When to have bloods checked

Mikey

Have you only had one injection of Nebido?

This is what Bayer, the manufacturer of Nebido, recommends European doctors to do:

The international medical societies European Association of Urology (EAU), International Society for the Study of the Aging Male (ISSAM), International Society of Andrology (ISA), American Society of Andrology (ASA), and European Academy of Andrology (EAA) have issued recommendations on the definition, investigation, treatment and follow-up of men with late-onset hypogonadism.1,2 They recommend:

Evaluate the patient 3 months after commencing treatment then annually to assess response of signs and symptoms of hypogonadism to treatment and to evaluate any adverse effects. Failure to benefit clinical manifestations should result in discontinuation of treatment. As testosterone normally results in improvements in mood and well-being, the development of negative behavioral patterns during treatment calls for dose modifications or discontinuation of therapy

Monitor serum testosterone levels 2–3 months after commencing treatment to ensure levels in the mid-normal physiological range have been attained

Check hematocrit at baseline, at 3 months, and then annually. Therapy should be stopped if hematocrit is >54%, indicating erythrocytosis. Patient should be evaluated for hypoxia and sleep apnea. When hematocrit decreases to a safe level therapy may be reintroduced at a decreased dose

Measure bone mineral density of lumbar spine and/or femoral neck after 1–2 years of testosterone therapy in men with osteoporosis or low trauma fracture

Perform digital rectal examination and determination of prostate-specific antigen (PSA) levels at baseline in men over the age of 45 years, then at 3 to 6 months after commencing testosterone treatment, at 12 months, and then yearly thereafter (or according to standard prostate cancer screening protocols)

Evaluate formulation-specific adverse events at each visit

Source: http://www.nebido.com/en/hcp/therapy/treatment-guidelines/index.php
 
Mikey

Have you only had one injection of Nebido?

This is what Bayer, the manufacturer of Nebido, recommends European doctors to do:

The international medical societies European Association of Urology (EAU), International Society for the Study of the Aging Male (ISSAM), International Society of Andrology (ISA), American Society of Andrology (ASA), and European Academy of Andrology (EAA) have issued recommendations on the definition, investigation, treatment and follow-up of men with late-onset hypogonadism.1,2 They recommend:

Evaluate the patient 3 months after commencing treatment then annually to assess response of signs and symptoms of hypogonadism to treatment and to evaluate any adverse effects. Failure to benefit clinical manifestations should result in discontinuation of treatment. As testosterone normally results in improvements in mood and well-being, the development of negative behavioral patterns during treatment calls for dose modifications or discontinuation of therapy

Monitor serum testosterone levels 2–3 months after commencing treatment to ensure levels in the mid-normal physiological range have been attained

Check hematocrit at baseline, at 3 months, and then annually. Therapy should be stopped if hematocrit is >54%, indicating erythrocytosis. Patient should be evaluated for hypoxia and sleep apnea. When hematocrit decreases to a safe level therapy may be reintroduced at a decreased dose

Measure bone mineral density of lumbar spine and/or femoral neck after 1–2 years of testosterone therapy in men with osteoporosis or low trauma fracture

Perform digital rectal examination and determination of prostate-specific antigen (PSA) levels at baseline in men over the age of 45 years, then at 3 to 6 months after commencing testosterone treatment, at 12 months, and then yearly thereafter (or according to standard prostate cancer screening protocols)

Evaluate formulation-specific adverse events at each visit

Source: http://www.nebido.com/en/hcp/therapy/treatment-guidelines/index.php

Of course no mention of E2. Why would that matter?

They also don't mention free test, SHBG, DHT, or thyroid panels. Some of those you can do without, but E2 free test, and SHBG are extremely important.

No mention of donating blood or therapeutic phlebotomy for hematocrit management?
 

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TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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