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      This is an example of just one protocol, since there really is no "one way" to do it. This has proven a very effective foundational protocol for Defy, but of course every patient is different and therefore treatments are individualized as needed.


      TRT: EndogenousRestoration protocol for Men Discontinuing TRT



      Male patients who have been taking any form of exogenous Testosterone long term, longer than 12 weeks, will have secondary hypogonadism induced by the negative feedback response to the exogenous T use. The purpose of this protocol is to stimulate the testes using HCG so that they are able to produce testosterone once again, while also preparing them to respond to endogenous LH/FSH(gonadotropins). Tamoxifen is taken beyond the HCG as it is shown, as a SERM, to stimulate the pituitaries release of LH/FSH whole suppressing the negative effects of excess estradiol. Estradiol can elevate in men who discontinueTRT so it is important to run the SERM for some time after discontinuingTRT to mitigate E2 rebound. ...
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      Testosterone propionate is definitely not for everyone, however, there are certain men who do benefit from including the ester in their therapy. Propionate needs to be injected more frequently than cypionate, roughly every 2-3 days if used as a monotherapy to keep serum testosterone stable. For this reason and due to its more robust peak (and trough) effect I personally dont favor propionate as a monotherapy, but it does appear to have anecdotal benefit when combined with a longer ester including cypionate. Some men benefit from a more robust androgen peak, perhaps those suffering from finsateride syndrome or who have trouble with downstream testosterone conversion. Others who do not metabolize the cypionate ester consistently might also benefit from including lower dosages of shortened ester for faster onset and peak before leveling out. Again, this is all anecdotal, but it appears that the different effects noticed with a cypionate/propionate blend are experienced with twice per week injections (q3days).
      ...
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      Compounded injectable testosterone medications like cypionate are presently being pushed out of the market.

      Compounding pharmacies provide a low cost alternative to standard and more expensive manufactured brand name medications. In the case of testosterone, compounding pharmacies are able to obtain the FDA approved raw material to compound testosterone into strengths, solutions, forms, and combinations not available on the market. Testosterone Cypionate is not under a patent, and is available as a raw material to be compounded as a sterile injectable in various custom strengths.

      Technically, a compounding pharmacy is not supposed to compound a drug in the same strength and form already available as a brand name.
      Since Testosterone Cypionate is available as a brand name (Pfizer, Watson, etc) in 10ml 200mg/ml form, many compounders alter the finished product to justify compounding it. For example they may offer it in a different strength, volume, or as a combination drug.
      ...
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      Hi all,

      I'm about to start TRT with Androgel 1.62% and was prescribed HCG 2x/week at 500 IU each dose to maintain fertility. Is this enough? The sticky mentions a study done by a doctor in Houston that prescribed 500 IU every other day.

      Also would there be any difference in taking the 1,000 IU weekly total spread over 2, 3, or 4x/week? I just saw a thread where someone mentioned HCG caused some issues for them and upon stopping they felt better. I'm guessing this has to do with the slight uptick in E2?? If so would spreading the dosage out help? Given I'm in my early 30s and want to retain my fertility I'd like to find an optimum balance.

      Also just curious as to what people are paying for HCG want to get an appropriate benchmark ...
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      An article in the International Journal of Drug Policy reports AAS users are performing self-phlebotomies. The abstract says:

      New evidence with regard to a previously undocumented practice – self phlebotomy, known as ‘bloodletting’ – in contemporary injecting performance and image enhancing drug (PIED) culture is the subject of this paper. While self phlebotomy has been evidenced in psychiatric patients previously, it was performed here in people who inject AAS as a self directed health care procedure. Data was collected from five publicly accessible internet discussion forums and coded using NVivo software. For the purposes of this study, posts in relation to bloodletting were extracted from the final set of records for analysis.

      ...
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      From the referenced content below which states these factors affect your testosterone levels, I was greatly violating most of them. Is it possible I should have fixed these before starting TRT? i wonder how much of an impact these could really have. how much can these factors affect someone? i have been on TRT for 8 months and am wondering if I should stop now and see where my base is since I've corrected all of the below now (i already started tapering 2 weeks)

      Summary:

      1) Drink water from glass or stainless steel and avoid plastic Tupperware.
      2) Avoid soy like the plague.
      3) Limit your alcohol consumption.
      4) Drink vodka on special occasions instead of beer.
      5) Sleep eight hours at night in a dark room.
      6) Eliminate stress when possible. Meditate, practice yoga, laugh and
      hang out with people who make you happy.
      7) Decrease your body fat.
      8) Eat foods rich in zinc.
      9) Eat healthy fats from the sources listed above
      10) Think about sex and openly discuss any issues with your partner.
      ...
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      Article Preview
      • Currently, only topical minoxidil (MNX) and oral finasteride (FNS) are approved by the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for the treatment of androgenetic alopecia.
      • Although FNS is efficacious for hair regrowth, its systemic use is associated with side effects limiting long-term utilization. Exploring topical FNS as an alternative treatment regimen may prove promising.
      • In its systemic form, various side effects such as gynecomastia, breast tenderness, malignant neoplasms of the male breast, decreased ejaculate volume, a decrease in testicular size, testicular pain, reduction in penile curvature, reduction in penile size, sexual disorder, male infertility, high-grade prostate cancer, and prostatitis have been reported.
      ...
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      Article Preview One of the most frequent, unwanted side-effect for men on TRT is the rise in hematocrit levels. A recent study of trans men highlighted the issue.



      • In trans persons on gender-affirming hormonal treatment, a decrease (in trans women) or increase (in trans men) in hematocrit is often observed.
      • 625 hormone-naďve trans persons were enrolled in the study.
      • Gender-affirming hormonal treatment was initiated at the first visit.
      • In trans men, serum hematocrit (Hct) levels increased during the first year (+4.9 Hct %, 95% CI 3.82-5.25), with the most pronounced increase during the first 3 months (+2.7 Hct %, 95% CI 1.94-3.29).
      ...
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      Article Preview A frequent cause of high blood pressure and water retention is when levels of certain hormones in the body are unbalanced or functioning poorly. The hormones that are frequently at fault are secreted by the kidneys and the pituitary or adrenal glands. They are called aldosterone, ACTH, and renin


      What is aldosterone?

      Aldosterone (ALD) is one of a group of connected hormones. They form the renin–angiotensin–aldosterone system (1); this system is activated when there is a decrease in blood flow to your kidneys following a drop in blood volume or blood pressure such as during heavy bleeding, or sodium levels fall below healthy levels (1).
      ...
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      Current infection with Helicobacter pylori (H. Pylori) was associated with significant subclinical coronary artery stenosis in a population with no prior arterial disease, suggesting a need for earlier diagnosis and treatment of this pathogen to forestall progression to overt disease, researchers reported.

      "This result suggests the possibility that H. pylori eradication might be worthwhile in preventing coronary artery disease, Shinae Kang, MD, PhD, of Yonsei University College of Medicine in Seoul, South Korea, and colleagues wrote online in PLoS One.


      • To address H. pylori's impact on the arteries of healthy individuals, Kang's group studied 463 consecutive patients who underwent voluntary health check-ups at Gangnam Severance Hospital in Seoul during 2007-2014. The mean age of participants was 54.2, and 336 were men.
      • The patients underwent post-biopsy rapid urease testing of gastric mucosa, using the Campylobacter-like organism test (CLO) and were then divided into two groups based on CLO status. Patients also underwent pulse-wave velocity (PWV) measurement and cardiac multidetector computed tomography.
      ...
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      To all members:

      Below is an overview of my history, and TRT cream protocol that I found most effective for myself and others

      I am a 55-year-old business owner who has always exercised, eat healthy foods, and tried to stay on the path of wellness. For the last ten years or so, I've noticed a decline in the positive results I'd been getting due to walking this path: loss of energy, loss of focus, belly fat. Like most people, I attributed this to getting older. As a teenager, I was a skinny kid who wanted to gain muscle, so I started eating more and working out. I would read muscle magazines and research what supplements to take. Back then, I saw consistent positive results and was inspired to continue the path. The problem for me as I aged was that these results were fewer and farther apart. Some thirty years later I found myself swimming around trying to find the magic supplement, and becoming more and more discouraged. As a result, approximately ten years ago, I started looking for a "wellness" doctor. ...
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      Synthetic cannabinoids are designer drugs that differ in some significant ways from the natural cannabinoids found in cannabis plants. They are often marketed as designer drugs or sold in products with claims they give the same effect as cannabis.

      Synthetic cannabinoids (SCs) have been increasingly used all over the world, particularly among young‐adult population. SCs can cause severe adverse effects on several organ systems. However, there are no studies in the literature which have stated the possible relationship between using of SCs and priapism. We present a case of 28‐year‐old man who was diagnosed with a 58‐hr lasting priapism after regular administrations of SCs.

      • The priapism did not resolve either after applying aspiration with irrigation or shunt surgery.
      • Penile prosthesis implantation was performed as a last treatment option.
      • The SCs have been increasingly used among young population in recent years; therefore, new SC‐related ischaemic priapism cases might be encountered in the emergency departments


      "A new cause of ischaemic priapism: Synthetic cannabinoids," Andrologica, 1 April 2018, https://onlinelibrary.wiley.com/doi/...1111/and.13013
      ...

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      Welcome to ExcelMale.com, one of the largest and best moderated men’s health forums on the Internet focused on increasing health, potency and productivity in men. With over 13,000 members (as of April 2016) that include educated men, physicians, pharmacists, dietitians, exercise trainers, nutritional supplement experts, and other professionals in the field, ExcelMale is fast becoming a leader in the field. Our forum topics range from testosterone replacement therapy, Trimix injections use for ED, HCG use for better fertility and libido, estradiol management, thyroid function optimization, peptide information, exercise routines, best supplements for men, high protein diets, testosterone side effect management and much more. We also provide men’s health information via Interviews with experts, Videos, and webinars. Last but not least, our members share their reviews of hormone replacement clinics and doctors, compounding pharmacies, pharmaceutical products, supplements, and much more. Our great moderators review every post daily to detect spammers or abuse, so ExcelMale is a safe environment for all men. And since every man wants to help important women in their lives, we do not neglect female health information as we include a folder called “ExcelFemale” to post the latest on HRT in women.


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      Register here to join our community! Don’t be shy, ask questions by posting in any forum folder. We can help each other to regain our best selves!.


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