Testosterone - Learn About Different Types of Testosterone Replacement Therapies

Getting Back on Track – Testosterone Enanthate Here I Come!

After a three-month waiting list (I live out in the boonies) I finally got to see the only endocrinologist within 50 miles. We did some blood work that I haven't gotten back yet, and he said my thyroid was swollen so I have to get a sonogram done on that in a couple of weeks. Those two things aside, we're going ahead with testosterone replacement therapy and I'm looking forward to getting life back on track again and settling into some kind of rhythm.

While my primary care idiot physician was only prescribing me one 200mg shot of testosterone cypionate every month (fucking moron! Sorry, couldn't help it.) and made me come into his office for it (so they could charge me $85 and wait an hour to get stuck.) this new endo is prescribing 200mg of testosterone enanthate every other week, and is letting me take it from home. He said if I'd rather take 100mg every week and don't mind the shots then he's all for it. I get a three-month supply for under $100 and even that is tax-free since it gets paid out of my health savings account.

He said he wanted to try just the testosterone for six months and then do some blood work. His hope, and mine, is that I can just take the test without any other drugs (estrogen blockers, aromatase inhibitors, HCG...) I know my boys will shrink away without the HCG, but my wife is pregnant now and we were only planning on having one kid. I have some "spares" in the sperm bank just in case.

So that's that. Hopefully there'll be no more bitching and whining from me about having to take testosterone for the rest of my life. I'm pretty sure I've accepted it, at least for now. You have to understand that the last few months of posts have been while I'm trying to function without much testosterone (hovering around 200 +/-) so if I've been acting like a little bitch it's because I've been feeling like one too.

No more. Today I got my first 200mg shot of test in awhile, and will be on TRT regularly. Acceptance is a good thing. I feel good.

I'll keep posting updates; will let you know if any health issues pop up that other TRT guys should think about. I might even use the TRT dose as a "cruise" does and go up to 500mg per week for a few months out of the year. My HPTA is already all fucked up, so I might as well have the advantage of not crashing out after a cycle. The only immediate problem I can see is how to get my wife's libido on the same track as mine is going to be. Something tells me that won't be easy. ;-)

The End of Hope for Natural Testosterone Production & The Beginning of Lifelong TRT

Between the Testim yesterday and today, and the HCG I've been taking - I feel great. I'm not back to "normal" yet, but I'm getting there and it's not just placebo. I'll probably have to switch to Androgel if I want my insurance to cover it, but there isn't much of a difference, other than smell and stickyness.

It has been a long, hard, six-month road of trying to get my natural testosterone production back up. I've tried several alternative treatments for low-T, including - for six months - only natural things like zinc, magnesium, tribulus and deadlifts at the gym. I didn't want to go on life-long TRT at my age, so my hope (once it was clear that my secondary hypogonadism was here to stay, and that I wasn't going to produce enough LH and FSH to make adequate testosterone) was that I could take Menopur or HCG instead of testosterone. That way at least my testes would stay "normal" and I'd be treating the problem at its source, rather than the symptom down below. But, alas, the US medical system wore me down. I just couldn't live like that anymore. I was depressed, losing more weight every month (185, 182, 179, 175, 170, 169... how low can I go?); was losing motivation and memory by the day; and generally just felt like CRAP.

The doctor still won't prescribe me injectable testosterone, and I'll be damned if I'm going to give those idiots $40 twice a month to stick a needle in my ass. So I'll continue to get my Testim or Androgel so I can stock-pile it away (because I'm paranoid about not having access to testosterone at some point in my life now that I'll be on it forever and life is miserable without it) and will instead be ordering injectable testosterone online from a compounding pharmacy somewhere. I'll be sure to use up the gel stuff before it expires, but they generally last 2-3 years unopened under the right storage conditions. And that's just the labels expiration date. They probably last a lot longer than that.

LONG STORY SHORT FOLKS...

I'm back on TRT. For good this time... unless something better comes along that is affordable (unlike menopur) and works without shutting down my testes directly (testosterone), or downregulating / desensitizing the leydig cells in the testes indirectly (HCG).

I feel good. I'm sure in six months I'll be back to feeling like I wish I didn't have to take this damn shot, or rub this damn gel in all the time - but right now I feel good. I'm looking forward to getting my life back. If you want to follow along the journey of a young man (33 now, 30 when I was first diagnosed, 31 when I started TRT, 32 when I tried to come off it and use alternatives) who has to take testosterone for the rest of his life - stick around. This blog is going to be up a looooooooooong time - providing, of course, that I don't get prostate cancer at an early age and die. If I do I'll try and let you know.

;-)

Doc Says NO to Self-Administered HCG. Insurance says NO to Menopur and HCG

Sometimes it seems like the healthCARE industry is more like a healthWON'T industry. Why do we always have to color within their lines when everyone's situation is different? I don't get it.

If the insurance company wants me to NOT have to buy medication, why don't they let the doctor prescribe me something that could help me without causing me to be a lifelong dependent of a drug that THEY would have to pay for? Why not let me try Menopur, or HCG instead of only giving me one option: Testosterone?

I decided at first to say F*&^ YOU to the insurance companies and just pay for HCG out of my own pocket. I've read a lot about using HCG for hormone replacement and I like the idea that I could stop at any time and still have working testes (providing I don't go higher than about 500 IU 3x per week, above which the leydig cells can become desensitized to FSH and LH). So I got the doctor to prescribe me HCG. First, he doesn't want to do less than 1,000 IU per injection, and no less than 3 injections per week. Good grief. Did you read the part in the parentheses?

OK, I was willing to work with the guy and let them give me 1,000 IU for a few weeks, then tell him to give me an E2 test and use that as evidence for him to reduce the doses since my E2 would probably be sky high. BUT...

Then it turns out that they are going to charge me $40 for every shot (not the medication, mind you, just the activity of injecting me) which would be $480 a month! Just for them to inject me!?!?! So I asked if I could inject myself at home. This way, not only could I reduce my dosage, but I could actually AFFORD to take this stuff. But noooooooo, they just can't do that. Why? Because. What if I take a class on injecting safely? No.

So now what? Now I'm going to have to go with one of these compounding pharmacies out there. A few of them are legit alternative resources. But many more of them are very shady and could be mixing up "dirty" medicine that could give me a major infection, at worst, or maybe even giving me under/over dosed medication, or no medication at all, or the wrong medication.... I am being FORCED to go underground to treat a legitimate health issue.

FUCKFUCKFUCKFUCK FUCKITY FUCK FUCK!

Excuse my language. I hate the healthcare system here. I really do.

Testim VS Androgel

The two major testosterone gel brands are Testim and Androgel. They are very similar and generally prescribed interchangeably, but sometimes insurance won't cover one or the other. Often, I hear that they won't cover Testim and people want to know if Androgel is just as good. So here is a general guide to choosing - if you are lucky enough to have the choice - which one is right for you.

Testim Vs Androgel

I would try whichever your insurance covers first. If your insurance covers both medications, try whichever one has coupons or kickbacks.

Now that price and availability are out of the way, lets deal with smell: Testim smells. Some people think it smells good, and some can't stand it. Either way, it's a strong scent! Personally, I like it and my wife likes it. I've found that women ask me what "cologne" I'm wearing, and mention that they like it too. Still, if you or your wife don't like the smell of something you have to put on every day, that would be a deal-breaker. So try out a tube and see what you and, if applicable, your partner thinks about the Testim scent. Androgel doesn't have much of a smell at all.

Testim is sticky. Androgel goes on much like that hand-sanitizer stuff, while Testim seems to remain stickier longer. Some say this is why Testim seems to work better for them: Because it stays on the skin and "soaks in" better.

These personal statements of efficacy can't be relied on as empirical data, however. But the fact that you can feel it on your skin longer, does bring up a question about Testim gel Vs Androgel: Does it take longer to soak in and, if so, does that increase the exposure time I have to worry about when it comes to my wife and children? The short answer is: NO. In-fact, according to US National Library of Medicine's website, the wait-time for AndrogGel is much longer:

You should not shower, bathe, swim, or wash the place where you applied the medication for at least 2 hours after you apply Testim® gel or at least 5-6 hours after you apply AndroGel ®.

Waste
Testim comes in little single-use tubes so you go through more of them and it generates more waste. If you are eco-minded this may factor into your decision. Androgel comes in a dispenser with a little pump on it (like soap) so there is less waste.

But the real question when considering AndroGel Vs Testim is: Which works better? Which is the best? Which testosterone topical gel is going to get my testosterone levels on track fast, keep my levels steady, and keep me there for the long term since I'll be taking this stuff for many years to come? As you might guess, both brands have their fans. Personally, I like Testim. And here is a study to back up my personal preference:

Efficacy of changing testosterone gel preparations (Androgel or Testim) among suboptimally responsive hypogonadal men.
Grober ED, Khera M, Soni SD, Espinoza MG, Lipshultz LI.
Division of Urology, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, ON, Canada.

Summary of the study:

A change in testosterone gel preparation among initially unresponsive hypogonadal men is justified prior to abandoning or considering more invasive TRT. Changing from Androgel to Testim offers hypogonadal men the potential for improved clinical and biochemical responsiveness. Changing from Testim to Androgel is indicated to eliminate or minimize unwanted side effects.

Note: This study was done to find out if switching brands would help men who were unresponsive to one brand or the other.

More important to me than such a study is to find out from others who have been on TRT for more than a year, preferably several years or more, and hear about their experiences with both or either drug. Please comment below with your own experiences.

I am inclined toward a weekly or bi-weekly injection over a daily testosterone gel application, but what does one's rear-end feel like after being used as a pin-cushion for decades? I dunno... any bodybuilders out there want to elaborate on that?

How Old Were You When You Started HRT / TRT Testosterone Replacement?

I have three more weeks until my "last test". I told my doctor I'd give it six months to correct itself and so far, after several tests, it hasn't. I'm going to get back into the gym serious for the next couple of weeks, take my zinc, get plenty of rest, make sure I have some decent sex... basically all the stuff you're supposed to do to "naturally" increase your testosterone levels. If I'm still under 400 (have been between 200-300 on a scale of 1100 with 350+ being normal - but don't quote me on those scales, they're from memory, which is increasingly poor these days) then screw it... I'm going on HRT for life. But is 33 years old too young for PERMANENT TRT? Has anyone been on replacement level testosterone therapy for more than, say, 20 years? I'm facing 40 or so years of it!!!! I would think the long-term risks are much worse than the typical bodybuilder doing cycles at low doses, or someone who starts HRT at 50 or 60+ years of age.

But I don't know. You tell me....
How old were you when you started hormone replacement therapy (HRT) and how long have you been on?

PS: I had a friend ask me if I had cancer today. He said "Man, every time I see you it seems like you've lost another five pounds. You look like you're wasting away. You'd tell me if you had cancer or something right?" Well, that's about the end of the line for me folks. If people think I look so bad that I have cancer, maybe I need to suck it up and just start taking the shots or gel again.

I Hate My Job and I’m Getting Dumber

These are two symptoms of low testosterone, and I have them - BIG TIME!

I'm just not on top of my game when it comes to work these days. I've felt like this before, and it was during the months leading up to my diagnoses of secondary hypogonadism. As soon as I started on the Testim Gel I began to get my "mojo" back at work. I started enjoying my job again and I was kicking ass and taking names during meetings.

Now that I've been off TRT for awhile I'm getting that way again. I waste my time in front of the computer. I keep my mouth shut during meetings. I don't take on any added responsibility and if it weren't for the paycheck I'd quick my job right this second. My memory is terrible and I can't focus. I actually feel like I've lost a few dozen IQ points this month.

So if you have recently started hating your job and feeling dumber, add that as one more likely symptom of low testosterone and talk to your doctor. As for me, I know what my problem is and if it doesn't get better by next month I'm going back on TRT. I can't take this much longer.

Good luck to you all.

Respectfully,

TRT Man

Who Might Know More About HRT Than Your Doctor? Hint: Big Biceps & Speedos

When it comes to diagnosing and treating any hormone deficiency - including testosterone, growth hormone and thyroid - your doctor should be the first stop. A primary care physician may run some tests, but eventually he or she will probably send you to an endocrine specialist (endocrinologist). The primary care doctor needs to know a little about everything, while the specialist needs to know a lot about a little, and that little happens to be the well-studied, FDA-approved, time-tested treatments for problems with your endocrine system (aka your hormones).

What the endocrinologist may not know, however, are the many alternative treatments, unapproved (by the FDA) ways to combat side effects, and other tidbits that come with the territory of injecting yourself with more than ten times the amount of male hormones (androgens) that would be found naturally in any human being. Bodybuilders have been doing exactly that for a very long time. Think back to when the governor of California was a teenager living in Austria and television was black and white. And yes, Arnold Schwarzenegger did steroids (he has admitted to taking them, including Dianobol).

Once again, I want to make this very clear: Your DOCTOR is who should be consulted when it comes to your health, including Hormone Replacement Therapy (HRT). But what I'm getting at here is that there are decades of accumulated, anecdotal information and opinions to be had out there on the web. All you have to do is look up "bodybuilding forums" on Google and find the steroids section.

While I would never take some random bodybuilder's advice over that of my doctor's (at least the one I have now, who I happen to trust - unlike the last one) some of the stuff I've read in these forums has given me the necessary background and confidence to ask my doctor the tough questions, such as: "Why are we treating the symptoms of secondary hypogonadism with something that will cause the much worse condition of primary hypogonadism?" Or how about the question: "Could you check my estradiol levels please? Because I read online that high estradiol levels can suppress testosterone production".

Mail Order Testosterone: Legal TRT?

Looking for an online TRT clinic? Check out these options.

Being an American, the first thing I worried about when my doctor said I needed to be on TRT (testosterone replacement therapy) for the rest of my life was: How is this going to affect my health insurance costs?

Maybe you have health insurance, but they won't cover testosterone injections unless the doctor gives them to you. Since most people can't afford to take time off work every week to visit a doctor's office, they're stuck taking either Testim or Androgel or getting testosterone by other means.

Some choose to contact a mail order compounding pharmacy, get some independent lab tests done, and have a "phone consultation" with one of their doctors.

The Nuts and Bolts of DIY Testosterone Injections

If you think you might need TRT and haven't been officially diagnosed as hypogonadal by a doctor yet there is an option that doesn't involve the record-hungry healthcare system: Get the test done privately and pay in cash. You don't need a doctor to read the test results. If your testosterone is low, contact a compounding pharmacy or hormone replacement / anti-aging clinic that doesn't take health insurance. You can take the shots yourself in the privacy and comfort of your own home; it won't be on your medical records; and you won't end up spending much more than you would with co-pays to the doctor and pharmacy if you'd gone the traditional route.

The Legality of Mail Order Testosterone:

This is a gray area. Testosterone is a schedule III drug and is illegal to obtain without a prescription. The compounding pharmacies and male HRT clinics (also many anti-aging clinics) often have a doctor in-house that will interpret your test results and have a phone consultation with you. That doctor, who you never see in person, will prescribe your testosterone (as well as growth hormone, which is an even grayer area) and any other ancillary drugs (such as Nolvadex or Arimidex to prevent side effects like gynecomastia). They usually don't accept insurance and will ship your HRT drugs out by mail within one week. SO... technically, you're getting your drugs from a legal pharmacy, which also happens to have a doctor on staff to provide the prescription. I don't think you'd have anything to worry about in court. The HRT or Anti-Aging clinic, on the other hand, might have some legal questions to answer should the DA or DEA ever decide to pay them a visit, which has happened in the past.

Tips on Ordering Testosterone Online
If you order testosterone online, follow these tips to stay as close as you can to being "legitimate" in the eyes of the American court system...

Never order from overseas
Always obtain test results from a legitimate lab showing abnormally low testosterone and/or growth hormone
Never deal with a compounding pharmacy, HRT or Anti-Aging clinic that does not have a legitimate doctor on staff. Get the doctor's name, find out what medical school they attended, and verify that they are still recognized by the appropriate boards.
Never send cash in the mail. A legitimate HRT clinic will usually accept credit cards, but if you feel uncomfortable with that you can send a check, cashier's check or money order.

Please read this disclaimer: I am not a doctor. I am not an attorney. I am not qualified to dispense legal or medical advice. The information above are only my opinions and should not be taken as legal or medical advice. Always speak to a qualified attorney when you have legal questions. Always see a qualified health professional when you have medical questions.

Menopur - An alternative to TRT for men with secondary hypogonadism?

ERT Vs TRT: The Great HRT Double Standard

Why is it ok for post-menopausal women to take estrogen, which is known to increase the risk of breast cancer, but it is taboo for men to take testosterone? What is the difference between estrogen replacement therapy (ERT) and testosterone replacement therapy (TRT)? They are both forms of hormone replacement therapy (HRT) designed to return hormone levels to the normal range for someone of a certain age and gender.

Do we care more about creating a "level playing field" in baseball than we do about our own health and wellbeing? The word "steroids" has been victim to so much stereotyping, so many unfounded rumors and quick-science, that the mere mention that you're taking testosterone sends friends and family members into a panic - as if you're setting out to destroy your life and become some gigantic freak bodybuilder.

Speaking of gigantic freak bodybuilders, I don't see anything wrong with that either. If an adult wants to risk their own health to change the way they look, what business is that of federal, state and local governments? Are they going to make plastic surgery illegal? It is essentially the same issue (risking your health to look "better") with the only difference being that many, MANY more people die, are disfigured permanently, and are permanently disabled due to plastic surgery every year than those who take steroids.

But back to the point at hand... It is a double standard, a downright sickening hypocrisy, that HRT for women is almost universally accepted as "healthcare", while HRT for men is almost universally rejected as "steroid abuse". As this website matures I will be further elaborating on this issue, as it is one that happens to be of great interest to me.