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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Should We Be Managing Estradiol and Hematocrit in Men on Testosterone Replacement?
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<blockquote data-quote="Dr Justin Saya MD" data-source="post: 71286" data-attributes="member: 12687"><p>Dr Nichols- you've mentioned many times in the thread "50 years of TRT data" when discussing and bolstering your positions, but let's make sure we're in agreement here:</p><p></p><p>The OVERWHELMING majority of the TRT data "over the past 50 years" is related to antiquated TRT regimens that are not similar to regimens that either of us prescribe [and that's a good thing as those regimens...i.e. low dose transdermals (androgel), q2week T cyp injections (or even worse q3-4week) - virtually always result in failure]. In other words, there ISN'T data from the past 50 years of patients with sustained levels you are describing with your patients of Total T 1500-2000, free T 40-50, estradiol 75 (as you state yours is...or in that vicinity for other patients) for prolonged periods of time (again we're talking potentially decades of TRT treatment). You also stated not checking DHT levels, which I would highly recommend with the transdermal 150mg BID directly to the scrotum as those DHT levels are almost certainly to be VERY high. Same goes for free T3 levels 4-7 as you mentioned, a free T3 of 7 is WELL within hyperthyroid range. There is no data of the safety of patients with a prolonged free T3 of 7, but there certainly are mountains of data on the risk with the hyperthyroid population. Main point being, the "50 years of data" is apples to oranges with the type of regimens that you're describing and, thus, is not relevant. In other words, you are in uncharted waters and please don't let the (inapplicable) 50 years of data give a false impression of patient safety considerations.</p><p></p><p>I'm going to pass this thread over to further discussion with you and the fellas...you've certainly sparked lively discussion.</p></blockquote><p></p>
[QUOTE="Dr Justin Saya MD, post: 71286, member: 12687"] Dr Nichols- you've mentioned many times in the thread "50 years of TRT data" when discussing and bolstering your positions, but let's make sure we're in agreement here: The OVERWHELMING majority of the TRT data "over the past 50 years" is related to antiquated TRT regimens that are not similar to regimens that either of us prescribe [and that's a good thing as those regimens...i.e. low dose transdermals (androgel), q2week T cyp injections (or even worse q3-4week) - virtually always result in failure]. In other words, there ISN'T data from the past 50 years of patients with sustained levels you are describing with your patients of Total T 1500-2000, free T 40-50, estradiol 75 (as you state yours is...or in that vicinity for other patients) for prolonged periods of time (again we're talking potentially decades of TRT treatment). You also stated not checking DHT levels, which I would highly recommend with the transdermal 150mg BID directly to the scrotum as those DHT levels are almost certainly to be VERY high. Same goes for free T3 levels 4-7 as you mentioned, a free T3 of 7 is WELL within hyperthyroid range. There is no data of the safety of patients with a prolonged free T3 of 7, but there certainly are mountains of data on the risk with the hyperthyroid population. Main point being, the "50 years of data" is apples to oranges with the type of regimens that you're describing and, thus, is not relevant. In other words, you are in uncharted waters and please don't let the (inapplicable) 50 years of data give a false impression of patient safety considerations. I'm going to pass this thread over to further discussion with you and the fellas...you've certainly sparked lively discussion. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Should We Be Managing Estradiol and Hematocrit in Men on Testosterone Replacement?
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