Frequency of Follow Up Blood Work

[gpetersmarck]

After not responding at all from Testim (testosterone actually went down), I have begun getting some success with testosterone injections.

40 yr old male
Original t level - 125
Updated t level 45 days after injections - 430

Two quick questions -
If my dosage stays the same (200mg every two weeks), will be levels keep elevating or will I need to increase dosage?
How often should I have my levels retested?

[kelkel]

Welcome to the forum!

Do you know what caused your low T? Did your doc search for a cause or just put you on testim?
When was blood drawn relative to your last injection?

Q#1: Herein lies the problem. Your doc does not know hormones. If he did he would not put you on such a protocol. The half-life of test is 5-7 days metabolism dependent. He's basing it on terminal life. Therefore shots have to be weekly at a minimum. 100mg is an avg dose. Most here prefer splitting their dosage and injecting every 3-4 days for more stable levels. With your every two week protocol you'll be good for the first handful of days then your T just continually drops during that second week. It's a bad roller-coaster ride.

Q#2: Initially at 6 weeks like you did. Then as often as needed to dial in your numbers. Once that's done most go twice per year, but that's between you and your doctor. Do you have more BW you can post? You also need to be concerned with E2 and many other levels. Take a look in the Finding A Doc Sticky thread for examples of BW to pull.

Remember, TRT is new to most doc's so you need to self-educate and be your own best advocate.

Again, Welcome.

kel

[gpetersmarck]

kel,

Thank you for all of the information. A few follow up items:

The doc didn't search for possible cause of the low T initially - just went into how to address/treatment mode.

Once we got to injections, he started me at every two weeks and did leave open the option/possibility of moving to every seven days depending on how I felt. Honestly, it took me awhile to begin feeling better and to your point, once I did begin to feel better, it didn't/hasn't seemed to last.

A factor in the frequency of injections was if the office was doing them vs myself. I did begin to self-inject in thigh but seemed to struggle knowing right spot, etc. Until I get comfortable self injecting, if you suggestion is at the minimum for me to drive to docs office weekly for injections, then I will do that (while I am sorting out if this is best doctor, regimen, etc).

I will pull my prior lab reports and hope to get them uploaded here early next week. I know my doc did mention needing to get E2 results and when those came back, he was comfortable with moving forward.

I see how I have much learning to do and thank you again for the reply/guidance.

Last few questions on the topic of learning, would you say all I need from a resource standpoint can be located here? If not, can you direct me to relevant source outside of here? Aside from the forum topic you mentioned above, any others for me to get a thorough handle on here?

Thanks!

[Rrexy]

If you're having trouble injecting into the muscle yourself, I would strongly suggest trying SubQ injections. As Kel suggested, 50mg/ 2x per week. SubQ is virtually painless and very easy to do yourself. The smaller, more frequent injections will keep your T & E levels much more stable - no more roller coaster "ups & downs". There are injection videos in the "stickies" at the top of the page that you can view to get an idea as to how the SubQ injections are done. I had never injected myself prior to TRT, but found the SubQ injections a breeze to do............

[kelkel]

What Rrexy said may be the way to go for you. Read and show this to your doc:

Subcutaneous administration of testosterone. A p... [Saudi Med J. 2006] - PubMed - NCBI

If your doc is willing and his ego is in check you can both learn along the way. Your not feeling better could easily be your protocol which gives you one good week followed by a crap week. Who wants that? But know that this is a marathon, not a sprint and it takes time and patience to dial things in. Repeat BW is the key as well as a good relationship with your doc.

Read all the sticky threads here. Continue to read this forum. We all learn so much from each other here, which is what makes it so worthwhile. If you were to read a couple books I'd pick up the following:

Testosterone, A Man's Guide by Nelson Vergel
Testosterone For Life by Abraham Morgantaler

You can learn a lot from both books.

I'm very interested in your pre-TRT Bloodwork to see if anything was missed that could have been fixed. Post it when you can please.

[gpetersmarck]

Thank you again for all of the great feedback/direction. I have the doctors office faxing my three BWs hopefully soon so I will start with uploading my original one from September of last year. Thanks again!

[Beethoven]

What Rrexy said may be the way to go for you. Read and show this to your doc:

Subcutaneous administration of testosterone. A p... [Saudi Med J. 2006] - PubMed - NCBI

If your doc is willing and his ego is in check you can both learn along the way. Your not feeling better could easily be your protocol which gives you one good week followed by a crap week. Who wants that? But know that this is a marathon, not a sprint and it takes time and patience to dial things in. Repeat BW is the key as well as a good relationship with your doc.

Read all the sticky threads here. Continue to read this forum. We all learn so much from each other here, which is what makes it so worthwhile. If you were to read a couple books I'd pick up the following:

Testosterone, A Man's Guide by Nelson Vergel
Testosterone For Life by Abraham Morgantaler

You can learn a lot from both books.

I'm very interested in your pre-TRT Bloodwork to see if anything was missed that could have been fixed. Post it when you can please.

I started doing subq about six weeks ago and it is way easier and more convenient. I just finished reading testosterone a mans guide and it well worth it, and if you're going to be on trt, very educational.

[gpetersmarck]

Ok, hopefully I did this correct. There should be four attachments that cover my initial bloodwork done 9/11/13. Based on these results, the doctor started me on Testim. I will post follow up labs from 10/18 in a different reply when I get them today. Please let me know if any of this is not readable. Thanks!

[kelkel]

Gotta workout so I'll get back to this shortly. In the meantime edit your name out of of of the copies if you so choose.

[gpetersmarck]

Gotta workout so I'll get back to this shortly. In the meantime edit your name out of of of the copies if you so choose.

Thanks for the heads up - should be edited w/o my info - just call be Einstein haha

[gpetersmarck]

Hi, just wanted to check into see if you are able to read my BW after I re-uploaded the files. Thanks in advance for your feedback!

[kelkel]

Readable but fuzzy. What I don't see is:

Full thyroid panel to include FT3, FT4, TSH, RT3, Antibodies, etc.
Prolactin
Cortisol
LH & FSH

LH & FSH show pituitary function. If they are there I don't see them so type in the ranges and levels in a follow up please. The others above can all impact testosterone production.

In brief, if LH & FSH are low then testosterone will be low and you need to look into pituitary issues (MRI) as the cause. If they are high and testosterone is still low then you look at the testicals as the issue. Or as stated, the other items you need to test can all suppress production as well.