Hello from Houston!

[Bluesjunky76]

Hi, I used to post occasionally on peaktestosterone.com, but to my surprise that site is apparently no more. So I signed up here. I'm the kind of poster who usually only pops in when I have labs to have interpreted, but I've been on depo-T for a long time and I've never had the results I've hoped for so I intend to get more proactive. So I hope you guys don't get too sick of me! I want to make my hormonal situation better because I know it can be.

My backstory: At age 27, after testing frighteningly low on a total T test (155! or something like that), I began getting injections. For years my testosterone treatment was managed by GP's who over medicated me and only tested for Total Testosterone. My estradiol was surely through the roof as I carried tons of water weight and just generally felt like crap. Eventually, I started seeing a urologist who lowered my dose and switched me to 2 injections a week. There was more knowledge but I've still never been able to to persuade a Dr to test for any hormones other than testosterone and estradiol. And on the surface those numbers always look pretty good, but I've always sensed something was wrong.

Here's the thing: I'm 46 but I look considerably younger. Though I grow (patchy) facial hair and have hair in all the right places, I haven't properly developed and I want to change this. After doing some research I suspect I have high SHBG, low free t, and/or low DHT. Last week I went in for my 6 month labs. My current urologist, who said he would test for free T and SHBG after I asked him to, for whatever reason did do not so. Annoying. So I guess I have to finally bite the bullet and go have these labs done on my own, out of pocket.

Anyway, my current labs, on .15ml injected biweekly (I know, pretty low--but I get bad anxiety if my T levels get too high):

PSA:.80
Estradiol: 32.6
Total Testosterone: 661.3
Hematocrit: 47.3

He didn't order liver tests, which is kind of odd, but I'm not worried about that because those numbers are always fine. On the surface these numbers look pretty good, but, as I said, something is off. One other strange thing to note: my pharmacy recently switched to Cipla brand depo-T, and my numbers went up from the 500-530 range I was at before on the Sun brand to 661.3. Interesting but I've had that happen before. Some brands, for whatever reason, just seem to be more potent.

So I'd love to know where do I go from here? Should I see an endocrinologist instead of a urologist? Test for SHBG, DHT, and free T? I live in the Houston area: are there any renowned men's Dr's here who understand that other sex hormones exist besides testosterone and estradiol? There's got to be. Also, I'm pretty interested in Boron. I would love to here anybody's experience with that mineral and if that could be something to help balance me out.

Anyway, I hope I didn't digress too much. It's just hormones can get a little complicated. Just hoping to get it right and I know there's got to be guys on this site who can relate to my experience. It's been a frustrating journey at times but I'm optimistic there's a way to get this right. Thanks and take care!

 

[Systemlord]

Should I see an endocrinologist instead of a urologist?

Endocrinologists aren’t much better. Western medicine doesn’t have a specialty doctor for sex hormones. Some GP’s, endocrinologists and urologist’s are into sex hormone therapies.

You're basically playing the doctor lottery.

You don’t need a doctor to test these hormones, discountlabs.com offers lab testing without the need of a doctor.

 

[Nelson Vergel]

Welcome. Many of us live in Houston. Houston is actually the Mecca for TRT. And the best urologists live here.

Go see Dr Khera or Dr Lipshultz. They both take insurance.

You can also run tests on your own.

Best Testosterone Test Price Near You- Discounted Labs

Looking for a testosterone test near me? Find reliable testing services near you and monitor your testosterone levels with ease.

www.discountedlabs.com

 

[Fernando Almaguer]

Welcome to Houston! Dr. Lipshultz and Nurse Amy are pretty awesome and open minded. That has been my experience but I also needed to stay on my homework here and other resources. They see many patients and we have to help them help us.

 

[Cataceous]

Welcome from another PeakTestosterone refugee! I'm sure you'll find ExcelMale is also a great place to be.

...
Anyway, my current labs, on .15ml injected biweekly (I know, pretty low--but I get bad anxiety if my T levels get too high):
...

One of my focal points is on what normal dosing is with injections. I'm trying to correct a skewed mentality about this. You've been influenced to think that 60 mg of testosterone cypionate taken over a week is "pretty low". But it's not. The average testosterone production level for healthy young men corresponds to 60-70 mg of testosterone cypionate taken over a week. A normal full reference range of production would run from about 30-90 mg TC equivalent per week. Therefore doses much over 100 mg per week should be considered "pretty high". You are in good company in discovering that more is not better. See links to what others have said here.

...
So I'd love to know where do I go from here? Should I see an endocrinologist instead of a urologist? Test for SHBG, DHT, and free T? I live in the Houston area: are there any renowned men's Dr's here who understand that other sex hormones exist besides testosterone and estradiol? There's got to be. Also, I'm pretty interested in Boron. I would love to here anybody's experience with that mineral and if that could be something to help balance me out.

Anyway, I hope I didn't digress too much. It's just hormones can get a little complicated. Just hoping to get it right and I know there's got to be guys on this site who can relate to my experience. It's been a frustrating journey at times but I'm optimistic there's a way to get this right. Thanks and take care!

Although still a hypothesis, it's considered likely that free testosterone levels are considerably more important than total testosterone. So it is important to see where you stand in this regard. If you have access to Quest then this test from Discounted Labs is a good and affordable option. I recommend also measuring SHBG. With SHBG and total testosterone you can calculate free testosterone, which provides a check on the measured values, which are not 100% reliable. Our general expectation is that free testosterone should vary in proportion to dose. When you see changes in total testosterone at a dose that's nominally the same then it's possible that variance in SHBG is responsible rather than a change in potency of the products you're using.

If your SHBG is normal then it's less likely that further fiddling with testosterone would lead to dramatic improvements. A couple avenues for experimentation include adding hCG to your protocol or switching to a short-acting form of testosterone. HCG replaces the LH that is suppressed by TRT. It can reverse testicular atrophy and often restores fertility. Some feel it increases libido and provides other benefits. With hCG you want to use the lowest dose possible to avoid side effects.

Short-acting testosterone is of interest because, unlike conventional TRT, it allows continued HPTA function, making it less disruptive of many other hormones. Short-acting forms of testosterone include nasal gels and troches. Switching to these would be more intrusive than other changes, because it can take many months for the HPTA to normalize. But if you get through that then you could experience higher testosterone without HPTA suppression, which seems to be effective for many.

If you are ok with telemedicine then Defy Medical is another possible provider. Many of us use them and appreciate their good service and expertise. You might need to rein them in on dose recommendations, but they are very responsive to patients' preferences.

 

[Bluesjunky76]

Welcome. Many of us live in Houston. Houston is actually the Mecca for TRT. And the best urologists live here.

Go see Dr Khera or Dr Lipshultz. They both take insurance.

You can also run tests on your own.

Best Testosterone Test Price Near You- Discounted Labs

Looking for a testosterone test near me? Find reliable testing services near you and monitor your testosterone levels with ease.

www.discountedlabs.com

Thank-you Nelson! I'm glad to be here and it's good to hear from another Houstonian.

Unfortunately, both of the Dr's you mentioned are out of my network, so I'll probably start by running my own tests. But if these Dr's are truly different from the ones I've dealing with all these years ("Your testosterone and estradiol are normal so there's reason to test for anything else.") then I would consider biting the bullet and going to see one of them. As you said, though, the best urologists live here so hopefully I can find one in my network who is willing to think outside the box. Thanks for your input!

 

[Bluesjunky76]

Endocrinologists aren’t much better. Western medicine doesn’t have a specialty doctor for sex hormones. Some GP’s, endocrinologists and urologist’s are into sex hormone therapies.

You're basically playing the doctor lottery.

You don’t need a doctor to test these hormones, discountlabs.com offers lab testing without the need of a doctor.

Yeah, I feel like every Dr I've seen has tunnel vision: testosterone and estradiol (GP's only testosterone, in my experience, but that was a while ago). And when you do advocate to get other labs done they're often dismissive. Thank-you for the link to that website. I'll check it out.

 

[Bluesjunky76]

Welcome to Houston! Dr. Lipshultz and Nurse Amy are pretty awesome and open minded. That has been my experience but I also needed to stay on my homework here and other resources. They see many patients and we have to help them help us.

Hello sir! Another Houston guy. Very cool. Yes, Nelson mentioned Dr. Lipshultz as well. Not in my network but sounds like he could be a good fit. Thanks!

 

[Bluesjunky76]

Welcome from another PeakTestosterone refugee! I'm sure you'll find ExcelMale is also a great place to be.

One of my focal points is on what normal dosing is with injections. I'm trying to correct a skewed mentality about this. You've been influenced to think that 60 mg of testosterone cypionate taken over a week is "pretty low". But it's not. The average testosterone production level for healthy young men corresponds to 60-70 mg of testosterone cypionate taken over a week. A normal full reference range of production would run from about 30-90 mg TC equivalent per week. Therefore doses much over 100 mg per week should be considered "pretty high". You are in good company in discovering that more is not better. See links to what others have said here.

Although still a hypothesis, it's considered likely that free testosterone levels are considerably more important than total testosterone. So it is important to see where you stand in this regard. If you have access to Quest then this test from Discounted Labs is a good and affordable option. I recommend also measuring SHBG. With SHBG and total testosterone you can calculate free testosterone, which provides a check on the measured values, which are not 100% reliable. Our general expectation is that free testosterone should vary in proportion to dose. When you see changes in total testosterone at a dose that's nominally the same then it's possible that variance in SHBG is responsible rather than a change in potency of the products you're using.

If your SHBG is normal then it's less likely that further fiddling with testosterone would lead to dramatic improvements. A couple avenues for experimentation include adding hCG to your protocol or switching to a short-acting form of testosterone. HCG replaces the LH that is suppressed by TRT. It can reverse testicular atrophy and often restores fertility. Some feel it increases libido and provides other benefits. With hCG you want to use the lowest dose possible to avoid side effects.

Short-acting testosterone is of interest because, unlike conventional TRT, it allows continued HPTA function, making it less disruptive of many other hormones. Short-acting forms of testosterone include nasal gels and troches. Switching to these would be more intrusive than other changes, because it can take many months for the HPTA to normalize. But if you get through that then you could experience higher testosterone without HPTA suppression, which seems to be effective for many.

If you are ok with telemedicine then Defy Medical is another possible provider. Many of us use them and appreciate their good service and expertise. You might need to rein them in on dose recommendations, but they are very responsive to patients' preferences.

Hi, I remember your name from the peaktestosterone.com! It's good to be here.

You make a great point about depo-t doses. For years I was told the standard dose was 100mg a week, but when I split that dose into 2 injections a week under the care of my former urologist I was a mess: anxious, BP spikes, insomnia, etc. Eventually, we brought it down to 80mg but it was still too high (Trough around 900-950). At 60mg my anxiety is much more manageable and the trough sits between 500-660. And yet my current urologist always makes it a point to tell me what a low dose on I'm on. In fact, I'm on the lowest dose of any guy he's ever treated, he says, which tells me there's a lot of guys getting seriously overmedicated! You have to listen to your own body.

So you think I should start with testing the SHBG then? And it sounds like I don't need to test free T if I can just calculate it from SHBG and my current TT numbers? Maybe I'll start there and that can give me a better sense of why my T levels are always pretty good and yet my body doesn't seem to be utilizing the hormone fully. And I would definitely be open to telemedicine as I hate going to Dr.'s offices! White coat hypertension and anxiety, though I'm getting better.

Anyway, thanks for your input and it's good to be here! The setup of the site feels a lot like Peaktestosterone, too.

 

[Deleted member 43589]

Hi, I used to post occasionally on peaktestosterone.com, but to my surprise that site is apparently no more. So I signed up here. I'm the kind of poster who usually only pops in when I have labs to have interpreted, but I've been on depo-T for a long time and I've never had the results I've hoped for so I intend to get more proactive. So I hope you guys don't get too sick of me! I want to make my hormonal situation better because I know it can be.

My backstory: At age 27, after testing frighteningly low on a total T test (155! or something like that), I began getting injections. For years my testosterone treatment was managed by GP's who over medicated me and only tested for Total Testosterone. My estradiol was surely through the roof as I carried tons of water weight and just generally felt like crap. Eventually, I started seeing a urologist who lowered my dose and switched me to 2 injections a week. There was more knowledge but I've still never been able to to persuade a Dr to test for any hormones other than testosterone and estradiol. And on the surface those numbers always look pretty good, but I've always sensed something was wrong.

Here's the thing: I'm 46 but I look considerably younger. Though I grow (patchy) facial hair and have hair in all the right places, I haven't properly developed and I want to change this. After doing some research I suspect I have high SHBG, low free t, and/or low DHT. Last week I went in for my 6 month labs. My current urologist, who said he would test for free T and SHBG after I asked him to, for whatever reason did do not so. Annoying. So I guess I have to finally bite the bullet and go have these labs done on my own, out of pocket.

Anyway, my current labs, on .15ml injected biweekly (I know, pretty low--but I get bad anxiety if my T levels get too high):

PSA:.80
Estradiol: 32.6
Total Testosterone: 661.3
Hematocrit: 47.3

He didn't order liver tests, which is kind of odd, but I'm not worried about that because those numbers are always fine. On the surface these numbers look pretty good, but, as I said, something is off. One other strange thing to note: my pharmacy recently switched to Cipla brand depo-T, and my numbers went up from the 500-530 range I was at before on the Sun brand to 661.3. Interesting but I've had that happen before. Some brands, for whatever reason, just seem to be more potent.

So I'd love to know where do I go from here? Should I see an endocrinologist instead of a urologist? Test for SHBG, DHT, and free T? I live in the Houston area: are there any renowned men's Dr's here who understand that other sex hormones exist besides testosterone and estradiol? There's got to be. Also, I'm pretty interested in Boron. I would love to here anybody's experience with that mineral and if that could be something to help balance me out.

Anyway, I hope I didn't digress too much. It's just hormones can get a little complicated. Just hoping to get it right and I know there's got to be guys on this site who can relate to my experience. It's been a frustrating journey at times but I'm optimistic there's a way to get this right. Thanks and take care!

WELCOME.....from another Houstonian

Boron....lots of very small studies done on this supplement. Kind of think it may raise FT levels some but as the study below showed doing a bodybuilding type of work out probably raises FT levels more than taking boron. The below study found no significant effect of boron supplementation on any of the dependent variables, plasma total and free testosterone, plasma boron, lean body mass, and strength measurements

Abstract​

---

The effect of boron supplementation was investigated in 19 male bodybuilders ages 20-27 years. Ten were given a 2.5-mg boron supplement while 9 were given a placebo every day for 7 weeks. Plasma total and free testosterone, plasma boron, lean body mass, and strength measurements were determined on Days 1 and 49 of the study. Plasma boron values were significantly (p < 0.05) different as the experimental group increased from (+/- SD) 20.1 +/- 7.7 ppb pretest to 32.6 +/- 27.6 ppb posttest, while the control group mean decreased from 15.1 +/- 14.4 ppb pretest to 6.3 +/- 5.5 ppb posttest. Analysis of variance indicated no significant effect of boron supplementation on any of the dependent variables. Both groups demonstrated significant increases in total testosterone, lean body mass, 1-RM squat, and 1-RM bench press. The findings suggest that 7 weeks of bodybuilding can increase total testosterone, lean body mass, and strength in lesser trained bodybuilders, and that boron supplementation had no effect on these measures.

The effect of boron supplementation on lean body mass, plasma testosterone levels, and strength in male bodybuilders - PubMed

The effect of boron supplementation was investigated in 19 male bodybuilders ages 20-27 years. Ten were given a 2.5-mg boron supplement while 9 were given a placebo every day for 7 weeks. Plasma total and free testosterone, plasma boron, lean body mass, and strength measurements were determined...

pubmed.ncbi.nlm.nih.gov

Another study:

Nothing Boring About Boron - PMC

The trace mineral boron is a micronutrient with diverse and vitally important roles in metabolism that render it necessary for plant, animal, and human health, and as recent research suggests, possibly for the evolution of life on Earth. As the ...

www.ncbi.nlm.nih.gov

Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines - PubMed

Boron possesses widespread properties in biochemistry and nutrition. Acute supplementation with 11.6 mg of boron resulted in a significant increase in plasma boron concentration. Given such a fast bioavailability, the objective was to determine whether acute (hourly or daily), and weekly...

pubmed.ncbi.nlm.nih.gov

This study in otherwise healthy men noted that acute supplementation of Boron, over the period of 6 hours, failed to increase total testosterone levels yet trended to increase free testosterone (+14.7%) and DHT (+9.9%) although neither was statistically significant, yet significantly reduced Sex-Hormone Binding Globulin (SHBG) by 9% at the 6 hour mark yet required 2 hours to reach significance. After 7 days of supplementation, the increase in free testosterone (28.3%) reached significance yet the SHBG decrease was not.

Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines - PubMed

Boron possesses widespread properties in biochemistry and nutrition. Acute supplementation with 11.6 mg of boron resulted in a significant increase in plasma boron concentration. Given such a fast bioavailability, the objective was to determine whether acute (hourly or daily), and weekly...

pubmed.ncbi.nlm.nih.gov

Another study using 4 weeks of 10mg Boron supplementation noted a trend towards increased testosterone (11.4%) but failed to reach statistical significance.

The effect of boron supplementation on its urinary excretion and selected cardiovascular risk factors in healthy male subjects - PubMed

Boron (B) is an essential trace element for plants and its interrelationship with mineral and bone metabolism and endocrine function in humans has been proposed. Relatively little is known about the occurrence of B in the food chain and hence a biomarker which reflects its intake is required...

pubmed.ncbi.nlm.nih.gov

I am not so sure boron is going to help you much. I think you are better off getting your TRT dialed in.

I won't tell you my doctor is the greatest at this but he was very willing to write a script which made me legal.

 

[Bluesjunky76]

WELCOME.....from another Houstonian

Boron....lots of very small studies done on this supplement. Kind of think it may raise FT levels some but as the study below showed doing a bodybuilding type of work out probably raises FT levels more than taking boron. The below study found no significant effect of boron supplementation on any of the dependent variables, plasma total and free testosterone, plasma boron, lean body mass, and strength measurements

Abstract​

---

The effect of boron supplementation was investigated in 19 male bodybuilders ages 20-27 years. Ten were given a 2.5-mg boron supplement while 9 were given a placebo every day for 7 weeks. Plasma total and free testosterone, plasma boron, lean body mass, and strength measurements were determined on Days 1 and 49 of the study. Plasma boron values were significantly (p < 0.05) different as the experimental group increased from (+/- SD) 20.1 +/- 7.7 ppb pretest to 32.6 +/- 27.6 ppb posttest, while the control group mean decreased from 15.1 +/- 14.4 ppb pretest to 6.3 +/- 5.5 ppb posttest. Analysis of variance indicated no significant effect of boron supplementation on any of the dependent variables. Both groups demonstrated significant increases in total testosterone, lean body mass, 1-RM squat, and 1-RM bench press. The findings suggest that 7 weeks of bodybuilding can increase total testosterone, lean body mass, and strength in lesser trained bodybuilders, and that boron supplementation had no effect on these measures.

The effect of boron supplementation on lean body mass, plasma testosterone levels, and strength in male bodybuilders - PubMed

The effect of boron supplementation was investigated in 19 male bodybuilders ages 20-27 years. Ten were given a 2.5-mg boron supplement while 9 were given a placebo every day for 7 weeks. Plasma total and free testosterone, plasma boron, lean body mass, and strength measurements were determined...

pubmed.ncbi.nlm.nih.gov

Another study:

Nothing Boring About Boron - PMC

The trace mineral boron is a micronutrient with diverse and vitally important roles in metabolism that render it necessary for plant, animal, and human health, and as recent research suggests, possibly for the evolution of life on Earth. As the ...

www.ncbi.nlm.nih.gov

Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines - PubMed

Boron possesses widespread properties in biochemistry and nutrition. Acute supplementation with 11.6 mg of boron resulted in a significant increase in plasma boron concentration. Given such a fast bioavailability, the objective was to determine whether acute (hourly or daily), and weekly...

pubmed.ncbi.nlm.nih.gov

This study in otherwise healthy men noted that acute supplementation of Boron, over the period of 6 hours, failed to increase total testosterone levels yet trended to increase free testosterone (+14.7%) and DHT (+9.9%) although neither was statistically significant, yet significantly reduced Sex-Hormone Binding Globulin (SHBG) by 9% at the 6 hour mark yet required 2 hours to reach significance. After 7 days of supplementation, the increase in free testosterone (28.3%) reached significance yet the SHBG decrease was not.

Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines - PubMed

Boron possesses widespread properties in biochemistry and nutrition. Acute supplementation with 11.6 mg of boron resulted in a significant increase in plasma boron concentration. Given such a fast bioavailability, the objective was to determine whether acute (hourly or daily), and weekly...

pubmed.ncbi.nlm.nih.gov

Another study using 4 weeks of 10mg Boron supplementation noted a trend towards increased testosterone (11.4%) but failed to reach statistical significance.

The effect of boron supplementation on its urinary excretion and selected cardiovascular risk factors in healthy male subjects - PubMed

Boron (B) is an essential trace element for plants and its interrelationship with mineral and bone metabolism and endocrine function in humans has been proposed. Relatively little is known about the occurrence of B in the food chain and hence a biomarker which reflects its intake is required...

pubmed.ncbi.nlm.nih.gov

I am not so sure boron is going to help you much. I think you are better off getting your TRT dialed in.

I won't tell you my doctor is the greatest at this but he was very willing to write a script which made me legal.

Hey --lots of Houston guys here!

Man, I'll tell you: it can be dizzying to parse through all the information available on the internet. The thing that got me optimistic about supplementing with boron was some interview I watched with a TRT doctor, I think, who recommended every man take 10 mg of boron daily to balance out their hormones. He cited numerous studies which sounded promising. Being a trace mineral, I wouldn't be as concerned trying it as I would with some other supplements, like tongkat ali?(not sure if I spelled that right), where there are legitimate safety concerns with the supplement being tainted.

Anyway, I appreciate the info. I'm going to cross that bridge (taking supplements/changing treatment) once I can get some more tests done to see where I'm at hormonally.

 

[Bluesjunky76]

I probably should create a new post but what I want to discuss relates to everything discussed in this earlier post. So, anyway, I talked about how I thought I might have high SHBG and maybe low DHT (plan on testing my SHBG on Tuesday)? Well, I should mention I LOVE green tea. I mean, I've been drinking 2-4 cups a day for years, thinking it's the healthiest drink in the world, but the more research I do the more it sounds like it may not be the best fit for a guy with hormonal issues. Potential to lower DHT and raise SHBG. For at least a while, I'm going to cut it out of my diet and see if any of my symptoms improve.

Any suggestions on healthy teas that don't negatively affect hormones? I thought I'd switch to ginger tea but that has DHT issues as well. I don't want to cut out green tea because I love it and it has so many amazing health benefits, but I've got to try something different here.

 

[Systemlord]

Well, I should mention I LOVE green tea. I mean, I've been drinking 2-4 cups a day for years, thinking it's the healthiest drink in the world, but the more research I do the more it sounds like it may not be the best fit for a guy with hormonal issues.

I research everything that goes into my mouth or onto my skin.

 

[Bluesjunky76]

I research everything that goes into my mouth or onto my skin.

Normally, I'm pretty good about researching what goes into my body as well, but I think I gave green tea a pass because everything I've always read about it said it was so healthy and I like it so much. Also, I've literally had ONE cold in the last 5 years. Can't prove that's because of the green tea, of course. I have a lot of healthy habits. But I figure it's probably helped.