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You have an interesting protocol 10mg-12mg subq daily. Just curious if you have drawn labs during this protocol to see how testosterone, DHT, and E2 levels maintain? If you metabolize propionate consistent with known pharmacokinetics then it could be likely that your level has a nice consistent...

Testosterone propionate is definitely not for everyone, however, there are certain men who do benefit from including the ester in their therapy. Propionate needs to be injected more frequently than cypionate, roughly every 2-3 days if used as a monotherapy to keep serum testosterone stable. For...

Spring 2018 Dr Lipshultz will be opening a concierge men's health and primary care clinic in Houston. Although it will be mostly cash pay, there will not be a long wait time to see him as with Baylor. In addition, he will not be as limited by the academic institution and will provide a more...

No problem Jake, hope I was able to help. Do not hesitate to post any more questions as this can also help others who might encounter the same issue. Empower will be launching their ODT tablets in roughly two weeks. In the meantime, ask Defy to order you sildenafil 100mg troches which can be...

Sustained release PDE-5 capsules are still commonly prescribed to be taken 60 min prior to sex. The reason that compounding pharmacies compound PDE-5 inhibitor capsules as a sustained release is because they cannot make a tablet or capsule that is too close to the commercial equivalent. In...

Chronic pelvic pain in men is more prevalent than I thought and often misdiagnosed. One potential cause that is often overlooked is referred pain from lower back injury/disc. I have seen cases where men have various pain/sensation throughout the pelvic/genitals, where they were convinced...

I agree with Dr Saya regarding the unfortunate limitations that the insurance model imposes on our healthcare system. I work with a few well known urologists who try hard to be progressive in their TRT protocols, however since they must take insurance as they are tied to academic/hospital...

Compounded Drug Products ThatAre Essentially Copies of aCommercially Available Drug is draft guidance, not regulation (yet). In addition, this issue appears to be isolated to APS pharmacy as I work with multiple 503a and 503b pharmacies that do not have to change their formulary. If you closely...

Empower for sure does potency, sterility, and endotoxin testing on every injectable batch before becoming available for dispensing to patients. It is required in both state and federal law for them to do so, and because I work with them I can confirm this is done. You are allowed to request a...

Your fears regarding "underdosed" bottles can be at ease due to the fact that no pharmacy, 503A or 503B, can dispense any sterile injectable without first passing third party analytical testing to confirm sterility, potency, and endotoxins. The test must pass FDA standards before being released...

The first course of action should be to request the analytical report from the pharmacy, which the clinic can do for you. Any pharmacy who compounds or manufactures a sterile medication must send each batch to a third party analytical lab to test for potency, sterility, and endotoxins before...

Comparative GH responses in individual subjects

Here is some basic information regarding the different GH secretagogues Hormones involved and related analog drugs •Growth Hormone Releasing Hormone: 1. Sermorelin 2. Tesamorelin •Ghrelin: 1. GHRP 2. Ipamorelin 3. Ibutamoren •Somatostatin •Growth Hormone...

APS is also in the process of changing over. Their last visit was in specific reference to their compounded testosterone cypionate.

You will find that almost all compounding pharmacies will be dispensing two 5ml bottles rather than 10ml of testosterone cypionate. The reason for this is because of the FDA draft guidance "Compounded Drug Products That Are Essentially Copies of a Commercially Available Drug Product Under...

It is not recommended to pre-load syringes for storage. To preserve potency and sterility during storage the syringe needs to be loaded in a sterile environment, such as under a hood. Contamination occurs when you are transferring within a non-sterile environment which then reduces the...

$72 for up to 200mg (20%) per ML T gel/cream. My suggestion is to request the 20% concentration so that less volume needs to be applied making the supply last longer (more cost effective)

It is important to understand the difference between compounded and brand name transdermal testosterone, in addition to the types of carriers used. Here is a thread that explains this...

There are a few medications which have shown to be effective for the treatment of alopecia when applied topically. These medications are available at compounding pharmacies like Empower who specialize in making custom medication formulas Here is a list of ingredients that are typically...

If you only have 5 pre-loads I would just toss them and switch to the multi-dosed vial you just received. Pre-loaded syringes are going to become obsolete after evidence shows that sterility is not well preserved, in addition to the rubber stopper degrading within the medication after sitting...

Benzodiazepines: How they work and how to withdraw https://www.excelmale.com/forum/showthread.php?6402-Benzodazapine-Dependency-and-Withdrawal&highlight=benzodiazapines

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The formula really does work for many women. As a pharmacy rep, I spoke with many doctors who prescribed it for treating sexual dysfunction in women. There was positive feedback from almost all physicians. My wife and many of her friends have also used it (and continue to use it) with...

Frank- Yes sir, you can ask any of the Defy clinicians for a prescription, but it is very easy to establish your wife as a patient. She can schedule her appointment with the physician or nurse, depending if she is going to be treated with HRT. There are two versions, one containing...

One question we receive a lot at the pharmacy is regarding how much testosterone can be dispensed at one time. Testosterone is a controlled substance in the US, specifically a schedule-3 controlled substance (in all but one State), and this includes any form of testosterone including...

Jasen Bruce Another method of administering testosterone is through transdermal absorption. Testosterone is available as a transdermal delivery system (TDS) in various concentrations for topical application. Testosterone is purchased in raw form (testosterone base) by compounding pharmacies...

The body can sometimes react when something foreign is injected. This will not occur once you get used to it. Another reason shortness of breath may occur is due to some of the solution entering the blood stream directly through vascular tissue. For example, if the needle passes through a vein...

Just wanted to share a reminder regarding patients who want to pre-load a syringe with an injectable medication for later use. It is not recommended to self pre-load a syringe for IM injection due to the fact there is exposure to contamination during the manual transfer from the bottle to the...

AMP-5 has been added to the FDA's "do not compound list" as they determined it was an unsafe and/or ineffective medication. All compliant US compounders and manufacturers have discontinued dispensing AMP-5 formulations.

What is Sermorelin Acetate? Sermorelin(GHRH) is a peptide hormone that has recently been genetically engineered to stimulate the secretion of Growth Hormone Releasing Hormone (GHRH) from the hypothalamus, a gland adjacent to the pituitary gland. GHRH is a peptide that contains the first 29...

SoCAl, thank you for sharing I wish all patient GP's were as accommodating as the system was designed for this exact interaction for optimal MD support.