Another new guy

[Smitty57]

nevermind

 

[Cataceous]

1. Yes, their services are available in the U.S.

2. They don't do video conferencing. You just need a phone.

3. Do you have any LabCorp or Quest locations nearby? As a Defy patient you'll get some of the best pricing for self-pay testing. Otherwise Defy will probably accept results from elsewhere if they include the required tests.

Give some serious thought to trying a testosterone nasal gel, such as Natesto or Empower's version, before going with full blown TRT. The nasal gel allows your own testosterone production to continue, potentially avoiding some of the problems that can occur with TRT.

 

[Systemlord]

I was called late last week and informed things were "normal" other than low test, but naturally "within range", and something regarding arthritis.

Trust me when I say you don't want your provider to prescribe you TRT. You can get so much better care privately.

I believe I've made a wise decision with current PCP choice (granted only 1 visit so far), but they seem thorough enough.

By thorough enough you mean your doctor ordered Total T, Free T (Equilibrium Dialysis or Ultrafiltration method), SHBG, CBC, lipids, prolactin, LH and FSH?

 

[madman]

OK, here's an update.

Appointment today to review labs, test was at 270, low range for insurance to cover?????

264, LOL....go figure

Have other results, not directly related, but all in all she said I was in pretty good shape (aside from test naturally).

Long story short, I had her write me a 'script and told her I'd just pay for it. 100mg/week, told her I would do 50mg 2x/week, subQ.

She had no issues with it.

Can't pick-up until 1st of the week. Dr had given me some syringes/needles, but they're 3mL, so I went ahead and ordered some 1cc with 21ga loading and 25x5/8" to inject.

Will go back for blood 4 weeks after I actually start. Dr is extremely accommodating and seems willing to work with me, so I'm going to let it roll for a while and see how it goes. $45 for 10 weeks is better for me ATM than shelling-out 15x that amount to go elsewhere. I always have that option, should it come to it.

Welcome!

Much to come as you start your journey.

Forget the 21G to load and 25G to inject.

Would be much more sensible let alone efficient to use 1ml or .5ml 27-31G (6MM/8MM/12.7MM needle length) LDS fixed insulin syringes.

The main benefits of using LDS (low dead space) fixed insulin syringes are a minimal waste of medication (esterified T), virtually painless, minimize scar tissue/trauma, easier to read for accurate dosing especially when injecting lower volumes of oil more frequently.

Keep in mind that since you are injecting 100mg/week split (50mg every 3.5 days) that you need to test at the true trough which would be 84 hrs post-injection.

You should have your TT, FT, estradiol, SHBG, DHT, prolactin, and DHEA let alone other critical blood markers such as RBCs/hemoglobin/hematocrit.

It is critical that you use the most accurate assays for TT/estradiol/DHT (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration).

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

Knowing where your SHBG sits is critical as it will have a significant impact on TT/FT let alone can dictate what injection frequency may suit one best.


post #2

week 4 on TRT - lots of ups / downs

just started; baseline; Total T: 226 ng/dl Free: 7.62 ng/dl Estradiol: 16.1 pg/ml doc gave me 100mg/2weeks ( i know this is too low, and he seemed to be willing to go up to 100mg/week once my next bloodwork comes back at 4 weeks) - i switched to 1x week - 50mg as of now. initially I went...

www.excelmale.com

Principles of Testosterone and hCG Injection Technique

Selecting the Devices There are many different syringes and needles, suiting many different procedures. It is important to choose the needles and syringes carefully according to the type of injection to be administered. For example, the length and gauge of the needle and type of syringe must...

www.excelmale.com

 

[madman]

I guess nothing's simple anymore. Never heard from Pharmacy, was told Mon/Tues for 'scrip to be filled.....so I just went to find out what the holdup was.

They had no clue who I was, nor anything regarding my prescription. After about 15 minutes of playing 20 questions, they finally found the hard copy of my 'scrip.....unfilled.

I will withhold adding what my opinion was to them as I snatched my prescription out of her worthless hand, and left.

Drove a couple blocks to Kroger, had it filled in 20 minutes, and for half the price I was told at the other place.

I did see it's only 100mg/ml. i thought 200 was the "norm"? Is my doc just being overly cautious, waiting for 4 week labs? Being at 270, I'd have thought I'd have been given more of a boost..

When it comes to trt the most commonly used esters are (cypionate/enanthate).

The majority are using 200 mg/mL strength.

Advantages would be more cost-effective let alone less volume of oil when injecting which is beneficial when injecting strictly sub-q.

I would wait 6 weeks before getting blood work done.

The most sensible piece of advice would be to start low and go slow.

You were already prescribed 100 mg/week split into twice-weekly injections (50 mg every 3.5 days) which is a sensible dose when starting trt.

You may very well end up achieving a high-end trough FT on such protocol.

Forget worrying about where your pre-trt TT sits.

I would be more concerned with where your SHBG sits as it will have a significant impact on TT/FT level achieved on such protocol (dose T/injection frequency).

Most men are injecting 100-200 mg/week (high-end dose) and trust me when I tell you that many men can easily achieve a healthy let alone high-end or even absurdly high trough FT on 100-150 mg/week.

Unfortunately, many of the run-of-the-mill T clinics are jacking men up on T (200mg/week) from the get-go let alone throwing in an AI to boot trying to control the sky-high estradiol!

Such protocol will have FT through the roof and in many cases can cause numerous issues as most will end up struggling one way or another.

Patience is key.

Much easier increasing your dose slightly (if need be) than getting jacked up from the get-go and having to come back down.

 

[madman]

Madman, thanks for the reply. Sorry it's taken me so long to reply, just been a bit hectic.

As it stands currently, I delayed bloods until the 5th week, the same day I was to PM dose, but prior to that (in the AM).

I've yet to hear back from the doc, even though I'd stopped-in a couple weeks later in hopes of picking up a copy of the results. Right now I'm in limbo, and not real happy about it, but not sure what I can do short of switching drs.

I've not noticed and change at all, possibly a slight bit of acne on shoulders and back of neck, but I have always had oily skin and acne here and there wasn't totally uncommon, so many be unrelated.

Outside of that, zero improvement. Still not sleeping worth a damn, I can sometimes get 3-4 hours of solid sleep, and after that, it's off and on until I just get up. Recently started mk-677 in an effort to see if it will help with sleeping, as well as the overall additional benefits claimed.

I'm probably going to call the doc next week to find out what's going on, because I want to bump-up the dosage 25ml/wk at a minimum. I'm guessing my improvements were minimal, and because I'd told her I was going the sub-q route (and printed her some info on it), she's seeing if she needs to tell me to try IM because of her lack of knowledge on the method (regarding test).

I'm tempted to go ahead and bump up the dose (to 125ml/week) on my own, but not sure how she'd take it.

Blood work should be done at 6 weeks!

Forget worrying about if a tweak to your protocol (dose T/injection frequency) until you receive your blood work as we need to see where said protocol (dose T/injection frequency) has your trough TT, FT, estradiol, SHBG let alone overall blood markers.

If your trough level is too low then your dose will need to be increased and depending on where your e2 sits let alone other blood markers other adjustments may be needed.

Do not increase your dose yet and if anything 20mg/week is a significant jump.

Increasing your dose by 20 mg/week will have a big impact on driving up TT, FT, and estradiol.

Wait on blood work before making any changes.