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But with ONCE WEEKLY injections (especially SubQ), you would likely have much LESS sawtooth effect than with multiple more frequent injections. I fail to see how a once weekly injection would produce more sawtooth effect than smaller more frequent injections... there is no physiologic or...

Yes, as I mentioned, the importance of practitioner knowledge, experience, and confidence cannot be discounted as this is often far more important than any lab value. For the surgeon...I wouldn't doubt it, but I would not want to be that surgeon's patient! Have enjoyed the back-and-forth...

I get the idea of "mass action" over the top of all of the SHBG, but still have difficulty reconciling this with larger, less frequent injections based solely on SHBG levels. The pharmacodynamics of the injection (regardless of method... IM vs SubQ) should not be dramatically altered for that...

As most of my patients are cash pay (occasionally insurance coverage), it is sometimes challenging to get ALL pertinent tests up front. As stated, I usually counsel and offer to draw additional labs (free T3, free T4, reverse T3 - agree absolutely have to check FREE levels to assess bioavailable...

As I understand estradiol levels (if high) also have a much larger effect on SHBG levels than do T levels in males (although both I've seen both bump SHBG levels when supraphysiologic). Dr Saya

As mentioned previously, I share a preference for LabCorp vs Quest (this may have not been completely clear in my previous post, but the discordant T levels I mentioned earlier 2000-2400 (Quest) vs 900-1200 (LabCorp) were drawn from the SAME PATIENT at the SAME TIME)... on three separate...

I am now confused... Seems conflicting, which do you prefer? Dr Saya

Interesting, although I'm sure Dr Crisler would take issue (as would I) with the WEEKLY Subq injections. It's a start though... Dr Saya

Yes water does not dissolve fat, water separates from fat. Oil also does not dissolve fat either, however, but disperses and "blends" in fat. Careful or some may think they can inject oil into their adipose tissue to dissolve it (an oil injectable lipo per se)...lol. To more closely mimic the...

You will undoubtedly HAVE functional and mental problems in the future if your T levels stay in that range. They would then likely place you on an antidepressant or similar medication which would then exacerbate said functional and mental problems (not to mention exacerbate some low T symptoms...

Your endo is amusing..."wonderfully great"... had my laugh for the day lol

They are permitted to charge an administrative fee for records, but as Gene noted they HAVE to give you your records as long as you fill out a release form. Dr Saya

From an organic chemistry perspective, the opposite should be more of an issue (injecting a hydrophilic -water soluble or "water loving" for forum members - substance into a hydrophobic medium - fat soluble or "water fearing"). Injection of a water-based substance into fatty medium usually will...

As an addendum to above, topical T preparations (non-esterified) are well known to disproportionately elevate DHT levels (as expected due to the 5 alpha reductase levels in the skin). Along these same lines, in theory although not always evident in practice, as these topical preparations are...

The fact that subq injections do not seem to raise E2 levels more than IM injections (as you originally feared, Dr Crisler), is likely due to the fact that the ester (be it propionate, cypionate, enanthate) is mostly cleaved from the testosterone by esterase enzymes IN THE BLOODSTREAM. This...

Prescription "OR" a website of your choosing??? Precisely what I was fearing Gene. These are prescription medications and members should only be encouraged to obtain them legitimately...ie: by prescription. If members obtain these online (and do not read my posts), then they will never receive...

Prescription "OR" a website of your choosing??? Precisely what I was fearing Gene. These are prescription medications and members should only be encouraged to obtain them legitimately...ie: by prescription. If members obtain these online (and do not read my posts), then they will never receive...

Dr John, Thanks for the input and the study, which is actually suggesting that the RIA method may overestimate E2 levels by cross-reacting with other estrogen metabolites, which it is presumed the LC/MS method does not. The only way to tell clinically how reliable a test is, is to correlate...

So that they can influence providers to order a more expensive (and more profitable) test that is likely unnecessary. In general I'm much more fond of LabCorp, I've had quite a few issues with Quest in the past (including me questioning the accuracy of some of their tests). On MULTIPLE occasions...

Gene, With regards to E levels and E testing, in cases where there were significant differences side-by-side between the ultrasensitive assay and the standard assay, who's to say which of the two was inaccurate? By the very nature of the sensitivity of the test, a "highly sensitive" assay is...

Although this varies from individual to individual, most males will find their ideal E2 level to be in the range of ~15-35 pg/ml. The recent research mainly points to what most in the field already know...LOW E2 is not ideal nor healthy for a male (or female as can be seen when women go through...

Have just registered for this forum and will try to be involved as my life schedule permits (with work and three kids at home)... Hello to everyone! Marshall and others: In general, members should be cautious of taking advice and getting all worked up from other members whom are not medical...