quality tribulus "probably" works. I'm not sure if its a good idea to stay on it for extended periods.

Mr. Goodtimes
01-24-10, 22:54
Im 21... is there any chance of me having low test levels?

Irish
01-24-10, 23:25
Just watched 30 Days: Season 1 Disc 1 from Netflix. A guy starts taking testosterone, I believe HGH and a few other things to get back in shape and trying to stay young... I'm in no way trying to contradict Will and his expertise but I believe it's worth watching due to the similarities of what I think this thread is about.

Ultimately the guy stops taking the stuff, my copy was scratched so I missed a few things, but he does experience some anger problems and his sperm count shoots to zero, maybe I should say drops to zero ;) Obviously this is only 1 case and isn't the end all be all but I thought that it might be worth a watch if you're considering this.

Netflix Description: Morgan Spurlock (of Supersize Me fame) hosts this one-hour documentary film series that places subjects for a month in situations they're unlikely to seek out on their own. By subjecting themselves to such circumstances, participants help shed light on social issues plaguing America today, such as the rift created by religious differences between Muslims and Christians in America, the incarcerated and the lawyers who put them in prison, and more.

AmpedUp
01-25-10, 00:47
Just watched 30 Days: Season 1 Disc 1 from Netflix. A guy starts taking testosterone, I believe HGH and a few other things to get back in shape and trying to stay young... I'm in no way trying to contradict Will and his expertise but I believe it's worth watching due to the similarities of what I think this thread is about.

Ultimately the guy stops taking the stuff, my copy was scratched so I missed a few things, but he does experience some anger problems and his sperm count shoots to zero, maybe I should say drops to zero ;) Obviously this is only 1 case and isn't the end all be all but I thought that it might be worth a watch if you're considering this.

Netflix Description: Morgan Spurlock (of Supersize Me fame) hosts this one-hour documentary film series that places subjects for a month in situations they're unlikely to seek out on their own. By subjecting themselves to such circumstances, participants help shed light on social issues plaguing America today, such as the rift created by religious differences between Muslims and Christians in America, the incarcerated and the lawyers who put them in prison, and more.

you can watch the full ep. on hulu.com
http://www.hulu.com/watch/5295/30-days-anti-aging

Iraq Ninja
01-25-10, 01:25
Im 21... is there any chance of me having low test levels?

Yes, especially if you are a female. Seriously though, it is possible. What makes you think you may have low testo?

Will,

How much is testo injections going for these days? Is it still very expensive like HGH?

WillBrink
01-25-10, 07:35
What about all those T-Boosters they sell in the mags? Do they have the same effect or are they just hype or dangerous?

Pure hype. Don't waste the $$$.

WillBrink
01-25-10, 07:38
Im 21... is there any chance of me having low test levels?

Unlikely, but not impossible. The only way to know is to have blood work done. Article on that topic was linked above.

WillBrink
01-25-10, 07:43
Will,

How much is testo injections going for these days? Is it still very expensive like HGH?

T is always much less then HGH. With script, it's what ever your co pay is for meds. Without insurance, but with script, approx $100 for 10cc bottle at 100mg per ml. At HRT doses, that lasts approx 10 weeks.

Regular blood work to tweak dose is essential. See article on blood work linked in above T write up.

usmcvet
01-30-10, 20:31
T is always much less then HGH. With script, it's what ever your co pay is for meds. Without insurance, but with script, approx $100 for 10cc bottle at 100mg per ml. At HRT doses, that lasts approx 10 weeks.

Regular blood work to tweak dose is essential. See article on blood work linked in above T write up.

+1 See your doc ref a simple blood test. I would also say trust your instincts, if you think something is wrong there is probably an issue somewhere; 21 is young. I'm 38 now and was about 33 when I noticed issues. 33 was young.

I did some Google searches trying to figure out what was up with me after my chemo. It was obvious there was a problem because my libido/function was nonexistent :o and was usually enough to irritate my wife. I went to the doc convinced I had low T and I was right.

Man I am using androgel, daily, it's about $600 a month. I have a high deductible insurance plan the first $3000 a year is on me then it is all covered. I should ask my doc about shots.

Funny note, my Physician's Assistant is a woman and friend, which made her comment even funnier. She told me the chemo knocked out my nuts and left me with hypogonadism.

I have HCL (hairy cell leukemia) in remission. Goggled that too and found out one of the causes is exposure to benzene! Sadam's boys lit the ****ing Al Bragan oil fields on fire. I spent Spring Break 1991 there with my unit. I was covered in the shit for weeks. I thought I had a great tan until we got real showers with hot water and the oil came off. We'd been using face cloths and canteen cups to clean up every few days but it was pretty ripe for 45-50 days. It's good to remember those days and appreciate the simple things like indoor plumbing and a real bed.

WillBrink
01-31-10, 09:17
Im 21... is there any chance of me having low test levels?

Only way to know is blood work. Article on that topic linked above. At your age, probably not an issue, but I have seen guys in their mid 20s with low T. At your age, if there are symptoms of low T, then step 2 is to do blood work and check.

WillBrink
01-31-10, 09:25
+1 See your doc ref a simple blood test. I would also say trust your instincts, if you think something is wrong there is probably an issue somewhere; 21 is young. I'm 38 now and was about 33 when I noticed issues. 33 was young.

I did some Google searches trying to figure out what was up with me after my chemo. It was obvious there was a problem because my libido/function was nonexistent :o and was usually enough to irritate my wife. I went to the doc convinced I had low T and I was right.

Man I am using androgel, daily, it's about $600 a month. I have a high deductible insurance plan the first $3000 a year is on me then it is all covered. I should ask my doc about shots.

Funny note, my Physician's Assistant is a woman and friend, which made her comment even funnier. She told me the chemo knocked out my nuts and left me with hypogonadism.

I have HCL (hairy cell leukemia) in remission. Goggled that too and found out one of the causes is exposure to benzene! Sadam's boys lit the ****ing Al Bragan oil fields on fire. I spent Spring Break 1991 there with my unit. I was covered in the shit for weeks. I thought I had a great tan until we got real showers with hot water and the oil came off. We'd been using face cloths and canteen cups to clean up every few days but it was pretty ripe for 45-50 days. It's good to remember those days and appreciate the simple things like indoor plumbing and a real bed.


Sorry to hear about the above, but I do know your pain. Many things, chemo a big one, can kill T levels. It's a damn shame how many men walk around with no T after chemo because no one thinks to check, but I digress. T levels and sperm counts have been dropping steadily (with some debate) in US men for decades, and it's unclear why. Whether it's estrogenic compounds we have added to the environment, life style changes, or other reasons is unclear at this time, but we are seeing younger men and or more men with low T levels.

Thank you for your service, and your sacrifices for this country. It's not forgotten.

D.S. Brown
02-01-10, 20:08
usmcvet,

I was diagnosed with LOW T levels in my late 30's, though I suspect the problem was occurring for FAAAAAAAAARRRRRRR longer than that. A normal male according to my doc should have between 300 and 800 nanograms (ng/dcl) per deciliter of T in their blood. I had 120 ng/dcl's. To put it in perspective a woman with "high" levels of T would have about 90 ng/dcl's. Yikes! Now I cruise along in the 600ng to 700ng range.

I use Testim 1% gel, about 5mg daily. On my insurance I get a three month supply through MEDCO for $62.50 YMMV. Good luck.

Best,

Dave

WillBrink
02-04-10, 13:40
usmcvet,

I was diagnosed with LOW T levels in my late 30's, though I suspect the problem was occurring for FAAAAAAAAARRRRRRR longer than that. A normal male according to my doc should have between 300 and 800 nanograms (ng/dcl) per deciliter of T in their blood. I had 120 ng/dcl's. To put it in perspective a woman with "high" levels of T would have about 90 ng/dcl's. Yikes! Now I cruise along in the 600ng to 700ng range.

I use Testim 1% gel, about 5mg daily. On my insurance I get a three month supply through MEDCO for $62.50 YMMV. Good luck.

Best,

Dave

120ng/dl in your 30s????!! What were you doing, watching Golden Girls or something? :eek:

D.S. Brown
02-04-10, 23:52
And listening to LOTS of Cher, Bette Midler, and Melissa Etheridge CD's, and almost attended Lilith fair once, Whew glad to get that off my chest.:p

Seriously though my doctor said that I have probably suffered since puberty, and many of my activities since did not help, over eating as a kid, too little exercise. Joined the Army in '86. Lost a lot of weight with the cardio, but slacking off caused it to come back very easily. Learned to lift weights in the Army, but could never seem to develop decent muscle mass, ( the latter I believe to be in direct proportion of the amount of running/cardio combined with low T).

However in all this time none of my sexual functions were affected. Psychologically I would be moody and irritable, unable to focus, fairly emotional. Taking T has helped with the moods and focus, though I think the moods are mostly in control, I've noticed a slightly shorter fuse than was present before.

Still it wasn't until about 8 years ago that low T was even on my radar. It would have been great to have been diagnosed when I was younger, it just never occurred to me or anyone else I knew.

Live and learn.

Best,

Dave

WillBrink
02-05-10, 10:16
And listening to LOTS of Cher, Bette Midler, and Melissa Etheridge CD's, and almost attended Lilith fair once, Whew glad to get that off my chest.:p
e

No Celine Dion? I actually did see her in concert once (long story...) and was stunned to find, she put on a great concert! I was lactating when I left, but that went away within a few days. :cool:

User Name
02-05-10, 10:58
Great thread. Why this stuff is illegal is beyond me. I have known a lot of folks in the 1000mg arena and have not seen "roid rage" yet. Of course HRT is legal though convincing your doctor to put you on a cycle of 500mg a week might be a difficult proposition.

WillBrink
02-05-10, 11:01
Great thread. Why this stuff is illegal is beyond me. I have known a lot of folks in the 1000mg arena and have not seen "roid rage" yet. Of course HRT is legal though convincing your doctor to put you on a cycle of 500mg a week might be a difficult proposition.

It's much more accepted now then it was just a few years ago, but yes, can be a real PITA to get doc to do it. Also depends on what part of the country you live in. Some areas are easier/tougher then others.

PS, I do NOT recommend 1000mg per week for anyone which is WAY above HRT/TRT levels. Just an FYI.

JonnyVain
03-21-10, 20:45
I'm a little surprised that with all the natural test boosting mentioned here, no one's discussed the importance of sleep. The stat I've heard is that 6 hours of sleep, as opposed to 8, can drop T as much as %60.

Oh, and I'm not sure about actually raising T, but Tribulus is a very effective adaptogen. I would easily put it above ginseng. I feel like a different person when I'm on it.

WillBrink
03-22-10, 09:28
I'm a little surprised that with all the natural test boosting mentioned here, no one's discussed the importance of sleep. The stat I've heard is that 6 hours of sleep, as opposed to 8, can drop T as much as %60.


Simply a different issue. Low fat diets are also bad for T, and studies find about 30% of cals optimal for T production. Sleep, nutrition, training, etc. are all factors of healthy T production, and no doubt, people should attempt to optimize T production via those means if possible. If interested, my thoughts on "T booster" type supplements:

https://www.m4carbine.net/showthread.php?t=46589

JonnyVain
03-22-10, 10:34
Simply a different issue. Low fat diets are also bad for T, and studies find about 30% of cals optimal for T production. Sleep, nutrition, training, etc. are all factors of healthy T production, and no doubt, people should attempt to optimize T production via those means if possible. If interested, my thoughts on "T booster" type supplements:

https://www.m4carbine.net/showthread.php?t=46589

I read your article. I agree with you there. I understand that tribulus may or may not increase T and that any increase is only minimal. All I know is that it makes me feel better than I do without it. Would you agree that ginseng has beneficial properties? That's what I equate trib to, but it has more effect on me (I've never noticed an effect with ginseng).

The effect that living a healthy lifestyle and eating green veggies has on T is all I expect from trib. I'm under a lot of physical stress right now, that's why I'm taking it.

WillBrink
03-22-10, 13:35
I read your article. I agree with you there. I understand that tribulus may or may not increase T and that any increase is only minimal. All I know is that it makes me feel better than I do without it. Would you agree that ginseng has beneficial properties? That's what I equate trib to, but it has more effect on me (I've never noticed an effect with ginseng).

The effect that living a healthy lifestyle and eating green veggies has on T is all I expect from trib. I'm under a lot of physical stress right now, that's why I'm taking it.

If you feel it's helping, I say keep using it. I just report the facts as they exist. The data on ginseng I can tell you is all over the place, some studies finding effects, many finding nadda.

jeff3vvv
04-12-10, 14:43
If you're wonder if you have low T, here's a simple way to find out without a trip to the Dr.
http://www.zrtlab.com/hormone-blood-spot-profiles-and-tests/testosterone-t-blood-total/flypage.tpl.html

Six Feet Under
05-05-10, 11:35
I'm planning on asking my doctor about this as soon as I get insurance. I don't want them to find anything now because it wouldn't be covered, so I'm going to wait.

I'm only 20 years old, but the listed symptoms fit pretty well. I've actually been wondering about this for a while, but never brought it up with the doctor or my parents (the doctor mostly because I don't have insurance, like I said before).

WillBrink
05-05-10, 11:59
I'm planning on asking my doctor about this as soon as I get insurance. I don't want them to find anything now because it wouldn't be covered, so I'm going to wait.

I'm only 20 years old, but the listed symptoms fit pretty well. I've actually been wondering about this for a while, but never brought it up with the doctor or my parents (the doctor mostly because I don't have insurance, like I said before).

It's a simply fairly inexpensive test, so best to do it sooner then later. Good luck.

Six Feet Under
05-05-10, 12:20
I'm still going to try to find insurance here sometime soon (or get a job where it's an option). I need it anyways, especially after getting shot last year with no insurance. I almost feel afraid to do anything potentially dangerous because I can't handle anymore medical debt seeing as I owe enough for a small house right now.

WillBrink
11-27-10, 07:44
Get you some! :cool:

Australian Firm To Sell World's First Armpit Testosterone Lotion In US
Updated: Friday, 26 Nov 2010, 11:30 AM EST
Published : Friday, 26 Nov 2010, 8:43 AM EST
By Jane Lee / news.com.au

An Australian company will sell the world's first armpit testosterone lotion in American stores next year after receiving approval from the US Food and Drug Administration, news.com.au reported Friday.
The lotion, created by Melbourne-based drug delivery firm Acrux, treats men with hypogonadism, a disease which produces low testosterone levels and includes symptoms such as erectile dysfunction, low sexual desire and performance.

Axiron -- an anagram for "iron ax" -- is the first testosterone replacement therapy to be applied in the armpit, with current treatments including a gel for the upper body and regular injections.

Only available by prescription, Axiron will be sold for the first time next year in the US, which has the world’s largest market for testosterone replacement, worth about $1 billion a year.

Acrux CEO Richard Treagus said: "What we’ve found is the population is aging in the US, Australia and around the world, and with [that comes] greater awareness around men’s health issues; more are now receiving treatment for them."

randolph
11-27-10, 08:12
Will
can/do you recommend these type of tests ?



If you're wonder if you have low T, here's a simple way to find out without a trip to the Dr.
http://www.zrtlab.com/hormone-blood-spot-profiles-and-tests/testosterone-t-blood-total/flypage.tpl.html

usmcvet
11-27-10, 09:02
Sounds good Pit stick T! I just had mine tested again for the first time following my chemo this summer. It is down to 85! Time to see the doc and have my dose increased.

Mikey
11-27-10, 11:34
usmcvet,

I was diagnosed with LOW T levels in my late 30's, though I suspect the problem was occurring for FAAAAAAAAARRRRRRR longer than that. A normal male according to my doc should have between 300 and 800 nanograms (ng/dcl) per deciliter of T in their blood. I had 120 ng/dcl's. To put it in perspective a woman with "high" levels of T would have about 90 ng/dcl's. Yikes! Now I cruise along in the 600ng to 700ng range.

I use Testim 1% gel, about 5mg daily. On my insurance I get a three month supply through MEDCO for $62.50 YMMV. Good luck.

Best,

Dave

I'm on the same dose of androgel. My levels were 60ng due to pituitary failure. Hypopituitarism with gonadotropin deficiency.

It's been great. I feel like a whole different person since I've been on it.

Mike

The_Biased_Observer
11-27-10, 11:58
Fat guy here, don't know how I snuck in the fitness section but the topic is close to home....

Been diagnosed as hypogonatic for about 9 years now, been through the whole routine with local doctors, their only solution is to prescribe testosterone. I've done the shots, which didn't last long when I was divorced and had to self shoot in the thigh. Went off meds for a long time but returned with Androgel. Had ok results with that then moved to Testim. Testim has a distinct odor to it my coworkers can smell....

None of it has helped me lose weight, with the shots I had some anger problems, or it may have been the marital situation....

I'd like to get deeper into the HRT science as I certainly feel that simply adding testosterone has a negative affect on whatever is being produced naturally... I think the current thought is the body reacts to foreign T by reducing natural production, obviously a problem as akin absorbtion rates will never match the bodies ability to produce. There are also thoughts that skin absorbtion rates drop over repeated dosings in the same area. My last self inject was bad and I don't see myself ever doing that again.

Problem for me is my endocrinologist won't hear of it and sees my T levels as the only factor. Any other doctors are part of some money making boutique setup, don't accept insurance and are not local.

WillBrink
11-27-10, 18:03
Problem for me is my endocrinologist won't hear of it and sees my T levels as the only factor. Any other doctors are part of some money making boutique setup, don't accept insurance and are not local.

Take a look at the Life Extension's info on HRT:

http://www.lef.org/protocols/male_reproductive/male_hormone_restoration_01.htm

I think their general info in that write up is solid (but I'm not sold on the supplements they are recommending per se,) but if you want something more "progressive" then standard fare reading on the topic, that's got some useful info in it for the non scientist.

WillBrink
11-28-10, 11:24
Will
can/do you recommend these type of tests ?


See article "It's In Your Blood" on the BrinkZone. That' a pretty good summary, but getting basic test for testosterone levels is easy enough.

onado2000
12-03-10, 18:46
I have read that glucagon release produces a realease of HGH.

usmcvet
12-03-10, 18:51
I have started applying my Androgel at night and I've noticed a change in concentration, mood+ and energy in just a few days. I dried myself following my morning shower and before applying my T in the morning but I don't think it was enough and my absorption was way off. Not sure if that helps any of you guys.

WillBrink
12-04-10, 09:46
I have read that glucagon release produces a realease of HGH.


How does that info apply to this particular discussion?

onado2000
12-04-10, 11:42
This is information which I learned a decade ago & have read/researched over years through periodicals. Do not take my word, look at the facts printed in journals. HGh is an endocrine hormone like T that declines with age. This thread earlier discussed before seeking exogenous hormone replacement, we should boost our our endogenous hormone production. Glucangon is released in response to low blood sugar. Avoid eating after dinner and sleeping 8 hours could help boost endogenous HGh.

WillBrink
12-04-10, 13:47
Glucangon is released in response to low blood sugar. Avoid eating after dinner and sleeping 8 hours could help boost endogenous HGh.


I believe you mean glucagon.

Suwannee Tim
12-04-10, 14:12
120ng/dl in your 30s????!! What were you doing, watching Golden Girls or something? :eek:

Don't get me wrong Will, I'm not trying to make you feel bad for busting on somebody who had a misfortune. I think the inventor of "gallows humor" is an ancestor of mine and I'm at my best, humorifically speaking when I'm going before the judge, going into surgery or trying to explain a new $3K rifle. That out of the way, the answer is, from my experience, fighting tooth and nail, unsuccessful, against declining health and fitness and increasing weight. To give you an idea of where I started from, on my 20th birthday I ran my usual 4 miles which I could do in 25 minutes on a good day. I ran by a chin-up bar at the local school and stopped to see how many I could do. 20 chin ups and I hadn't done one in three or four years. At age 50 I had come to the point of despair, weighing 270 pounds (I'm six feet tall, medium build), watching my strength, fitness and health decline and weight increase, despite day long bicycle rides, hours in the pool and strenuous dieting. I had my testosterone tested and it was 70 ng/dcl. The answer is, no you don't watch the Golden Girls, you watch yourself slowly die. I'm now on the needle, my health has improved, my strength is doubled, endurance is way up and I'm just doing a lot better. My advice to every man over 50 and every man struggling with increasing weight and declining fitness and health, get it tested, get it fixed.

WillBrink
12-04-10, 14:29
My advice to every man over 50 and every man struggling with increasing weight and declining fitness and health, get it tested, get it fixed.

Glad you hear you have turned it around. Personally, I recommend all men over 40 have a hormonal panel done yearly, including T. I have had my T tested since my 20s and can see it decline each decade. Waiting until one has symptoms is reactive medicine vs pro active medicine. ;)

One does not (hopefully!) wait until they have had an MI to check their cholesterol/lipid levels...

Suwannee Tim
12-04-10, 15:01
Forgot to mention thyroid. That's another saga. Firmly agree on annual hormone tests. It is imperative that one takes charge of their health insofar as it is possible for a layman to do. The internet is a big, big help in this regard. The doctor looks for two things, the easy stuff and the deadly stuff. There is a lot of nasty stuff in between easy and deadly. I remember a physician, Dr. Marshal A. Burns saying to his nurse in my presence "must eat like a pig." No, Dr. Burns it is was a medical problem, one you missed, thank you very much.

WillBrink
12-04-10, 15:08
Forgot to mention thyroid. That's another saga.

Indeed. My full write up on that topic here:

https://www.m4carbine.net/showthread.php?t=28424&highlight=thyroid

Lot of good info for those dealing with thyroid issues.;)

Suwannee Tim
12-04-10, 19:39
Glad you hear you have turned it around........ MI to check their cholesterol/lipid levels...

Can't say I've turned it around yet but I'm working on it. Speaking of MI, heart disease is one of the effects of hypogonadism.

WillBrink
12-05-10, 10:56
Can't say I've turned it around yet but I'm working on it.

One day at a time as they say.


Speaking of MI, heart disease is one of the effects of hypogonadism.

Addressed briefly in the OP. :cool:

I don't believe there are any direct intervention studies showing a reduced rate of CVD and or MI per se, but studies that exist are strongly suggestive that low T is a risk factor for CVD.

WillBrink
12-18-12, 08:33
TESTOSTERONE DEFICIENCY AND DISEASE

My friend Dr. Steve Joyal discusses testosterone deficiency in men and it's relation to metabolic disease and other related topics.


http://www.youtube.com/watch?v=5cht3Qq9H6Y

Doc Safari
12-18-12, 09:44
I got into this as part of the "want to feel better" crowd.

I knew I didn't want to go to straight testosterone, or any of the precursors like androsteindione.

What I did, and do, is alternate between the herbs that stimulate the so-called "luteinizing hormones" that cause your body to naturally boost its own testosterone.

I alternate between tribulus terrestris, catuaba, fenugreek, and I think there is another I can't remember the name of right now.

I have begun a limited experimentation (as in: occasional use) of D-aspartic acid, and the corresponding aromatose inhibitor (because DA can bacfire from what I understand and get converted into estrogen).

All seem to work to varying degree, but there is no "miracle boost" to any of them.

All in all, I think I feel better "with them" than "without them", although I cannot discount a possible placebo effect, either.

WillBrink
12-18-12, 10:14
I got into this as part of the "want to feel better" crowd.

I knew I didn't want to go to straight testosterone, or any of the precursors like androsteindione.

What I did, and do, is alternate between the herbs that stimulate the so-called "luteinizing hormones" that cause your body to naturally boost its own testosterone.

I alternate between tribulus terrestris, catuaba, fenugreek, and I think there is another I can't remember the name of right now.


None of which have ever been shown to cause physiological relevant increases in T and or have never been shown to increase T. If one is low in T, none of those will fix that. There's a difference between trying to "boost" T levels and actual HRT, and regular blood work needed in addition to symptoms of low T, key for HRT.

My articles in "testosterone boosters" if interested:

http://www.brinkzone.com/articles/the-facts-on-testosterone-boosting-supplements/

Doc Safari
12-18-12, 10:34
None of which have ever been shown to cause physiological relevant increases in T and or have never been shown to increase T. If one is low in T, none of those will fix that. There's a difference between trying to "boost" T levels and actual HRT, and regular blood work needed in addition to symptoms of low T, key for HRT.

My articles in "testosterone boosters" if interested:

http://www.brinkzone.com/articles/the-facts-on-testosterone-boosting-supplements/

Interesting. I want to delve into your site in-depth so I won't comment just yet.

Your write-up on that page suggests that the supplements I'm taking may be boosting things other than testosterone. I know that I seem to have more energy when taking them.

What is a good supplement, if any, to boost T naturally? In other words, not a drug?

WillBrink
12-18-12, 10:44
Interesting. I want to delve into your site in-depth so I won't comment just yet.

Your write-up on that page suggests that the supplements I'm taking may be boosting things other than testosterone. I know that I seem to have more energy when taking them.

What is a good supplement, if any, to boost T naturally? In other words, not a drug?

If you give that article a full read, you'll see I have no faith in any supplement to boost T. Some general thoughts on boosting T via nutrition, and other variables can be found in this vid:

http://www.brinkzone.com/general-health/boosting-testosterone/

Useful articles also found below that vid BTW. :cool:

Doc Safari
12-18-12, 11:15
Not that I'm going to order any, but what is your opinion of products like "Ageless Male" that purport to increase "free" testosterone levels or prevent conversion of testosterone to estrogen?

The reason I think products like this are a scam is that a lot of them want you to "subscribe" and receive automatic shipments. I've not investigated this particular one, but it sounds like late-night TV marketing.

WillBrink
12-18-12, 11:32
Not that I'm going to order any, but what is your opinion of products like "Ageless Male" that purport to increase "free" testosterone levels or prevent conversion of testosterone to estrogen?

Show me any data supporting it's claims, and I'll give you an opinion. It's a set up, there is no solid data. :p

Read article fully, then apply info to any of these products on the market.

Not one of them can pass the simple BS/smell test I outline in that article on T boosters.

As far as estrogen, that too is not something to mess with minus blood work, and there's no reason to suppress it if it's not elevated.

Wanna crash your HDL? Lower your estrogen levels to nothing via a real aromatase inhibitor such as ARIMIDEX® (anastrozole).

Articles linked under vid also discuss blood work.

WillBrink
05-28-13, 10:54
RE, TRT and cancer risks, a few studies of interest found showing either no apparent increase in risk, or even a possible reduction in risk:

This study ran a full year and was done in a population of men with elevated risk of prostate cancer, yet didn't find an increased risk of prostate cancer from TRT:

CLINICAL UROLOGY: Original Articles:

Testosterone Replacement Therapy in Hypogonadal Men at High Risk for Prostate Cancer: Results of 1 Year of Treatment in Men With Prostatic Intraepithelial Neoplasia
(CLINICAL UROLOGY: Original Articles Testosterone Replacement Therapy in Hypogonadal Men at High Risk for Prostate Cancer: Results of 1 Year of Treatment in Men With Prostatic Intraepithelial Neoplasia)

ABSTRACT

Purpose

One of the greatest concerns among clinicians regarding testosterone replacement therapy (TRT) is the fear of causing or promoting prostate cancer. We evaluated prostatic changes in hypogonadal men with and without high grade prostatic intraepithelial neoplasia (PIN), which is considered a prostatic precancerous lesion, after 1 year of TRT.

Materials and Methods

A total of 75 hypogonadal who completed 12 months of TRT were studied. All underwent prostate biopsy prior to initiating treatment. Of the men 55 had benign prostate biopsies (PIN−) and 20 had PIN without frank cancer (PIN+). All men with PIN underwent repeat biopsy to exclude cancer prior to the initiation of testosterone treatment. Prostate specific antigen (PSA), and total and free testosterone were determined prior to treatment and at 1 year. Repeat biopsy was performed for a change noted on digital rectal examination or for a PSA increase of 1 ng/l or greater.
Results

PSA was similar at baseline in men with and without PIN (1.49 ± 1.1 and 1.53 ± 1.6 ng/dl, p >0.05) and after 12 months of TRT (1.82 ± 1.1 and 1.78 ± 1.6 ng/dl, respectively, p >0.05). A slight, similar increase in mean PSA was noted in the PIN− and PIN+ groups (0.25 ± 0.6 and 0.33 ± 0.6 ng/dl, p >0.05). One man in the PIN+ group had cancer after biopsy was performed due to abnormal digital rectal examination. Four additional men in the PIN− group and 2 in the PIN+ group underwent re-biopsy for elevated PSA and none had cancer. No differences were noted between the PIN− and PIN+ groups with regard to total and free testosterone at baseline and at 1 year (p = 0.267).

Conclusions

After 1 year of TRT men with PIN do not have a greater increase in PSA or a significantly increased risk of cancer than men without PIN. These results indicate that TRT is not contraindicated in men with a history of PIN.
___________________________________________
Testosterone replacement therapy and cancer risk

Michael Eisenberg; Paul Betts; Danielle Herder; Dolores Lamb; Larry Lipshultz

Abstract: 1506

Introduction and Objectives

Given that some cancers are androgen dependent, there is concern that testosterone replacement therapy will increase a man’s risk of developing cancer. To date there are no long term, prospective studies which evaluate the incidence of cancer in men on testosterone supplementation. In such cases, retrospective observational studies can be helpful. We examined our patient database to determine if TRT altered a mans risk of prostate cancer.

Methods

We queried our hormone database for all men with a serum testosterone level and then examined charts to determine testosterone replacement status. In all, 786 men had charts available for review. We limited our analysis to men living in the state of Texas and then linked our patient records to the Texas Cancer Registry, to determine the incidence of cancer. Men accrued time at risk from the date initiating TRT or the first office visit for men not on TRT.

Results

Of the 722 men who met inclusion criteria, 397 were on testosterone replacement therapy and 325 did not use testosterone. The mean age at entry was 46.8 years with a mean follow up duration of 8.7 years. Baseline testosterone levels were lower in men on TRT (330 ng/dL) compared to those not on TRT (371 ng/dL, p<0.01). In all, 54 men developed cancer--32 (8.1%) of the men not on TRT and 22 (6.8%) of the men on TRT. After adjusting for age and year of evaluation, there was no significant difference in the risk cancer incidence based on TRT (HR 1.06, 95% CI 0.61 – 1.83, p=0.94). There was no significant change in conclusions when examining only men with >10 years of follow up (580 men with 51 incident cancer cases) or men > 60 years of age at the time of linkage (129 men with 20 incident cancers). Compared to the general Texas population, men on TRT had an age-adjusted standardized cancer incidence rate of 1.4 (95% CI 0.9-2.2) while those not on TRT had an SIR of 1.5 (95% CI 1.0-2.2). Interesting, when examining prostate cancer alone, compared to the general Texas population, men on TRT had an age-adjusted standardized prostate cancer incidence rate of 2.3 (95% CI 1.2-4.2) while those not on TRT had an SIR of 3.2 (95% CI 1.9-5.1).

Conclusions

There appears to be no change in overall cancer risk for men utilizing long term testosterone replacement therapy. There may be a decrease in prostate cancer risk for men on TRT.

Date & Time: May 7, 2013 08:00 AM

Session Title: Sexual Function/Dysfunction/Andrology:Medical and Non-surgical Therapy

Sources of Funding: Endo Pharmaceuticals, investigator initiated grant

jc75754
05-29-13, 08:08
Im 21... is there any chance of me having low test levels?

I am 26 and diagnosed with secondary hypogonadism. Yes it is possible, but if your situation is similar to me you will have a difficult time finding a doctor to diagnose or treat you.

Check your family history. Both my father and grandfather have the same issues.

Also look at your lifestyle. Do you lift? How is your diet? Too much lean food and not enough fats will kill test production. How are your vitiman d levels, iodine levels, zinc?

Have bloods drawn to check and specifically ask that they do the test as early as possible and run labs for the following: fsh, lh, free test, psa, e2, total test, and prostate exam.

Also check thyroid function as well.

And finally, read, read, read. Knowledge is power and most docs are ill informed or completley ignorant. I was told for two years that my levels were normal. They were if i was 80.

WillBrink
05-29-13, 08:58
I am 26 and diagnosed with secondary hypogonadism. Yes it is possible, but if your situation is similar to me you will have a difficult time finding a doctor to diagnose or treat you.

Check your family history. Both my father and grandfather have the same issues.

Also look at your lifestyle. Do you lift? How is your diet? Too much lean food and not enough fats will kill test production. How are your vitiman d levels, iodine levels, zinc?

Have bloods drawn to check and specifically ask that they do the test as early as possible and run labs for the following: fsh, lh, free test, psa, e2, total test, and prostate exam.

Also check thyroid function as well.

And finally, read, read, read. Knowledge is power and most docs are ill informed or completley ignorant. I was told for two years that my levels were normal. They were if i was 80.

True enough. I can say, info and links supplied (to articles, web sites, etc) in this thread will get most up to speed on what they need to know to move forward.

The_War_Wagon
05-29-13, 09:01
I've been trying my whole LIFE to get rid of testosterone! Now that I've finally achieved it, you're not ABOUT to sell it BACK to me!!! :stop:


http://www.tvacres.com/images/nomaam1.jpg

WillBrink
05-29-13, 09:08
I've been trying my whole LIFE to get rid of testosterone! Now that I've finally achieved it, you're not ABOUT to sell it BACK to me!!! :stop:


http://www.tvacres.com/images/nomaam1.jpg

And how did you achieve that? Nad removal due to marriage? :D

The_War_Wagon
05-29-13, 15:24
And how did you achieve that? Nad removal due to marriage? :D

Exactly! Nothing kills ye olde sex drive LIKE marriage. And kids. :fie:

WillBrink
05-29-13, 17:31
Exactly! Nothing kills ye olde sex drive LIKE marriage. And kids. :fie:


BTW, not even a joke. Married men generally have lower T levels:

http://www.newscientist.com/article/dn2310-married-men-have-less-testosterone.html

It's probably a good thing from an evolutionary perspective (see reasoning in link) but not perhaps that beneficial to the individual man per se.

WillBrink
05-30-13, 08:07
Getting your health advice from Consumer Reports is like getting your car advice from the New England Journal of Medicine! :D

Consumer Reports (CR) has a long history of truly crappy reporting when it comes to any topic well outside their expertise, such as nutrition, or supplements, and now testosterone.

I'll give you the quick take home for their "concerns" and my response:

Major concern #1 appears to be:

"The magazine is urging men to think carefully before starting on testosterone therapy, citing risks such as enlarged prostate or breasts, blood clots, sleep apnea and cardiovascular effects."

While (1) ignoring all the well documented health risks of low testosterone which FAR outweigh the risks of treatment for low testosterone (2) ignoring the data showing most of those potential issues are not true and mythology or easy to treat as needed.

They have broken a golden rule of basic science/medicine: the risk to benefit assessment.

Major Concern #2 appears to be:

"...experts worry that many are using the drugs for lifestyle reasons--to look or feel younger, or increase sexual drive or improve performance--regardless of their proven effects or of FDA's officially approved indications."

The HORROR! For sure, every man should "age gracefully" and feel bad he wants to use a hormone that allows him feel younger, increase sexual drive or improve performance. That one does not require a response and stands alone as to it idiocy and moral BS vs actual science.

The only legit points made in their report is big pharma is cashing in big time on T and doing their best, via ads on TV etc, to convince every man he's low on T and to run to their doctor for tests, but that's another issue unrelated to their general anti T hit piece and worthless advice to men on the issue.

To summarize, CF sucks for anything beyond cars and microwaves and is willing to ignore the facts, data, and clinical experience of doctors in favor of exactly what they accuse big pharma: profit

I cancelled my subscription years ago after a really piss poor "report" they did on supplements I recall.

If you wanna read the REAL DEAL on TRT/HRT to counter that nonsense (as someone no doubt will bring it up) see Monica Mollica article on the BrinkZone:

http://www.brinkzone.com/bodybuilding/testosterone-replacement-therapy-why-is-it-so-controversial/

usmcvet
06-01-13, 18:50
Just had my bi monthly 2CC T shot yesterday. I tried to do it myself. I did once with a nurse at the doctors office. I couldn't do it again. Freaking needle was way to big for me. :D

Had my T tested last Friday and it was 617. It seems to be working well for me along with a huge weight loss.

Anyone doing weekly shots? 1CC at a time would be much more comfortable. The inspection site hurts for days. But it is worth it.

I hit 41 in January.

WillBrink
06-01-13, 18:56
Just had my bi monthly 2CC T shot yesterday. I tried to do it myself. I did once with a nurse at the doctors office. I couldn't do it again. Freaking needle was way to big for me. :D

Had my T tested last Friday and it was 617. It seems to be working well for me along with a huge weight loss.

Anyone doing weekly shots? 1CC at a time would be much more comfortable. The inspection site hurts for days. But it is worth it.

I hit 41 in January.

Many do weekly shots at lower doses, which will give you much more steady serums levels. Experienced HRT/TRT docs will almost universally recommend weekly if using standard T esters found in the US.

BTW, you can use an insulin needle for your T shots which is essentially painless. Has to be done correctly, but it can indeed be done. It's the difference between a .50 BMG and a .223 in size ;)

Suwannee Tim
06-01-13, 19:24
Just had my bi monthly 2CC T shot yesterday. I tried to do it myself. I did once with a nurse at the doctors office. I couldn't do it again. Freaking needle was way to big for me. :D

Had my T tested last Friday and it was 617. It seems to be working well for me along with a huge weight loss.

Anyone doing weekly shots? 1CC at a time would be much more comfortable. The inspection site hurts for days. But it is worth it.

I hit 41 in January.

I shoot the T once a week, 1/2 ml of 200 mg/ml for a dose of 100 mg of testosterone cypionate. I think there are 100 mg/ml formulations out there, if that is what you are using you should put in for the 200 mg/ml stuff in a 10 ml bottle so you will get the same dose in half the volume. And yes, 2 ml is a lot of stuff to inject. 1/2 ml is plenty for me. Testosterone cypionate has a half life of 8 days in the body, at the end of 2 weeks your level has been cut by half almost twice so you are down to a bit more than 1/4 your high of two weeks ago. That's why you want to shoot every week. Or every five days. With respect to needles, testosterone cypionate is viscous stuff and hard to draw out of the bottle with a small needle. You should be using a 18 gauge fill needle to draw it out of the bottle then switch to a 25 gauge, 26 gauge or even 27 gauge needle (higher gauge numbers smaller bore, just like shotguns). The problem is availability, you may have to take what the pharmacy has available. It may be a long needle, 1 inch is long enough, 1-1/2 inch you may want to hold off full insertion 1/2 or 1/4 depending on how thick your muscle is. You don't want to inject it into the bone! Make sure and wring the small gauge needle on the hub good and tight, it takes a lot of pressure to move the stuff through the small needle, you don't want to blow the needle off. Another consideration, the timing of the blood test. If you test a day or two after the injection your level will read high. Test a week or two from the injection you will test low. The Doctor may want to reduce you if you test high, I don't want to be reduced so I always time my blood test appropriately. Reading the risks and benefits I concluded I want my level high, 600 or better and I don't even want to think about a lower dose. Study up on it yourself, YMMV.

When you inject, you want to apply pressure to the injection site for 20 to 30 minutes. Just mash in on it with your thumb. I got a nasty hematoma once, I don't want another. I inject sitting in front of the computer then sit there reading and mashing for a half hour then I go to bed to give it all night to seal up. Don't shoot the injection then go to work. Shoot it at night then go to bed.

skydivr
06-01-13, 19:25
Jeez, I do the gel daily and can't get mine over 200...617 I'd be a new man :)

WillBrink
06-01-13, 19:34
Jeez, I do the gel daily and can't get mine over 200...617 I'd be a new man :)

If 200 is the best you can do on the gel, you need to talk to doc about using more, or changing to another route. Most men are higher then that without HRT/TRT. 200 with HRT/TRT would not acceptable HRT/TRT to me, nor should it be to you.

Suwannee Tim
06-01-13, 19:49
Jeez, I do the gel daily and can't get mine over 200....

Gel is bullshit. It's not a half measure, more like a 1/8th measure or 1/16th measure used by doctors as a "conservative first step". You move the needle on the testosterone test with an injection. The patch, the gel will bump it but not move it. Doctors need to understand the conservative approach is not good with low testosterone because low testosterone is dangerous and the condition needs to be treated effectively and promptly and that means the needle. A lot of doctors are afraid of testosterone due to unfamiliarity and the old wives tales of roid rage and prostate cancer. Moving a man from low T levels to normal will not cause psychiatric problems and there is no reliable evidence that testosterone accelerates prostate cancer growth.

You need to persuade your doctor to get you to normal or better, high normal and now, not half a year from now or a year from now. If your doctor will not cooperate you need to find another doctor. To repeat: low testosterone is dangerous, it was killing me.


......617 I'd be a new man :)

That is correct.

WillBrink
06-01-13, 20:02
I shoot the T once a week, 1/2 ml of 200 mg/ml for a dose of 100 mg of testosterone cypionate. I think there are 100 mg/ml formulations out there, if that is what you are using you should put in for the 200 mg/ml stuff in a 10 ml bottle so you will get the same dose in half the volume. And yes, 2 ml is a lot of stuff to inject. 1/2 ml is plenty for me. Testosterone cypionate has a half life of 8 days in the body, at the end of 2 weeks your level has been cut by half almost twice so you are down to a bit more than 1/4 your high of two weeks ago. That's why you want to shoot every week. Or every five days. With respect to needles, testosterone cypionate is viscous stuff and hard to draw out of the bottle with a small needle. You should be using a 18 gauge fill needle to draw it out of the bottle then switch to a 25 gauge, 26 gauge or even 27 gauge needle (higher gauge numbers smaller bore, just like shotguns).

One can use a 30g 1/2" insulin needle as mentioned above. It must be injected where men are leanest, usually outer upper thigh, or shoulder.



The problem is availability, you may have to take what the pharmacy has available.

Any pharmacy will have insulin needles. Some are OTC, some not, so check your state laws. One trick to the viscosity issue of the oil, run it under hot water for a while. Does no harm to the T, and makes the oil much more viscous. Needs some good steady finger pressure, but it goes fine.

Of course smaller volumes easiest to push, so using 200mg/ml vs 100mg/ml recommended but not essential per se.



It may be a long needle, 1 inch is long enough, 1-1/2 inch you may want to hold off full insertion 1/2 or 1/4 depending on how thick your muscle is. You don't want to inject it into the bone! Make sure and wring the small gauge needle on the hub good and tight, it takes a lot of pressure to move the stuff through the small needle, you don't want to blow the needle off. Another consideration, the timing of the blood test. If you test a day or two after the injection your level will read high.

Most accurate is considered the day before your next shot and that's when docs will tell you to get the test. Going before or after to manipulate the numbers I wont comment on... :o



Test a week or two from the injection you will test low. The Doctor may want to reduce you if you test high, I don't want to be reduced so I always time my blood test appropriately. Reading the risks and benefits I concluded I want my level high, 600 or better and I don't even want to think about a lower dose. Study up on it yourself, YMMV.

When you inject, you want to apply pressure to the injection site for 20 to 30 minutes. Just mash in on it with your thumb. I got a nasty hematoma once, I don't want another. I inject sitting in front of the computer then sit there reading and mashing for a half hour then I go to bed to give it all night to seal up. Don't shoot the injection then go to work. Shoot it at night then go to bed.

Rarely an issue with a 30g 1/2" and you can barely even notice it. If you got a hematoma type thing, you hit a vascular area and it filled with blood.

Suwannee Tim
06-01-13, 20:25
I'll have to try the insulin needle, thanx for the advice. Even the 25 gauge needle hurts. The hematoma was a big bad one. I don't want another. I went to the ER with it, cost me half a day of work and $500. Doc said it was no big deal but not before he did an Xray, bloodwork a CT scan and some stuff I don't remember. Most doctors are skeered of the gubmint, you know the dee ee ay and them folks. The only doctor I ever met that wasn't skeered of them was Dr. Jacob Greene, a neurologist who was treating my wife. He gleefully offered her a script for pain meds and when she refused he asked if she was sure. Three days later I read his obituary. (http://www.legacy.com/obituaries/timesunion/obituary.aspx?n=jacob-green&pid=125965501#fbLoggedOut) Only way a doctor comes to be free of fear of the dee ee ay.

Anyway, testosterone is a schedule C drug, is that right? Right up there with some of the most highly desired pain meds and the object of scrutiny by the law. That's another reason docs are reluctant to prescribe.

usmcvet
06-01-13, 20:37
Many do weekly shots at lower doses, which will give you much more steady serums levels. Experienced HRT/TRT docs will almost universally recommend weekly if using standard T esters found in the US.

BTW, you can use an insulin needle for your T shots which is essentially painless. Has to be done correctly, but it can indeed be done. It's the difference between a .50 BMG and a .223 in size ;)
I like to think I'm not a wimp. :D I can take the shot in the ass but just could not give it it was a larger gauge needle to mix then I switched. I could deal with an insulin type needle.


I shoot the T once a week, 1/2 ml of 200 mg/ml for a dose of 100 mg of testosterone cypionate. I think there are 100 mg/ml formulations out there, if that is what you are using you should put in for the 200 mg/ml stuff in a 10 ml bottle so you will get the same dose in half the volume. And yes, 2 ml is a lot of stuff to inject. 1/2 ml is plenty for me. Testosterone cypionate has a half life of 8 days in the body, at the end of 2 weeks your level has been cut by half almost twice so you are down to a bit more than 1/4 your high of two weeks ago. That's why you want to shoot every week. Or every five days. With respect to needles, testosterone cypionate is viscous stuff and hard to draw out of the bottle with a small needle. You should be using a 18 gauge fill needle to draw it out of the bottle then switch to a 25 gauge, 26 gauge or even 27 gauge needle (higher gauge numbers smaller bore, just like shotguns). The problem is availability, you may have to take what the pharmacy has available. It may be a long needle, 1 inch is long enough, 1-1/2 inch you may want to hold off full insertion 1/2 or 1/4 depending on how thick your muscle is. You don't want to inject it into the bone! Make sure and wring the small gauge needle on the hub good and tight, it takes a lot of pressure to move the stuff through the small needle, you don't want to blow the needle off. Another consideration, the timing of the blood test. If you test a day or two after the injection your level will read high. Test a week or two from the injection you will test low. The Doctor may want to reduce you if you test high, I don't want to be reduced so I always time my blood test appropriately. Reading the risks and benefits I concluded I want my level high, 600 or better and I don't even want to think about a lower dose. Study up on it yourself, YMMV.

When you inject, you want to apply pressure to the injection site for 20 to 30 minutes. Just mash in on it with your thumb. I got a nasty hematoma once, I don't want another. I inject sitting in front of the computer then sit there reading and mashing for a half hour then I go to bed to give it all night to seal up. Don't shoot the injection then go to work. Shoot it at night then go to bed.
Smeof the nurses are great. Some are horrible. There is one who pushes it way to fast. Really freaking hurts.

The direct pressure is a good tip. I usually do it Friday mornings in the way to work. Tried having the wife do it but that didn't work out.


Jeez, I do the gel daily and can't get mine over 200...617 I'd be a new man :)

The gel and patches did not work for me even with high doses. It sucked. Give the injections a serious look. They're much cheaper too.


Gel is bullshit. It's not a half measure, more like a 1/8th measure or 1/16th measure used by doctors as a "conservative first step". You move the needle on the testosterone test with an injection. The patch, the gel will bump it but not move it. Doctors need to understand the conservative approach is not good with low testosterone because low testosterone is dangerous and the condition needs to be treated effectively and promptly and that means the needle. A lot of doctors are afraid of testosterone due to unfamiliarity and the old wives tales of roid rage and prostate cancer. Moving a man from low T levels to normal will not cause psychiatric problems and there is no reliable evidence that testosterone accelerates prostate cancer growth.

You need to persuade your doctor to get you to normal or better, high normal and now, not half a year from now or a year from now. If your doctor will not cooperate you need to find another doctor. To repeat: low testosterone is dangerous, it was killing me.



That is correct.


One can use a 30g 1/2" insulin needle as mentioned above. It must be injected where men are leanest, usually outer upper thigh, or shoulder.



Any pharmacy will have insulin needles. Some are OTC, some not, so check your state laws. One trick to the viscosity issue of the oil, run it under hot water for a while. Does no harm to the T, and makes the oil much more viscous. Needs some good steady finger pressure, but it goes fine.

Of course smaller volumes easiest to push, so using 200mg/ml vs 100mg/ml recommended but not essential per se.




Most accurate is considered the day before your next shot and that's when docs will tell you to get the test. Going before or after to manipulate the numbers I wont comment on... :o



Rarely an issue with a 30g 1/2" and you can barely even notice it. If you got a hematoma type thing, you hit a vascular area and it filled with blood.

Good info thanks guys.

Wonder why my doc has me tested after seven days?

I'm going to try to switch to weekly. Need a script for smaller needles! The warm water was an awesome tip,too.

usmcvet
06-01-13, 20:39
It also makes me wonder how high my level gets and how low it gets!

Suwannee Tim
06-01-13, 20:40
Syringes and needles are OTC in Florida. If your state regulates them that creates a problem in that the pharmacist has to fill the script as written. That is if the script specifies a 26 gauge 1-1/2 needle the pharmacist can't fill it with a 25 gauge needle or a 1 inch needle.

skydivr
06-01-13, 20:55
I actually have appointment to see him next week and get another test. I'm going to print and study this before I talk to him.

usmcvet
06-02-13, 16:24
Syringes and needles are OTC in Florida. If your state regulates them that creates a problem in that the pharmacist has to fill the script as written. That is if the script specifies a 26 gauge 1-1/2 needle the pharmacist can't fill it with a 25 gauge needle or a 1 inch needle.

Just checked. They're OTC here in VT too.
http://healthvermont.gov/prevent/hepatitis_c/clean_needles.aspx


I actually have appointment to see him next week and get another test. I'm going to print and study this before I talk to him.
Cool. Good luck.

WillBrink
06-02-13, 17:42
Gel is bullshit. It's not a half measure, more like a 1/8th measure or 1/16th measure used by doctors as a "conservative first step".

TESTOSTERONE GELS = POOR ADHERENCE RATES (1).

Overall satisfaction with topical T gels is low in my experience. I wonder if this poor Adherence rate is due to dissatisfaction with the T gels. Would be interesting to see how it compares to IM routes and if it correlated to T levels achieved with the gels. My hunch, Adherence might correlate strongly to T levels achieved with gels.

Most of the men I know who quit the gels generally gave the "I didn't notice any difference using it" response which I found was a factor of the gel having minimal actual impact on their T levels.

Conversely, most men do report a difference in subjective symptoms with IM route, and perhaps a higher Adherence rate. That would be an interesting study, if one does not currently exist.

(1) Medication Adherence and Treatment Patterns for Hypogonadal Patients Treated with Topical Testosterone Therapy: A Retrospective Medical Claims Analysis (http://onlinelibrary.wiley.com/doi/10.1111/jsm.12114/abstract)

WillBrink
09-24-13, 13:51
Here is a new meta analysis looking at TRT and the Cardiovascular System:

Beneficial and Adverse Effects of Testosterone on the Cardiovascular System in Men

Johannes B. Ruige,
D. Margriet Ouwens and
Jean-Marc Kaufman

The Journal of Clinical Endocrinology & Metabolism September 24, 2013 (http://jcem.endojournals.org/content/early/2013/09/23/jc.2013-1970.abstract)

Abstract

Context: The widespread use of T therapy, particularly in aging males, necessitates knowledge of the relationship between T and the cardiovascular system.

Evidence Acquisition: The review is based on a 1970 to 2013 PubMed search with terms related to androgens in combination with cardiovascular disease, including T, dihydrotestosterone, trial, mortality, cardiovascular disease, myocardial infarction, blood pressure, endothelial function, dyslipidemia, thrombosis, ventricular function, and arrhythmia. Original articles, systematic reviews and meta-analyses, and relevant citations were screened.

Evidence Synthesis: Low T has been linked to increased blood pressure, dyslipidemia, atherosclerosis, arrhythmia, thrombosis, endothelial dysfunction, as well as to impaired left ventricular function. On the one hand, a modest association is suggested between low endogenous T and incident cardiovascular disease or cardiovascular mortality, implying unrecognized beneficial T effects, residual confounding, or a relationship with health status. On the other hand, treatments with T to restore “normal concentrations” have so far not been proven to be beneficial with respect to cardiovascular disease; neither have they definitely shown specific adverse cardiovascular effects. The cardiovascular risk-benefit profile of T therapy remains largely evasive in view of a lack of well-designed and adequately powered randomized clinical trials.

Conclusions: The important knowledge gap as to the exact relationship between T and cardiovascular disease would support a cautious, restrained approach to T therapy in aging men, pending clarification of benefits and risks by adequately powered clinical trials of sufficient duration.

Suwannee Tim
09-24-13, 20:12
Johannes B. Ruige,
D. Margriet Ouwens and
Jean-Marc Kaufman

.......The important knowledge gap as to the exact relationship between T and cardiovascular disease would support a cautious, restrained approach to T therapy in aging men, pending clarification of benefits and risks by adequately powered clinical trials of sufficient duration.

No thanks Johannes, Margriet and Jean-Marc. I was dying and T saved my life and not just a little T, a big 'ole honkin syringe full of it. I will eschew the cautious and restrained approach to saving my life thank you very much.

WillBrink
09-25-13, 07:01
No thanks Johannes, Margriet and Jean-Marc. I was dying and T saved my life and not just a little T, a big 'ole honkin syringe full of it. I will eschew the cautious and restrained approach to saving my life thank you very much.

My personal opinion is, the data and clinical experience strongly suggests the benefits far outweigh the risks, but risks exist as there's no free lunch in human biology.

ABNAK
10-18-13, 03:34
My wife (RN) shoots me once a week with 1/2cc of 200mg/ml Test Cypionate, so basically 100mg per week. Keeps the balance better than every 2 weeks.

Last time I asked the doc what the level was it was in the 400's. When I started in 2009 I was 44yo and my T level was 186.

I take the most advantage of HRT and work out religiously: ~ 160 minutes a week of cardio and weights 3x per week. Have done so for years, even before I started on Test injections. Within a year or so of starting Test I lost about 20 pounds (of course I was running twice a week then too) and my wife says I look better than ever. 6' 1" and 225lbs and kinda buffed if I do say so myself! I've lifted for well over 24 years but didn't start doing cardio until 1998. Intensity of cardio is considerably higher now than when I started, hence the ability to keep my weight at ~ 225 even though running isn't in my repetoire anymore due to knees. Still pretty strong for 48 but shit hurts these days, i.e. joints (5 shoulder and one knee surgery....getting old sucks but I won't quit damnit!).

Is 100mg per week a "normal" HRT dose? Is the 400's a good range to be in Test-wise or should it be higher?

onado2000
10-20-13, 11:08
Im 40 and felt like 60. For years I felt like I was wearing a suit of lead on my body, took an hour to get out of bed in the morning, i felt like shit ! any effort to workout hurt my bones & joints, didnt go up in weight for a year (i keep journal of daily workouts) and in some cases went backwards using less weight. At age 20 after lifting for a year I remember benching 225 for 10 sets of 10reps. A few months ago I barely did 1 set of 10 with 225. Anyway, my T was low normal (300s) and my TSH was high. I started taking clomid to trick my body to produce more T.Between synthroid and clomid, with in two months I started to feel better and a little stronger. I stepped up and asked for T, Insurance refused to pay because T was low normal, not yet below the labs range. Out of pocket transdermal T is $500/ month, but 2gms of t cypionate is about a quarter of that. FYI, I was told by someone to have my blood test done in the evening when serum t is lowest and that certain labs have lower T ranges than others.
Recently, I started at 200mg everyother week per Md order, but think every week would be best. My question is heavy weight and low reps or high reps with light weight, and each body part once or twice weekly to failure ??? I know diet and conditioning are key, but I dont want to waste anymore time. I want to have more muscle, lean mature muscle. (sorry if I hijacked thread).
Im fortunate to have a great relationship with my MD. For those that get only resistance, talk to your doctor and tell them how lousy you feel, how low t effects quality of life and your lifestyle. good luck.

WillBrink
10-20-13, 11:54
This is an interesting and useful study I thought regarding long term metabolic effects of TRT in men diagnosed low T:

Long-term testosterone therapy in hypogonadal men ameliorates elements of the metabolic syndrome: an observational, long-term registry study (http://onlinelibrary.wiley.com/doi/10.1111/ijcp.12319/abstract)

Summary

Aim

The goal of this study was to determine if long-term testosterone (T) therapy in men with hypogonadism, henceforth referred to as testosterone deficiency (TD), ameliorates or improves metabolic syndrome (MetS) components.

Methods

We performed a cumulative registry study of 255 men, aged between 33 and 69 years (mean 58.02 ± 6.30) with subnormal plasma total T levels (mean: 9.93 ± 1.38; range: 5.89–12.13 nmol/l) as well as at least mild symptoms of TD assessed by the Aging Males' symptoms scale. All men received treatment with parenteral T undecanoate 1000 mg (Nebido®, Bayer Pharma, Berlin, Germany), administered at baseline and 6 weeks and thereafter every 12 weeks for up to 60 months. Lipids, glucose, liver enzymes and haemoglobin A1c analyses were carried out in a commercial laboratory. Anthropometric measurements were also made throughout the study period.

Results

Testosterone therapy restored physiological T levels and resulted in reductions in total cholesterol (TC) [7.29 ± 1.03 to 4.87 ± 0.29 mmol/l (281.58 ± 39.8 to 188.12 ± 11.31 mg/dl)], low-density lipoprotein cholesterol [4.24 ± 1.07 to 2.84 ± 0.92 mmol/l (163.79 ± 41.44 to 109.84 ± 35.41 mg/dl)], triglycerides [3.14 ± 0.58 to 2.16 ± 0.13 mmol/l (276.16 ± 51.32 to 189.78 ± 11.33 mg/dl)] and increased high-density lipoprotein levels [1.45 ± 0.46 to 1.52 ± 0.45 mmol/l (56.17 ± 17.79 to 58.85 ± 17.51 mg/dl)] (p < 0.0001 for all). There were marked reductions in systolic and diastolic blood pressure, blood glucose, haemoglobin A1c, C-reactive protein (6.29 ± 7.96 to 1.03 ± 1.87 U/l), alanine aminotransferase and aspartate aminotransferase (p < 0.0001 for all).

Conclusions

Long-term T therapy, at physiological levels, ameliorates MetS components. These findings strongly suggest that T therapy in hypogonadal men may prove useful in reducing the risk of cardiometabolic diseases.

FloridaWoodsman
11-04-13, 09:58
This thread has been an interesting read. I suspect my doctor has been overly conservative, and just hitting the minimum levels may not be enough.

warpigM-4
11-04-13, 12:02
I am 44 and just started taking a shot from my DR once a month . the andjogel is super expensive so I have to go to the Dr to get shots , I have just had my first and getting ready for my second .
I have noticed a little more energy and my mood has been getting better .
I did ask my DR about all the ads about the pills you see sold at GNC and in men's mags .
He Said "that they are hype ,stay away from them .Once the pill hits your stomach acids that is pretty much it for the T. the body needs to take it in in either a gel or shot through the muscle to be effected ".

WillBrink
11-04-13, 12:42
I am 44 and just started taking a shot from my DR once a month . the andjogel is super expensive so I have to go to the Dr to get shots , I have just had my first and getting ready for my second .
I have noticed a little more energy and my mood has been getting better .
I did ask my DR about all the ads about the pills you see sold at GNC and in men's mags .
He Said "that they are hype ,stay away from them .Once the pill hits your stomach acids that is pretty much it for the T. the body needs to take it in in either a gel or shot through the muscle to be effected ".

If you are in the US, unless they are offering something new I am not aware of different from the two common ester of T (Cyp or Enanth), that will be a very sub optimal schedule. I recommend reading this thread and the "low T at 26" thread for more details on that, which you may want to discuss with your doc once you have that intel.

Good luck.

warpigM-4
11-04-13, 21:23
thank Will I should ask a few more questions about what i am getting .
they told me My T was on the low normal side ?? which would be the best for my case ??
this is what i received it the mail on my Lab work

Comprehensive metabolic Panel
Testosterone 205 normal range :175-781 ng/dL

Plus a full list of other things checked
I am in The US in Alabama been seeing the same DR for about 5 years now

WillBrink
11-05-13, 07:48
thank Will I should ask a few more questions about what i am getting .
they told me My T was on the low normal side ?? which would be the best for my case ??
this is what i received it the mail on my Lab work

Comprehensive metabolic Panel
Testosterone 205 normal range :175-781 ng/dL

Plus a full list of other things checked
I am in The US in Alabama been seeing the same DR for about 5 years now

Give the threads mentioned a full read. They are loaded with info that will help you optimize dose, levels, etc. Feel free to ask additional Qs after that as needed. It will be a big intel dump for you, but worth it I assure you. ;)

FloridaWoodsman
11-05-13, 20:10
This news today seems to raise some questions:
http://abcnews.go.com/blogs/health/2013/11/05/testosterone-supplements-tied-to-heart-attacks-strokes-early-death/

WillBrink
11-09-13, 16:02
This news today seems to raise some questions:
http://abcnews.go.com/blogs/health/2013/11/05/testosterone-supplements-tied-to-heart-attacks-strokes-early-death/

Questions are good, and data coming in is important. However, the vast majority of recent data associates low T with increased risks of CVD and other diseases, and or, finds no effects. Also, see:

Flawed Testosterone Analysis Spurs Misleading Media Headlines (http://www.lef.org/featured-articles/Response-to-Media-Reports-Associating-Testosterone-Treatment-with-Greater-Heart-Attack-Risk.htm?sourcecode=INL303E&utm_source=ConsumerAlert_1108&utm_medium=email&utm_term=ConsumerAlert_1108&utm_content=text_link&utm_campaign=INL303E)

FloridaWoodsman
11-09-13, 20:45
Questions are good, and data coming in is important. However, the vast majority of recent data associates low T with increased risks of CVD and other diseases, and or, finds no effects. Also, see:

Flawed Testosterone Analysis Spurs Misleading Media Headlines (http://www.lef.org/featured-articles/Response-to-Media-Reports-Associating-Testosterone-Treatment-with-Greater-Heart-Attack-Risk.htm?sourcecode=INL303E&utm_source=ConsumerAlert_1108&utm_medium=email&utm_term=ConsumerAlert_1108&utm_content=text_link&utm_campaign=INL303E)

It kind of reminds me of the many tests on coffee through the years - it's good - it's bad - it's good - it's bad...

Anyway, my doc has been keeping me at a minimal level and I may need to talk to him about that.

WillBrink
11-10-13, 10:50
It kind of reminds me of the many tests on coffee through the years - it's good - it's bad - it's good - it's bad...

Anyway, my doc has been keeping me at a minimal level and I may need to talk to him about that.

Not exactly. Remember, what you were reading is the media's take on that, which is always designed to sound black/white. It's true that some things we eat considered "bad" * have indeed been found to have potential health benefits, such as coffee, chocolate, etc, but one sees trends in science that will show how findings are changing. That's the strength of science, it's always evolving. For say non science types, that can get frustrating no doubt.

* = The very term is of no real value and just adds confusion for people.

Six Feet Under
11-10-13, 11:50
It's a simply fairly inexpensive test, so best to do it sooner then later. Good luck.

I know this is an old post I'm quoting, but I just got my insurance card in the mail the other day now that I have coverage through the PD. :dance3:

Blood work done through Quest is free, so I'll call and schedule that soon.

WillBrink
11-15-13, 08:30
An excellent new article by BrinkZone author Monica Mollica looking at the effects of testosterone replacement therapy (TRT) on fat loss, metabolic syndrome, and other essential health related topics of TRT. A MUST read article for those interested in this topic.

Testosterone Replacement Therapy (TRT) in Testosterone Deficient men – effects on fat loss, waist reduction and metabolic syndrome components (http://www.brinkzone.com/mens-health/testosterone-replacement-therapy-trt-in-testosterone-deficient-men-effects-on-fat-loss-waist-reduction-and-metabolic-syndrome-components/)

Testosterone deficiency in men, aka hypogonadism, is associated with increased total and abdominal fat mass, and reduced muscle mass, which negatively impacts body composition.[1, 2] This contributes to development of risk factors like insulin resistance, chronic inflammation, and atherogenic dyslipidemia (a triad of increased blood levels of small, dense LDL particles and triglycerides, and decreased levels of HDL particles), which increase the risk for cardiovascular disease, metabolic syndrome and diabetes.[1, 3-16]

Previous studies have shown that testosterone replacement therapy ameliorates these risk factors in testosterone deficient (hypogonadal) men; it increases insulin sensitivity [17-20] and HDL (the “good” cholesterol)[9, 10, 20, 21], and reduces waist circumference [9, 20, 22], fasting blood glucose [9, 20] triglycerides (blood fats)[9], LDL (the “bad” cholesterol) [19, 22-24], and several inflammatory markers.[17, 25]

A 2011 meta-analysis concluded that testosterone replacement therapy improves metabolic control, as well as reduces abdominal obesity.[9] Many studies have shown that testosterone replacement therapy in hypogonadal men increases muscle mass and reduces fat mass.[19, 26-32] Further, adding testosterone (50 mg/day for 1 year, administered as a transdermal gel) to a diet and exercise program results in greater therapeutic improvements of glycemic control and reverses the metabolic syndrome.[20]

Testosterone also has direct (non-obesity mediated) beneficial effects on many metabolic and cardiovascular risk factors [12, 33-37], and reduces death risk independently of body fat status.[38] In line with all these effects, low testosterone levels are associated with increased risk of cardiovascular complications [39], and all-cause and cardiovascular disease death [40-42]. Low testosterone may thus be a predictive marker for men at high risk of cardiovascular disease.[41] In a group of men aged 50-91 who were followed for 20 years, it was found that men whose total testosterone levels were in the lowest quartile (241 ng/dl or lower) were 40% more likely to die than those with higher levels, independent of age, adiposity, lifestyle or presence of cardiovascular risk factors.[38]

Thus, treatment of testosterone deficient men with testosterone has demonstrated considerable health benefits. Despite this, critics state that most of the studies on testosterone replacement therapy were too small. They also argue that the studies were of too short duration (most of them lasting 6-12 months), and that the long-term effects of testosterone on body composition are not known.

Two 5 year long studies were just published that addressed the duration and small study size shortcomings in previous research…

Cont:

http://www.brinkzone.com/mens-health/testosterone-replacement-therapy-trt-in-testosterone-deficient-men-effects-on-fat-loss-waist-reduction-and-metabolic-syndrome-components/

WillBrink
11-15-13, 08:31
I know this is an old post I'm quoting, but I just got my insurance card in the mail the other day now that I have coverage through the PD. :dance3:

Blood work done through Quest is free, so I'll call and schedule that soon.

This is an ongoing thread, so all good.

Rampy
11-18-13, 13:41
I get 300mg IM every 2 weeks of testosterone cypionate, for me it's extremely hard to wrap my mind around this & accept the fact I need the shot every 2 weeks and am dependent on it. Right now I'm 2.5 weeks late with the next one & not sure what I'll do. I can't do it myself as there is something about doing it in the thigh that I can't overcome & thus need somebody to stab me in the butt. It's a huge struggle for me to get the shot every 2 weeks.

WillBrink
11-18-13, 14:18
I get 300mg IM every 2 weeks of testosterone cypionate, for me it's extremely hard to wrap my mind around this & accept the fact I need the shot every 2 weeks and am dependent on it. Right now I'm 2.5 weeks late with the next one & not sure what I'll do. I can't do it myself as there is something about doing it in the thigh that I can't overcome & thus need somebody to stab me in the butt. It's a huge struggle for me to get the shot every 2 weeks.

Read through this thread and this (https://www.m4carbine.net/showthread.php?128035-low-T-at-26!!!!)thread, for some potential help with those issues, such as using tiny needles more frequently and or other methods of delivering T, such as gels, etc. Take the time to read the threads (which contain a ton of intel on the issue), ask Qs if needed.

Good luck.

Rampy
11-18-13, 15:09
Have read them thanks....I started out with the gel & then patch (s) and they did not bring my low T up enough to be therapeutic, thus went 200mg IM and then to 300mg every 2 weeks to achieve a therapeutic level. The smallest needle I can use is a 1 inch 20ga, everything else it's to slow as we have tried all viable options. My biggest problem is my inability to wrap my head around having to be dependent on the shot. I hate it, the feeling of weakness, vulnerability relying on a med and somebody to stick it n me. I've always been independent & now have to rely on not only somebody else but a drug....that is my major problem & as much as I want to accept what it is...


Read through this thread and this (https://www.m4carbine.net/showthread.php?128035-low-T-at-26!!!!)thread, for some potential help with those issues, such as using tiny needles more frequently and or other methods of delivering T, such as gels, etc. Take the time to read the threads (which contain a ton of intel on the issue), ask Qs if needed.

Good luck.

WillBrink
11-18-13, 15:35
Have read them thanks....I started out with the gel & then patch (s) and they did not bring my low T up enough to be therapeutic, thus went 200mg IM and then to 300mg every 2 weeks to achieve a therapeutic level. The smallest needle I can use is a 1 inch 20ga, everything else it's to slow as we have tried all viable options.

If you read the threads closely, you'd see that's not the case. You can use 25g easily and even 30g (insulin needles) with a little knowledge on that, and 300mg every 2 weeks will be a sub optimal dosing schedule. If you feel below 20g is too slow (not clear what that means exactly) and you don't mind getting jabbed by that harpoon for the rest of your days (expect scar tissue to form BTW), that's up to you really.



My biggest problem is my inability to wrap my head around having to be dependent on the shot. I hate it, the feeling of weakness, vulnerability relying on a med and somebody to stick it n me. I've always been independent & now have to rely on not only somebody else but a drug....that is my major problem & as much as I want to accept what it is...

I don't know your medical reason for being in TRT, but for most, TRT is a lifetime commitment. Stop brushing your teeth, cavities happen and so forth. Just one more thing to incorporate into a schedule, and done. You learn to give your own shot, one less thing to be dependent on another person for.

Remember, you don't have to do anything in this life but die. I'd say the benefits of the TRT far outweigh the negatives overall, but it's still voluntary on your part.

Rampy
11-18-13, 16:01
If you read the threads closely, you'd see that's not the case. You can use 25g easily and even 30g (insulin needles) with a little knowledge on that, and 300mg every 2 weeks will be a sub optimal dosing schedule. If you feel below 20g is too slow (not clear what that means exactly) and you don't mind getting jabbed by that harpoon for the rest of your days (expect scar tissue to form BTW), that's up to you really.

I've tried the 25g needle & the different Doc's, RN's and the pharmacist's I've talked to about it all advise against it, when I use a smaller needle it increases the injection time, causes more pain and actually have more T pushed out the IM site vs using a larger gauge needle and for whatever reason I bleed more. It's a mental thing for me doing it in the thigh, have been trying to quite hard to over come that & really do not understand why it's so hard for me...When I go to 3 weeks between shots my levels drop to low as the 3rd week is when I really taper down bad....but the 2nd week it's not as my last test was at 499.73 (Male = 241-827 ng/dL) 3 Oct & the blood was taken in the morning prior to the injection.


I don't know your medical reason for being in TRT, but for most, TRT is a lifetime commitment. Stop brushing your teeth, cavities happen and so forth. Just one more thing to incorporate into a schedule, and done. You learn to give your own shot, one less thing to be dependent on another person for.

Remember, you don't have to do anything in this life but die. I'd say the benefits of the TRT far outweigh the negatives overall, but it's still voluntary on your part.

Per my Doc she thinks it's due to 20 years in the military, then working fire/ems and all the stresses, abuse and bad habits that puts on the body. I'm with ya about one more thing to put into the scheduled and want to, it's just playing hell with wrapping my head around it & having to depend on the shot.

WillBrink
11-18-13, 16:28
I've tried the 25g needle & the different Doc's, RN's and the pharmacist's I've talked to about it all advise against it, when I use a smaller needle it increases the injection time, causes more pain and actually have more T pushed out the IM site vs using a larger gauge needle and for whatever reason I bleed more. It's a mental thing for me doing it in the thigh, have been trying to quite hard to over come that & really do not understand why it's so hard for me...When I go to 3 weeks between shots my levels drop to low as the 3rd week is when I really taper down bad....but the 2nd week it's not as my last test was at 499.73 (Male = 241-827 ng/dL) 3 Oct & the blood was taken in the morning prior to the injection.



Per my Doc she thinks it's due to 20 years in the military, then working fire/ems and all the stresses, abuse and bad habits that puts on the body. I'm with ya about one more thing to put into the scheduled and want to, it's just playing hell with wrapping my head around it & having to depend on the shot.


If you feel it's working for you, and you're getting the the objective and subjective effects you wanted, then drive on. :cool:

Averageman
11-20-13, 06:55
The biggest issue I seem to be having with this is getting a MD to listen. It would seem the two I have seen both are insistent on not prescribing T as a therapy. It makes no issue that now after a 1 1/2 year treatment for thyroid (Hashimoto's) and high Cholesterol, they refuse to address the T.
I have had a weight loss of 36 pounds after 6 months of strict dieting gotten my cholesterol well under control with levels of Triglycerides of 115, HDL at 51 and LDL at 121.
It would seem they wont consider the T therapy but are pushing me toward a sleep study and antidepressants, both of which I reject outright. I wonder why they refuse to address my mid 200 range T levels at age 52 as a cause of my lethargy and blah mood?
To say I'm a bit pissed that they wont even consider anything but sleep apnea or depression, is an understatement.

WillBrink
11-20-13, 10:14
The biggest issue I seem to be having with this is getting a MD to listen. It would seem the two I have seen both are insistent on not prescribing T as a therapy. It makes no issue that now after a 1 1/2 year treatment for thyroid (Hashimoto's) and high Cholesterol, they refuse to address the T.


It can be very challenging to find a doc to work with on that matter. I don't know your situation or if TRT is indeed indicated for you, so your docs could be right, I don't know.



I have had a weight loss of 36 pounds after 6 months of strict dieting gotten my cholesterol well under control with levels of Triglycerides of 115, HDL at 51 and LDL at 121.
It would seem they wont consider the T therapy but are pushing me toward a sleep study and antidepressants, both of which I reject outright. I wonder why they refuse to address my mid 200 range T levels at age 52 as a cause of my lethargy and blah mood?


I couldn't tell you specifically, but acceptance of TRT/HRT in men ranges widely within the medical community. That's changing as evidence continues to grow however. TRT is not without its potential downsides also, which should not be ignored.



To say I'm a bit pissed that they wont even consider anything but sleep apnea or depression, is an understatement.

Like any relationship, you have to find the right that that works with you vs (seemingly) against your wishes. Me personally (not medical advice) I would not be happy with those T levels, and as one can see from the articles and studies I posted or wrote, the data very much supports the risk/benefit of TRT strongly in favor of TRT in my view.

You could also send them various articles/studies I have posted to see if that helps their position/attitude toward it.

Good luck.

usmcvet
11-20-13, 10:21
I had some success talking to my PA. Not sure she read any of the articles I sent her but she listened to me. The biggest issue I had was using weekly doses and smaller needles. They didn't think it would work because it wasn't getting IM. It has worked very well for me.

WillBrink
11-20-13, 10:27
I had some success talking to my PA. Not sure she read any of the articles I sent her but she listened to me. The biggest issue I had was using weekly doses and smaller needles. They didn't think it would work because it wasn't getting IM. It has worked very well for me.

Did you pass along the studies I posted showing sub Q appears equally effective method? Some people and docs I know prefer it. Regardless, you should be getting IM if done in the correct locations per prior discussions here. The data I have seen (some which I posted here) shows IM or Sub Q appears effective for TRT and steady T levels, though of course IM has been SOC for decades. I think the only important issue there would be consistently using one or the other.

usmcvet
11-20-13, 12:59
Will

I don't think she read any of it but listened to my summaries of your articles.

Not sure now I'm doing it right. With the smaller needle does the shot location matter?

WillBrink
11-20-13, 13:23
Will

I don't think she read any of it but listened to my summaries of your articles.

Not sure now I'm doing it right. With the smaller needle does the shot location matter?

As long as the location consistently gets the achieved delivery method (IM or sub Q) done, then what's important appears to be the consistency there. Intentional sub Q for example, usually done by pinching an area in the abdominal region(1), but there are other areas for sub Q and IM, when done with short thin needles, in areas where you tend to be leanest: thigh and shoulders being common locations. You wouldn't, for example, put a short needle into your glute if IM administration is the goal.

Thigh and or shoulders are vascular areas with nerves you can hit, so important to discuss with doc and do your homework on that in terms of best locations if you are not already experienced with that. That's the basics, but don't use it as a replacement for direct medical advice on the issue if you have Qs.


(1) http://www.drugs.com/cg/how-to-give-a-subcutaneous-injection.html

Averageman
11-20-13, 17:59
The original test shows a level of 204 with a scale of 175 to 781 being acceptable.
The Doctor would neither look at the paperwork I had with me or even consider TRT and it was an ouright denial.
From what I have seen my Cholesteral in comparison was no where near the upper 1/3 of the scale, but they were happy to prescribe over the counter and prescription suggestions. My T being on the lower 1/3 of that scale and it's all about "well, suck it up."
Is there a reason why they are uneducated in the lastest and greatest information or is this just not the money maker for the Pharma, Hospitals and Doctors I am going to? Is there a reason when presented with the information they wont even touch it?
I feel like it is time to get with my insurance company and do some Doctor shopping. I just dont think if I sit in there and try and get them to look at the facts as presented here, I'm going to get anything done.

2002zo6
11-20-13, 19:03
I was tested when I was 40 (male) and found out was in low 100's. I was prescribed Androgel (both strengths with no improvment) For the past few months I have been recieving testosterone injections (once a month for starters). The doctor says I will most likely have to continue recieving these shots for the remainder of my life.

usmcvet
11-22-13, 10:43
Will

Once again Brother thanks for all of the great information. I gave myself my shot today, in the abdomen per the instruction sheet. I could not even feel it with the smaller needle, it did push very slowly but worked awesome. It was a big step for me being able to do the shot myself.

WillBrink
11-22-13, 10:50
I was tested when I was 40 (male) and found out was in low 100's. I was prescribed Androgel (both strengths with no improvment) For the past few months I have been recieving testosterone injections (once a month for starters). The doctor says I will most likely have to continue recieving these shots for the remainder of my life.

Read this thread and others mentioned. That injection schedule is sub par, assuming you are in the US and using standard esters of T offered in the US. TRT is, as a rule, a life time commitment yes.

WillBrink
11-22-13, 10:56
Will

Once again Brother thanks for all of the great information. I gave myself my shot today, in the abdomen per the instruction sheet. I could not even feel it with the smaller needle, it did push very slowly but worked awesome. It was a bit step for me being able to do the shot myself.


Congrats bro. Once over that hill, the "why did I make such a big deal over this?" sensation kicks in, but that too is normal. Remember, we are hard wired to resist "harming" ourselves for obvious reasons, and the higher intellectual parts of our brains can't always control our lower base hard wired parts of our hard wired survival instincts. I for one, hate having blood taken out in any form. I will do it, but it always makes me anxious. I use the "you don't have to like it, you just have to do it" approach to that one. Growing up in Brooklyn in NY in the 70s, the goal at all times was to keep the blood in your body, a sensation I have never fulling gotten past. ;)

WillBrink
11-27-13, 18:23
Latest article in the series covers an essential topic for those concerned about this topic: How low testosterone is diagnosed and other essential info relating to that issue:

"Testosterone deficiency, popularly known as “low T”, has entered the center stage in both the lay and medical communities. However, how is testosterone deficiency (a.k.a. hypogonadism) diagnosed? What is the testosterone level threshold below which you can say you have low T? What are the references ranges for healthy men?

Here you will find out what the medical guidelines say, what critical information they are ignoring, what you should point out to your doctor if he/she doesn’t think you have low T…

What do current clinical practice guidelines say about how to diagnose testosterone deficiency?

The Endocrine Society clinical practice guideline recommends making a diagnosis of testosterone deficiency only in men with consistent symptoms and signs, who also have unequivocally low blood testosterone levels.[1] They recommend testosterone therapy for men with symptomatic androgen deficiency, with the goal to improve their sexual function, sense of well-being, muscle mass and strength, and bone mineral density.

The Endocrine Society clinical practice guideline is against starting testosterone therapy in patients with:[1]

- Prostate cancer or prostate-specific antigen (PSA) greater than 4 ng/ml or greater than 3 ng/ml in men at high risk for prostate cancer (such as African-Americans or men with first-degree relatives with prostate cancer without further urological evaluation).

- Hematocrit greater than 50%.

- Severe lower urinary tract symptoms with International Prostate Symptom Score (IPSS) above 19,

- Uncontrolled heart failure.

When testosterone therapy is instituted, we suggest aiming at achieving testosterone levels during treatment in the mid-normal range with any of the approved formulations, chosen on the basis of the patient’s preference, consideration of pharmacokinetics, treatment burden, and cost. Men receiving testosterone therapy should be monitored.[1]


CONT:

http://www.brinkzone.com/mens-health/how-is-testosterone-deficiency-low-t-diagnosed-things-you-need-to-know-before-going-to-your-doctor/

usmcvet
11-27-13, 18:58
http://i859.photobucket.com/albums/ab160/usmcvet0331/photo_zpsdf169bae.jpg (http://s859.photobucket.com/user/usmcvet0331/media/photo_zpsdf169bae.jpg.html)

Thought if you guys today while my son and I were injecting our turkey!

onado2000
11-28-13, 09:02
I started weekly shots about two months ago. Nevermind energy, mood and overall feeling of wellbeing, I have significantly increased benchpress & squat weight/reps, lost body fat, something that i couldnt achieve in a years time prior. this treatment is amazing, at 41 i feel like im in my 20s.

skydivr
11-28-13, 09:34
You guys are killing me. My Dr. Continues to only proscribe Androgel; after two years of it I still don't have any improvement. Last weeks test yielded a 177, yet he still doesn't seem to sense any need to do something about it. I like this guy, but I'm going to have to find another Doctor. I'm SOOO tired of being tired all the time...

WillBrink
11-28-13, 10:23
You guys are killing me. My Dr. Continues to only proscribe Androgel; after two years of it I still don't have any improvement. Last weeks test yielded a 177, yet he still doesn't seem to sense any need to do something about it. I like this guy, but I'm going to have to find another Doctor. I'm SOOO tired of being tired all the time...

Your numbers would be poor for non treatment status, much less being treated with TRT. Find a doc you can work. Good luck.

skydivr
12-10-13, 16:29
Your numbers would be poor for non treatment status, much less being treated with TRT. Find a doc you can work. Good luck.

Will, I finally asked my Doctor (when getting my refill today) to either raise my dosage, strength or change something, because I'm getting pretty fed up with it all. He agreed (why he didn't do it earlier when he knew it was low himself) to up my dosage 50% for this month, then retest to see if I had any improvement. When I went to the Pharmacy, I asked asked the Pharmacist if he might have any idea why my Dr. seems hesistant to want to do anything more. He said the only thing he could think of was the increased cancer chances. I also asked if it might be because of my other prescriptions/family risk, etc. - He couldn't say. I asked him if they had others with this script and if these dosages were working for them (he said he'd ask). I asked him why, after two years, this didn't seem to be working and all he could say is just maybe my skin doesn't absorb it.

What would the side effects/risks be that would cause my doctor to hesitate to go further? Just his lack of education on it? Looking above, I don't have any of the PSA/Prostate problems specified above...I like my Doc otherwise, but I'm getting aggravated enough to look for another...

WillBrink
12-10-13, 17:04
Will, I finally asked my Doctor (when getting my refill today) to either raise my dosage, strength or change something, because I'm getting pretty fed up with it all. He agreed (why he didn't do it earlier when he knew it was low himself) to up my dosage 50% for this month, then retest to see if I had any improvement. When I went to the Pharmacy, I asked asked the Pharmacist if he might have any idea why my Dr. seems hesistant to want to do anything more. He said the only thing he could think of was the increased cancer chances. I also asked if it might be because of my other prescriptions/family risk, etc. - He couldn't say. I asked him if they had others with this script and if these dosages were working for them (he said he'd ask). I asked him why, after two years, this didn't seem to be working and all he could say is just maybe my skin doesn't absorb it.

What would the side effects/risks be that would cause my doctor to hesitate to go further? Just his lack of education on it? Looking above, I don't have any of the PSA/Prostate problems specified above...I like my Doc otherwise, but I'm getting aggravated enough to look for another...

Unfortunately, the only one who can really answer those questions is your doc. Why he decided to continue with a dose that kept you low for an untreated man, etc, only he/she knows, and you'd need to ask. It would only be a WAG on my end, and it could be due to the reasons you listed above or other(s). I have posted a number of articles and studies in this and other threads addressing some of the concerns he/she may have which can be worth forwarding to a doc for further discussions.

skydivr
12-10-13, 17:17
Unfortunately, the only one who can really answer those questions is your doc. Why he decided to continue with a dose that kept you low for an untreated man, etc, only he/she knows, and you'd need to ask. It would only be a WAG on my end, and it could be due to the reasons you listed above or other(s). I have posted a number of articles and studies in this and other threads addressing some of the concerns he/she may have which can be worth forwarding to a doc for further discussions.

Thanks for such a quick response. The hard part about discussing it with him is that the test results don't come back until AFTER my visit, which normally is every 90 days; by that time, the test results are dated. I need to go back thru this thread and look for and try to print some of the relevant articles (unless you have them all in one place somewhere?)...Since he wants to retest next month, I think this would be the time to try and pin him down with some supporting research and ask him why he's so hesitant. He's also an older doc, and it may just be he doesn't want to try anything else if he's getting close to retirement.

I talked to one of my coworkers whose had same issue (his daughter works for his doc, so he has full access to his records). He's doing Testim instead of A-gell; his number a year ago was 28 (Even I don't think mine has ever been that low); now a year later his is around 500; his doc considers 345 low - in his case the Testim worked apparently. One of my other co-workers husband's get's the shot; she says he's a LOT different than he was when he started...

usmcvet
12-10-13, 20:02
Brother. They are your records. Ask for them. I call and ask for my stuff when I want it. The results don't belong to your doc. They're yours. They should not give you a hard time about that. If they do I would get a new doc.


Thanks for such a quick response. The hard part about discussing it with him is that the test results don't come back until AFTER my visit, which normally is every 90 days; by that time, the test results are dated. I need to go back thru this thread and look for and try to print some of the relevant articles (unless you have them all in one place somewhere?)...Since he wants to retest next month, I think this would be the time to try and pin him down with some supporting research and ask him why he's so hesitant. He's also an older doc, and it may just be he doesn't want to try anything else if he's getting close to retirement.

I talked to one of my coworkers whose had same issue (his daughter works for his doc, so he has full access to his records). He's doing Testim instead of A-gell; his number a year ago was 28 (Even I don't think mine has ever been that low); now a year later his is around 500; his doc considers 345 low - in his case the Testim worked apparently. One of my other co-workers husband's get's the shot; she says he's a LOT different than he was when he started...

FloridaWoodsman
12-10-13, 21:16
Will, I finally asked my Doctor (when getting my refill today) to either raise my dosage, strength or change something, because I'm getting pretty fed up with it all. He agreed (why he didn't do it earlier when he knew it was low himself) to up my dosage 50% for this month, then retest to see if I had any improvement. When I went to the Pharmacy, I asked asked the Pharmacist if he might have any idea why my Dr. seems hesistant to want to do anything more. He said the only thing he could think of was the increased cancer chances. I also asked if it might be because of my other prescriptions/family risk, etc. - He couldn't say. I asked him if they had others with this script and if these dosages were working for them (he said he'd ask). I asked him why, after two years, this didn't seem to be working and all he could say is just maybe my skin doesn't absorb it.

What would the side effects/risks be that would cause my doctor to hesitate to go further? Just his lack of education on it? Looking above, I don't have any of the PSA/Prostate problems specified above...I like my Doc otherwise, but I'm getting aggravated enough to look for another...

Another possible cause of his hesitation is that it is a regulated item that is frequently subject to abuse.

WillBrink
12-11-13, 12:00
Another possible cause of his hesitation is that it is a regulated item that is frequently subject to abuse.

In this particular situation, unlikely, but not impossible. His T levels (which are poor for an un treated man) completely rule out any abuse on his end, but stranger things have happened. Docs are human being with their own set of pre existing positions and feelings on various topics, and (being human) can be resistant to changing those positions, regardless of the (often) growing evidence to the contrary.

WillBrink
12-11-13, 12:03
Brother. They are your records. Ask for them. I call and ask for my stuff when I want it. The results don't belong to your doc. They're yours. They should not give you a hard time about that. If they do I would get a new doc.

I always recommend asking for copies of all blood work, and any doc who refuses is no doc I'd be willing to work with or recommend. My docs usually send me my results as a matter of course with their comments and recs.

WillBrink
12-11-13, 12:14
Thanks for such a quick response. The hard part about discussing it with him is that the test results don't come back until AFTER my visit, which normally is every 90 days; by that time, the test results are dated. I need to go back thru this thread and look for and try to print some of the relevant articles (unless you have them all in one place somewhere?)...Since he wants to retest next month, I think this would be the time to try and pin him down with some supporting research and ask him why he's so hesitant. He's also an older doc, and it may just be he doesn't want to try anything else if he's getting close to retirement.

I talked to one of my coworkers whose had same issue (his daughter works for his doc, so he has full access to his records). He's doing Testim instead of A-gell; his number a year ago was 28 (Even I don't think mine has ever been that low); now a year later his is around 500; his doc considers 345 low - in his case the Testim worked apparently. One of my other co-workers husband's get's the shot; she says he's a LOT different than he was when he started...

Docs are busy people, and they often don't have time to keep up with the latest on various topics. It's often the case that an open minded doc is brought up to speed on some topic by a patient who is active, interested, and researching a condition for which they are being treated. I don't expect any doc to be up to speed on all topics, as that's simply not possible, but I do expect them to be open to working with me on the issue, and by supplying them good reading info on a topic/area of concern they may have, helps them be better docs and you a better treated happy patient.

But, it's a working relationship, and like all relationships, professional or personal, the right fit can take some work and or is not always smooth.

Big A
12-11-13, 12:54
Thanks for such a quick response. The hard part about discussing it with him is that the test results don't come back until AFTER my visit, which normally is every 90 days; by that time, the test results are dated. I need to go back thru this thread and look for and try to print some of the relevant articles (unless you have them all in one place somewhere?)...Since he wants to retest next month, I think this would be the time to try and pin him down with some supporting research and ask him why he's so hesitant. He's also an older doc, and it may just be he doesn't want to try anything else if he's getting close to retirement.

I talked to one of my coworkers whose had same issue (his daughter works for his doc, so he has full access to his records). He's doing Testim instead of A-gell; his number a year ago was 28 (Even I don't think mine has ever been that low); now a year later his is around 500; his doc considers 345 low - in his case the Testim worked apparently. One of my other co-workers husband's get's the shot; she says he's a LOT different than he was when he started...

Skydivr, I would suggest you find a new doctor that uses a faster lab. I don't see how it can take 90 days for a lab to analyzie a blood draw and get the results to your doctor. My doc uses Quest Diagnostics and they give him the results the next week from when I have my blood drawn.

I also recomend you ask about switching to Testim. Andro-gel didn't do shit for me. It actually made feel worse and I was an emotional trainwreck. I had wild mood swings from rage to crying to suicidal ideation and it didn't do a damn bit to help increase my T levels.

Big A
12-11-13, 12:58
Congrats bro. Once over that hill, the "why did I make such a big deal over this?" sensation kicks in, but that too is normal. Remember, we are hard wired to resist "harming" ourselves for obvious reasons, and the higher intellectual parts of our brains can't always control our lower base hard wired parts of our hard wired survival instincts. I for one, hate having blood taken out in any form. I will do it, but it always makes me anxious. I use the "you don't have to like it, you just have to do it" approach to that one. Growing up in Brooklyn in NY in the 70s, the goal at all times was to keep the blood in your body, a sensation I have never fulling gotten past. ;)

Ever have an Arterio-blood gas done? I had to have that done when I had a real bad case of phnomea and after having experienced that having a regular blood draw don't bother me in the least...

skydivr
12-11-13, 14:41
Brother. They are your records. Ask for them. I call and ask for my stuff when I want it. The results don't belong to your doc. They're yours. They should not give you a hard time about that. If they do I would get a new doc.

That's not what I meant. I get a copy of every test with his notes within a week. It's just that, those notes say "Let's continue to monitor and see you again in three months" vs. "Come over tomorrow afternoon and let's up your dosage/switch brands/come and get a shot"...I really think he's just an old dog that doesn't really want to learn any new tricks..


Another possible cause of his hesitation is that it is a regulated item that is frequently subject to abuse.

In the last 2 months I've noticed I now have provide ID and sign something...it amazes me that it's harder to get this than cold pills that make meth...


Skydivr, I would suggest you find a new doctor that uses a faster lab. I don't see how it can take 90 days for a lab to analyzie a blood draw and get the results to your doctor. My doc uses Quest Diagnostics and they give him the results the next week from when I have my blood drawn.

I also recomend you ask about switching to Testim. Andro-gel didn't do shit for me. It actually made feel worse and I was an emotional trainwreck. I had wild mood swings from rage to crying to suicidal ideation and it didn't do a damn bit to help increase my T levels.

Did Testim actually work with you? Did it give you the improvement that I need?

Big A
12-11-13, 18:19
For about a year and a half, yes. Then it began to taper off so now I'm on a once a month booster shot. I can actually tell when I'm due for a shot because I start to feel the T wearing off. I'm supposed to get my shot Friday and I could already feel it wearing off last week. My numbers are really low and we're trying to get them where they need to be but the Testim wasn't enough by itself.

Hope you get this stuff figured out because it really sucks. I really didn't like the Andro-gel and much prefer the Testim.

WillBrink
12-11-13, 18:58
For about a year and a half, yes. Then it began to taper off so now I'm on a once a month booster shot. I can actually tell when I'm due for a shot because I start to feel the T wearing off. I'm supposed to get my shot Friday and I could already feel it wearing off last week. My numbers are really low and we're trying to get them where they need to be but the Testim wasn't enough by itself.

Hope you get this stuff figured out because it really sucks. I really didn't like the Andro-gel and much prefer the Testim.

Booster shot? If the topical simply wont get your T levels up as high as needed (a common issue with topicals for some users) then why not just go the IM route? Topical + booster shots (If i'm reading correctly) don't make much sense at that point. IM is steady and predictable and in my view, still the preferred method.

Big A
12-11-13, 19:46
Booster shot? If the topical simply wont get your T levels up as high as needed (a common issue with topicals for some users) then why not just go the IM route? Topical + booster shots (If i'm reading correctly) don't make much sense at that point. IM is steady and predictable and in my view, still the preferred method.

I'm not sure what you mean by IM, intra muscular? Can you expand on this please?

I'm guessing you mean a shot more than once a month?

WillBrink
12-12-13, 07:23
I'm not sure what you mean by IM, intra muscular? Can you expand on this please?

I'm guessing you mean a shot more than once a month?

Yes, smaller weekly shots that get levels you want that stay consistent. You'll find the topic covered in this thread and others FYI. Topical + shots makes little sense.

Big A
12-12-13, 10:24
Yes, smaller weekly shots that get levels you want that stay consistent. You'll find the topic covered in this thread and others FYI. Topical + shots makes little sense.

Yeah, I read through the thread a while ago and didn't want to go back through the whole thing.

I have been thinking about getting my doc to switch me to just the shots as I no longer think the gel is having any effect. My weight loss has seemed to hit a plateu. I'm busting my ass at the gym without any decernable progress. My weight has stayed the same for about 5 months now with no loss of body fat and no noticable muscle growth.

Have you heard of people building up a resistance to the gels before?

For the first year and a half the Testim was great for me but now I don't feel the same as when I started it.

WillBrink
12-12-13, 13:35
Yeah, I read through the thread a while ago and didn't want to go back through the whole thing.

I have been thinking about getting my doc to switch me to just the shots as I no longer think the gel is having any effect. My weight loss has seemed to hit a plateu. I'm busting my ass at the gym without any decernable progress. My weight has stayed the same for about 5 months now with no loss of body fat and no noticable muscle growth.

Have you heard of people building up a resistance to the gels before?

For the first year and a half the Testim was great for me but now I don't feel the same as when I started it.

I have not heard of people experiencing a resistance to gels that took place over time, no. But, there's a wide range of effects in people with topicals, both objectively and subjectively that usually show themselves fairly early. I wouldn't use the gym, or efforts there in, as whether TRT is having the desired effects, as that can and does lead to a more is better approach and or your lack of progress may be unrelated to the T levels. I'd go by labs, and usual subjective symptoms of low T.

IM route is more predictable, gets levels to where you and the doc want them, and subjectively, men often report feeling better using that route compared to others in my experience. Obviously, major drawback is the injection part, but as outlined in this and other threads, very small needles etc, can be used with minimal drama.

usmcvet
12-15-13, 09:42
That's not what I meant. I get a copy of every test with his notes within a week. It's just that, those notes say "Let's continue to monitor and see you again in three months" vs. "Come over tomorrow afternoon and let's up your dosage/switch brands/come and get a shot"...I really think he's just an old dog that doesn't really want to learn any new tricks.




Frustrating.

I used to have to sign for my Androgel shipments. They leave my injectable T in the mail box. I think it has more to do with the cost than the product. The Androgel was $600 a month, the injectable is a few hundred for 3 months worth. Anyone else have a similar experience?

skydivr
12-15-13, 11:16
Frustrating.

I used to have to sign for my Androgel shipments. They leave my injectable T in the mail box. I think it has more to do with the cost than the product. The Androgel was $600 a month, the injectable is a few hundred for 3 months worth. Anyone else have a similar experience?

As someone who has apparently been able to convince their doctor to 'make the switch', how's that working out for you? How long did it take for you to notice?

usmcvet
12-15-13, 11:46
As someone who has apparently been able to convince their doctor to 'make the switch', how's that working out for you? How long did it take for you to notice?

It was actually my doctors idea it might have bee my PA not sure. I used Androgel until my insurance changed and I just could not afford it. Then patches which did not work for me, they would not stay on and left a nasty glue residue on my skin! Sucked. Then we went to injections with me going to the office for a shot. I've been doing them at home for months now with the wife's help and on my own for a month now. I just opened my mail and have a bill for 30 ML Testostorone CYP in oil 200MG/ML Injectible it is $284 that is 30 weeks. I still have a few months of the 1ML bottles left, I might save som, they'd be much easier to travel with. Going to St. Martin in February and will be ther ten days. I'm doing 1ML shots weekly now and it is an awesome improvement. The large compounded bottle is much more affordable. I can't remember how assertive you've been with the doc but if you've already turned up the assertiveness then it is probably time to switch doc's.
Also not sure if you can consult with someone online or over the phone. Not sure how that works? I went to buy needles and syringes at my local pharmacy several months ago and all they would sell me is tiny diabetic/heroin needles. They said I needed a script. I went online and ordered luer-lok needles and syringes with no issue and no script. I bought a box of 100 BD 3ml 25gx5/8" needles to inject with. I use 18gx1" to draw and bought a box of just those needles to put on the syringe and then switch back to the 25g to inject.

usmcvet
12-15-13, 12:20
I don't remember how long it took to notice but it was fairly quick. The mood is better and my sexual ability is a 100% improvement. That's what brought me to see my PA. I came in after chemo in 2004. It took me a while to notice, a few weeks I'd say but I had notice I did not want sex and then noticed I couldn't get an erection. That really bothered me as a 32 year old guy. I googled my symptoms and came up with the same conclusion my PA did. Hypogonadism is my diagnosis. She cracked me up. She told me the chemo knocked out my nuts. This was confirmed with blood work. I did go see a Endrocronoligist and she recommended the T. My T was lower than the normal range for a woman. So I've been doing T replacement for ten years now. The Androgel worked well at first then didn't work well and was too expensive. With the Androgel I think absorption was the issue. I was on a very high dose and it just did not work. The doctors asked how I was feeling with the shots. I asked for more and I'm happy with where I'm at now. With the Androgel and patches I was using Viagra, tried Levitra and then Cialis for daily use. The C rocked compared to the others. But I don't need them now. It is a good feeling.

skydivr
12-15-13, 14:01
Thanks for sharing your experience. When I was 32 I was good to go, but at 52, I'm not. I'm glad it's worked for you. I haven't been assertive enough with my Doctor, but I'm working on it....

usmcvet
12-15-13, 17:36
For me it was a shock like a switch had been turned off. It was.

WillBrink
12-16-13, 09:06
One treatment new to the US that's supposedly approved, or very close to it, is Nebido. Nebido is a single IM injection that lasts up to 6 months. It's been used in other countries for a while with good success. Would be sold under the name Aveed in the US. The FDA has gone back and forth with the manufacturer on approval, but it appears that it's a go:

http://www.pharmalive.com/fda-accepts-endos-response-to-aveed-crl

http://www.nebido.com/

This product could be a game changer for men who don't want to take regular IM injections and don't want to use, or don't get the effects they want, from the other options, such as topicals. etc.

warpigM-4
12-25-13, 10:46
I would like to share something to the thread .as I stated earlier in the thread My DR wanted to put me on the andogel ,But it was way out of my price range even with insurance .So i asked for the shot .Once a month i have been going in for a T shot
what I have noticed on my 5th Month
My Mood is better ,I feel like I have more energy ,My sex drive is up and I just all around feel better,I am not tired all the time after a hard day at work .I am not as stressed all the time and my wife says she has noticed that I feel better .i thought at first I don't need this ,But i am glad I did !!!talk to your DR and go for it ,it does help .

I have not noticed any bad side effects My back did break out the first couple of shots But that quickly cleared up .
I thank you Will for starting this thread .I have educated myself more on it and understand that at 45 something was happening to me and I needed to take action to fix the problem .

I noticed the changes after the second shot which was my second month .the first one I noticed nothing but after that It has been getting better with each one

WillBrink
12-25-13, 12:44
I would like to share something to the thread .as I stated earlier in the thread My DR wanted to put me on the andogel ,But it was way out of my price range even with insurance .So i asked for the shot .Once a month i have been going in for a T shot
what I have noticed on my 5th Month
My Mood is better ,I feel like I have more energy ,My sex drive is up and I just all around feel better,I am not tired all the time after a hard day at work .I am not as stressed all the time and my wife says she has noticed that I feel better .i thought at first I don't need this ,But i am glad I did !!!talk to your DR and go for it ,it does help .

I have not noticed any bad side effects My back did break out the first couple of shots But that quickly cleared up .
I thank you Will for starting this thread .I have educated myself more on it and understand that at 45 something was happening to me and I needed to take action to fix the problem .

I noticed the changes after the second shot which was my second month .the first one I noticed nothing but after that It has been getting better with each one

What is the monthly dose? Where is your T levels at the end of the month? If you have not read through this thread and others, I'd highly recommend you do. While once per month is better than nothing, it's far from an optimal schedule (assuming you are in the US using what's currently offered for IM T) and you'll see additional benefits if a more optimal dosing schedule protocol is adopted.

heat-ar
12-26-13, 14:09
Well after a year and a half and many doctors i found a doc who believes my t levels are low enough to cause my extreme fatigue. 8/15/13 my total T was 256ng/dl and my free T was 35.4 pg/ml. So i try 100mg of cream for 4 mos. and my new levels as of 12/14/13 was total T 254ng/dl and my free T was 26.7pg/ml. So yea i am going in the wrong direction so i started 200mg of shots every 2 weeks and hope that gets my T back up there. How long does it take for injections to start making difference in one life??? And i would like to thank everybody in this thread for all the info it has help a bunch. All my other so call doctors said there was nothing wrong with me.

heat-ar
01-03-14, 13:24
Well i gave myself my first T shot today and i must say it was easy. It felt better than someone else giving it to me.

usmcvet
01-03-14, 17:24
Well i gave myself my first T shot today and i must say it was easy. It felt better than someone else giving it to me.

Good job! It took me quite a while to get up the nerve! Now it is no big deal.

WillBrink
01-05-14, 09:02
This recent article should be of interest to those in this thread. We know age related decline in testosterone takes place, but we also know life style and other factors play an important part in that. Studies have not examined those factors in isolation, until now.

Can Age-Related Declines in Testosterone Levels be Prevented or Reversed? (http://www.brinkzone.com/mens-health/can-age-related-declines-in-testosterone-levels-be-prevented-or-reversed/) By BrinkZone.com author Monica Mollica

The essential finding:

"The sharper decline in both testosterone levels in people with poor health, among whom obesity, metabolic syndrome, diabetes and cardiovascular disease is common, indicates that a substantial proportion of the apparent aging effect is attributable to changes in health status. Thus, the age-related testosterone decline can be partially prevented and/or slowed down by adherence to a healthy lifestyle incorporating a sound diet and regular exercise."

Full article has more info and details if interested.

Vic303
01-05-14, 11:56
Doc just allowed us to switch DH to a weekly injection protocol, and bumped him up to .75ml/week to see if that brings things up to the desired point. Doc is concerned that DH is not absorbing the cypionate well, and may switch him to Testopel. Docs says they have had good success with their pts on T-pel, with only one pellet backing out of the incision in 4 years.

heat-ar
01-12-14, 21:44
I am taking 200mg injection every two weeks and about 7 days after the shot i start to loose my energy and by day 14 i am really tired again. WillBrink do you think taking more smaller dosages would help with the highs and lows??

usmcvet
01-12-14, 21:49
I am taking 200mg injection every two weeks and about 7 days after the shot i start to loose my energy and by day 14 i am really tired again. WillBrink do you think taking more smaller dosages would help with the highs and lows??

You doing the shot yourself? If so try doing it every seven days. It worked for me.

WillBrink
01-13-14, 06:56
I am taking 200mg injection every two weeks and about 7 days after the shot i start to loose my energy and by day 14 i am really tired again. WillBrink do you think taking more smaller dosages would help with the highs and lows??

I cover that topic length in this and other thread mentioned, so I'd read through the threads to get all the info. Yes, smaller weekly doses would fix that if your total dose is also right for you.

heat-ar
01-13-14, 12:20
You doing the shot yourself? If so try doing it every seven days. It worked for me.

Yes i am giving shots to myself. I think i will start taking them every 7 days.

heat-ar
01-13-14, 12:24
I cover that topic length in this and other thread mentioned, so I'd read through the threads to get all the info. Yes, smaller weekly doses would fix that if your total dose is also right for you.
Its been awhile since i read the whole thread i will go back and read it.Thanks.

heat-ar
01-17-14, 20:28
Anybody know much about using testosterone and HCG and a estrogen blocker for a treatment plan??

WillBrink
01-17-14, 21:57
Anybody know much about using testosterone and HCG and a estrogen blocker for a treatment plan??

Have you taken the time to read through the thread?

Heavy Metal
01-17-14, 23:27
My total was 218. Doc put me on a half CC per week of Cyponiate.

I shoot it into my leg, took the 5th one Wednesday night.

The 1st shot felt like somebody shot me point blank with a paintball gun. 2nd week slight discomfort. 3rd hardly tell it. 4th, can't tell I had a shot.

I inject it into my left thigh very, very slowly and it don't hurt anymore.

I can feel it working starting this week.

I can see it in my workouts, I am coming off my plateau. Some old stubborn injuries are improving rapidly.

WillBrink
01-18-14, 08:09
My total was 218. Doc put me on a half CC per week of Cyponiate.

I shoot it into my leg, took the 5th one Wednesday night.

The 1st shot felt like somebody shot me point blank with a paintball gun. 2nd week slight discomfort. 3rd hardly tell it. 4th, can't tell I had a shot.

I inject it into my left thigh very, very slowly and it don't hurt anymore.

I can feel it working starting this week.

I can see it in my workouts, I am coming off my plateau. Some old stubborn injuries are improving rapidly.

Size (gauge) of needle used?

Is that half CC of 200mg/ml?

Heavy Metal
01-18-14, 10:27
Diabetic needles but a half CC is 500ml. A Diabetic needle will hold a Cubic Centimeter (or one thousandth of a liter) when full. I load half-full.

The Doc wanted me to do 1000ml every other week. I talked him in to doing 500ml every week. He is kind of new to this. My belief is splitting it in half and doubling the frequency is better due to the 5 day half-life.

WillBrink
01-18-14, 10:35
Diabetic needles but a half CC is 500ml. A Diabetic needle will hold a Cubic Centimeter (or one thousandth of a liter) when full. I load half-full.

The Doc wanted me to do 1000ml every other week. I talked him in to doing 500ml every week.

Test cyp or Enanth, in the US will come in 100mg/ml or 200mg/ml. Majority of docs will use the former, forcing you to use more volume of oil and go through the bottle (10CC typical multi use size for T in the US) faster. Two, 0.5 ml per week is either 50mg of T or 100mg depending on which you have. The former will not be sufficient as a TRT dose in the vast majority of men and the latter a typical starting dose and usually sufficient depending on where the doc wants you to be in the range (another topic...)

Hence, the Q, Take a look at the bottle. It will say 100mg/ML or 200mg/ML. The latter is preferable for a variety of reasons, most practical and some times financial.

Heavy Metal
01-18-14, 10:38
Ok, you are asking me about concentration.

200mg.

It's Watson. I think it might be aqueous and not oil based. I wanted oil-based but I also wanted to get something readily available and start using it and worry about fine-tuning it later.


A friend told me to avoid the Sandoz Labs stuff at all costs. He has been into T therapy for years.

Heavy Metal
01-18-14, 10:42
Doc is also running a full Metabolic Panel and PSA in a few weeks as a follow-up.

WillBrink
01-18-14, 10:44
200mg.

It's Watson. I think it might be aqueous and not oil based.

If Cyp or Enanth, the standard IM T used for TRT in the US, it's oil based. Only one testosterone will be water based, and that's testosterone suspension. Any doc using suspension for TRT is a doc to avoid. Suspension is nasty useless crap, and I don't tend you use terms lie that or openly second guess a doc like that often....Unlikely you have a T suspension. Will say on the bottle.

Heavy Metal
01-18-14, 10:45
No, its Cyp. Says so on the label. Good to know I am already using the right stuff.

WillBrink
01-18-14, 10:48
No, its Cyp. Says so on the label. Good to know I am already using the right stuff.

You had me worried there for a moment dude. :cool:

Heavy Metal
01-18-14, 10:49
The needle looks to be a half-inch long. I am putting it into the side of my left thigh about 7 inches above the knee.

I stick the needle in until it is flush with the leg, all the way in. No real fat there, I can feel the texture of the muscle thru the skin at that point.

My 74 year old Foot Doctor, who injects T himself and IMO knows more than my young 38 GP who scripted the T, gave me the needles and recommended I use them as much as I hate needles. They are what he uses.

He looks and acts like he in in his late 50's BTW. Nobody would EVER guess his age.

heat-ar
01-18-14, 11:36
Have you taken the time to read through the thread?

Yes..

Big A
01-18-14, 11:42
Two weeks ago I went to see an Endocrinologist to get a second opinion about my treatment and he was shocked to find out how my General Practioner was treating my T-levels and my diabetes. He switched all of my diabetes meds and said that they should help kick start my weight loss. I have to be off all T treatments for two more weeks so he can get clear blood results to determine how to treat my problems.

Being off the T really has had a negative impact on my workouts. I have absolutely no strength and it sucks big time...:(

For those of you seeing your GP for your T threapy I recomend you get a second opinion from an Endocrinologist if you have that option. I'm pissed at myself because I should've done this two years ago...:mad:

WillBrink
01-18-14, 11:44
The needle looks to be a half-inch long. I am putting it into the side of my left thigh about 7 inches above the knee.

I stick the needle in until it is flush with the leg, all the way in.

My 74 year old Foot Doctor, who injects T himself and IMO knows more than my young 38 GP who scripted the T, gave me the needles and recommended I use them as much as I hate needles. They are what he uses.

He looks and acts like he in in his late 50's BTW. Nobody would EVER guess his age.

If you have read this thread and others, you see i spent a fair amount of time convincing people that 28-30g ("insulin needles") work just fine for TRT. A surprising % of docs don't know that (but improving), and some flat out refuse to believe it will work. To the point, I had to go to the docs office of a buddy and demonstrate it for him. From then on, doc recommended that route.

Sure, takes a bit more time and effort to be sure, but, more than worth it.

Heavy Metal
01-18-14, 11:47
They are a bitch to load, otherwise, they work great!

It takes me much longer to load the needle than to give the injection and I give it super-slow.

WillBrink
01-18-14, 13:48
Yes..


Cool. But, that should give you a perspective no generic advice on such things would be offered, at least not by anyone looking to be responsible and medically sound. TRT and associated meds you mention are used via (hopefully responsible and knowledgeable) practitioners who doing a work up on an individual, using labs, to decide the correct course of action for the individual. Hence, I'd avoid anyone offering some "stack" advice on the 'net.

WillBrink
01-18-14, 14:05
They are a bitch to load, otherwise, they work great!

It takes me much longer to load the needle than to give the injection and I give it super-slow.

Are you using the same needle to draw from the multi use via? If so, how to solve that: use standard 21g to draw, take plunger from insulin needle, load it up. You have to be a little careful when replacing the plunger of the insulin needle, but it's easy enough once you do it a few times.

Trick two, once plunger is back and all air removed, run the insulin needle body under hot water (making sure not to allow water to hit needle as he water is not sterile) and that makes the push much easier.

Bam, draw issues and or push issues, solved.

Heavy Metal
01-18-14, 14:07
The draw is a bitch but the push is ok. It seems to help keep the injection site from getting sore if I inject slowly.

I pull the syringe all the way back, insert into the vial, put air into the vial to eq the pressure and then pull it back to .7.

Once it is nearly full, I push it back to just over .5 and remove.

Then I level it to .5 and inject. I want to see a bit of fluid come out to make sure there is no air.

Heavy Metal
01-18-14, 14:10
The problem is going to be when the vial gets nearly empty. I will try your trick at that point.

Heavy Metal
01-18-14, 14:17
I am going to try and re-use my syringes. You think if I clean them carefully with isopropyl I can get three uses per syringe?

Irish
01-18-14, 15:06
I started weekly shots about two months ago. Nevermind energy, mood and overall feeling of wellbeing, I have significantly increased benchpress & squat weight/reps, lost body fat, something that i couldnt achieve in a years time prior. this treatment is amazing, at 41 i feel like im in my 20s.


Being off the T really has had a negative impact on my workouts. I have absolutely no strength and it sucks big time...:(

Is there really that big of an impact on performance? I just passed the 40 mark and am a bit on the sluggish side but haven't had any sort of testing done yet.

One more quick question. I notice guys saying they feel happier, better mood, etc. after getting on T. But, are there examples of the opposite? Shorter temper and that type of thing?

WillBrink
01-18-14, 17:27
The draw is a bitch but the push is ok. It seems to help keep the injection site from getting sore if I inject slowly.

I pull the syringe all the way back, insert into the vial, put air into the vial to eq the pressure and then pull it back to .7.

Once it is nearly full, I push it back to just over .5 and remove.

Then I level it to .5 and inject. I want to see a bit of fluid come out to make sure there is no air.

If that works, all good. Most just use method of larger gauge to draw the T. Another benefit is, the rubber stopper dulls the needle, so using a draw syringe avoids that issue, which should = less trauma to tissue at the IM site, less potential for scar tissue formation, etc.

WillBrink
01-18-14, 17:31
I am going to try and re-use my syringes. You think if I clean them carefully with isopropyl I can get three uses per syringe?

Standard advice is no. That's not to say people have not done it/do it, but you do increase your risk of infections. Insulin needles are dirt cheap, so unless you have to for some reason, I'd advise to not do that.

Heavy Metal
01-18-14, 17:40
I can easily clean them with an isopropyl bath.

WillBrink
01-18-14, 17:59
I can easily clean them with an isopropyl bath.

Of course, and people have/do. I don't believe that achieves a level sterility at the level of the sterile needles you're pulling out of their intended one time use package, but not my area of expertise. The increased risk of infections is likely very low, but I'm repeating the SOP advice on that issue. Done correctly, used perhaps 2-3 times, my understanding of risk of infection is extremely low. But, me personally, I'd only do it forced to due to cost and or availability.

I can say, the risk may be low, but the outcome of rolling that dice if your number comes up can be very bad. Not a risk/benefit I can make for you there. Maybe the docs here can weigh in on that one.

harm
01-18-14, 18:15
I've been researching this issue and several other potential causes of low T are head trauma & or concussions, spinal injuries, extreme caloric restriction (usually not an American issue) or repetitive incorrect weight cutting - so if you wrestle, box or compete in any weight measured sports be careful. I know I'm going to be a lot more sensible w my boys approaching wrestling as they move out of peewee.

Sent from my DROID RAZR using Tapatalk

Irish
01-18-14, 18:19
http://www.nebido.com/

Any update on this Will? The website doesn't list the U.S. currently.

WillBrink
01-18-14, 18:28
Any update on this Will? The website doesn't list the U.S. currently.


My understanding is it's not yet FDA approved as TRT in the US, but the company has passed some major hurtles that prevented approval prior, and supposedly, should get FDA approval in the near future. You find the FDA status of it online with some Google Fu if you want most up to date status of it's current FDA approval status.

WillBrink
01-19-14, 08:56
One of my regular authors (Monica M) for my site just put this up. Thought it was interesting and useful to this thread:

Young men might also suffer health consequences of low testosterone levels (http://www.brinkzone.com/mens-health/young-men-might-also-suffer-health-consequences-of-low-testosterone-levels/)

The consequences of low testosterone levels have been primarily investigated in middle-age and older men. However, low-T in young men aged 20-39 years can confer health risks as well…

Low total testosterone levels are associated with an adverse blood lipid profile, which includes high TG and low HDL [1, 2], and a decline in total testosterone levels predisposes men to increased risk of cardiovascular disease (CVD) and mortality.[3-7]

In a notable study 1468 men aged 20–79 years were followed for 5 years to investigate if baseline total testosterone levels might be related to future development of an adverse lipid profile (aka dyslipidemia).[8]

When all age groups were analyzed as whole, those men with the lowest total testosterone levels at baseline were found to have an increased risk to develop of an adverse lipid profile by 28% compared to the men with the highest baseline total testosterone levels.

More interestingly, age-specific analysis revealed that young and middle-aged men (20–39 years) with the lowest baseline total testosterone levels had the highest risk of incident dyslipidemia. Compared to age-matched men with the highest baseline total testosterone levels of 663 ng/dl or higher, those with the lowest baseline total testosterone levels of 418 ng/dl or below had on average a 51%, and up to a twofold, greater risk of developing an adverse lipid profile that in turn could contribute to future risk of cardiovascular disease.[8]

This study shows that testosterone levels have health implications for men of all ages. Since treatment of low-T with testosterone replacement therapy (TRT) has beneficial effects on blood lipids and cardiovascular risk factors [9-11], this study further underscores the importance of early detection and treatment of low-T in men regardless of age.

Citations HERE (http://www.brinkzone.com/mens-health/young-men-might-also-suffer-health-consequences-of-low-testosterone-levels/).

Big A
01-19-14, 09:07
Is there really that big of an impact on performance? I just passed the 40 mark and am a bit on the sluggish side but haven't had any sort of testing done yet.

One more quick question. I notice guys saying they feel happier, better mood, etc. after getting on T. But, are there examples of the opposite? Shorter temper and that type of thing?

For me there is. I couldn't get through my chest or arm work outs this week like I usually can. My leg work out was good but I'm not working on strengthening my legs so much as improving my flexibility and mobility. It could all be mental but it sure does suck and it killed my mood for the rest of the week at the gym.

I've haven't noticed any effect on my temper positive or negative. I work with inmates everyday so I have to have a lot of patience. However I can definitely vouch for a more positive mood and outlook when on the T as opposed to off. Even my friends and family notice it.

All I can tell you is this: If you don't feel like you used to and you have insurance go see an endocrinologist. It will only cost you whatever your co-pay is and a couple of vials of blood. If your perfectly healthy you'll get some peace of mind and if you need some form of treatment you'll be able to get started on that.

Irish
01-19-14, 10:03
One of my regular authors (Monica M) for my site just put this up. Thought it was interesting and useful to this thread:
More quality ammo. Thanks Will.

For me there is. I couldn't get through my chest or arm work outs this week like I usually can. My leg work out was good but I'm not working on strengthening my legs so much as improving my flexibility and mobility. It could all be mental but it sure does suck and it killed my mood for the rest of the week at the gym. Interesting, thanks.

I've haven't noticed any effect on my temper positive or negative. I work with inmates everyday so I have to have a lot of patience. However I can definitely vouch for a more positive mood and outlook when on the T as opposed to off. Even my friends and family notice it. That's big to me. I've been a bit of a curmudgeon lately.

All I can tell you is this: If you don't feel like you used to and you have insurance go see an endocrinologist. It will only cost you whatever your co-pay is and a couple of vials of blood. If your perfectly healthy you'll get some peace of mind and if you need some form of treatment you'll be able to get started on that.
Good advice, thank you!

WillBrink
01-19-14, 12:08
More quality ammo. Thanks Will.

Good advice, thank you!


Basic rule of how it works in terms of the difference it makes (with obvious potential for individual responses to any med, hormone, etc) is the farther from healthy physiological levels the more dramatic the response.

People with severe hypothyroidism will notice a huge difference when that's corrected. People with mild hypothyroidism, will notice less of an impact (subjectively) and so forth. A man with the T levels of a 12 year old girl, once corrected, will be given a new life the differences are so obvious. A man who's on the low end of "normal" range, will notice improvements in various areas, but not to the extent of the former example, and so forth.

Any subjective feedback is only useful in the context of the starting point of the person, how they are treated, and other factors, some known at this time, some not. Hence, why they tend to be all over the place, but generally trend in an obvious direction.

Irish
01-19-14, 12:25
Basic rule of how it works in terms of the difference it makes (with obvious potential for individual responses to any med, hormone, etc) is the farther from healthy physiological levels the more dramatic the response.

Any subjective feedback is only useful in the context of the starting point of the person, how they are treated, and other factors, some known at this time, some not. Hence, why they tend to be all over the place, but generally trend in an obvious direction.
Totally in agreement but I do like to hear other's experiences.

Anybody have any experiences or things they'd like to share about the Low T Centers (http://www.lowtcenter.com)? Just curious if there's a consensus on them being the "McD's" of T therapy or if they're legit with knowledgeable doctors?

onado2000
01-19-14, 12:31
Is there really that big of an impact on performance? I just passed the 40 mark and am a bit on the sluggish side but haven't had any sort of testing done yet.

One more quick question. I notice guys saying they feel happier, better mood, etc. after getting on T. But, are there examples of the opposite? Shorter temper and that type of thing?

Its so worth it. i feel young again, i can keep up with my kids. . as i said before, i felt like i was wearing a lead suit all the tine. Any effort was a challenge. my thyroid and T were. off. now im in normal range and feel great like a second chance at youth. No real agressive behavior, but i did feel anxious once for no real reason, no roid rage though. Then again i take 200mg a week, not 2gms of six hormones each, so i guess agression may be relative to dosage. If you can try it and see for yourself the difference it can make in your life.

WillBrink
01-19-14, 18:17
Totally in agreement but I do like to hear other's experiences.

Anybody have any experiences or things they'd like to share about the Low T Centers (http://www.lowtcenter.com)? Just curious if there's a consensus on them being the "McD's" of T therapy or if they're legit with knowledgeable doctors?

It varies widely in my experience talking to many people who have used such places.

WillBrink
01-19-14, 18:19
Its so worth it. i feel young again, i can keep up with my kids. . as i said before, i felt like i was wearing a lead suit all the tine. Any effort was a challenge. my thyroid and T were. off. now im in normal range and feel great like a second chance at youth. No real agressive behavior, but i did feel anxious once for no real reason, no roid rage though. Then again i take 200mg a week, not 2gms of six hormones each, so i guess agression may be relative to dosage. If you can try it and see for yourself the difference it can make in your life.

What are your T levels, free and total at that dose? Do you track E2 also?

onado2000
01-20-14, 09:39
The only bloodwork i had was initial Testosterone level which was low 200s. This value was low norm according to lab range so insr wont pay because its still within normal (f#ing insurance !). i was started on 200mg every two weeks, after a month i read about dosage adjusting iand increased my dosage to weekly. I then asked doc to also increase script to weekly, which he did. I feel great now and maintain dosage based on how i feel. Ive been on T since Oct. I have a great relationship with my primary doc. Im in medical field and he trusts me enough to accomodate my request. From reading 200mg /week is a low end dose. I have no acne, i do have some water retention though (my blood pressure is good) & appetite increase. FYI patches are about $500/month and a 2gm vial of T. cyp. is $120 which lasts ten weeks. I didnot have. estrogen levels drawn, should I ? Would taking this dosage cause incrsed Estrogen? Thanks for input.

WillBrink
01-20-14, 10:02
The only bloodwork i had was initial Testosterone level which was low 200s. This value was low norm according to lab range so insr wont pay because its still within normal (f#ing insurance !).

Depends on which lab s used and their reference range.



i was started on 200mg every two weeks, after a month i read about dosage adjusting iand increased my dosage to weekly. I then asked doc to also increase script to weekly, which he did. I feel great now and maintain dosage based on how i feel. Ive been on T since Oct. I have a great relationship with my primary doc. Im in medical field and he trusts me enough to accomodate my request. From reading 200mg /week is a low end dose.

No, it's on the high end for TRT. At least annual blood work advised. 100mg - 150mg per week is pretty standard, with 200mg weekly (assuming typical T esters in the US are being used) 200mg/wk would likely put you in the high normal range, or above. That's why labs are essential to the clinical picture.




I have no acne, i do have some water retention though (my blood pressure is good) & appetite increase. FYI patches are about $500/month and a 2gm vial of T. cyp. is $120 which lasts ten weeks. I didnot have. estrogen levels drawn, should I ? Would taking this dosage cause incrsed Estrogen? Thanks for input.

I'd read through this thread and This (https://www.m4carbine.net/showthread.php?128035-low-T-at-26!!!!) thread for more info in general. If you have additional Qs after that, will do my best to answer them.

Very least, total T, free T, E2, should be checked. Water retention for example, can be caused by elevated E2 levels.

Big A
01-20-14, 10:24
Totally in agreement but I do like to hear other's experiences.

Anybody have any experiences or things they'd like to share about the Low T Centers (http://www.lowtcenter.com)? Just curious if there's a consensus on them being the "McD's" of T therapy or if they're legit with knowledgeable doctors?

The "Men's Clinics" around my AO seem sketchy to me, They advertise on radio and TV all the time and seem like those doctor and lawyer referal services you hear all over the radio and TV.

I used my insurance's website to find an endrocrinologist and that is the best recomendation I can give to you based on my personal experiences.

skydivr
01-20-14, 11:51
My update: After my last test (November) I was still under 200 with Androgel (1% 50MG x 5GM) (2 packets daily). Under pressure, my doctor raised my script to 3 packets daily and asked to wait until next test before doing anything more drastic. Last Tuesday I got retested. Even with a 50% increase in the dosage, mine only got to 226.2. I questioned him again on why he seemed hesitant to go further; his response this time was that he doesn't keep it in his office because of break ins (?). I'm convinced the real reason is he just doesn't want to fool with it. Now he wants to refer me to my urologist (?) (I have one for kidney stones), when I would think that this would be better served by an Endocrinologist (I have one of those too, again for kidney stones). He did reissue my script in order to give me time to get seen (I had a hernia fixed the next day so I'm not going to want to do anything drastic until I heal a little). In the next week or so, I'm going to decide if I should follow up with my Urologist (I've never gotten a good vibe w/him), or go see my Endocrinologist, OR, go down the street and get an appointment with another GP doctor who I know does this with some of my neighbors. I think I'm gonna have to flat-out just about demand the shot in order to get it...

WillBrink
01-20-14, 12:12
My update: After my last test (November) I was still under 200 with Androgel (1% 50MG x 5GM) (2 packets daily). Under pressure, my doctor raised my script to 3 packets daily and asked to wait until next test before doing anything more drastic. Last Tuesday I got retested. Even with a 50% increase in the dosage, mine only got to 226.2. I questioned him again on why he seemed hesitant to go further; his response this time was that he doesn't keep it in his office because of break ins (?). I'm convinced the real reason is he just doesn't want to fool with it. Now he wants to refer me to my urologist (?) (I have one for kidney stones), when I would think that this would be better served by an Endocrinologist (I have one of those too, again for kidney stones). He did reissue my script in order to give me time to get seen (I had a hernia fixed the next day so I'm not going to want to do anything drastic until I heal a little). In the next week or so, I'm going to decide if I should follow up with my Urologist (I've never gotten a good vibe w/him), or go see my Endocrinologist, OR, go down the street and get an appointment with another GP doctor who I know does this with some of my neighbors. I think I'm gonna have to flat-out just about demand the shot in order to get it...


As I have said in this thread and others here, topical routes are generally sub par for getting T levels where needed, and for some (like you it appears) are close to worthless. Very common in my experience. See urologist (they are more than capable of dealing with your issue) and go in being very clear what you want, and knowing the details of what you want and why. Take some time to re read this and other threads on the T topic, and in armed with details of what you feel would be best for you, and if he/she is a decent doc, will work with you to find the appropriate course of treatment for you based on your prior experiences and current status.

Good luck.

Big A
01-20-14, 13:00
Will,

Just curious why you would recomend a Urologist over an Endocrinologist?

Irish
01-20-14, 13:20
It varies widely in my experience talking to many people who have used such places.


The "Men's Clinics" around my AO seem sketchy to me, They advertise on radio and TV all the time and seem like those doctor and lawyer referal services you hear all over the radio and TV.

I used my insurance's website to find an endrocrinologist and that is the best recomendation I can give to you based on my personal experiences.
Thanks guys.

WillBrink
01-20-14, 14:03
Will,

Just curious why you would recomend a Urologist over an Endocrinologist?

I'm not, I was just saying the Urologist should be fine, and that appears to be who his PCP wants to direct him to see. So, rather than get into a pissing match with PCP, see the Urologist if that's who the PCP wants to refer to. Many of the more progressive and up to date on the lit docs doing TRT/HRT are often Urologists I find.

Big A
01-20-14, 14:19
Ah, Thanks for the clarification.

Irish
01-20-14, 17:34
Trying to learn and read more on the subject. Does anyone use HCG and Arimidex in conjunction with their T shots?

WillBrink
01-20-14, 18:32
Trying to learn and read more on the subject. Does anyone use HCG and Arimidex in conjunction with their T shots?

The question is should they. Under the guidance of a well informed practitioner, they both have their potential benefits. Used without supervision, regular labs, and using incorrect doses and or dosing patterns, they can cause more harm than good. Some docs out there seem to have a good handle on the use of Arimidex (to control elevated E2/estradiol), but very few use HCG in conjunction with TRT.

Irish
01-21-14, 17:37
Dropped an email to my doc and he just ordered blood tests for me… Any truth to having them done first thing in the morning? He said prior to 8:30am would be best, does it matter?

ETA - I thought this was a pretty good article for the layman (http://www.artofmanliness.com/2013/01/16/normal-testosterone-levels/) and it also has 2 age related T charts that I hadn't seen before.

WillBrink
01-21-14, 18:41
Dropped an email to my doc and he just ordered blood tests for me… Any truth to having them done first thing in the morning? He said prior to 8:30am would be best, does it matter?

ETA - I thought this was a pretty good article for the layman (http://www.artofmanliness.com/2013/01/16/normal-testosterone-levels/) and it also has 2 age related T charts that I hadn't seen before.

T levels for men tend to be highest in the morning, so that's why it's generally recommended to do it then.

Irish
01-21-14, 18:52
T levels for men tend to be highest in the morning, so that's why it's generally recommended to do it then.
Thanks, that's what I thought. I would think you'd want to know what it is at your lowest point as well… Maybe that's why I don't wear a stethoscope. :)

WillBrink
01-21-14, 18:57
Thanks, that's what I thought. I would think you'd want to know what it is at your lowest point as well… Maybe that's why I don't wear a stethoscope. :)

I'd say the most important issue is consistency but various factors can alter T levels over the day, so morning, consistent time, allows consistency in the results, which is the more important issue.

skydivr
01-22-14, 14:31
As I have said in this thread and others here, topical routes are generally sub par for getting T levels where needed, and for some (like you it appears) are close to worthless. Very common in my experience. See urologist (they are more than capable of dealing with your issue) and go in being very clear what you want, and knowing the details of what you want and why. Take some time to re read this and other threads on the T topic, and in armed with details of what you feel would be best for you, and if he/she is a decent doc, will work with you to find the appropriate course of treatment for you based on your prior experiences and current status.

Good luck.

Thanks Will, soonest I could get with the Urologist is Feb 4th. The saga continues. At least my GP Dr did refill my androgel script thru that period. I think this may be a wild goose chase and will eventually have to change to another GP doctor who I know WILL do this, but trying to honor existing Dr's wishes first.

Big A
01-23-14, 10:34
Dropped an email to my doc and he just ordered blood tests for me… Any truth to having them done first thing in the morning? He said prior to 8:30am would be best, does it matter?

ETA - I thought this was a pretty good article for the layman (http://www.artofmanliness.com/2013/01/16/normal-testosterone-levels/) and it also has 2 age related T charts that I hadn't seen before.

I've always done mine first thing in the morning because I have to be fasting and I want to get something to eat ASAP. I'm getting a full panel of tests for cholesterol, A1C levels, etc....

Did your doctor say if you're supposed to fast? (Nothing to eat or drink except water after midnight)

Vic303
01-23-14, 11:05
Fasting is to get a good read on blood glucose. It may affect other tests to buy is primarily glucose related.

Sent from my SGH-M919 using Tapatalk 2

Irish
01-23-14, 13:30
Just got my results back today.
Testo = 553 @ 40 years of age. Maybe slightly low for my age range, chart says 668, but I think I can boost that naturally.
TSH = 1.77 but I'm not sure what that is.
VIT B-12 = 739
VD25-OH = 50.3

And about 50 other things but they're all in the middle of the ranges.

heat-ar
01-23-14, 15:09
Just got my results back today.
Testo = 553 @ 40 years of age. Maybe slightly low for my age range, chart says 668, but I think I can boost that naturally.
TSH = 1.77 but I'm not sure what that is.
VIT B-12 = 739
VD25-OH = 50.3

And about 50 other things but they're all in the middle of the ranges.
What was your level of free testosterone??

Irish
01-23-14, 15:39
What was your level of free testosterone??

I believe it was 553. Really I think I'd like to have it around 800 but I haven't had a chance to talk to my doc about the results yet.

ETA That was the total actually. Not sure if it's listed on mine. I'll have to double check.

WillBrink
01-23-14, 17:09
I believe it was 553. Really I think I'd like to have it around 800 but I haven't had a chance to talk to my doc about the results yet.

ETA That was the total actually. Not sure if it's listed on mine. I'll have to double check.


It looks unlikely you're a candidate at this time for TRT/HRT, but this article has lots of useful info one should know before embarking on that:


How Is Testosterone Deficiency “low T” Diagnosed? – Things you need to know before going to your doctor
(http://www.brinkzone.com/mens-health/how-is-testosterone-deficiency-low-t-diagnosed-things-you-need-to-know-before-going-to-your-doctor/)

WillBrink
01-25-14, 18:35
One fear over the years was the testosterone replacement might increase the risk of prostate cancer, and men with prostate cancer or history of it, generally told they should not use TRT. A recent study appears to show a reduced risk for prostate cancer for men on TRT.

Testosterone Therapy May Be Safe for Prostate Cancer Patients

Testosterone replacement therapy (TRT) is not associated with an increased risk of cancer-specific or all-cause mortality in patients with prostate cancer (PCa), according to a new study.

In fact, PCa patients who received TRT had significantly lower death rates than those who did not, researchers reported online ahead of print in The Journal of Sexual Medicine. Additionally, the study demonstrated that TRT was not associated with an increased likelihood of requiring salvage hormone therapy.

Alan L. Kaplan, MD, of the David Geffen School of Medicine at the University of California Los Angeles, and colleagues identified 149,354 men (median age 73 years) diagnosed with PCa from 1992 to 2007 using linked Surveillance, Epidemiology, and End Results-Medicare data. Of these, 1,181 (0.79% received TRT following their cancer diagnosis.

TRT use was associated with younger age and higher education.

The median follow-up after the PCa diagnosis was eight years for TRT group and six years for the no TRT group. The cancer-specific and overall mortality rates were 0.92 and 5.40 deaths, respectively, per 100 person years in the TRT group compared with 1.57 and 6.88 deaths per 100 person years in the no TRT group.

“The reason for lowered mortality rates among men receiving TRT is not clear, but as the Charlson index was approximately the same in the two groups, comorbidities are evidently not the explanation,” they authors wrote.

The findings suggest that TRT may be considered in men with a history of PCa but confirmatory prospective studies are needed, the investigators concluded.

Source: http://www.renalandurologynews.com/testosterone-therapy-may-be-safe-for-prostate-cancer-patients/article/330796/

heat-ar
01-29-14, 16:19
Back on Dec 8 2013 the nurse gave me a t shot in the right butt cheek and today i still have a light circle around the injection sight what cause this??

WillBrink
01-29-14, 16:27
Back on Dec 8 2013 the nurse gave me a t shot in the right butt cheek and today i still have a light circle around the injection sight what cause this??

Too vague to really comment, but I have not seen anything last that long at the injection site that would be typical, such as bruising and such from the needle. Discuss with your doc.

WillBrink
02-01-14, 10:27
Those of you on TRT or considering it, no doubt, are concerned about a recent study that supposedly showed an increased rate of heart attacks with TRT. So, here's the examination of this study and it's major flaws:

Comment on study: “Increased Risk of Heart Attack Following Testosterone Therapy” by BrinkZone.com author Monica Mollica

A few days ago, Jan 29th 2014, a controversial study was published showing that men aged 65 years and older, had a two-fold increase in the risk of heart attack in the 90 days after filling an initial testosterone therapy (TT) prescription, regardless of cardiovascular disease history. Among younger men below 65 years of age with a history of heart disease, the study reported two to three-fold increased risk of MI in the 90 days following an initial TT prescription (and no excess risk was found in younger men without such a history).

This study have stirred up heated discussions and media headlines. Let’s dissect it and look under the hood…

Cont HERE (http://www.brinkzone.com/mens-health/comment-on-study-increased-risk-of-heart-attack-following-testosterone-therapy/)

Irish
02-01-14, 15:49
It looks unlikely you're a candidate at this time for TRT/HRT...

Being back in school the VA is handling my medical needs currently. My primary is a NP who ordered the original test which was only total T, not free. I saw my neurologist yesterday and he mentioned the same thing that the "free T" was the most important of the 2. Any ideas on whether it's worth getting the additional test if my total is at 550? Could the free T be lower than the recommended number with the total T being at that level?

WillBrink
02-01-14, 17:01
Being back in school the VA is handling my medical needs currently. My primary is a NP who ordered the original test which was only total T, not free. I saw my neurologist yesterday and he mentioned the same thing that the "free T" was the most important of the 2. Any ideas on whether it's worth getting the additional test if my total is at 550? Could the free T be lower than the recommended number with the total T being at that level?

No matter what your numbers end up being, it's good to have a known baseline. So, having total T, free T, estradiol (E2) and others is at the very least, a baseline for what's "normal" for you. I think men over 40 would benefit from having a full hormonal profile done yearly. Most men only get such hormones tested after they are suffering various subjective symptoms and by then, it may have been going on for years. I do think that with a growing understanding of the various hormones and their importance to health, well being, etc, there may be the inclusion of regular testing of them along with your other tests (cholesterol, TSH, etc) during routine physicals and such.

One can also get carried away with testing, and practical issues such as cost, etc also become a factor. A full hormonal profile done out of pocket gets expensive, and even with insurance, can get expensive.

So, my personal feeling is, with total T numbers above 500 as you are, I doubt you need to have free T done per se, but having those numbers is a sound idea in my view. That is not however the general medical consensus view point at this time, so personal opinion only.

skydivr
02-04-14, 17:58
Thanks Will, soonest I could get with the Urologist is Feb 4th. The saga continues. At least my GP Dr did refill my androgel script thru that period. I think this may be a wild goose chase and will eventually have to change to another GP doctor who I know WILL do this, but trying to honor existing Dr's wishes first.

Update: I FINALLY had my appointment with my Urologist today. He told me the following:

1. Yes, mine was low in his opinion (I took him all two years of test results). He personally only proscribes Androgel up front and for a short time to see if patient responds. If they don't (and he said that's usually the case), then he goes for the shot. He said he wished I'd come to him a long time ago - Well I would have except my Primary Care doc didn't REFER ME. I think that's the tipping point and I'm going to find a new Primary. He must be getting a kickback from Androgel ($800/month worth for over 2 years with little result)

2. He says that different tests and different testing facilities give different results.

3. He was adamant that anything over 300 or so was too high. He says once you get in that higher range, the risk of a whole lot of bad side effects get's alot worse quickly. He also mentioned a new study released yesterday that supports this (?). We talked about this awhile and he wouldn't budge. When I said 600, he said he wouldn't go along with that...I've know this guy a long time; he's treated my dad for bladder stones, and probably taken 50 kidney stones out of me...I told him I had NOT gone to the "XYZ Low-T center" advertising on the radio...he said: "you'll walk out of there a thousand dollars lighter and taking a huge risk" if I did....

4. He said his big question was WHY is mine low. One of the things he mentioned: I had a hyperparathyroid and it had to be removed about 8 years ago (it was taking calcium out of my bones and putting it in my bloodstream - hence the bad kidney stones) and thought maybe that might be the reason.

4. So, after getting felt up and poked (all was good), I NOW have a script, a shot once every 3 weeks, Testosterone CYP 200MG/ML, 1ML Injection. As soon as I get my script (I did today) I am to call his nurse and come in with my wife, and the nurse will show her how to give me the shot (in my ass). He also scripted a 18-gauge needle, but neither pharmacy had them so they gave me 21 gauge instead. The pharmacist said they'd had a lot of people switch to 21 gauge. At the end of two months (2 shots), I'm supposed to set a date 2 weeks after the last shot for him to test me and see where I am.

5. Interestingly enough, at the Pharmacy they would only give me one dose. When I asked, they said that since it had changed into a controlled substance, that I could only get a month's worth of dosage, and since it's 1 every 3 weeks, I could only get one. If it had been bi-weekly, then I would have been able to get 2. Is this now correct? I know some others who have a lot more than one month's dosage on hand, but don't know if they've tried to refill lately. Good news is it only cost $10...vs. $800 MY INSURANCE COMPANY WAS BEING SOAKED FOR.

I think it will be Thursday before we can go in and start the shots. After that we'll see. Now that I've got something to compare with, I'm going to go back and re-read this entire thread...I'm so sick and tired of being tired...

THANK you for all your help Will; If I hadn't read this thread, I probably would just have accepted my PC doc's opinion and wasted bookoo bucks on Androgel with pitiful results!

WillBrink
02-04-14, 18:08
Update: I FINALLY had my appointment with my Urologist today. He told me the following:

1. Yes, mine was low in his opinion (I took him all two years of test results). He personally only proscribes Androgel up front and for a short time to see if patient responds. If they don't (and he said that's usually the case), then he goes for the shot. He said he wished I'd come to him a long time ago - Well I would have except my Primary Care doc didn't REFER ME. I think that's the tipping point and I'm going to find a new Primary. He must be getting a kickback from Androgel ($800/month worth for over 2 years with little result)

2. He says that different tests and different testing facilities give different results.

3. He was adamant that anything over 300 or so was too high. He says once you get in that higher range, the risk of a whole lot of bad side effects get's alot worse quickly. He also mentioned a new study released yesterday that supports this (?). We talked about this awhile and he wouldn't budge. When I said 600, he said he wouldn't go along with that...I've know this guy a long time; he's treated my dad for bladder stones, and probably taken 50 kidney stones out of me...I told him I had NOT gone to the "XYZ Low-T center" advertising on the radio...he said: "you'll walk out of there a thousand dollars lighter and taking a huge risk" if I did....

4. He said his big question was WHY is mine low. One of the things he mentioned: I had a hyperparathyroid and it had to be removed about 8 years ago (it was taking calcium out of my bones and putting it in my bloodstream - hence the bad kidney stones) and thought maybe that might be the reason.

4. So, after getting felt up and poked (all was good), I NOW have a script, a shot once every 3 weeks, Testosterone CYP 200MG/ML, 1ML Injection. As soon as I get my script (I did today) I am to call his nurse and come in with my wife, and the nurse will show her how to give me the shot (in my ass). He also scripted a 18-gauge needle, but neither pharmacy had them so they gave me 21 gauge instead. The pharmacist said they'd had a lot of people switch to 21 gauge. At the end of two months (2 shots), I'm supposed to set a date 2 weeks after the last shot for him to test me and see where I am.

5. Interestingly enough, at the Pharmacy they would only give me one dose. When I asked, they said that since it had changed into a controlled substance, that I could only get a month's worth of dosage, and since it's 1 every 3 weeks, I could only get one. If it had been bi-weekly, then I would have been able to get 2. Is this now correct? I know some others who have a lot more than one month's dosage on hand, but don't know if they've tried to refill lately. Good news is it only cost $10...vs. $800 MY INSURANCE COMPANY WAS BEING SOAKED FOR.

I think it will be Thursday before we can go in and start the shots. After that we'll see. Now that I've got something to compare with, I'm going to go back and re-read this entire thread...I'm so sick and tired of being tired...

THANK you for all your help Will; If I hadn't read this thread, I probably would just have accepted my PC doc's opinion and wasted bookoo bucks on Androgel with pitiful results!

You're welcome but, from what you have written above, you're only slightly better off sadly.

heat-ar
02-04-14, 18:14
Skidivr my doc up my dosage to 1ml every week that's up from 1ml every 2 weeks. My doc wrote another prescription for cyp and i have enough for 6 mos doc said that was as far out he could write it. Maybe your state has different laws.

skydivr
02-05-14, 09:29
You're welcome but, from what you have written above, you're only slightly better off sadly.

Maybe so. Like I said, I'm gonna switch PC doctors, the one I'm going to has a different opinion about levels than either of these. Its still a start in the right direction. I was thinking about this last night. If they don't test my blood until two weeks after the shot, that would suggest that the 300 number he's looking for would be the lower result, and the number would be higher every other time during that period. How much higher I don't really know. Don't know how high 1/ML ever 3 weeks would take me...still need to re-read this thread.


Skidivr my doc up my dosage to 1ml every week that's up from 1ml every 2 weeks. My doc wrote another prescription for cyp and i have enough for 6 mos doc said that was as far out he could write it. Maybe your state has different laws.

Again, maybe so. I'm trying to pinpoint exactly who IS the agency (Dr, Pharmacy, Insurance, State or Fed) that's giving me this. I'll know more Thursday when I go get my first shot.

onado2000
02-05-14, 10:06
Skydivr. seek a second opinion. my doc increased my dose based on how i felt (my request ) not labs. we have a great relationship which is not for everyone. i have read greater 500/wk risk increases and some taking 1000/wk without issue. now this is very high dosing and not recommended. get a new doc whos on board and get labs. Exercise while on T, you will feel like a new man. I workout for two years and without progress for one year. i couldnt increase bench or squat during that year. after T , everything improved.
Its worth the effort. Also pharmacy dispensed a vial 2000/10ml $120 T cyp.

WillBrink
02-05-14, 10:26
Maybe so. Like I said, I'm gonna switch PC doctors, the one I'm going to has a different opinion about levels than either of these. Its still a start in the right direction. I was thinking about this last night. If they don't test my blood until two weeks after the shot, that would suggest that the 300 number he's looking for would be the lower result, and the number would be higher every other time during that period. How much higher I don't really know. Don't know how high 1/ML ever 3 weeks would take me...still need to re-read this thread.

Other than his switching you to IM route, the info given to you by that Urologist is either way out of date or simply incorrect and not supported by the bulk of the data, such as his 300 number, using 18g (18g!!!!) needles, dose schedule, etc, etc, and I very rarely openly criticize a doc like that. What I recommend is, take some real time to sit down and read this thread, and the "low T at 26" thread. Take notes, look for topics covered that really apply to you, as well as advice given by this Urologist. Pay special attention to the studies posted. Take your time with it, and ingest it at a rate it starts to show a complete picture for you. You'll also see the info covered above in depth.

Make notes, that are Qs for the doc, and if he'll work with you to achieve the numbers and such you want, great. If not, look for another, and ask questions of them.




Again, maybe so. I'm trying to pinpoint exactly who IS the agency (Dr, Pharmacy, Insurance, State or Fed) that's giving me this. I'll know more Thursday when I go get my first shot.

I don't know TN law, but again, this seems like total BS and someone is f-ing with you me thinks to make $$$, or there's some miscommunication, etc.

skydivr
02-05-14, 12:18
Its worth the effort. Also pharmacy dispensed a vial 2000/10ml $120 T cyp.

How long ago?

ABNAK
02-05-14, 15:24
Those of you on TRT or considering it, no doubt, are concerned about a recent study that supposedly showed an increased rate of heart attacks with TRT. So, here's the examination of this study and it's major flaws:

Comment on study: “Increased Risk of Heart Attack Following Testosterone Therapy” by BrinkZone.com author Monica Mollica

A few days ago, Jan 29th 2014, a controversial study was published showing that men aged 65 years and older, had a two-fold increase in the risk of heart attack in the 90 days after filling an initial testosterone therapy (TT) prescription, regardless of cardiovascular disease history. Among younger men below 65 years of age with a history of heart disease, the study reported two to three-fold increased risk of MI in the 90 days following an initial TT prescription (and no excess risk was found in younger men without such a history).

This study have stirred up heated discussions and media headlines. Let’s dissect it and look under the hood…

Cont HERE (http://www.brinkzone.com/mens-health/comment-on-study-increased-risk-of-heart-attack-following-testosterone-therapy/)

So if you don't have a history of heart disease (high BP but I take BP meds and it's controlled, not sure if that counts) and you make it past the first 90 days you should be good to go?

Been taking it since Spring of '09, so almost 5 years. Still kickin'.

ABNAK
02-05-14, 15:42
How long ago?

Since we live near each other, let me ask: was it the PV Pharmacy? I get mine from there and get a 10ml bottle of Test Cypionate without any flak. Usually lasts me 4+ months. I take 1/2cc every week as opposed to 1cc every 2 weeks; that keeps the level closer to baseline more consistently. i.e. there are no wild up-and-down fluctuations over a 2 week period.

My wife is an RN and shoots me in the ass every Sun. or Mon., depending on which day I do my chest workout (it's the most intense and I figure that's a good day to have a fresh does in my system to enhance "rebuilding" the muscles overnight). I mark my calendar with an L or R each week so I can rotate the side that gets a shot.

We gotta get together and shoot once this crappy weather goes away!

skydivr
02-05-14, 15:54
Spoke to the Nurse. Now I know why it was only one dosage, because he only PROSCRIBED one dosage. Two weeks after that, I'm supposed to come in and let him test me; after that he'll either proscribe more or change the dosage depending on the results. Talked her into giving me the shot on Friday without trying to coordinate with wife so we can just get on with it. I wouldn't think one dose would make that much a difference?


Since we live near each other, let me ask: was it the PV Pharmacy? I get mine from there and get a 10ml bottle of Test Cypionate without any flak. Usually lasts me 4+ months. I take 1/2cc every week as opposed to 1cc every 2 weeks; that keeps the level closer to baseline more consistently. i.e. there are no wild up-and-down fluctuations over a 2 week period.

My wife is an RN and shoots me in the ass every Sun. or Mon., depending on which day I do my chest workout (it's the most intense and I figure that's a good day to have a fresh does in my system to enhance "rebuilding" the muscles overnight). I mark my calendar with an L or R each week so I can rotate the side that gets a shot.

We gotta get together and shoot once this crappy weather goes away!

You live in PV? I thought you lived in Clarksvegas. No, it wasn't PV Pharmacy it was Walgreens in Nashville (near my work). Do you see Nordquist? He's the Primary Care guy that I'm going to probably switch to as I understand he does this for a lot of guys in PV. It didn't have crap to do with the DEA I was getting BS from the Pharmacy - and since I know you aren't having any issues I'll get mine from there in the future.

Shooting would be fine by me or if you do live nearby I'd have lunch with you one Saturday. Thanks!

P.S. If you are a PV native, you know what happened today with the decision about our illustrious Police Chief?.... Let's take this to PM as not to get OT...

ABNAK
02-05-14, 16:09
Spoke to the Nurse. Now I know why it was only one dosage, because he only PROSCRIBED one dosage. Two weeks after that, I'm supposed to come in and let him test me; after that he'll either proscribe more or change the dosage depending on the results. Talked her into giving me the shot on Friday without trying to coordinate with wife so we can just get on with it. I wouldn't think one dose would make that much a difference?



You live in PV? I thought you lived in Clarksvegas. No, it wasn't PV Pharmacy it was Walgreens in Nashville (near my work). Do you see Nordquist? He's the Primary Care guy that I'm going to probably switch to as I understand he does this for a lot of guys in PV. It didn't have crap to do with the DEA I was getting BS from the Pharmacy - and since I know you aren't having any issues I'll get mine from there in the future.

Shooting would be fine by me or if you do live nearby I'd have lunch with you one Saturday. Thanks!

P.S. If you are a PV native, you know what happened today with the decision about our illustrious Police Chief?.... Let's take this to PM as not to get OT...


Your PM's are full. I'll check back from work this evening.

onado2000
02-05-14, 16:33
How long ago?
started about mid oct. 2013. last refil was two weeks ago. i go to one of the more popular pharmacy thats on every corner in my area : )
BTW if you search online you can find a website that list pharmacys and med pricing,

skydivr
02-05-14, 16:42
Your PM's are full. I'll check back from work this evening.

oops I corrected sent you one. 50 MSG limit is pretty small, but I understand why.

WillBrink
02-05-14, 16:44
So if you don't have a history of heart disease (high BP but I take BP meds and it's controlled, not sure if that counts) and you make it past the first 90 days you should be good to go?

Been taking it since Spring of '09, so almost 5 years. Still kickin'.

I'll quote the end of the article linked: "Current available evidence generated from well designed randomized controlled trials show overall that TRT in men is not associated with an increase in cardiovascular adverse events."


The answer to your Q is, the vast majority of data to date, of much higher value than these recent studies (see article for details) leads us to conclude, per the quote above. Nothing is black and white, and research on ongoing. Is it possible some sub set of men have a higher risk of cardiovascular adverse events that slipped through the other, better controlled studies? Anything is possible, but it's also a number game. Low T comes with it's own set of risks and increased rates of diseases and such, so the Q is does the risk/benefit favor treating the low T compared the risk according the majority of the data that exists? The answer in my is yes. That's my personal opinion that will not be shared by everyone.

ABNAK
02-05-14, 23:18
I'll quote the end of the article linked: "Current available evidence generated from well designed randomized controlled trials show overall that TRT in men is not associated with an increase in cardiovascular adverse events."


The answer to your Q is, the vast majority of data to date, of much higher value than these recent studies (see article for details) leads us to conclude, per the quote above. Nothing is black and white, and research on ongoing. Is it possible some sub set of men have a higher risk of cardiovascular adverse events that slipped through the other, better controlled studies? Anything is possible, but it's also a number game. Low T comes with it's own set of risks and increased rates of diseases and such, so the Q is does the risk/benefit favor treating the low T compared the risk according the majority of the data that exists? The answer in my is yes. That's my personal opinion that will not be shared by everyone.

Yeah, when I first started taking the shots almost 5 yars ago I did some reading up on it. Obviously, having been into working out for eons I was well aware of testosterone, uh, "enhancement" that some folks do. This is a much more controlled, lower dosage of the same drug with actual therapeutic benefits. The primary benefit I gleaned from reading (without oversimplifying it) is it essentially turns the clock back a tad biologically. Again, that may be a glaring oversimplification but things like hardening of the arteries is one of the repercussions of aging and T seems to slow that down (among other things).

Quite frankly, I think TRT is the wave of the future and will be more widely accepted and recommended as time goes on. But you know what they say about opinions......

onado2000
02-06-14, 08:09
ABNAK, Question, have you had any ill effects from repeated IM injections over five years (5yrs x 52wks = 260 injection). Any scar tissue development abscess or boils ? I inject my quads, i have a fear of hitting nerve in my glute.Any advice to other sites. Thanks

WillBrink
02-06-14, 09:06
Yeah, when I first started taking the shots almost 5 yars ago I did some reading up on it. Obviously, having been into working out for eons I was well aware of testosterone, uh, "enhancement" that some folks do. This is a much more controlled, lower dosage of the same drug with actual therapeutic benefits. The primary benefit I gleaned from reading (without oversimplifying it) is it essentially turns the clock back a tad biologically. Again, that may be a glaring oversimplification but things like hardening of the arteries is one of the repercussions of aging and T seems to slow that down (among other things).

Quite frankly, I think TRT is the wave of the future and will be more widely accepted and recommended as time goes on. But you know what they say about opinions......

Absolutely. That's a given and it's really just beginning. All manner of HRT/TRT technologies are being developed, some of which will be a real benefit, some of which will be improperly used per usual.

WillBrink
02-06-14, 09:09
ABNAK, Question, have you had any ill effects from repeated IM injections over five years (5yrs x 52wks = 260 injection). Any scar tissue development abscess or boils ? I inject my quads, i have a fear of hitting nerve in my glute.Any advice to other sites. Thanks


I won't answer the Q for him, but that can easily be avoided by using 29-30g needles (insulin needles) which I discuss at length in this and other threads. There's no reason to use the typical 18-21g harpoons that pass for needles used by docs.

skydivr
02-06-14, 10:12
Will, I've gone back and read thru this entire thread. It would appear that my Dr. has given me the right strength and dosage to start with. Since he's not going to retest me until 2 weeks after the injection, and the shot only lasts about 8 days, I would assume that his test result will be the LOWEST my T will be during that period, therefore during that period my T will be somewhere above what he considers minimum. If I go get tested in the PM vs. the AM, that will also lower the baseline test. If his fav number was 300, and that was the lowest it was during the period, that would be a decent start. Once I get him to fine tune the amount, and issue a larger script, then I can work on the smaller needle issue and weekly vs. bi-weekly with a smaller dose to balance it out.

A question I didn't really get a good answer for: I see where ppl recommend warming the bottle/syringe for better flow. I see were you recommend using bigger needle to draw then squirt into insulin needle. What I didn't get a good feel for was exactly HOW and WHERE you use the insulin needle and how slowly you have to inject. Is there a drawing, a youtube video, etc. that might further explain? I would prefer to self inject rather than having to ask my wife to do it, but I'm not particularly a fan of big needles - as a child, I'd fight the Dr/Nurse/parents when I had to have a shot, and while I now as an adult can control myself better, I still don't particularly like it.

I would appreciate those of you self-injecting with an insulin needle to be a little more clear on exactly how you do it. Thanks!

I go tomorrow morning for my first shot. First time in my life I ever looked FORWARD to doing that...

WillBrink
02-06-14, 10:40
Will, I've gone back and read thru this entire thread. It would appear that my Dr. has given me the right strength and dosage to start with. Since he's not going to retest me until 2 weeks after the injection, and the shot only lasts about 8 days, I would assume that his test result will be the LOWEST my T will be during that period, therefore during that period my T will be somewhere above what he considers minimum. If I go get tested in the PM vs. the AM, that will also lower the baseline test. If his fav number was 300, and that was the lowest it was during the period, that would be a decent start. Once I get him to fine tune the amount, and issue a larger script, then I can work on the smaller needle issue and weekly vs. bi-weekly with a smaller dose to balance it out.

I think you have made an excellent general assessment and your approach - given current circumstances - a good one. Nicely done!



A question I didn't really get a good answer for: I see where ppl recommend warming the bottle/syringe for better flow. I see were you recommend using bigger needle to draw then squirt into insulin needle. What I didn't get a good feel for was exactly HOW and WHERE you use the insulin needle and how slowly you have to inject. Is there a drawing, a youtube video, etc. that might further explain? I would prefer to self inject rather than having to ask my wife to do it, but I'm not particularly a fan of big needles - as a child, I'd fight the Dr/Nurse/parents when I had to have a shot, and while I now as an adult can control myself better, I still don't particularly like it.

I would appreciate those of you self-injecting with an insulin needle to be a little more clear on exactly how you do it. Thanks!

I go tomorrow morning for my first shot. First time in my life I ever looked FORWARD to doing that...

If it was not on this thread, than probably discussed at length in the "Low T at 26" thread, but I recall fairly detailed discussion on that. Sadly, if you ask the doc or nurses on that, they will look at you with a blank stare of incomprehension 98% of the time. I had one doc tell a friend of mine it was impossible, could not be done. I literally had to go to the docs office with my friend (who was otherwise an excellent doc BTW) and show him it could be done, and was easy to do.

Now he recommends it to his patients as SOP. BTW, what some do who don't want to deal with transfers, etc, is use the smallest needle that does not need to transfer, but is still much smaller than the normal needles, that's a 25G 1" which is a big improvement over usual sizes. However, if one wants essentially zero pain, and least lowest risk of developing scar tissue, smallest needle is the 29g or 30g insulin needles..

Vic303
02-06-14, 11:22
Absolutely. That's a given and it's really just beginning. All manner of HRT/TRT technologies are being developed, some of which will be a real benefit, some of which will be improperly used per usual.

Very true. Having just begun some HRT under the guidance of my specialist doc, I am beginning to see some benefit already. And I will be discussing thyroid issues with my PCP in a week or so, along with why they opted to run an Anti-GAD antibody test last time around when my A1C is in the low 5's. I am seeing some skewing of my thyroid numbers over a several year span that seems to correspond to my metabolism being in the dumps and my increasing sensitivity to cold.

skydivr
02-06-14, 11:29
I think you have made an excellent general assessment and your approach - given current circumstances - a good one. Nicely done!



If it was not on this thread, than probably discussed at length in the "Low T at 26" thread, but I recall fairly detailed discussion on that. Sadly, if you ask the doc or nurses on that, they will look at you with a blank stare of incomprehension 98% of the time. I had one doc tell a friend of mine it was impossible, could not be done. I literally had to go to the docs office with my friend (who was other an excellent doc BTW) and show him it could be done, and was easy to do.

Now he recommends it to his patients as SOP. BTW, what some do who don't want to deal with transfers, etc, is use the smallest needle that does not need to transfer, but is still much smaller than the normal needles, that's a 25G 1" which is a big improvement over usual sizes. However, if one wants essentially zero pain, and least lowest risk of developing scar tissue, smallest needle is the 29g or 30g insulin needles..

My wife is concerned about transferring/sterile issues, but we'll figure out how to overcome that. I will go re-read the "T26" thread...

THANK YOU again, and thanks for the PM!

WillBrink
02-06-14, 11:35
My wife is concerned about transferring/sterile issues, but we'll figure out how to overcome that. I will go re-read the "T26" thread...

THANK YOU again, and thanks for the PM!

Done correctly, sterile is not an issue. But, essential precautions need to be taken.

skydivr
02-06-14, 12:08
Done correctly, sterile is not an issue. But, essential precautions need to be taken.

and those would be/include (or you may have already covered this in the other thread)...?

WillBrink
02-06-14, 12:24
and those would be/include (or you may have already covered this in the other thread)...?

That I don't recall. The basic answer is, don't let the needles or any part of them (plunger, etc) touch non sterile things or surfaces. If draw needle and insulin needle are sterile, and they don't touch anything not sterile, GTG. The draw needle can be reused many times as long as it's only used for that purpose and never used to inject into flesh or touches non sterile things/surfaces. The insulin needles should not be re used in my opinion, but some do, and we did discuss that at length either in this thread a few pages back or the other, not sure which.

usmcvet
02-06-14, 13:35
I won't answer the Q for him, but that can easily be avoided by using 29-30g needles (insulin needles) which I discuss at length in this and other threads. There's no reason to use the typical 18-21g harpoons that pass for needles used by docs.

Listen to Will's sage advice. =)


Will, I've gone back and read thru this entire thread. It would appear that my Dr. has given me the right strength and dosage to start with. Since he's not going to retest me until 2 weeks after the injection, and the shot only lasts about 8 days, I would assume that his test result will be the LOWEST my T will be during that period, therefore during that period my T will be somewhere above what he considers minimum. If I go get tested in the PM vs. the AM, that will also lower the baseline test. If his fav number was 300, and that was the lowest it was during the period, that would be a decent start. Once I get him to fine tune the amount, and issue a larger script, then I can work on the smaller needle issue and weekly vs. bi-weekly with a smaller dose to balance it out.

A question I didn't really get a good answer for: I see where ppl recommend warming the bottle/syringe for better flow. I see were you recommend using bigger needle to draw then squirt into insulin needle. What I didn't get a good feel for was exactly HOW and WHERE you use the insulin needle and how slowly you have to inject. Is there a drawing, a youtube video, etc. that might further explain? I would prefer to self inject rather than having to ask my wife to do it, but I'm not particularly a fan of big needles - as a child, I'd fight the Dr/Nurse/parents when I had to have a shot, and while I now as an adult can control myself better, I still don't particularly like it.

I would appreciate those of you self-injecting with an insulin needle to be a little more clear on exactly how you do it. Thanks!

I go tomorrow morning for my first shot. First time in my life I ever looked FORWARD to doing that...

I will get you better info tonight. I bought 100 syringes with needles and then 100 18G needles. I open the package and remove the smaller gauge needle and put on the 18G to draw, it is much faster. I wipe the top of the bottle with an alcohol wipe before I draw. I then put the small needle, I think it is a 25G 1" I tried 30G 1" and it was tough to inject. I have a photo of the 30G 1" I used, I had to stop and switch. I've attached a photo, I will double check tonight. http://i859.photobucket.com/albums/ab160/usmcvet0331/needles_zpse005c254.jpg (http://s859.photobucket.com/user/usmcvet0331/media/needles_zpse005c254.jpg.html)

I then use the same wipe and clean a spot on my belly. I switch back and forth weekly. The pain is almost nothing, MUCH better than the harpoon to the backside. I never minded being given the shot but with in an hour it hurt bad, some time for days, but that was with a 18G needle to the upper buttocks or thigh.

usmcvet
02-06-14, 13:37
Just ordered a 3 month supply of T. My co pay was fifteen bucks.

WillBrink
02-06-14, 14:23
Listen to Will's sage advice. =)

I then use the same wipe and clean a spot on my belly. I switch back and forth weekly. The pain is almost nothing, MUCH better than the harpoon to the backside. I never minded being given the shot but with in an hour it hurt bad, some time for days, but that was with a 18G needle to the upper buttocks or thigh.

I seem to recall a guy who was very nervous about doing all that, now able to give others useful advice on the issue. :dance3:

skydivr
02-06-14, 14:27
I seem to recall a guy who was very nervous about doing all that, now able to give others useful advice on the issue. :dance3:

Hopefully I will be able to do same someday! Pay it back!

Edit rather than add post: I went back and looked at the "26" thread in it's entirety...some interesting items there also.

I should mention: While discussing with my Urologist, he said he'd really like to know the reason WHY mine off, but since I'd been on Androgel so long it would be difficult to pinpoint. A cause MAY be the Hyperparathyroid I had removed about 8 years ago...which would approximate the time I started slowing down, gaining weight and feeling more rundown....

Texas42
02-06-14, 15:26
Will, I've gone back and read thru this entire thread. It would appear that my Dr. has given me the right strength and dosage to start with. Since he's not going to retest me until 2 weeks after the injection, and the shot only lasts about 8 days, I would assume that his test result will be the LOWEST my T will be during that period, therefore during that period my T will be somewhere above what he considers minimum. If I go get tested in the PM vs. the AM, that will also lower the baseline test. If his fav number was 300, and that was the lowest it was during the period, that would be a decent start. Once I get him to fine tune the amount, and issue a larger script, then I can work on the smaller needle issue and weekly vs. bi-weekly with a smaller dose to balance it out.

A question I didn't really get a good answer for: I see where ppl recommend warming the bottle/syringe for better flow. I see were you recommend using bigger needle to draw then squirt into insulin needle. What I didn't get a good feel for was exactly HOW and WHERE you use the insulin needle and how slowly you have to inject. Is there a drawing, a youtube video, etc. that might further explain? I would prefer to self inject rather than having to ask my wife to do it, but I'm not particularly a fan of big needles - as a child, I'd fight the Dr/Nurse/parents when I had to have a shot, and while I now as an adult can control myself better, I still don't particularly like it.

I would appreciate those of you self-injecting with an insulin needle to be a little more clear on exactly how you do it. Thanks!

I go tomorrow morning for my first shot. First time in my life I ever looked FORWARD to doing that...


I know it isn't the question you asked, but testing your testosterone level in the afternoon invalidates the test. It simply isn't accurate way to diagnose hypogonadism, and shouldn't be used to guide therapy or to initiate therapy.

And sticking yourself with an 18 gauge needle. . . . . just sounds painful. I only use those to draw things up in, and I wouldn't let anyone near me with anything nearly as big. . . unless they were putting in a central line or an IV.

Since I never give IM injections, I can't remember if you can use insulin needles or not (as they are made for subcutaneous injections). I think you should just avoid the really short needles, and you should always rotate injection sites. And I wouldn't ever re-use needles, even if I though they were sterile. Needles are cheep. A soft tissue infection can be very expensive. . . . and most of the people out there aren't what I would call health care professionals.

skydivr
02-06-14, 15:39
I know it isn't the question you asked, but testing your testosterone level in the afternoon invalidates the test. It simply isn't accurate way to diagnose hypogonadism, and shouldn't be used to guide therapy or to initiate therapy.

And sticking yourself with an 18 gauge needle. . . . . just sounds painful. I only use those to draw things up in, and I wouldn't let anyone near me with anything nearly as big. . . unless they were putting in a central line or an IV.

Since I never give IM injections, I can't remember if you can use insulin needles or not (as they are made for subcutaneous injections). I think you should just avoid the really short needles, and you should always rotate injection sites. And I wouldn't ever re-use needles, even if I though they were sterile. Needles are cheep. A soft tissue infection can be very expensive. . . . and most of the people out there aren't what I would call health care professionals.

- Ok, then I will go in when they direct me to.

- I coudn't even buy an 18 ga needle as proscribed (went to 2 pharmacys); they gave me a 25 x 1.5 instead. I'm glad after I got to looking at HOW BIG that needle really is. I have to get them to use that small needle with the hose when drawing blood, because I can't stand that larger needle with the cup on the end of it for swapping vials...

- I wasn't contemplating reuse and wouldn't, just asking about drawing with one and putting it into a fresh insulin needle. After re-reading both threads in their entirety, it would appear that there IS a study that supports SC being as good as IM. But this first shot will be IM.

ABNAK
02-06-14, 15:46
ABNAK, Question, have you had any ill effects from repeated IM injections over five years (5yrs x 52wks = 260 injection). Any scar tissue development abscess or boils ? I inject my quads, i have a fear of hitting nerve in my glute.Any advice to other sites. Thanks

Nope, no problems. Like I said earlier, I rotate ass cheeks each week. My wife uses an alcohol swab to clean the site first. I wondered the same thing but so far no issues.

It's funny: sometimes I barely feel it, others it stings like a bitch!

ABNAK
02-06-14, 15:57
I won't answer the Q for him, but that can easily be avoided by using 29-30g needles (insulin needles) which I discuss at length in this and other threads. There's no reason to use the typical 18-21g harpoons that pass for needles used by docs.

Will, I have to say from (obviously long) experience that the T is too thick for an insulin syringe/needle setup. At least the Cypionate is. We currently use 21G needles that are 1 1/2" long. Yeah, harpoon is right! However, it needs to get deep into the muscle for a proper IM injection (my wife is an RN and knows all about that kind of stuff). Not saying your advice is incorrect at all but this is what I've personally found to be the case.

Oh, any of you guys doing it: make damn sure the needle is on TIGHT to the syringe. I've had it disconnect and a whole dose of T squirts onto your skin, thereby wasting it!

WillBrink
02-06-14, 16:33
I know it isn't the question you asked, but testing your testosterone level in the afternoon invalidates the test. It simply isn't accurate way to diagnose hypogonadism, and shouldn't be used to guide therapy or to initiate therapy.

Cite? The difference between typical times to draw T (am) and the after noon, are not so radically different it would "invalidate" the test. If you're levels are 200nd/dl at 3pm, they were not 550ng/dl at 8am, and so forth. It's best to get it taken at essentially the same time of day (morning usually recommended) for consistency, but the differences are not so wide as to invalidate the testing.



And sticking yourself with an 18 gauge needle. . . . . just sounds painful. I only use those to draw things up in, and I wouldn't let anyone near me with anything nearly as big. . . unless they were putting in a central line or an IV.


Since I never give IM injections, I can't remember if you can use insulin needles


You can as discussed in detail in this and other threads.



,or not (as they are made for subcutaneous injections).



In the areas men are generally lean (shoulder, outer thigh, etc) they will go IM, however, recent studies (citations posted in prior threads) show sub Q route is just as effective for TRT so it's actually a moot issue. The important issue appears to be consistent with which route you go, but either is fine. There's a number of docs I know who prefer sub Q and have considerable clinical experience that supports the study findings.




I think you should just avoid the really short needles, and you should always rotate injection sites. And I wouldn't ever re-use needles, even if I though they were sterile. Needles are cheep. A soft tissue infection can be very expensive. . . . and most of the people out there aren't what I would call health care professionals.

100% truth, but most health care professionals tend to be woefully inadequate regarding this specific topic, so it's very difficult for men to get good care in this area as the pages and pages of frustrated men show, which is the norm in my experience.