T Nation

31 Year Old. 2 Time Testicular Cancer Survivor, New to T Replacement

6 years ago i was diagnosed with testicular cancer had Testicle removed. No further treatment or T issues.

Fast forward to 10/25/2018 I was diagnosed with testicular cancer for the second time and had surgery on 11/7/2018. On surveillance again with holding chemo for now as long as i continue to have clean CT scans and blood work. Started 2 pumps of andro gell 1.62 11/8/2018 T level was basically 0. One month later T was tested again with came in at Total 166ng/dl and Free at 24pg/ml. Doctor changed to 3 pumps and just had my T tested yesterday and came in at Total 252 ng/dl Free 37 pg/ml. He is now increasing to 4 pumps today but I don’t think its going to get me back into feeling normal again. Were going to discuss other methods at my next appointment 1/20/19 since I’m not responding to the gel very well. As much as I would like to avoid the needle i dont think i have any other options.

I haven’t been able to find much info on completely replacing T most guys are just low. Can anyone suggest what there using who are also incapable of producing any T.

Injections are the most efficient delivery system. You can even go SUB Q if you are worried about poking muscles so often. Its not so bad.

I use to do SUB Q and I do IM now, and i’m just use to it.

Gels, pellets, patches, and all that other crap are garbage.

Generally speaking, a good protocol to start would be :

100mg split into 2 shots a week. SUB Q or IM, depending on preference and if one works better for you. Then you can titrate up or down depending on your needs.

I was just about to get into HCG, but I don’t think that would be applicable to you. Maybe for LH receptors in the rest of the body? not sure, someone else will have to pipe in.

Once somebody gets on TRT, he essentially stops all natural production. So the treatment is the same. Read everything you can. Use the search engine and if your Dr is resistant to HOW YOU FEEL rather than numbers, find a new Dr.

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What an ordeal. You came to the right place. Technically we are all replacing our T. Some guys take HCG to keep their natural system going but most of us are on exogenous T with shut down systems. What @studhammer said.

What made you switch from SUB Q to IM? Did you experience different highs and lows by injecting differently? Beside the needle the highs and low of injecting worry me.

Makes sense. Good to know. Lots of info out there not sure how much of it is fact. Glad i found this site.

I have higher SHBG, so I wanted to try IM to see if the higher peaks gave me more bang for my buck. I feel better on IM, but I also did a slight increase in test dose. I may go back to SQ at some point, or if my e2 gets out of control.

Doing twice a week shots will get you fairly zeroed so the peaks and valleys are not far apart.

Gels work for a very, very smaller percentage of men, insurance companies hate gels ($$$) and so the only people who benefit from these gels mostly is big pharma.

Gels have a very low percentage of testosterone that it’s almost a scam. Injections is 100 percent absorbed and nothing gets wasted and is the cheapest most effective delivery system.

You need to take into account SHBG levels when deciding on a TRT protocol since SHBG influences free T and free estrogen. A Total T of 500 will see my Free T at the very top of the ranges where other men with higher SHBG would need more Total T to equal similar Free T.

Default to 50mg twice weekly if SHBG is unknown, but still you should find out where SHBG sits. Do not even consider an estrogen blocker until you’ve attempted to adjust T dosage in an attempt to lower estrogen.

Often all that’s needed is to increase injection frequencies by injection smaller doses more often, if you’re having huge problems controlling estrogen 20mg EOD or even 7-10mg daily.

Ive had my SHBG tested also yesterday. It came in at 46nmol/L which puts me right in the middle. Im fortunate to have very good insurance so my copay has only been 5$ a month for the gell. The endocrinologist Im seeing right now seams to know what he’s talking about. He gave me the option to go with injections or try the gell. I figured it was worth a chance to avoid injecting but the more I read I prolly should have went straight to injections…

Gels are typically not effective, there are outliers. There’s always a possibility later in life absorption will cease forcing you to hit the reset button and figure out your dosage on injections.

Then there’s the studies that show more muscle mass on injections.

Muscular responses to testosterone replacement vary by administration route: a systematic review and meta-analysis.

CONCLUSIONS:
Intramuscular TRT is more effective than transdermal formulations at increasing LBM and improving muscle strength in middle-aged and older men, particularly in the lower extremities. A 10-13% increases in total body strength.

That right there is a deal breaker if I’ve ever seen one.

Fellow x2 TC survivor. After second I/o went on a Androgel for almost 3 years. It was ok for me at best but always had elevated E2 and SHBG and low free T. Was on the 1.62% 3-4 pumps and it was a lot of up and down with mood and energy always sucked. Bloated with about 15lbs of water and got some minor Gyno. I was 38 years old and couldnt imagine slathering gel and lotion on my arms for the rest of my life and feeling like i was 80 years old. Something had to change.

Switched to cypionate injections about a year ago. It’s easy, practically painless and quick and I still get to control it at home. Subq injections x2 a week and I feel almost back to normal before all this cancer shit derailed 6 years of my life.

Bottom line, find what works for you and make sure your endo understands how you feel along with monitoring your labs.

Good luck to you!

That’s basicaly where I’m at and how I feel. Thought it was in my head but what you described is exactly how I feel with mood and energy. Also the extra 20lbs I’ve put on with no change in diet with minor gino. I have an apt with my doctor on the 24th and am going to push for some form of 2x a week injections. I’ve only felt like this for 3 months I can’t imagine 3 years…

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Well I gave gels as much of a chance that I could. I tried all different number of pumps, split doses, lotions and phlogel for better absorption. I felt absolutely dog tired every morning like I was hung over and lean up against the shower wall. Then I would get the gel on after drying off and get a rush of energy for about 3 hrs and then a quick decline after lunch and ready for bed by 5pm. No motivation to do anything. Not to mention night sweats and panic attacks the longer I was on it because the absorption was not getting through the dry scaly skin that it caused.

Though I wasn’t thrilled about needles, when you feel like crap you will do just about anything to feel better. But I can say it has been a night and day difference. Took a few months to level out but it was worth it. Hang in there. And here is to future “all clears” with your surveillance.

That’s exactly where I’m at in the morning. I switched from 3 to 4 pumps a lil over a week ago and it’s gotten rid of the hot flashes. My energy improved for the first 2 days but I was in the worst state of depression I’ve ever felt. Now my mood is kinda better but the energy is gone. Ive worked 8-12 hour days starting a new distillery for the past 5 years. Not only is my energy not there my mood could care less about work. Not me at all. It’s kinda like when you have a really bad cold for a week then one day you feel a lil better you get excited but really you still feel like shit compared to normal. When you switched to injections it took you a couple months to level out but how long did it take you to feel a real difference compared to the gel?

Feeling “good” was an accumulative process as I noticed different things over a few weeks to months. The first thing I remember noticing within the first week was feeling more clear in the head as I was always a little foggy on the gel. Plus the water weight started coming off around that time as well. Then energy started to become more pronounced after a month or so where I felt like working out and doing things again. Which also helped me to feel better. Not too mention the libido was more noticeable and still strong today.

There was one month during the transition where I felt a little achy on the joints and my guess was that looking at my e2 levels my estrogen levels dipped lower than I had been on the gels (which was always elevated), so I increased my dose a little and that seem to help clear that up.

Of course everyone responds different. And the one thing I have come to accept is this is for life. When it comes to hormones change one thing at a time, be patient and wait at least 6-8 weeks to evaluate how you feel and check labs before adjusting further.

Switched to 100mg Enthanlate Injections 2 weeks ago and already feel a lot better. Im trying to wrap my head around HCG. Is the only necessary to maintain testicular function? Should i be asking my doc for that also even tho I no longer have testicles? Does if have other benefits?

Dang your story is exactly like Furious Pete’s! He had testicular cancer like 5 years ago and had one testicle removed. He did fine until 2 months ago and found out the cancer returned so he got second testicle removed a couple of weeks ago. He is 33 right now almost same age as you too. He said he must go on TRT now. Sucks.

Being a x2 TC survivor I have wondered the same thing about HCG with no more boys down below. Is it worth it, would it help backfill the pathways for other hormones? Not sure on that one either.