Are you a fast metabolizer of medicines?

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Nelson Vergel

Founder, ExcelMale.com
efficacy_graph1.png

Differences in your DNA that make up the CYP2D6 gene can change how well you are able to break down certain medicines. If you break down a medicine too fast or too slowly, this may cause a bad reaction to the medicine. By testing your DNA (with a pharmacogenetic test), we may find DNA differences that can allow us to predict how well your CYP2D6 enzyme will work. The result of this test will guide your doctor to choose the correct dose of medicine to give you. The results of your CYP2D6 test will place you into one of four groups: Read attachment
 

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Defy Medical TRT clinic doctor

SomeG

New Member
fast metabolizer HCG

Nelson,

My doctor has recently referred me as a 'fast metabolizer' for the HCG that I am on, so this makes sense. I've had some moderately positive results and effects from the HCG monotherapy, but honestly, it does feel like the injections only 'last' for 1-1.5 days and I take a pretty high dose (2500 iu, up from 1500 iu) 3 times a week.

two months of 1500iu hcg monotheraphy got me from 350ng/dl to 475 ng/dl and I will soon find out how much help two months of 2500 iu hcg will have changed things.

Since my response has been moderate- and my free T has been stubbornly low (0.8 to 1.0 % free T), I am either going to push for adding in a little testosterone to the mix and/or daily hcg.

Does this make sense?
 

Nelson Vergel

Founder, ExcelMale.com
SomeG

You can attain good testosterone blood levels and sperm quality (and save money) with TRT+HCG compared to higher dose HCG monotherapy.

Let us know how it works for you!.
 
unnamed.jpgI just had the CYP2D6 test done which concluded I am an "intermediate metabolizer". The results then breakdown commonly prescribed drugs which are metabolized by the CYP2D6 enzyme and explain how your body can potentially metabolize the drug. As an intermediate metabolizer, certain drugs may have reduced efficacy due to a limited formation of active metabolites. Knowing how drugs are going to metabolize once take can be a great tool for people as they age and may require more long term medications. This kind of testing allows doctors to provide individualized treatment rather than blanket treatments that don't work for everyone. In addition it can reduce risk of side effects with certain medications.

I am looking forward to learning more about genetics testing
 

SomeG

New Member
Just switched to test and hcg --need advice re needle size snafus

SomeG

You can attain good testosterone blood levels and sperm quality (and save money) with TRT+HCG compared to higher dose HCG monotherapy.

Let us know how it works for you!.

Nelson

Thanks. I was able to convince my doctor to switch me to Test + hcg.

By the way, do you know a good way of buying needles and syringes?

My doctor sent an order for syringes with 18 gauge needles (to draw test) and 25 gauge needles to inject, but local pharmacy is being absolutely moronic- they gave me just 25 gauge syringe/needles and keep on telling me that they didn't get the 18 gauge order.. And now tell me after a few days and multiple calls to doctor office and pharmacy that they are back ordered... It is going on a week that I've had the test but cannot even start it!! (And I'm off the hcg mono by now)

At this point, I even wonder if these 18 gauge needles they will get me in however long it takes them may not even fit the 25 gauge syringe /needle combo they gave me.

Is it that difficult to fill that syringe order? Can't I just get them from a medical supply place?

Can I just draw and inject with the 25 gauge needles?
 

captq

Member
Nelson

Thanks. I was able to convince my doctor to switch me to Test + hcg.

By the way, do you know a good way of buying needles and syringes?

My doctor sent an order for syringes with 18 gauge needles (to draw test) and 25 gauge needles to inject, but local pharmacy is being absolutely moronic- they gave me just 25 gauge syringe/needles and keep on telling me that they didn't get the 18 gauge order.. And now tell me after a few days and multiple calls to doctor office and pharmacy that they are back ordered... It is going on a week that I've had the test but cannot even start it!! (And I'm off the hcg mono by now)

At this point, I even wonder if these 18 gauge needles they will get me in however long it takes them may not even fit the 25 gauge syringe /needle combo they gave me.

Is it that difficult to fill that syringe order? Can't I just get them from a medical supply place?

Can I just draw and inject with the 25 gauge needles?


Prices seem pretty good and they ship very quickly and also have a very broad selection

Like Nelson I draw and inject with a 28G 1/2 inch into my shoulder or bicep

Like you I found getting the syringes at CVS a hassle they don't stock a large selection and they seem to ration them out and I just like to stock up not buy 10 at a time especially since I inject every 3 days.
 
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SomeG

New Member
Thanks for the replies, guys. I apologize if the post came off as a bit cranky in tone.

They took forever to get 18 gauge sharps ordered (3-4 days later), but they didn't fit the syringes that the 25 gauges came in, so it was pointless. They didn't understand that both sharps would have to fit the same syringe for me to draw, switch the sharp, and then inject.

I got exasperated with them and just asked for twice the amount of 25 gauge needle/syringe pairs.. so, at the very least I will not be injecting with the same needle as I draw with.

Only down side is that it takes forever to load the syringe.. thankfully it is only 0.3 ml (60 mg) test 2/ week.

My HCG compounding pharmacy, on the other hand, has always been lovely to me. They pre-fill the syringes, give me more needles than I ever need, and have dealt with ever-changing doses from the time I was on monotherapy (1500 and 2500 IU) to now (750 iu).

P.S. Thanks for the video on injections. I do the sub-Q with HCG into my belly and the IM into my thigh. Just starting the second week into this regimen and it's going well.
 

Nelson Vergel

Founder, ExcelMale.com
From Nature.com:
Genetic variation in the androgen metabolizing enzymes is important to identify and feature as they may influence the risk of prostate cancer and help clarify the etiology of the disease. Human 17beta-hydroxysteroid dehydrogenase type 5 (AKR1C3) is highly expressed in the prostate gland and plays a major role in the formation and metabolism of androgens. We identified five novel polymorphisms in the AKR1C3 gene. One of those an A>G substitution in exon 2 that confers a Glu77Gly change occurred in 4.8% in Caucasians but was completely absent in Orientals. Interestingly, the testosterone level in serum was significantly lower in subjects with the Gly77 allele. A promoter A>G polymorphism was associated with significantly altered promoter activity in reporter constructs, but was not associated with any change in testosterone levels. In conclusion, the Glu77Gly polymorphism is associated with lower testosterone levels in serum.
 

Nelson Vergel

Founder, ExcelMale.com
The CYP3A418 Genotype in the Cytochrome P450 3A4 Gene, a Rapid Metabolizer of Sex Steroids, Is Associated With Low Bone Mineral Density

by Kang, YS; Park, SY; Yim, CH; Kwak, HS; Gajendrarao, P; Krishnamoorthy, N; Yun, S‐C; Lee, KW; Han, KO

Osteoporosis is influenced by genetic factors. The interindividual variability in the activity of CYP3A, the metabolic enzyme of sex hormones, may result from genetic polymorphisms. In a study of 2,178 women of ages 40 to79 years, the presence of the CYP3A4*18 variant was found to be significantly associated with low bone mass. In vitro functional analyses indicate that CYP3A4*18 is a gain of estrogens and testosterone; in vivo pharmacokinetics using midazolam (MDZ) verify the altered activity of the CYP3A4*18, showing lower metabolic turnover in the mutant than in the wild type. Molecular modeling reveals the structural changes in the substrate recognition sites of CYP3A4*18 that can cause changes in enzymatic activity and that potentially account for the difference between the catalytic activities of estrogen and MDZ, depending on the genotype. The results indicate that a genetic variation in the CYP3A4 gene—as a gain function mutation in the metabolism of certain CYP3A substrates, including sex steroids—may predispose individuals to osteoporosis.

Clinical Pharmacology & Therapeutics (2009); 85 , 3, 312-318 doi: 10.1038/clpt.2008.215
 

Nelson Vergel

Founder, ExcelMale.com
"The major pathway of testosterone oxidation by human liver microsomes is the formation of 6-hydroxytestosterone, which is catalyzed by CYP3A4/5 and which accounts for 80% of all metabolites formed."
 

ERO

Member
I recently found out that I am an extremely fast metabolizer due to CYP2D6. There is a huge list of drugs that likely would have little or no effect on me. I don't take any of them, fortunately.
 

PAUL-E

Member
Thanks, I did the family tree family finder DNA test(dad=MIA I was curios about ethnicity) I going look into that 1st
 

ERO

Member
Yes, I have used LiveWello as it gives some good health and variance reports and I have also used Promethease - it may even be more detailed.
 
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