T Nation

36 New to TRT in Toronto

Hi all, so I’ve started taking trt. I’m seeing Dr. Larry Komer out of Burlington.

Basically I did steroids from 2011 to Dec 2014. Plus I did a lot of kickboxing when I was younger, so lots of head impact. When I finished my last cycle I did a standard 5 week nolva pct. I then saw a fertility doc to make sure I was still able to have kids, and about my test levels. This is mid 2015, and I had all low t symptoms. No libido, weak boners, brain fog, inability to lose bodyfat regardless of diet and cardio. Just felt like crap in general.

He told me while I was still fertile. I was “in range” and prob just have to wait for my test level to return to normal, and it takes the amount of time you did steroids for that to happen. He said all my symptoms were just depression and he recommended a therapist. This is a guy named Dr. Casey based out of Oakville and apparently he says this to all guys who go to him.

So Dr. Komers nurse put me on 0.55 mls delatestryl once a week to start. Package says 1000mg/5ml. Can anyone tell me how much this is exactly in mg a week?

I’ve also decided to inject twice a week instead of once. 0.275 sun/wed. For those on delatestryl, does this matter at all?

Thanks for the help.

110mg/week is the dosage you’re taking.

Delatestryl is testosterone enanthate. You’re taking 110mg a week. By far, most guys on TRT inject once a week. On internet forums, you’ll see a lot of guys injecting more often, even daily.

In other word this doctor doesn’t prescribe steroids to men, the “in range” common is just a ploy to deny treatment with steroids which is demonized in western medicine. There is just too much bad politics attached to TRT and some doctors want no part of it.

Sadly Dr. Casey was trained in socialized medicine and whenever there is depression in patients, the standard procedure is a referral to a therapist and if there are ED issues, you get a referral to a sex therapist. Sex hormone knowledge in socialized medicine is almost non-existent.

Here he says levels are “in range”, but then says, "and probably just have to wait for your test level to return to “normal”, so he is saying you’re levels aren’t normal but are “in range”. Got it!

Well 50% of 1000 is 500mg, so 55ml would be just over 550mg if I’m not mistaken. If you’ve done weekly injections on cycle and never had any serious estrogen management issues, one weekly is fine, no harm is injecting twice weekly and if anything trough levels will be higher.

He was trained in medicine. There is no special course for socialized medicine. It doesn’t sound like he did anything any different than in the US, or virtually anywhere else. The uneducated comments are less than helpful and getting old.

He may have been trained in medicine, but it is regulated by the government and that’s is socialized medicine, so it isn’t anything like our medical system, but if you want a taste of what’s it’s like go to the VA for TRT and you can expect the same stupid uneducated statements.

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I am Canadian, and American. I’ve used both, and my wife was a legal transcriptionist who typed up endless VA nonsense. The only difference is that Canada is a single payer system with price controls. Same guidelines, same Hippocratic oath, they recognize medical degrees from each others Universities, they share research. Doctors follow guidelines, it’s what they do. They also are supposed to “First, do no harm”. They are not actually in the business of optimizing lives or health, in any country. They are there to keep people alive. If you want more than that, you are moving from healthcare to the realm of something else. Period. Nicaragua has socialized medicine, and I can buy whatever I want OTC without a prescription. If they have it, I can buy it, no questions no problem. And I don’t even have to have a shirt or shoes. The difference in these things is whether or not government is protecting us from ourselves - and some people need to be protected from their own stupidity unfortunately.

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Yes, but he did not inject half the vial. Eleven of the vials would total 55mL, they are 5mL vials. It is 1000mg per 5mL, or 200mg per mL. A dose of .55mL would be 110mg.

This is a common unit conversion exercise…

0.55 ml * (1000mg / 5ml)… you have ml on top and bottom so they cancel out leaving you with mg for units…and in this case, 110.

Other ways to do it - simply the vial measurements - you have 1000mg in 5 ml, so that’s 1000/5= 200mg/ml. .55 * 200 = 110 mg…

Ie basic math.

I think original post may be misunderstood - Dr. Komer is treating the OP with TRT, and on top of this, referred the OP to a local specialist to help with depression.

Komer is awesome, I’ve been very impressed with him. Aside from TRT, he’s also one of the top post-concussion specialists in Canada - I see him for both conditions. Something I found interesting with him is that he’s a strong advocate for 1x week injections. He’s got over 10,000 TRT patients and he’s had patients self-experiment with every injection frequency under the sun, and he said 1x/week is what most ultimately come back to. I’ve switched to this and it’s worked very well for me. He’s also not a big fan of SHBG testing, as it fluctuates so widely in response to a variety of factors, and a single blood test (snapshot in time) doesn’t really tell you much. Totally agree with him on that one.

Re: Canadian vs. US healthcare, pros and cons to each, but having experienced both I prefer the Canadian system for a number of reasons. In an advanced country, I cannot wrap my head around an uninsured person having to pay hundreds of thousands of dollars out of pocket for care.

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Thanks for all the replies,

To clarify, I didn’t want to write too much so I left it brief. I’m definitely not depressed. The first doc said my low libido, brain fog, etc were symptoms of having depression.

So I waited 4+ years after seeing the first doc hoping my body would return to normal with no change. That’s why I gave up waiting, researched, and found out about Dr. Komer.

I have no affiliation with the place, but I know several guys who had good experiences with a place called tru balance health care dot com. I’m in Montréal and I know several guys in Toronto, Ottawa and Gatineau using them. They also do the trans scrotal cream. Several docs there trained by Dr Rouzier. Hope that helps.

Just got my appointment with Komer today. Have been self administering wondering if you guys got a feeling from him of his attitude towards that. Wondering how long I should be off before seeing him. What we’re your levels at when you were tested?

I think I would just continue what you’re doing so he can see how you are responding to that and take it from there. I would be pretty sure he’s seen and heard it before.

Possibly although I think he may want to see natural levels first. High pull, switching from 75 mg x2 a week to once a week. Just do 150 on my next scheduled day?

Then he can ask you to stop. You’ll need to be off for a while to see where natural levels are.

That is what I would do.

I haven’t seen him yet. Only the nurse. My testosterone levels are below. Range at lifelabs is 8.4-28.8

Dec 2015 14.6
July 2019 22.5

Dec 2019
Test 17.4
Estradiol 58
DHEA 3.1

Did nurse prescribe forvyou at that level?

That would be .6cc for me. Too much for sub q? Switch to shallow im?