Ksman, Please Advise...

Pharma / TRT Testosterone Replacement
1

I’ve read a lot on here about HRT but can’t seem to find out the consensus of using pellets vs. injections. My doc is referring me to another doc who uses BioTE pellet system. I was wondering if anyone has tried the pellets and what they think of them. The reason I’m being referred is because my E2 climbs so high sometimes (183 at one point) with the injections and my doc will not prescribe an AI.

So, he thinks the pellets will serve me better, plus the doc he referred me to uses an AI and HCG. Thoughts please KSman I trust you’re opinion.

2

I wouldn’t do the pellets. Implanting is considered a surgical procedure and pellets don’t deliver the “steady” release dose that some would claim.

If the doctor you’re being referred to uses hcg and an AI, explain that you would like to use T injections in addition to the hcg and AI. Just my 2 cents,

3

Thank you, I will ask.

4

Hi
I’ve been in pellets for 2 years and am ready to switch over to shots.

Any comments?

5

Injected T esters have the ester groups removed/cleaved-off by enzymes in many different parts of the body and the result is bio-identical testosterone. Don’t get fooled by the bio-identical hype. If you inject T frequently, you have a delivery system with very smooth levels. If you get in trouble, you can stop or make changes. Pellets have you locked in and then the option is the scalpel and T–>zero.

Please post all of your supplements and drugs, OTC and Rx as well as any medical issues.

You have not explained how you feel or symptoms etc. There is more going on than T and E2!

Injecting every week or two causes major problems with E2.

You need anastrozole to control T–>E2 conversion and you may have a liver condition that limits the ability to clear estrogens from your blood.

As always:
100mg T per week in divided doses, twice a week or EOD
1mg anastrozole per week in divided doses injected when you inject T
250iu hCG EOD

Please post more labs [with ranges!] and info as per the “advice for new guys sticky” and NOTE the first paragraph there. <<<<<<<<<<<<

AI+hCG is really only an option for younger guys who have health testes and secondary hypogonadism.

Please provide more info and tag me at the KSman is here sticky.

6

KSman,
A lot has transpired since I started this thread. Long story short, I finally got my PC to prescribe your protocol after trying other things. I haven’t got the HCG yet ,waiting for him to call it in to the pharmacy. Which brings me to my first question. Which brand is best? The pharmacist nor my doc doesn’t know exactly how it’s written or the name of it.

Okay, to answer all questions and to provide as much info as possible.

I’m 46 yrs old
5’10" 235 lbs
Skinny legs, no ass and carry most of my fat in belly and chest and back.
36 waist
Normal facial hair, but hairy back, legs and butt. Which all is starting to thin with age. Still a lot of thick hair on my head which runs in family.

I have just slight high blood pressure.
I have sleep apnea treated with cpap.
I have mild psoriasis on my hands only which seems to come and go with TRT changes or Vit D

Rx includes: Benicard and Verapmil for high blood pressure.
Baby aspirin for high hemocrit level due to TRT
Potassium
Vit. D
Depo Testosterone 100mg in dived doses 2 x weekly
Arimidex, .25 mg twice weekly with test injections. Just started last week.
HCG coming as soon as my doc and the pharmacy get together on it.
I take no OTC drugs except the baby aspirin.

Labs and ranges as of 10/24/14
Testosterone serum, 796 (348-1196)
Estradiol, 58.9 (7.6-42.6 pg/ml) H
Estrogen total, 190 ( 40-115 pg/ml ) H
WBC, 8.3 ( 3.4-10.8 )
RBC, 5.93 (4.14-5.8) H
Hemoglobin, 17.8 (12.6-17.7) H
Hematocrit, 52.3 (37.5-51.0) H This was really high in the spring of this year. 55.1
LH, 0.1 (1.7-8.6) L. Of coarse
FSH, 0.8 (1.5-12.4) L
Cholesterol total, 131 (100-199)
Triglycerides, 220 (0-149) H
HDL , 35 ( >39 ) L
VLDL , 44 (5-40) H
LDL, 52 (0-99)

Currently I don’t have a lot of energy. I’ve put on about 30 lbs in eight months because as I posted in another thread (which you responded to , thank you, you were right about it) my Achilles’ tendons were damaged due to my e2 driven to low with femara which at your advice, I stopped for several weeks and started arimidex. I sleep pretty good and have morning woods almost every morning (about 3:30am for some reason). My libido is suppressed but I can be aroused very quickly by my wife and get the job done. I’ve never really had erections problems even when my testosterone was at its lowest (199) when I started TRT.
I had my pituitary checked and it came back fine. I’ve had stress test and passed with flying colors. I haven’t been eating real good lately but just started watching my diet due to my recent labs. My mood goes up and down but I run two businesses and employees drive me crazy. One year ago my weight was190 and I jogged and hiked a lot but fell away from that a little and hovered around 200 until my Achilles tendons were damaged by plummeted E2 from femara and then put on the thirty pounds I mentioned.
I await your response. Thank you sir !!

7

Cholesterol total, 131 (100-199)

  • this is horrible low and a major health threat

Cannot find a drug called "Benicard "

Weight gain: This can be a thyroid issue. You use iodized salt? Check your waking and mid-afternoon body temperatures as per the thyroid basics sticky. Do you feel cold easily?

Any TSH, fT3, fT4, T3, T4, AM cortisol lab data?

Stress can mess with your adrenal and increase rT3 which then blocks fT3, reducing fT3 delivery into your cells.

Your weight puts you at risk for diabetes. Fasting glucose?

8

Quick question, I have switched to SC injections 2x a week (100mg .5ml each)T running 825 all good. Last 3 injections I wound up with a lump 3 days after injection and it stayed there and itchy for about a week. T cyp allergy? should I switch to T eth.? I never want to go back to IM injections
again Thanks

9

[quote]KSman wrote:
Cholesterol total, 131 (100-199)

  • this is horrible low and a major health threat

Cannot find a drug called "Benicard "

Weight gain: This can be a thyroid issue. You use iodized salt? Check your waking and mid-afternoon body temperatures as per the thyroid basics sticky. Do you feel cold easily?

Any TSH, fT3, fT4, T3, T4, AM cortisol lab data?

Stress can mess with your adrenal and increase rT3 which then blocks fT3, reducing fT3 delivery into your cells.

Your weight puts you at risk for diabetes. Fasting glucose?

[/quote]
I’m sorry the medication is “Benicar”. No “d”. It’s a low dose blood pressure med. Benicar-HCT 40-25
The weight gain is strictly my fault for eating horribly, I am in the process of changing my diet. I do use iodized salt. I do not have a labs for thyroid and I actually am warm a lot, hardly ever cold. I’ll start checking my temps tonight.

How is a total cholesterol of 131 bad in a range of 100-199 so I can tell my doc? What is affected?
Update oh HCG: my pharmacy can’t get it I have to use a compounding pharmacy. Any specifics on what I need to tell them.

10

Total cholesterol levels below 160 are associated with increased all-cause mortality, which means there is more of everything that can kill you.

Cholesterol is the foundation for all of your steroid hormones:

That included your own vitamin D production, and cortisol.

“”"
Steroid hormones can be grouped into five groups by the receptors to which they bind: glucocorticoids, mineralocorticoids, androgens, estrogens, and progestogens. Vitamin D derivatives are a sixth closely related hormone system with homologous receptors. They have some of the characteristics of true steroids as receptor ligands, but lack the planar fused four ring system of true steroids.
“”"

“”"
Abnormally low levels of cholesterol are termed hypocholesterolemia. Research into the causes of this state is relatively limited …
“”"

11

Okay thanks, ill study up on this.
Im a bit confused. I just found a compounding pharm that will mail me Hcg. Did i read that Hcg is useless for pts. with primary Hypogonadism. Because my pituitary was fine under mri scan last yr. So am i wasting $ and time using HCG? Cuz, i really hate the “shriveled up” look and my mood could certinly use a boost. Will it still take care of the retracted testes and scrotum and help with mood issues?

12

It will be helpful. A MRI that shows that you do not have an adinoma or damage does not mean that the pituitary and hypothalamus were working and testes were failed.

Weight gain: This can be a thyroid issue. You use iodized salt? Check your waking and mid-afternoon body temperatures as per the thyroid basics sticky. Do you feel cold easily?

Any TSH, fT3, fT4, T3, T4, AM cortisol lab data?

Stress can mess with your adrenal and increase rT3 which then blocks fT3, reducing fT3 delivery into your cells.

Your weight puts you at risk for diabetes. Fasting glucose?