No longer allowed to self administer?

[criscofats]

Hi all,

I'm a 28 year old Male
5'9"
190lbs
~20% BF

Back in 2011 I had labs done and my test levels were around 378ng/dL, which my doctor at the time said was fine according to the numers. I dealt with the symptoms until I moved to a new city and decided to get checked out again. I was placed on TRT back in June due to my symptoms and labs. I was placed on 100mg of Test Cyp 1x/wk

My labs prior to treatment came back like this 03/04/2015:
Testosterone , Serum:
535 ng/dL Reference 348-1197 ng/dL
LH
4.3 mIU/mL Reference 1.7-8.6 mIU/mL
FSH, Serum
4.6 mIU/mL Reference 1.5-12.mIU/mL
Estradiol
23.7 pg/mL Reference 7.6-42.6 pg/mL


Here are my most recent labs 11/09/2015:
Testosterone, Serum:
599 ng/dL Reference 348-1197 ng/dL
Free Testosterone(Direct)
18.3 pg/mL Reference 9.3-26.5 pg/mL
Estradiol
28.1 pg/mL Reference 7.6-42.6 pg/mL

Not sure why my recent labs aren't more comprehensive

Anyway, due to the slight increase in my levels and the persistence of symptoms the clinic has opted to up my dosage to 200mg of Test Cyp 1x/wk to see where that lands me after 6 weeks.

Now my question isn't exactly about my levels or the protocols, but about what the clinic recently told me. I was scheduling a time to come pick up my next round of dosages (they usually give them in preloaded syringes) and I was told and I'm quoting the email "Unfortunately I regret to inform you that we are no longer able to accommodate our patients with the take home self-injections for Testosterone . It is not a company decision. Testosterone Cypionate is a controlled substance and as of October 1st, 2015 the DEA has more stringent rules and regulations for medical offices and clinics that handle this drug."

They mention after this that if I want to home administer that I can always use their "bio identical" 15% testosterone cream.

What I'm wondering is does anyone know what my clinic is actually talking about? I emailed them asking for information on these new rules but never got anything back. I'm wondering if this is something they are pushing to sell more of their cream (I'm paranoid I know) or just something that they're not willing to deal with so they're just making everyone drive in for their shots now? Should I ride this out and make the weekly drive out there, or try and find a closer urologist that might be able to work with me better?

Thanks for anyone who took the time to read this

[2Sox]

I'd suggest you find another doctor/clinic. It's perfectly legal for a doctor to write a script for T Cyp and for you to inject at home. In fact, the FDA no longer permits doctors to keep stocks of Testosterone in office. I should think if you brought the records of your past history to a new urologist's office, this is exactly what will happen.

[kelkel]

Good advice above.

Also, it's ridiculous to literally double your dose. Incremental titrations are always best and produce the least amount of side effects.
When were your most recent labs pulled relative to your last injection?
Is this a TRT specific clinic?
Do you have to pay for each weekly visit?

Take note of your initial labs. Your LH and FSH levels are just fine. This indicates the issue, if any, is probably downstream and testicular in nature. Have you ever suffered any testicular trauma?

[criscofats]

Good advice above.

Also, it's ridiculous to literally double your dose. Incremental titrations are always best and produce the least amount of side effects.
When were your most recent labs pulled relative to your last injection?
Is this a TRT specific clinic?
Do you have to pay for each weekly visit?

Take note of your initial labs. Your LH and FSH levels are just fine. This indicates the issue, if any, is probably downstream and testicular in nature. Have you ever suffered any testicular trauma?

I thought a double dosage was pretty crazy as well. My labs were pulled the Monday following my Thursday night injection, so injection on the 5th and labs on the 9th.

It is supposed to be a "Men's sexual health" clinic, they do mostly test and erectile dysfunction treatments. You can either pay monthly, or pay in blocks of 3, 6, or 18 month intervals. I believe that if you decide to leave they refund however many months you would have left.

I don't recall any noteworthy trauma occurring, but I've always had what I considered small testicles, not that I really had anything to compare them with.

I have to be honest, if the post doesn't make it apparent enough, I don't have a whole lot of confidence in these guys for various reasons. Their preloaded syringes don't actually say what the dosage of test is, it says 0.5cc of test cyp, I had to ask them what I was actually getting injected into me before we started, and they don't even mention AI's or HCG unless you specifically mention it to them. I tried asking once why I can't just pick up my prescription at a pharmacy and they said something about it coming from a special compounding company...

[InternalFire]

kelkel, talking about testicular trauma, does falling balls down on to the bycicle frame ending up days past that event in severe pain but nonswelling, and about week later the pain is all gone, dies that sound like it? I dont mean to hijack thread but just thought as were on kinda same topic I could ask? heppened to me in my teens at least 5 times or more

[kelkel]

I thought a double dosage was pretty crazy as well. My labs were pulled the Monday following my Thursday night injection, so injection on the 5th and labs on the 9th.

It is supposed to be a "Men's sexual health" clinic, they do mostly test and erectile dysfunction treatments. You can either pay monthly, or pay in blocks of 3, 6, or 18 month intervals. I believe that if you decide to leave they refund however many months you would have left.

I don't recall any noteworthy trauma occurring, but I've always had what I considered small testicles, not that I really had anything to compare them with.

I have to be honest, if the post doesn't make it apparent enough, I don't have a whole lot of confidence in these guys for various reasons. Their preloaded syringes don't actually say what the dosage of test is, it says 0.5cc of test cyp, I had to ask them what I was actually getting injected into me before we started, and they don't even mention AI's or HCG unless you specifically mention it to them. I tried asking once why I can't just pick up my prescription at a pharmacy and they said something about it coming from a special compounding company...

Ok, I asked about the timing of the BW so we can estimate your levels based on Tests normal metabolism. It has about a 5-7 day half-life.
Test is normally dosed at 200 mgs per ml so .5 ml would equal 100 mgs.
Your "small balls" statement is curious to me and again makes me wonder if there's an issue there. Varicocele, etc. But as stated in my first post, if there is an issue there's no big red flag other than how you feel. Your numbers are not great but for some, it's the cards their dealt (idiopathic.) Know that endogenous test levels can swing dramatically based on so many different things. Regardless, if it were me I'd be curious about a testicular ultrasound to rule in/out issues. It would at least give you peace of mind.

In closing, it sounds like finding a knowledgeable doctor would be prudent. Title doesn't matter, just that they know hormones.

kelkel, talking about testicular trauma, does falling balls down on to the bycicle frame ending up days past that event in severe pain but nonswelling, and about week later the pain is all gone, dies that sound like it? I dont mean to hijack thread but just thought as were on kinda same topic I could ask? heppened to me in my teens at least 5 times or more

Yes, that type of trauma can impact testosterone production. Head trauma can do the same. Only BW would clue you in.

[criscofats]

Thanks Kelkel, I was hoping you'd weigh in on this. I'll work on trying to find a knowledgeable doctor in my area, hopefully I can track someone down soon.

[kelkel]

Thanks Kelkel, I was hoping you'd weigh in on this. I'll work on trying to find a knowledgeable doctor in my area, hopefully I can track someone down soon.

Google A4M Doctor finder and search by zip code. Maybe you'll get lucky. Other than that, read the Finding A Doctor Sticky at the top of the forum for tips on finding a doc.