Read this first since it is the most common testosterone side effect: High hematocrit
Solution and Comments
· Accutane– a powerful prescription item - 40 mg/day for one week sometimes stops acne if started at the first sign or as directed by your doctor. Accutane is potentially highly liver toxic and can lower testosterone. Do not use unless as last resort.
· Nizoral shampoo– Available by prescription and over-the-counter as a lower dose product.
Increased sex drive
· A problem? Sex drive is part of quality-of-life. This is not necessarily a bad side effect. Enjoy it.
Unresolved erectile function
· Viagra, Cialis, Levitra – Available by prescription; enables robust erections. If you have sinus congestion or headaches/backaches (Cialis) take non-drowsy allergy medication and ibuprofen. ED drugs can be combined with alpha-blockers and/or nitric oxide precursor amino acids (arginine or citrulline)
· Sleeping medications – e.g. Ambien, Sonata, Lunesta, Restoril
· Have your doctor prescribe a sleep study if you snore and wake up tired even after 7 hours of sleep. Some people may have to wear a C-PAP machine to breathe at night. Visit Home - SleepApnea.org for more information. There are also oral devices for those people who fail CPAP. Fatigue- When Testosterone Is Not Enough
· Human Chorionic Gonadotropin (hCG)– One 2,000 unit injection per week for 2 weeks, followed by maintenance of 350-500 IU twice a week. For men who want to remain fertile while on TRT, 500 IU every other day has been studied. Watch this video on hCG and men
Enhanced assertiveness or reactivity.
· Make sure you are getting enough sleep.
High blood pressure/water retention
· Blood pressure medications - Elevated blood pressure may be transient or not. Try ACE or ARBs since they seem to have fewer sexual dysfunction related effects.
Gynecomastia- RARE in TRT (male breast development)
· Arimidex (anastrozole) Inhibits estrogen production. Available by prescription. 0.5 mg/week max. Ensure that your estradiol is never under 20 pg/ml (by sensitive test) since it is needed for bone, skin, brain, lipids, libido, good lipids and hair health. Only 0.3-0.4% of testosterone is aromatized to estradiol. Current lab ranges were derived from men not on TRT. Most men on TRT do not need anastrozole. Be careful not to crash your estradiol.
To find out how long it takes testosterone replacement to potentially show benefits, read this article.
For affordable blood tests in most cities in the U.S. (Prescription provided): DiscountedLabs.com
We also highly recommend reading this and other articles from our friend Lee Myers from peaktestosterone.com : Testosterone Risks
Metzger, DL, et al. Estrogen receptor blockade with tamoxifen diminishes growth hormone secretion in boys: evidence for a stimulatory role of endogenous estrogens during male adolescence. J Clin Endocrinol Metab (1994) 79(2):513-518.
[ii] el-Sheikh, MM, et al. The effect of Permixon (saw palmetto) on androgen receptors. J Acta Obstet Gynecol Scand (1988) 67(5):397-399.
[iii] Suzuki, K, et al. Endocrine environment of benign prostatic hyperplasia: prostate size and volume are correlated with serum estrogen concentration. Scand J Urol Nephrol (1995) 29:65-68.
[iv] Gann, PH, et al. A prospective study of plasma hormone levels, nonhormonal factors, and development of benign prostatic hyperplasia. The Prostate (1995) 26:40-49.
BLOOD TEST TARGETS FOR TESTOSTERONE REPLACEMENT THERAPY