Low T Treatment Update

Low testosterone issues, impacts on health & marriage, treatments, etc.
GaryB
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Low T Treatment Update

Postby GaryB » Fri May 26, 2017 8:14 pm

Since a test result of 174 ng/dL in early Feb, I've been injecting (my wife actually) 1 ml (200 mg total) intramuscularly every 14 days. After 3 months, it is now 1209 ng/dL, which was tested 7 days following the last injection. I'm being treated by an endocrinologist. My urologist referred me since my prolactin was slightly above normal range indicating possible pituitary issues. Subsequent tests are normal, besides my endocrinologist would only have been alarmed if 1000 mg/mL or higher. All other tests are within normal range.

Honestly, I don't feel any different than before treatment. I didn't have any issues other than feeling lethargic. No MB problems although occasionally had difficultly in achieving an orgasm when having PIV with my wife. I attributed that with my young 56 year old body.

Doctor did say that 40% of patients will see no benefit from increasing testosterone. After my last consult, he will likely recommend to discontinue treatment, but it's my choice.

Is it too soon to feel a difference? Should I continue for another 3 months and reevaluate?


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gratefulman
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Re: Low T Treatment Update

Postby gratefulman » Fri May 26, 2017 8:16 pm

I recommend you get a full male hormone panel done, or at least estradiol, I bet that it's elevated.


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tjw
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Re: Low T Treatment Update

Postby tjw » Sat May 27, 2017 5:54 am

GaryB wrote: Doctor did say that 40% of patients will see no benefit from increasing testosterone.


I was one of the 40% subdistribution, too. My sexual potency didn't change at all, I found no change in the loss of muscular strength I got from turning 54. The only thing I got from T was a sore butt. My initial test was 107 ng/dl (total) and testopel brought it only up to mid 300s. Endo found no issues with prolactin, not sure if estradiol was checked. I never tried IM injections, androgel was lot of money and my insurance wouldn't pay, but testopel was covered because it was a "surgical procedure".

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Re: Low T Treatment Update

Postby His son and daughter » Sat May 27, 2017 6:02 am

Regardless of how you "feel" I would continue the treatment. The Testosterone assists you in maintaining your metabolism, maintain/build muscle.

Having had low T for years and all the while exercising 3-4 x week in an attempt to lose weight, I never seemed to have any increase in strength or stamina. Now after being on T injections for the last few years, i have increased muscle mass (do not read bulk), increased stamina (have now completed 3 marathons). My blood pressure has come down and I am gradually losing weight. No T did not necessarily make my libido better or my erections stronger, but the other benefits are worth the effort it takes to get blood levels every few months and injected every 2 weeks.

In addition to this I have watched my father who has prostate cancer be given medications that eliminate his testosterone and I see him losing muscle mass, strength and endurance as well as depression creep in to a man that has always been optimistic.

These have been my experiences and wanted to share my perspective.

Blessings!

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be64
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Re: Low T Treatment Update

Postby be64 » Sat May 27, 2017 7:51 am

Testosterone replacement is a complicated issue which I could write pages about but I'll try to give a simple answer. First, your doctor doesn't know much about TRT since he is giving you injections every two weeks. They should be weekly or more frequent than that. That large injection produces a huge testosterone spike which leads to a high conversion to estradiol. Estradiol essentially undoes alll the benefits of testosterone. If your doctor isn't monitoring total, free, and boiavailable testosterone, SHGB, estradiol and DHT then you should probably find another doctor.

Many of the benefits of testosterone replacement can take up to a year to see results. When you have low testosterone for a long time I believe you get a reduction of testosterone receptors. It takes a while for the receptors to increase such that you can get the benefit of increased testosterone.

I believe for most men to be happy with TRT they will need to be on testosterone injections, a small amount of anastrozole to control estradiol and HCG to maintain testicle size and function and to stimulate the LH receptors in the brain.

tjw, mid 300s is still very low. It's no wonder you would not have seen a benefit. Self injections are the cheapest and easiest way to increase testosterone.
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SquarePants
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Re: Low T Treatment Update

Postby SquarePants » Mon May 29, 2017 8:13 pm

I agree with BE64 in that your doctor doesn’t know much about testosterone therapy if he’s prescribing injections every 14 days. They should be given at least weekly. You can do subcutaneous injections into the fat, which can be performed with small needles.

Also, any doctor prescribing testosterone therapy absolutely should be monitoring estradiol levels. If your estradiol levels are elevated (which is EXTREMELY likely if you are taking 200 mg injections every 2 weeks and have a testosterone level of 1209), then you won’t feel any benefit from the testosterone. You’d feel great with a level of 800 if your estradiol was under control. I’m on testosterone therapy, and I feel zero benefit of testosterone if my estradiol levels rise. Be64 had it right. A small dose of anastrozole (Arimidex) is VERY commonly used with testosterone treatment to control estradiol levels.

I’d suggest either finding another doctor, or do some reading about testosterone therapy and try to guide your doctor. One good book is “Testosterone Replacement Therapy: A Recipe for Success,” by John Crisler.

I'll bet that you don't feel so well the last few days before your next injection.


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