Starting TRT Therapy

Training Over 35 Lifter
21

[quote]Rich5561 wrote:
KNB wrote:
You’ve hit the nail on the head, it’s all about the “rules” the doctors are supposed to follow.
I’ve never seen a range of 262-2593, I wish my doctor had those numbers to go by…

My point is you’re 46,and your doctor wants you to be around 800-900 most likely. The real question is: what day was the blood drawn? Did you put T gel on that day? If so, your test results are wrong, and your doctor is bordering on moron status. There is NO WAY I would go every third day using gel, it’s gonna bite you eventually.

You appear to someone that doesn’t naturally convert a lot of your T to E2. That’s a good thing. The next time you do a blood test (if you didn’t do this already)is no T gel for three days (or as long as possible) before the blood test. That way your blood work will show the lowest possible number so your doc will stop cutting you back.

If you have X quantity to use every third day, divide it up to use it everyday, except once again, before testing.

How’s your hair? still the same, maybe thinner possibly? I ask because your PSA went up. You might be converting to DHT and bothering your prostrate. I already know there are disagreement over this, but if you can get a DHT test on your next blood test, you may find out what’s causing the change in your prostrate. Keep us posted.

Sorry, that was a typo, I meant 1593. Well as an update, my numbers came back and my Total T has plummeted to 390 and Free T to 10.5! Needless to say, I’m pissed and stepping up my frequency to get my numbers back up! LOL My endo says, “Don’t worry, it’s only numbers” and I said, “So I should have said that to YOU when I was 1399!”

If I don’t get the results I want, I’m going to see a Dr. who prescribes TRT through a “compounding pharmacy”, that is, they make up their own topical solution. Main reason is that it’s cheaper and I’m self-pay (long story). Does anyone have any experience with a “compounding pharmacy”?

No, my hair is not thinning noticeably (yet, knock on wood!) No I did not gel the day of my bloodwork, not even the night before if memory serves… Would it fluctuate that much, that quickly?

How often do I need to cycle off? It will be a year this March… Could this be part of the reason my numbers have dropped so dramatically? Also I had broken up with my (b*tch) girlfriend that week, I wonder how much the psychological had an effect?

[/quote]

I was on AndroGel for 10 days and it didn’t do anything for me. I just do not absorb it like other people do. I have also heard of other men that do not absorb it as well and some after they been on it a while. IMPO I would go to the injections. Even though I am new to HRT I believe this is the best way to do it. Or at least for me.

22

[quote]sdmlsu1 wrote:
Do any of you guys know if there may be a connection with degenerative neck/back problems and Low T / Hormone deficiencies? Also the same question as related to general allergy problems. My Low T symptoms started when I was in my late 20s, I’m now 34. I have not started any TRT/HRT therapy, but I had my GP test my T levels in 2006 which came back very low normal.

About 3 weeks ago my Urologist tested my T levels in addition to other hormones and my T was low out of range and many of my other levels were either low or high. I was retested by an Endo. last Monday and will meet with him on Feb. 4 to review the results. I started having problems with my neck and back in 2005. I had an MRI in April 2006 showing severe spinal stenosis from C2-C7 with 3 disc herniations, 2 of which are impacting my spinal cord. I also have 2 disc herniations in my thoracic region of my back, one of which is very large with spinal cord impaction.

I had another MRI about a week ago. I met with my Ortho. today to review the results and my condition has worsened significantly. In 2006 my Ortho. recommended surgery on my neck but said I could put it off as long as I could stand it with injections and pain meds. My Ortho. is conservative when it comes to surgery, but he told me today if I was seeing a Neuro Surgeon they would probably hog tie me and escort me to the operating room immediately, that is how serious my condition is.

Also my thoracic has worsened significantly and his exact words were “you have a very impressive disc herniation”. I guess to get to the point he says my condition is degenerative and my spine is deteriorating rapidly. Apparently I have had very Low T and other hormone deficiencies for quite a while. Do ya’ll know of any data that would support a connection between Low T / Hormone Deficiency and my spinal issues?

The allergy issue may be a stretch, but it seems my allergies are getting worse with age which is unusual. I don’t have the lab results ordered by my Endo, but I have the ones from 2006 and 3 weeks ago if posting these would be helpful. I realize if there is some sort of connection between Low T and my spinal problems starting TRT probably won’t repair my spine but it may slow the deterioration process. My Endo also tested my IGF-1 level, but I won’t know the results until Feb. 4.
[/quote]

This is interesting I am new to HRT and I have had degenerative disks for a long time. I have had C5, C6, C7 replaced and a plate put in. The neck feels better but my lower back is not good either and in need of repair. I have also read somewhere that opiates can also mess with you Testosterone levels and I was on them for a long time.

Its funny you get on HRT and start finding out all these things that might have messed with your body and no doctor even thinks about checking out the cause of things. they just want to treat things. Well I am not going to go on a rant.

23

[quote]Rich5561 wrote:
KNB wrote:
You’ve hit the nail on the head, it’s all about the “rules” the doctors are supposed to follow.
I’ve never seen a range of 262-2593, I wish my doctor had those numbers to go by…

My point is you’re 46,and your doctor wants you to be around 800-900 most likely. The real question is: what day was the blood drawn? Did you put T gel on that day? If so, your test results are wrong, and your doctor is bordering on moron status. There is NO WAY I would go every third day using gel, it’s gonna bite you eventually.

You appear to someone that doesn’t naturally convert a lot of your T to E2. That’s a good thing. The next time you do a blood test (if you didn’t do this already)is no T gel for three days (or as long as possible) before the blood test. That way your blood work will show the lowest possible number so your doc will stop cutting you back.

If you have X quantity to use every third day, divide it up to use it everyday, except once again, before testing.

How’s your hair? still the same, maybe thinner possibly? I ask because your PSA went up. You might be converting to DHT and bothering your prostrate. I already know there are disagreement over this, but if you can get a DHT test on your next blood test, you may find out what’s causing the change in your prostrate. Keep us posted.

Sorry, that was a typo, I meant 1593. Well as an update, my numbers came back and my Total T has plummeted to 390 and Free T to 10.5! Needless to say, I’m pissed and stepping up my frequency to get my numbers back up! LOL My endo says, “Don’t worry, it’s only numbers” and I said, “So I should have said that to YOU when I was 1399!”

If I don’t get the results I want, I’m going to see a Dr. who prescribes TRT through a “compounding pharmacy”, that is, they make up their own topical solution. Main reason is that it’s cheaper and I’m self-pay (long story). Does anyone have any experience with a “compounding pharmacy”?

No, my hair is not thinning noticeably (yet, knock on wood!) No I did not gel the day of my bloodwork, not even the night before if memory serves… Would it fluctuate that much, that quickly?

How often do I need to cycle off? It will be a year this March… Could this be part of the reason my numbers have dropped so dramatically? Also I had broken up with my (b*tch) girlfriend that week, I wonder how much the psychological had an effect?

[/quote]

Okay 262-1593 would give my doctor more room to work, as he is “progressive” in many ways. Generally speaking, as far as costs go, injectable is WAY cheaper, especially if you can get to #1 a Sam’s Club, or #2 a Costco. The Testosterone in the gel they are probably using is T-Prop, and has a VERY short half life, somewhere around 24 hours I believe. That’s why you have to put it on every day because it doesn’t load up in the blood stream.
I have used compounding pharmacies, and you basically get the same product as a “pre-mixed” gel, hopefully for less money…

HRT/TRT does not “cycle” ever unless you’re interested in being depressed, and moody, and, well, you get the point.
It would seem the reason your numbers dropped like a stone is because you doctor screwed up. That’s why. Psychological factors not withstanding. Your numbers dropping may now be partially due to you converting to Estrogen and/or DHT. Your body may have “tricked” you, from long term gel use.

I suggest you get SHBG and E2 blood work done soon as a precaution, because all the T in the world is useless if your E2 numbers start climbing out of control and compromising both your Total T and Free T numbers. I hope this made sense. PM if necessary.

KNB

24

[quote]jakeman124 wrote:
sdmlsu1 wrote:
Do any of you guys know if there may be a connection with degenerative neck/back problems and Low T / Hormone deficiencies? Also the same question as related to general allergy problems. My Low T symptoms started when I was in my late 20s, I’m now 34. I have not started any TRT/HRT therapy, but I had my GP test my T levels in 2006 which came back very low normal.

About 3 weeks ago my Urologist tested my T levels in addition to other hormones and my T was low out of range and many of my other levels were either low or high. I was retested by an Endo. last Monday and will meet with him on Feb. 4 to review the results. I started having problems with my neck and back in 2005. I had an MRI in April 2006 showing severe spinal stenosis from C2-C7 with 3 disc herniations, 2 of which are impacting my spinal cord. I also have 2 disc herniations in my thoracic region of my back, one of which is very large with spinal cord impaction.

I had another MRI about a week ago. I met with my Ortho. today to review the results and my condition has worsened significantly. In 2006 my Ortho. recommended surgery on my neck but said I could put it off as long as I could stand it with injections and pain meds. My Ortho. is conservative when it comes to surgery, but he told me today if I was seeing a Neuro Surgeon they would probably hog tie me and escort me to the operating room immediately, that is how serious my condition is.

Also my thoracic has worsened significantly and his exact words were “you have a very impressive disc herniation”. I guess to get to the point he says my condition is degenerative and my spine is deteriorating rapidly. Apparently I have had very Low T and other hormone deficiencies for quite a while. Do ya’ll know of any data that would support a connection between Low T / Hormone Deficiency and my spinal issues?

The allergy issue may be a stretch, but it seems my allergies are getting worse with age which is unusual. I don’t have the lab results ordered by my Endo, but I have the ones from 2006 and 3 weeks ago if posting these would be helpful. I realize if there is some sort of connection between Low T and my spinal problems starting TRT probably won’t repair my spine but it may slow the deterioration process. My Endo also tested my IGF-1 level, but I won’t know the results until Feb. 4.

This is interesting I am new to HRT and I have had degenerative disks for a long time. I have had C5, C6, C7 replaced and a plate put in. The neck feels better but my lower back is not good either and in need of repair. I have also read somewhere that opiates can also mess with you Testosterone levels and I was on them for a long time.

Its funny you get on HRT and start finding out all these things that might have messed with your body and no doctor even thinks about checking out the cause of things. they just want to treat things. Well I am not going to go on a rant.

[/quote]

Easy answer; if you don’t have T you don’t make E, and if you don’t have E, you get osteoporosis as a side effect. Therefore, the two are related. Last year in the new PDA, there finally was a legitimate, documented, published, (you get the idea) mention of long term opiate use causing “secondary hypogonadism”,

the same thing that happened to me due to back issues and surgery, that’s why I know. Well I know because my doctor told me, and then I printed it out and forced my insurance company to pay for my HRT too. Use Google to find more articles than you can read about low hormone levels and bone/joint problems. Good luck.

25

I met with my Endo today to review my labs and discuss the go forward on my TRT. I was definately a little paranoid about the visit due to things I’ve read about other peoples problems with Endos. The visit went silk smooth. I went prepared with questions about E / DHT / HCG. He listened patiently and answered all my questions.

He started me on 100mg wk Test Cyp injections and had his nurse show me how to inject myself so I can do it at home. He explained the different options of creams / gels / patches / injections, but left the choice up to me. He said he would monitor my E / DHT and treat when necessary. He also plans to start me on HCG therapy in a few months. I could not have been more happy with the outcome.

26

[quote]sdmlsu1 wrote:
I met with my Endo today to review my labs and discuss the go forward on my TRT. I was definately a little paranoid about the visit due to things I’ve read about other peoples problems with Endos. The visit went silk smooth. I went prepared with questions about E / DHT / HCG. He listened patiently and answered all my questions.

He started me on 100mg wk Test Cyp injections and had his nurse show me how to inject myself so I can do it at home. He explained the different options of creams / gels / patches / injections, but left the choice up to me. He said he would monitor my E / DHT and treat when necessary. He also plans to start me on HCG therapy in a few months. I could not have been more happy with the outcome. [/quote]

Why wait a “few months” for your testes to shrink? That is not right. Your HPTA will be shutdown in one week.

http://dspace.hsl.washington.edu/dspace/bitstream/2012/52/1/JCEM_2005_Low_Dose_Human.pdf

Read and print for your endo. You should be asking for 250iu SC EOD as in the research.

“Treating E when necessary”… have you two agreed on what your E2 target should be? E2 effects can hit hard in 6 to 8 weeks. Make notes. The problem is docs who think that normal lab ranges mean that everything is fine.

Are you injecting once a week?

27

[quote]KNB wrote:
Easy answer; if you don’t have T you don’t make E, and if you don’t have E, you get osteoporosis as a side effect. Therefore, the two are related. Last year in the new PDA, there finally was a legitimate, documented, published, (you get the idea) mention of long term opiate use causing “secondary hypogonadism”,

the same thing that happened to me due to back issues and surgery, that’s why I know. Well I know because my doctor told me, and then I printed it out and forced my insurance company to pay for my HRT too. Use Google to find more articles than you can read about low hormone levels and bone/joint problems. Good luck.[/quote]

With all due respect, KNB, this is not completely accurate.
Did you mean specifically Estradiol?

This image may help:

Estradiol is what men don’t want too much of, but they need some. There are two ways Estradiol is made: either aromatization from Testosterone via the “aromatase” enzyme, or conversion from Estrone by the enzyme 17b-hydroxysteroid dehydrogenase, and that precursor Estrone comes from Androstenedione, not “T”.

Estrogen is also synthesized in the Leydig Cells of the testes in response to Luteinizing Hormone, not “T”.

I will start a thread about estrogen with a few links.

BD

28

[quote]KNB wrote:
KNB wrote:
Okay 262-1593 would give my doctor more room to work, as he is “progressive” in many ways. Generally speaking, as far as costs go, injectable is WAY cheaper, especially if you can get to #1 a Sam’s Club, or #2 a Costco. The Testosterone in the gel they are probably using is T-Prop, and has a VERY short half life, somewhere around 24 hours I believe. That’s why you have to put it on every day because it doesn’t load up in the blood stream.
I have used compounding pharmacies, and you basically get the same product as a “pre-mixed” gel, hopefully for less money…

HRT/TRT does not “cycle” ever unless you’re interested in being depressed, and moody, and, well, you get the point.
It would seem the reason your numbers dropped like a stone is because you doctor screwed up. That’s why. Psychological factors not withstanding. Your numbers dropping may now be partially due to you converting to Estrogen and/or DHT. Your body may have “tricked” you, from long term gel use.

I suggest you get SHBG and E2 blood work done soon as a precaution, because all the T in the world is useless if your E2 numbers start climbing out of control and compromising both your Total T and Free T numbers. I hope this made sense. PM if necessary.

KNB[/quote]

Thanks, I WILL get SHBG and E2 checked @ my next bloodwork. In the meantime, I’m going back to daily Testim and see if it helps. I don’t see any obvious visual signs of increased E, but…? I think I’m also going to doctor-shop and get compounded cream as well. Glad to know you don’t cycle gels or creams… Ask KSman, I’ve been threatening to start injecting for months! All I need is a cool doc.

29

[quote]Rich5561 wrote:
KNB wrote:
KNB wrote:
Okay 262-1593 would give my doctor more room to work, as he is “progressive” in many ways. Generally speaking, as far as costs go, injectable is WAY cheaper, especially if you can get to #1 a Sam’s Club, or #2 a Costco. The Testosterone in the gel they are probably using is T-Prop, and has a VERY short half life, somewhere around 24 hours I believe. That’s why you have to put it on every day because it doesn’t load up in the blood stream.
I have used compounding pharmacies, and you basically get the same product as a “pre-mixed” gel, hopefully for less money…

HRT/TRT does not “cycle” ever unless you’re interested in being depressed, and moody, and, well, you get the point.
It would seem the reason your numbers dropped like a stone is because you doctor screwed up. That’s why. Psychological factors not withstanding. Your numbers dropping may now be partially due to you converting to Estrogen and/or DHT. Your body may have “tricked” you, from long term gel use.

I suggest you get SHBG and E2 blood work done soon as a precaution, because all the T in the world is useless if your E2 numbers start climbing out of control and compromising both your Total T and Free T numbers. I hope this made sense. PM if necessary.

KNB

Thanks, I WILL get SHBG and E2 checked @ my next bloodwork. In the meantime, I’m going back to daily Testim and see if it helps. I don’t see any obvious visual signs of increased E, but…? I think I’m also going to doctor-shop and get compounded cream as well. Glad to know you don’t cycle gels or creams… Ask KSman, I’ve been threatening to start injecting for months! All I need is a cool doc.

[/quote]

Is it possible to make it a strictly financial issue with the doctor? A bottle of T-cyp is $53.00, and at 100mg/week lasts 20 weeks. That’s $2.50 a week. I’m quite sure you can’t even get close to that, custom compounded or not. Tell the doc it’s a financial thing, you’re getting a rash, your clothes are stained, it rubs off too much, etc… Make up a story and stick to it.(no pun intended) Just my $0.02

KNB

30

[quote]KNB wrote:
Rich5561 wrote:
KNB wrote:
KNB wrote:
Okay 262-1593 would give my doctor more room to work, as he is “progressive” in many ways. Generally speaking, as far as costs go, injectable is WAY cheaper, especially if you can get to #1 a Sam’s Club, or #2 a Costco. The Testosterone in the gel they are probably using is T-Prop, and has a VERY short half life, somewhere around 24 hours I believe. That’s why you have to put it on every day because it doesn’t load up in the blood stream.
I have used compounding pharmacies, and you basically get the same product as a “pre-mixed” gel, hopefully for less money…

HRT/TRT does not “cycle” ever unless you’re interested in being depressed, and moody, and, well, you get the point.
It would seem the reason your numbers dropped like a stone is because you doctor screwed up. That’s why. Psychological factors not withstanding. Your numbers dropping may now be partially due to you converting to Estrogen and/or DHT. Your body may have “tricked” you, from long term gel use.

I suggest you get SHBG and E2 blood work done soon as a precaution, because all the T in the world is useless if your E2 numbers start climbing out of control and compromising both your Total T and Free T numbers. I hope this made sense. PM if necessary.

KNB

Thanks, I WILL get SHBG and E2 checked @ my next bloodwork. In the meantime, I’m going back to daily Testim and see if it helps. I don’t see any obvious visual signs of increased E, but…? I think I’m also going to doctor-shop and get compounded cream as well. Glad to know you don’t cycle gels or creams… Ask KSman, I’ve been threatening to start injecting for months! All I need is a cool doc.

Is it possible to make it a strictly financial issue with the doctor? A bottle of T-cyp is $53.00, and at 100mg/week lasts 20 weeks. That’s $2.50 a week. I’m quite sure you can’t even get close to that, custom compounded or not. Tell the doc it’s a financial thing, you’re getting a rash, your clothes are stained, it rubs off too much, etc… Make up a story and stick to it.(no pun intended) Just my $0.02

KNB[/quote]

Wow, the cheapest I’ve found my T-cyp for is $83 and that’s through the doctor’s office that my wife works for. At the local pharmacy it’s $115.

31

I just bought my first 10ml vial of T-Cyp 200mg/ml while I’m waiting for the pre-authorization with my insurance to process and it cost me $104.00. My FSA will pick up the cost and I’ll get all my money back. All future purchases will be about $10-$15 dollars.