TRT information

[mrgeeky]

www.allthingsmale.com/word_docs/TRT.doc

[mrgeeky]

Hey guys, I have had to change doctors..

The doc that originally put me on TRT lives to far away for me to see him as often as I would like.

The doctor that I am going to now admits to not having a lot of knowledge around TRT. I'm not getting any blood tests done etc through him.

He basically just administers what I ask him too.

I'm wondering would that file above be a good one to print out for him to have a read of or is there some better info that I can supply him with that will help him manage my TRT?

Any thoughts please guys?

[Daz69]

Hey guys, I have had to change doctors..

The doc that originally put me on TRT lives to far away for me to see him as often as I would like.

The doctor that I am going to now admits to not having a lot of knowledge around TRT. I'm not getting any blood tests done etc through him.

He basically just administers what I ask him too.

I'm wondering would that file above be a good one to print out for him to have a read of or is there some better info that I can supply him with that will help him manage my TRT?

Any thoughts please guys?

Why change what's working... Depot Test-C ... Thank You..!!!

[mrgeeky]

why change whats working. ie: doctors?

Because seeing the doc that's been treating me is too hard..

My doc lives very handy. I need my doc to take over dishing out the meds but he doesn't really appear to know what he is doing when it comes to TRT.

I don't see any reason why I cant get my doc schooled up with this stuff..

He has all the underlying knowledge. After all he's a doctor.. :-)

I cant help but wonder if that form in the first link would be a great idea to explain all.

[Daz69]

why change whats working. ie: doctors?

Because seeing the doc that's been treating me is too hard..

My doc lives very handy. I need my doc to take over dishing out the meds but he doesn't really appear to know what he is doing when it comes to TRT.

I don't see any reason why I cant get my doc schooled up with this stuff..

He has all the underlying knowledge. After all he's a doctor.. :-)

I cant help but wonder if that form in the first link would be a great idea to explain all.

He basically just administers what I ask him too.

I meant if your new Doc is prepared to administer what you ask, then just let him...

[mrgeeky]

why change whats working. ie: doctors?

Because seeing the doc that's been treating me is too hard..

My doc lives very handy. I need my doc to take over dishing out the meds but he doesn't really appear to know what he is doing when it comes to TRT.

I don't see any reason why I cant get my doc schooled up with this stuff..

He has all the underlying knowledge. After all he's a doctor.. :-)

I cant help but wonder if that form in the first link would be a great idea to explain all.

He basically just administers what I ask him too.

I meant if your new Doc is prepared to administer what you ask, then just let him...

The problem is, Im more clueless that my doc..

I have no idea what bloods need taking, when to take them or why they even need taking.. Im reading lots but not understanding a lot of it..

If I can get my doc up to speed so he knows what he is doing it would be good. He has a far more basic understanding of this stuff than I do so it makes more sense that he takes control.. No????

I kind of sense that some just think the answer is, the higher dose of TRT you can get the better.. And nothing else matters..

hey if that's the case, Im cool with that.. But the reality is I just don't know!

I probably need to spend a lot more time on here reading..

[Daz69]

why change whats working. ie: doctors?

Because seeing the doc that's been treating me is too hard..

My doc lives very handy. I need my doc to take over dishing out the meds but he doesn't really appear to know what he is doing when it comes to TRT.

I don't see any reason why I cant get my doc schooled up with this stuff..

He has all the underlying knowledge. After all he's a doctor.. :-)

I cant help but wonder if that form in the first link would be a great idea to explain all.

He basically just administers what I ask him too.

I meant if your new Doc is prepared to administer what you ask, then just let him...

The problem is, Im more clueless that my doc..

I have no idea what bloods need taking, when to take them or why they even need taking.. Im reading lots but not understanding a lot of it..

If I can get my doc up to speed so he knows what he is doing it would be good. He has a far more basic understanding of this stuff than I do so it makes more sense that he takes control.. No????

I kind of sense that some just think the answer is, the higher dose of TRT you can get the better.. And nothing else matters..

hey if that's the case, Im cool with that.. But the reality is I just don't know!

I probably need to spend a lot more time on here reading..

It might be better if you get yourself up to speed, therefore you have some control over the dosage, not your GP.. remember its you who knows how you feel on any given dose or application method....

Doctors can at times be too cautious...

You are self administering a natural essential hormone.... there's nothing to it, I've been doing it 32 years only with slightly higher doses.... :wink:

[mrgeeky]

Not sure if Im allowed to link to the site so I'll just quote it. This quote says we should permanently be on hCG and possibly arimidex as well ( anastrozole ) Now I got to go and google what hCG is.

"Many guys ask for these details. Here is enough info to get started. You probably will not get your doctor aligned with this without a struggle [or a new doctor]. This is really a small part of what most guys need to know.

TRT: Protocol for Injections

* 100mg test cypionate or ethanate injected per week with two or more injections per week.

* 250iu hCG SC EOD [every other day]

* 1.0mg Arimidex/anastrozole per week in divided doses.

Injecting testosterone once a week induces spikes in testosterone levels followed by lows. This can make many feel bad or worse at the end of the week than their pre-TRT state. As time goes on the dead zone gets wider and they feel no relief with injections. These feel much better injecting twice a week or even EOD [every other day].

Injecting every 2, 3 or 4 weeks is horrible. You need to self inject and inject frequently. With frequent injections the volumes are very small and one can inject in the quads [vastus lateralis] with #29 0.5ml 0.5" [50iu] insulin syringes.

These are slow to load but injection times are reasonable as the small plunger diameters create very high pressures. Do not use 1.0ml syringes. This same size syringe can be used for hCG injections, which are also SC.

EDIT: Injecting EOD [sometimes written as E2D] or E3D [every third day] can be a difficult schedule. You can set up reminders or appointments in calendar software, such as MS Outlook, for E2D or E3D etc.

Small needles will reduce muscle damage. Some use #25 1" needles, but this may not be any "faster" than the above 50iu insulin needles.

You do not need to inject into your gluts with 1.5" needles!

Canadian clinical research has demonstrated that TRT by SC [under the skin injections into body fat] produce steadier testosterone levels and improves sense of well-being. Feel free to find out what is more comfortable for you.

For those who train and sweat/shower a lot, transdermal T creams and gels are not appropriate.

Transdermal T creams [and patches] are expensive. At best, only about 10% of applied testosterone is absorbed. Transdermal delivered dose is a crap shoot. Guys who have low thyroid levels are typically non-absorbers. Some absorb transdermals at the start, but skin changes can shut off absorption after a while. With injections, there are no unknowns about drug delivery.

hCG is a water based peptide hormone can be injected to replace the lost LH hormone that TRT shuts down. Without hCG, the LH receptors in the testes are no longer getting activated. The results are:

* The testes shrink. Over time for some the testes can eventually become small undifferentiated lumps of collagen. This is drug induced organ failure. The degree of shrinking varies from guy to guy and may be more of a problem for the older guys.

* Fertility can be greatly reduced or eliminated. If making babies is important, you need to inject hCG. If hCG is not used, its use after a long time may or may not recover fertility.

* When the testes get smaller, some feel an ache in their testes 24x7. hCG injections can eliminate that pain or avoid the whole episode.

* When there is no LH or hCG, the scrotum pulls up tight to the body. This has the appearance of a pre-pubescent boy. This is not good for ones sexual self image and this also affects how women perceive you sexually. Some women get very upset when they see this maleness disappear, thus affecting their sexuality and interest in you.

* The testes are the single largest producer of the hormone pregnenolone. Pregnenolone is important for proper mental functioning, and is the precursor to all of the steroid hormones such as DHEA, testosterone, DHT, estrogen, cortisol... Injecting hCG prevents a drug induced pregnenolone deficiency and helps support the other hormones. When guys are on T without hCG and then start hCG, they report a significant improvement in mood that many attribute to restored pregnenolone levels. [if that is not the case, hCG must have some direct effects in the brain.]

When injecting hCG, you inject into the fat under the skin just the same as diabetics inject insulin. The product literature is all about use a fertility drug for women with large IM [injected into muscle] doses. There is no need for men to inject hCG IM.

Research using SC injections in men has demonstrated the effectiveness of the 250iu EOD dosing. You can seek diabetic patient educational material for insulin injection techniques to use for hCG and/or testosterone injections.

Elevated normal [30pg/ml and up] serum E2/estradiol can block many of the benefits of testosterone replacement. Serum E2=22pg/ml is near optimal and one should dose anastrozole to get close to this level. Many who start TRT have some good results that soon vanish as E2 levels increase. My recommendation is to start anastrozole at 1.0mg per week [in divided doses] starting the day of the first injection. The let the first follow up E2 lab drive any needed anastrozole dose adjustments. It is not a good idea to wait and see how high E2 levels go before taking action. Dose anastrozole EOD if possible.

A few guys are anastrozole over responders. This is not known in the drug literature. These guys will get E2 in the single digits and will feel like crap physically and mentally. They may feel a spike of short lived libido as they fall through the E2 levels sweet spot. These guys need to take 1/4th or 1/8th of the expected anastrozole dose -something to watch for. If this is suspected, stop anastrozole for 6-7 days then resume at 1/4th the dose.

The 100mg dose of injected T should get guys into the 800-900 total testosterone [TT] range. That is nice to see, but one should be looking at free testosterone [FT] or bio-available testosterone [bio-T]. Some docs, who know what they are doing, will not bother checking TT numbers at all. SHBG levels increase with age and FT ratios drop.

A TT=1000 in a young man is not the same as TT=1000 in an older man with higher SHBG levels as the FT numbers will be well below that of the young man with the same TT. This may very well create TT levels that are above the youthful lab ranges and should not be a concern. Lab ranges shown on lab reports will be age adjusted. You need to be using the ranges for youthful men.

You need to know about PSA, prostate issues and DREs [digital rectal exam]. E2 is a large cause or aggravator of BPH [enlarged prostate]. Many find that lowering E2 to near E2=22pg/ml improves their BPH and urine flow is improved.

You need to monitor hematocrit levels as part of your routine lab work. "

[mrgeeky]

gee, the more I read the more complicated this stuff appears to get lol

[DIANABOL]

gee, the more I read the more complicated this stuff appears to get lol

I think you way over complicate it and over think it.

[mrgeeky]

that's funny..

Coz it was lack of info that got me where I am.

Now that Im trying to do it all properly by doing the research and educating myself, your saying I shouldn't?

Boy oh boy some of you guys can be confusing lol

So do I do the research and try to learn about this stuff or not????????????

[dannyjay]

inject the shit, sit back & relax

[mrgeeky]

inject the shit, sit back & relax

:shock:

[DIANABOL]

that's funny..

Coz it was lack of info that got me where I am.

Now that Im trying to do it all properly by doing the research and educating myself, your saying I shouldn't?

Boy oh boy some of you guys can be confusing lol

So do I do the research and try to learn about this stuff or not????????????

Mate you'll be 70 or 80 years old by the time you get your head around it and by that time what will be the point...

Its testosterone replacement therapy. I dont see what makes it so complicated.

[mrgeeky]

that's funny..

Coz it was lack of info that got me where I am.

Now that Im trying to do it all properly by doing the research and educating myself, your saying I shouldn't?

Boy oh boy some of you guys can be confusing lol

So do I do the research and try to learn about this stuff or not????????????

Mate you'll be 70 or 80 years old by the time you get your head around it and by that time what will be the point...

Its testosterone replacement therapy. I dont see what makes it so complicated.

because everything Im reading says to do it properly there is much more to it than just shoving a needle in your arm every week and getting it wrong could lead to health implications.

Ie , family jewels shriveling up and dying, prostate issues, lethargy setting back in, etc etc etc..

[DIANABOL]

that's funny..

Coz it was lack of info that got me where I am.

Now that Im trying to do it all properly by doing the research and educating myself, your saying I shouldn't?

Boy oh boy some of you guys can be confusing lol

So do I do the research and try to learn about this stuff or not????????????

Mate you'll be 70 or 80 years old by the time you get your head around it and by that time what will be the point...

Its testosterone replacement therapy. I dont see what makes it so complicated.

because everything Im reading says to do it properly there is much more to it than just shoving a needle in your arm every week and getting it wrong could lead to health implications.

Ie , family jewels shriveling up and dying, prostate issues, lethargy setting back in, etc etc etc..

Youre 50 or 60 something right?

All the best for your research, hopefully the time you find the right / 'proper' way to do it you will be young enough to get some sort of benefit from it.

[mrgeeky]

http://www.youtube.com/watch?v=XHneA79Uyvk

[mrgeeky]

51

I don't think I would want to end up with problems at 60, then have to live with going to the toilet during the night every 5 minutes with prostate problems until Im 85..

That's one problem among many possibles.

so are you saying just because your an elder person you should accept all the issues that may come with it in your future?

[Android]

no mrgeeky,

with all due respect I think he's implying that you've been looking into this so long and still haven't grasped the research.

I can remember last year you were going to research more into it and we steered you in the direction back then.

In the end, risk/ reward seems to be difficult for you to weigh up (possibly a sign of a Libra...off topic).

No-one has problems on 100-200mg/week TRT for life. But to further qualify, no-one can predict the future that accurately as to what you are genetically pre-disposed to. If you're a candidate already for prostate issues then guess what...you'll get them regardless of the TRT. Never heard of anyone requiring PCT or AIs while on TRT but regular blood tests will indicate whether you need them so don't stress UNTIL it arises. You can't take small doses of Test and screw up your body unless it was already screwed, testosterone is a naturally-occurring hormone.

IMO...hurry up and get on a program of 200mg/week oil-based testosterone and enjoy the next 30yrs or you'll be 60 before you decide what to do and other things in life may have passed you by.

For whatever reason you need TRT (dodgy Deca experiences, natural loss of Test levels, stress, lack of sleep, diet, or exercise things) just start taking the stuff regularly and don't stress anymore. Enjoy, forget about the non-issues and find a new hobby that provides new life experiences.

hope that makes sense, too deep for me :pfft:

[Dinesh]

51

I don't think I would want to end up with problems at 60, then have to live with going to the toilet during the night every 5 minutes with prostate problems until Im 85..

That's one problem among many possibles.

so are you saying just because your an elder person you should accept all the issues that may come with it in your future?

[mrgeeky]

lol great posts guys..

Ok, point taken and has sunk in..

There's enough of you saying the same thing for me to be a believer and understand.

Although one last question of I may, does that include ignoring bloods?

Or if not, are there any specific bloods I should be asking my doc to do?

Total Testosterone

Free Testosterone

SHBG

DHT

Estradiol (E2)

PSA

Prolactin

Cortisol

Thyroid Panel

CBC-complete blood count

Comprehensive Metabolic Panel

Lipid profile/panel

or

Total Testosterone

Free Testosterone

DHT

Estradiol (E2)

Thyroid Panel

CBC

Comprehensive Metabolic Panel

Lipid profile

Prolactin ????????

Cortisol ?????

Is that about it? Or should I just ignore getting bloods done? Please remember my current doc although I think he is great appears to have no knowledge in the area of TRT.. That's why I need to know what I should be asking him to get done..

kudos handed out where deserved! cheers for the advice again guys.

[Android]

lol great posts guys..

Ok, point taken and has sunk in..

There's enough of you saying the same thing for me to be a believer and understand.

Although one last question of I may, does that include ignoring bloods?

Or if not, are there any specific bloods I should be asking my doc to do?

That's my one very last q and I'll stop being an annoying pain.. I promise lol

kudos handed out where deserved! cheers for the advice again guys.

don't ignore bloods!

Many people are pretty lax with getting bloods if everything "feels" ok, myself included. But that doesn't mean we're doing it right.

Bloods as often as the doctor needs, probably more often to begin with and then if things look ok, less often...at a guess mate

good luck, keep us posted btw

[mrgeeky]

sorry android just edited the above post..

Have I got those bloods right? Just asking as my current doc hasn't a clue..

I need to know what to tell him.

[mrgeeky]

good luck, keep us posted btw

hahaha hope you don't regret that comment..

You'll probably be telling me not to be so annoying later.. heh heh..

This has become one of my fav sites..

Im going to stick up some before and after pics later and my diet and routine once I get my shoulder fixed just for the hell of it.

The before photo's aren't pretty! :pfft:

So yeah, I'll definitely stay in touch and let you guys know what's happening..

[mrgeeky]

Come on guys we need a TRT forum lol

Im posting this purely because it could be handy for any one on TRT that are still feeling like shit! A good read!

=========================

"I am sorry to say that you are the poster child for TRT done wrong. If I seem angry, its not with you, but with your doctor. What you are doing probably cannot be done worse. The problem is not injecting and the answer is not T gels.

Make the changes and see how your blood - hematocrit responds in time. Some need to have blood removed, or make blood donations.

Injecting every two weeks will create more T-->E aromatization and more E leads to more SHBG. SHBG reduces your free testosterone. Your T:E ratio goes to shit.

Even injecting T every other day (EOD) with high TT and FT numbers can be a total crock if E2 levels are elevated.

With injections every two weeks, as the T wears off, the E is still hanging around. You can feel terrible, worse that before TRT started.

You must inject at least once a week, twice a week would be much better. Your program is a complete mess and your doctor is what we term here ... a complete idiot.

Your testicles are small and your scrotum is pulled up and tight? TRT shuts down your HPTA and there is no LH to keep the testes working. With the testes shut down, you loose most of your pregnenolone production which is important to the brain and is also the 'feedstock' for DHEA production.

Injecting 250iu hCG SC EOD will maintain the testes. Many report a fast acting improvement in mood with hCG... see pregnenolone above.

If you are injecting hCG EOD, you might as well be injecting your T ester EOD as well.

Estrogen can mess up your brain, mood, energy, libido and prostate if too high. Without lab numbers, you do not know what you are doing. Do you have and retain copies of all of your blood work? With T levels changing over two weeks, the correct amount of arimidex is not achievable. Too little E can also create probems with brain, mood, energy, libido. A few are over-responders to arimidex/anastrozole and must use 1/4 or 1/8th of the expected dose. Some who get good E numbers at first with 1mg/wk often later need to almost double that as some changes take place. You need the numbers.

Example:

250iu HCG SC EOD

.14ml test cyp (200mg/ml) IM EOD

1mg/wk Arimidex in divided doses

Adjust Arimidex to get a serum E2 number in the lower 20's (0-53pg/ml)

When injecting small amounts of T esters (cypionate, ethanate) you can use a 1" #25 needles for the quads (vastus lateralis). If your skin/fat is thin, you can inject with .5" .5ml #28 insulin syringes. You do not need to use 1.5" needles in your butt.

You cannot understand any of the above? Research these items.

Getting TRT done right requires a good doctor... very hard to find. Most doctors have no idea what to do. Endos are not in any way particularly qualified to do any of this. Many GPs do a better job, because they are wanting to learn. Endo's have been seen here to be, as a group, frequently stupid and have ego problems that prevent them from thinking that there is anything that they might need to learn. You need to understand what you want and need and fight to get it. You probably have to dump your endo.

Many of us here have been through all of this. "