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This is a very good thread!

Sure. For some men, Clomid is just awful. For others, it works very well. The only way to find out to which group you belong is to try. And "try" means initiating therapy, waiting about 3 weeks, running labs, evaluating them, then making any necessary adjustments. That is because how you feel...

A problem for the physician is every fertility expert in the country would immediately stop the TRT, and start Clomid. Adding HCG to Clomid makes sense for the same reason as adding it to TRT. That is also why additional HCG may be prescribed to go with Menotropin (which is LH and FSH): to...

That is a fascinating paper. Dr. Lipshultz has been a real blessing to our field of medicine. I would note that maintaining fertility is quite different than restoring it.

...and don't forget Mr. Gene Divine. If he were a doctor, I would let him take care of my patients.

That's really nice to hear. I believe SC injection technique for testosterone is the way to go. Even though WE know how good it is, and how safe, we have a long way to go to bring wide acceptance. The majority of the medical community thinks TRT causes cardiovascular events and prostate cancer...

EXCELLENT topic, Jasen. Thank you. Another reason for an increase in the number of guys running out early is the shift toward split doses during the week. That multiplies that drop that is lost inside the syringe each time. I encourage my patients to draw, and inject, with the same needle...

I wonder what it would take to learn to administer the procedure from my office. If enough guys wanted it done I would consider it. Already Level IV Certified for cosmetic fillers and BOTOX. I have been thinking of getting trained up in the "P Shot", and its sister procedure, the "O Shot". An...

It would be helpful if the nice folks at the FDA would take a look at this site.

Why is it I keep comparing this "expert"panel's findings to the place statin drugs have found in the marketplace?

Use a short needle that won't reach the muscle.

Yes. And to be taken with a fat load.

So it is like Andriol then, an oral preparation which is absorbed via the gut lymphatics. ...and is not a very effective therapy, BTW.

I can't advise my patients to inject into the delts, etc, of course.

Some guys go all the way down to a 29ga. needle.

That does not mean you would have the same reaction under this test study protocol.

Empower makes good medications. Are you still in the fat at 5/8"? Yes, I tell my patients to just push it straight in.

Go to what is left of your fat at the top of your glutes. That is what I do. And "subcutaneous" really is a misnomer. Inject it into the fat, not damaging the skin trying to raise a weal just under same. I hope this helps.

No. What did you inject? BigPharma or compounded? Needle size? Did you properly prep with alcohol?

This is a teaser they use for promotional purposes. The actual lecture goes an hour. IF I could arrange it--and I do not know if I can--I would have to pay royalties and so forth. Would anyone be willing to buy a copy of the full lecture?

You think of everything, Nelson.

I didn't say what the slide stated when I couldn't remember the next side effect of Low T....it was "Loss of memory". LOL

I would be happy to introduce you to Dr. Nakamoto. I think you make a great point about the inappropriate prescription of AI's.

Employment of RIA laboratory methodology is one reason Nelson keeps pushing back against the inappropriate use of aromatase inhibitors. This invalid methodology tends to overestimate actual estrogen concentration, so doctors who treat merely by the numbers on the laboratory printout are giving...

LabCorp's "Sensitive Estradiol" #140244 employs the Radioimmunoassay (RIA) methodology. It is much better than their Standard Estradiol, but still falls short of cutting edge technology....and reliability. If you are to use LabCorp, their new "5 Series" (just my name for it) uses LC/MS...

This remains a wonderful piece, that we can rely upon for references detailing the dangers of inappropriate estrogen levels.

Right. I discussed this very topic with my new friend Jon Nakamoto MD PhD, Director of Quest Diagnostic's Nichols Institute, while in Chicago a few months ago. Quest assembled half a dozen of us to form their new Health Aging Advisory Committee. Dr. Nakamoto (who is also a very nice fellow)...

That is a very good article, Jasen. Have you had any success masking the aroma of spironolactone in topical administeration.

I would not have heard of this product yet were I not a member here.

Many insurance companies do not pay for HCG for TRT because it is listed as a fertility drug--even though it is approved for secondary hypogonadism. In that case, a compounded product may be your best option, as it can cost little more than the copay you would have been responsible for anyway...

Thank you, Nelson! I am honored to be in the presence of such esteemed gentlemen.