New to HRT and need some help

[Oldhighlander]

I am new to HRT and need some help.I am a 54 year old male,6'4" tall and I weigh 295.I will post my 3 blood test so you guys have an idea of where I am at.I have been in the gym for 30 years and still actively compete in strongman and highland games so hence my size.I was tested in september and started Hrt shortly after so the first test results are the baseline and the second is after 6 weeks of the patch and the third is after testosterone cypionate injection.After the third test the doc upped my dosage from .5ml to 1.0ml.I am to retest in about 5 weeks.My symptoms are like a male dog going to the vet with 2 balls and coming back with none.Tired,general lack of zest for life,sexual function,etc.I have read the pinned stuff and it has given me some info I didn't have but I am looking for more so any input would be a help.As you can see by my test results it was at 311 baseline and after the patch went to 318.When I switched to the injection it went down to 267.I was real surprised by that.Any ideas as to why it dropped below baseline?As you can see my cholesteral and blood sugar improved.I must add that in that time frame from the first test until now I have dropped 50 pounds.I finally got back in the gym after some injuries that were work related and I was unable to do anything because you never know who is watching.Didn't want to take a chance and screw up my workmans comp.I have an HMO and my primary doc is a good one and she is willing to help me.Should she be ordering more tests then she already is?Should I stick with her or look for a specialist?If I look for a specialist what kind of doc would it be?When I go test again she is doing glycosylated hemoglobin,basic metabolic panel, and testosterone free and total male adult.Should she be doing more tests?If so what kind?Thanks in advance for any help.Double click on the image to make it bigger.They should be in the order they were taken.Attachment 120439Attachment 120440Attachment 120441Attachment 120442

[Oldhighlander]

By the way I am on a statin and I do have sleep apnea but I have a CPAP for it.

[HRTstudent]

What is the concentration of the Test you are injecting? Just a volume does not help us really... What is your exact drug intake and how often do you take it/them?

Also, your recent labs do show you have low test still.

Quite simply, the best guess at this point is that you are on too low a dose. The small changes from 1 blood test to the next could easily be normal variation because it's such a small change. Do remember that when you first start TRT you are getting the exogenous T in addition to your own natural production. After 3-4'ish weeks, however, that production becomes negligible.

Changing docs at this point is up to you. It might get you a better doc or it might just make you wait months.

Finally, you need a estradiol sensitive test to see if that is a problem.

PS. Please break your longer posts in paragraphs so it's easier to read

[zaggahamma]

What is the concentration of the Test you are injecting? Just a volume does not help us really... What is your exact drug intake and how often do you take it/them?

Also, your recent labs do show you have low test still.

Quite simply, the best guess at this point is that you are on too low a dose. The small changes from 1 blood test to the next could easily be normal variation because it's such a small change. Do remember that when you first start TRT you are getting the exogenous T in addition to your own natural production. After 3-4'ish weeks, however, that production becomes negligible.

Changing docs at this point is up to you. It might get you a better doc or it might just make you wait months.

Finally, you need a estradiol sensitive test to see if that is a problem.

PS. Please break your longer posts in paragraphs so it's easier to read

THIS^^

GLACIER?

what did your doctor say about the drop in test instead of rising? never seen/heard such a thing around here

[Oldhighlander]

Sorry for the rambling opening,I'm not an english major.As for the drop test there was no real explanation.I was Ill at the time with cold/flu stuff and she said maybe from that but I'm not really buying it.I was kind of shocked that it dropped and was hoping for a better explaination.
As for what I am on now it is from watson pharma testosterone cypionate 200mg/ml oil if that helps.I am taking 1ml every 2 weeks right now up from .5ml every 2 weeks.The doc said to test again in about 4 more weeks to see where we are at.If you guys need more info let me know and I will do my best to provide it.
What are your thoughts on dosage as far as how often?From reading the package insert it seems to me once a week would be better then twice a week because of the half life of the drug.Logic tells me that I would maintain a level better that way then have a roller coaster effect.Or am I off base?

[zaggahamma]

yes albeit a common prescribed dose (200mg e2w) its better to inject more often for the reason you thought...some do better on small doses twice a week even but on average weekly is most common...if you are injecting at home then you easily find whats best for you

like i said in my first post i NEVER heard of test levels going DOWN on 200mg of inject..pretty much any inject actually...i believe i have heard of it happening on gels(androgel /testim)...might have even happened to me i'm pretty sure it did but thats 6 years ago and the gel is far behind

watson pharma is usually a quality pharm grade product and i've never heard anything bad about it

about your 50lb weight loss, would you attribute any of that to the testosterone ? i know that it aided me in fat loss

get your thyroid checked, estradiol, and actually dont the cpap machines need inspecting /tweaking now and then?

[Oldhighlander]

I am calling Watson today.My pharmacist suggested doing so and ask about dosage and off label use such as once a week injection. As for my weight lose I think it was mainly busting my ass in the gym and really cleaning up my diet.I don't think the test helped much because my levels are so low.I have had my thyroid checked and its OK.The cpap has been tweaked but I may need another sleep study because I am still having issues. I will post what I find out from Watson.Now I just hope my doc will be onboard with everything.

[zaggahamma]

Well u sound patient and like u have a positive attitude about your health ....good group of guys around here that have been thru most of the low t pit falls and many to have overcome
Welcome and good luck

[zaggahamma]

Well u sound patient and like u have a positive attitude about your health ....good group of guys around here that have been thru most of the low t pit falls and many to have overcome
Welcome and good luck

[Oldhighlander]

Patient to a point.I try to be proactive with my health. That is the reason I joined this board. I want to have all the info I can get to be proactive and well informed So I get the treatment I need.I don't want the doc to say you are in a normal range now and leave it at that if I'm not feeling any better. It's all about quality of life to me.No stone left unturned. Or lifted if I can help it.

[HRTstudent]

The 100mg of test every 2 weeks is very very low. I don't doubt you wouldn't see improvement from that.

Some things to keep in mind: about 30mg of every 100mg of test cypionate is actually ester. That means you actually only inject about 70mg of test when you inject 100mg of Testosterone Cypionate solution. Additionally, the natural production of a male is about 5-10mg of testosterone per day.

Because of this, it's why a lot of people on injactable TRT have a dose of around 100mg per week. And weekly injections are far superior to your well being compared to biweekly. That doesn't necessarily mean double the dose, but simply split it up. I strongly recommend you get your doc to agree with this. There is legitimate medical text that touts the superiority of weekly. Practicing physicians will come around eventually, but right now the average doc has little knowledge about TRT beyond what the drug reps tell them.

[zaggahamma]

Where did he say 100mg e2w?

[Oldhighlander]

I had mentioned to the doc about the half life and if it would be better to do half as much twice as often and she sounded reluctant.I am not into this very long (only since september) and she wants to take it slow.She said she wants the lowest possible dose to get the best result and I agree with that.Where can I find the medical text to back up weekly?I would like to give it to the doc to help convince her.I had mentioned the half life to my pharmacist and she looked up the info and agreed with the weekly scenario.She said to call watson and speak with a medical rep about off label use to see what they say about once a week.If anyone has any medical text to back up once a week please let me know so I have more ammo to give to my doc.I am not sayinfg my doc won't go along with my wishes but if she needs to be convinced then I want the evidence.Do your homework and be prepared I say.

[Oldhighlander]

By the way are you guys self injecting?If you are how do you go about doing it?I get the swab, stick, inject part but how do you draw the plunger back to check for blood after the stick?Number one,drawing it back by yourself is next to impossible and number two,I can't see behind my back to check for blood even if I could draw the plunger back.I have someone injecting me now but that may not always be the case.

[Mr Bill]

I inject into the outer quad while I am in a seated position. In this position I can reach the syringe with both hands. Once in awhile my wife will give me the shot in the glutes because I can't pull back the plunger when in that position.

[zaggahamma]

Wish I had that kinda back width guess I was designed for basketball not bb LOL

[HRTstudent]

Where did he say 100mg e2w?

200mg/ml oil if that helps.I am taking 1ml every 2 weeks right now up from .5ml every 2 weeks

He was taking 100mg per 2 weeks but has since changed to 200mg every 2 weeks.

[Brohim]

You can print out some literature and bring it to your doc. 100mg every week is a whole lot better than 200mg every 2 weeks. Try all things male dot com to get some info. But if you were on 100mg every 2 weeks you will feel a lot better on 200mg even if it's every 2 weeks. I can't beleive doc's are this uneducated about test half lives. They don't teach drug half lives in med school anymore?

[zaggahamma]

Guess imma bit lost and now more half life talk....brothers help me out here

[HRTstudent]

You can print out some literature and bring it to your doc. 100mg every week is a whole lot better than 200mg every 2 weeks. Try all things male dot com to get some info. But if you were on 100mg every 2 weeks you will feel a lot better on 200mg even if it's every 2 weeks. I can't beleive doc's are this uneducated about test half lives. They don't teach drug half lives in med school anymore?

This is a big gripe Dr Crisler has about testosterone injections - "nowhere else in medicine is half life of drugs ignored like it is in testosterone repla***ent"

He has a good point, and only recently is the medical education catching on. Tons of docs still do injections 1 time per 3 weeks. That's pretty blatant ignorance.

[Oldhighlander]

The package insert says every 2 to 4 weeks.Can't image you would have much left after 4 weeks let alone 2.

[Oldhighlander]

Mr.Bill that must be a helluva big quad you have.I have fairly large legs and would be a little concerned about injecting in my quad.Did you have your docs approval to inject there?Anyone else who self injects with any tips?

[Mr Bill]

Mr.Bill that must be a helluva big quad you have.I have fairly large legs and would be a little concerned about injecting in my quad.Did you have your docs approval to inject there?Anyone else who self injects with any tips?

Nothing to be concerned about. 1" 25g strait in pull back and then push down slowly.

Check out this site [URL="http://howtodoinjections.com/IM/quads.html"]

[Oldhighlander]

Thanks.Is the needle vertical or horizontal?

[SEOINAGE]

I had the same problem as you, initial dose caused my starting T levels to drop in half, but doctor only increased it from .5 ml to .6 ml, but that is weekly. I wish he wouldn't be so conservative in his approach, but I believe it drops below baseline because there are days where you are likely above after injection, or just simply because exogenous test shuts down your natural production. I was experiencing a lot of low T sides the one and two days before my next injection on a weekly injection cycle. I don't see how increasing my test by .1 ml can take my from around 200 where I am at with .5 to 800 where I need to be. So this is what I did, going to stick with this new dose for now, but I am injecting it in two half doses twice a week, this will keep me from getting as low as I was getting before. And if I still don't feel good I am just going to start injecting more. And the other big thing is I am trying to get in to this new doctor, but it will be paying out of pocket for him. Some things to consider, luckily your doctor was willing to double that really low dose she first gave you. She should be willing to let you do weekly, although my doctor probably wouldn't condone my twice weekly, he was willing to do weekly even though the product says every two weeks. If she is willing to really work with you that's great but sometimes you just have to find someone that knows how to handle TRT properly.

[Mr Bill]

Thanks.Is the needle vertical or horizontal?

The injection site for that muscle is the middle third of your outer thigh between you knee and hip. In a seated position and the top of your thigh being 0 degrees go to the outerside of your thigh about 45 degrees. If you flex you should be able to see the seperate muscles. When you inject the needle is 90 degreed to the skin.

[Oldhighlander]

Thanks Mr.Bill.I will also check out the link you posted when I get the chance.

[Herman Munster]

Mr.Bill that must be a helluva big quad you have.I have fairly large legs and would be a little concerned about injecting in my quad.Did you have your docs approval to inject there?Anyone else who self injects with any tips?

Old - Welcome, I am new here as well and this board has a great group of educated (trial/error) TRT'ers w/ sound advice.

Shots: I self inject, both delts and right quad similar to Mr. Bill. I find the delts to be the easiest for me, there is no pain at all. For some reason I have pain in my left quad so I tend to stay away from there. As for the glutes, too awkward for me, I'm not comfortable w/ my position and have little control over the syringe. I am using a 25ga 1". I keep it on a 90degree angle to the area I am injecting.

[Oldhighlander]

Thanks Herman for the info.I have heard of guys injecting in the delt but wasn't sure it was OK or not.Just might have to give the alternate sites a try so I can do the injection myself.If the wife is pissed at me when she gives me the injection she can exact a little revenge.And she is always pissed at me.

[SEOINAGE]

Thanks Herman for the info.I have heard of guys injecting in the delt but wasn't sure it was OK or not.Just might have to give the alternate sites a try so I can do the injection myself.If the wife is pissed at me when she gives me the injection she can exact a little revenge.And she is always pissed at me.

Lucky you have a helper, mine leaves the room.

[Oldhighlander]

Mine may be leaving me altogether.So just leaving the room ain't so bad.

[Oldhighlander]

My doc has me using a 22g 1 1/2" that's why I wondered about alternate sites.Seems to me the 1 1/2 would be to long for any other place but the glute.So in everyones opinion what is the best needle gauge and length?Sorry I couldn't get this up sooner,been stupid busy.

[J DIESEL3]

I like using 25 Gage 1 inch.I just started rotating from delts to glutes,quads using only the 25g 1 inch.

I would never use anything lower than a 23 Gage other than to draw with it IMO.Also thinking about giving the sub q a try soon.

[Mr Bill]

My doc has me using a 22g 1 1/2" that's why I wondered about alternate sites.Seems to me the 1 1/2 would be to long for any other place but the glute.So in everyones opinion what is the best needle gauge and length?Sorry I could get his up sooner,been stupid busy.

I use a 18 gauge to load my test and B 12 and a 1" 25g to inject. The 1" in good for glute and quad but I have never used the delt for injection. I only inject once a week so with the glute and quads that gives me enough areas to use

[Oldhighlander]

I called Watson pharmaceutical today to see if they had any off label info and the Rep just toed the company line and there package insert.So I don't have any ammo to take to my doc about dosage,how often to inject,needle gauge and length,and injection sites except what I have read on this board and from the responses I have gotten from it's members.I also had mention an estrial test and he said they aren't recommending it.I hope my doc will listen to what I have learned here and respect my wishes on how to proceed and for me to reach my health and well being goals.Again if anyone can point me in the right direction to find any studies or any other literature to bring to my doc I would appreciate it.

[Mr Bill]

I called Watson pharmaceutical today to see if they had any off label info and the Rep just toed the company line and there package insert.So I don't have any ammo to take to my doc about dosage,how often to inject,needle gauge and length,and injection sites except what I have read on this board and from the responses I have gotten from it's members.I also had mention an estrial test and he said they aren't recommending it.I hope my doc will listen to what I have learned here and respect my wishes on how to proceed and for me to reach my health and well being goals.Again if anyone can point me in the right direction to find any studies or any other literature to bring to my doc I would appreciate it.

Have you went to this site that others have recomended? http://www.allthingsmale.com/index.html

If you go to this site and check out the Doctors publications he lays out what needs to be done for TRT.

[Oldhighlander]

I have looked at the site and there seems to be some controversy about this doc from what I have seen.Maybe I'm wrong. I need to read further.

[HRTstudent]

There is definitely controversy over Dr Crisler.

However, one thing that's pretty much for sure is that he makes a lot of guys very happy by fixing their hormones. He also does it in a fairly straightforward manner and doesn't get too crazy. I feel docs that prescribe Deca or winstrol are far more extreme than Crisler.

[Oldhighlander]

I just read his paper on how to administer trt and he is big on the gel.So why do most of you use the injection method?There was lots of good info there and I am considering printing it and giving it to my doc.I know a doc thru my highland games competitions and have contacted him to see if he has any experiance with prescibing trt and to see if he can be of some help with how best to approach your doc with outside info and not have them shut down on you.Some have a god complex and know it all and some do not and are willing to listen and work with you.I think my doc is the later but never really had to give a lot of input like I do on this subject.If I learn anything from the doc I know from the games I will pass the info along.Thanks to everyone who has helped me with this.There seems to be a lot of knowledge here and people with real world experiance.

[J DIESEL3]

I believe what you were reading oldhighlander was not a updated version.Dr. Crisler at one time did prefer the gel for trt but now recommends injection.Someone correct me on this if I'm wrong.