I am a 59 year old male 5’11" 185lbs. diabetic under with sugar under control.I have suffered with Ed and lack of sex drive for quite a few years. I tried everything and finally my MD started me on 200mg. of T every 14 days. I didn’t really see much change. I was talking to a bodybuilding friend and he suggested I start 200mg. per week. I did, and man what a difference in the last month! Sex drive is through the roof and have made love to my wife three times in the last two days. I feel so much better I can’t believe it.
The problem is my DR. She does not want me to take that much T in spite of the results. I have explained to her how much better it all is but she’s not hearing it. What do you guys think? Is it a safe dose and what can I expect if I continue taking this amount?My last blood test my T was 722 .Before beginning the treatment it was around 450. Thanks. Great site.
Oh shit, another “Steroid phobic republican doctor” problem. Who wants this one, Headhunter? KSman? Happydog?
Irrp11, the above paragraph has nothing to do with you, just that your problem is WIDESPREAD. For starters, you have every right to a good sex life and achieving it with 200mg T per week is very safe and reasonable. Especially as a diabetic, the chanllenge of ED is serious and your doc should know this. Your T level of 722 is still well below the top of the normal range and your doctor should have NO problem with it. She is just trained, by the PDR, to believe T (is it cypionate or enanthate?) has a near two week duration of effect, and believes only what she has read.
You have three options. The best is to educate yourself with the various literature on TRT, much of which you can find links to right here, and present printed copies of this literature to your doctor to “educate” her. Since she gave you T in the first place, she might listen. If not, you need to get another doctor. The third option, I hate having to point out, is self-medicating. Many frustrated T-Nation folks have resorted to option 3.
There are many other issues involved. You need to know your Estradiol levels, and it is actually possible that if it is too high, reduction of E2 with an A.I. could give you the same positive improvement in libido and performance with the dose of T she gave you. That “good zone” you found at 200mg per week is as much as function of T to E ration as it is to total T. However, most TRT users (like 99%) have found that longer than once per week dosing does not give sustained good results. So you might end up doing well with just 125mg T per week plus and A.I. (like Arimidex).
These are just some early pointers, but you are looking in the right place for answers. Doc
Doc wrote:“However, most TRT users (like 99%) have found that longer than once per week dosing does not give sustained good results” Does this mean longer periods of time? Thanks for your response it is very helpful and reassuring. I receive my medical care the local VA and for many reasons this type of problem is not a high priorty but I will present the evidence to my DR. I take Cypionate and getting the other blood tests you mentioned could prove a challenge with them but I will give it my best.The results are so impressive in my life that I have no intention of not pursuing this direction.Thanks agiain. Any more info or links to articles would be appeciated.
lrrp11: my urologist last April started me me on 200mg per week. He told me the HALF-life is roughly 8 days. Perhaps your doctor thinks that for 14 days you will have a constant level from your injection. That is just not true. She needs to read up on the pharmacology.
I am pre-diabetic, and can relate to your situation, though I’m only 37 and started TRT (different doctors) at 34. My current doctor is #5, and by far the best. You may need to find a new doctor.
Also, if your metabolism is like me, your body probably is good at converting T to estrogen. Insist that you get Estradiol (highly sensitive assay), SHBG, Free T, DHEA-S and DHT testing. A doctor needs to be looking at more the whole picture. Total T amounts to “once upon a time” without telling the rest of the story.
Because that 200mg per week sent my E2 and DHT right to the top of the range (not good), he prescribed Arimidex. I also am tapering down a bit on shots, and actually split the dose to inject every other day totaling my weekly dose. This is because I don’t like the rollercoaster affect of peaking on the 2nd-3rd day after the injection, then sinking by day 5-6-7. Every other day keeps me pretty much constant moodwise, libido-wise, strength wise.
I learned a lot from KSman. I agree with Dr.Powerclean’s advice. Get education. You may end up teaching doctors something they really need to know…but they may not welcome the free education either.
If you have the funds, lef.org can order and do tests for you. If you can only afford one, get Estradiol tested. Let the VA test your T.
[quote]lrrp11 wrote:
Doc wrote:“However, most TRT users (like 99%) have found that longer than once per week dosing does not give sustained good results” Does this mean longer periods of time? Thanks for your response it is very helpful and reassuring. I receive my medical care the local VA and for many reasons this type of problem is not a high priorty but I will present the evidence to my DR. I take Cypionate and getting the other blood tests you mentioned could prove a challenge with them but I will give it my best.The results are so impressive in my life that I have no intention of not pursuing this direction.Thanks agiain. Any more info or links to articles would be appeciated.[/quote]
Yes, he means that one per week is the minimum time between doses and most guys find that EOD is best. That means you’d do something like 55mg every other day.
Dr John Crisler has a great protocol that you may want to try to give to your doctor. Here’s the link to the page:
The paper you want is called: TRT: A Recipe for Success
You’re taking the first steps on what will most likely be a long journey. Good luck!
It’s quite possible you may need the higher testosterone dosages if your SHBG is higher, to get your free test up.
100mg per day isn’t a magic number for everybody. It depends on a lot of factors. Unfortunately not a lot of doctors see that way. They tend to be myopic.
I’ve read a lot that it is better to break up the T dose rather than one dose all at once. Will I still get the same effect as I do when I take a full amount?