This is another example of extrapolating personal experiences to the remainder of the world. Are any of the doctors you have heard (where did you hear this?) using pellets in their practices? I would guess no.
I am like them. Patients I see that were using pellets are not happy with the results, so they are looking for other options. They ask around, come across a patient that I see and end up in the office with their unhappy story. I could go around saying all these former pellet patients I see are much happier on injections and pellets didn’t work. I would be correct. However, if I said, based on that, “patients doing well on pellets are the minority,” I would be wrong. Just because you do not hear of them, or the doctors you “heard” do not see them, or myself for that matter, does not mean they do not work. They do and probably for most people that try them. They just are not showing up in my office looking for injections.
Have you spoken to, or heard from, doctors using pellets exclusively? I have and guess what? They have thriving practices with satisfied patients. Pellet therapy has been around for quite a while. If it only worked for a minority of patients I think they would have lost favor with the public by now.
There are many delivery methods for TRT and many more protocols. Everyone has to find what works best for them and there is no one size fits all approach.
I’m just stating my personal experiences and based on conversations with docs, if you have some data that shows something different, I’ll be glad to have a look at the data.
I don’t doubt it, but how many unsuccessful versus successful cases, do you know or are you only counting the successful cases?
In general, I agree with this comment. I can only speak from my own and the experiences of hundreds of guys I’ve communicated with in forums like this. Which have formed the basis of my opinions. We all have to keep in mind that what you read hear (and hear from practicing physicians) are just that, opinions.
having said that, I think the basic opposition to the use use of the injection delivery system is the antiquated protocols that many docs put patients on and (unfortunately) reverberate through these forums (even this one).
One of the first things that I usually advise guys is that frequent injections (i.e., more than once per week) of smaller doses of T esters will give you a smoother ride and with fewer side-effects. It’s also a paradigm shift in thinking regarding needle size. With these smaller volumes, you don’t need a harpoon to get it deep into your muscle. A small 28G insulin syringe will do nicely. Not much more than a mosquito bite. It’s also MUCH MUCH less expensive.
So, yeah, if you don’t mind going to a doctor’s office an a regular basis to have these implants reinserted, and you have the money to pay for the procedure, and you are afraid of mosquito bites, then implants may be the way to go. However, FOR ME, I will stick with what’s worked for the last 8+ years, which is 0.25-03 mL of T-cyp self-injected with a 28G needle into my quadriceps muscle every 3 days. Easy, quick and inexpensive with great results.
I would say the same thing. Saying the majority of pellet patients get unacceptable results, based on your experiences and those you talked to, and mine, is not correct.
Talk to some pellet doctors, you might even consider it, you’ve tried a lot things, might work for you with "stable " levels. I don’t know. Anyway, I bet pellets doctors see plenty of cases in which injections did not work out well.
Maybe they are not telling me the truth. They could always be liars. However, one of them does not take new patients and another, if you call the office, you’ll get a recording telling you to leave a message and someone will call back………………in three weeks! Must have a lot of unsuccessful cases then.
I suppose, when you question “do you know” the answer is I don’t know. All I know is what these people have told me. I did not travel to their office, interview all the patients, witness the pellet insertion, etc.
Don’t tell, show me, otherwise I’ll take it as you opinion.
I will admit some could be exaggerating simply because they hated the implant procedure and scars while the therapy was effective, but I don’t think the pellet therapy is as successful are you are claiming and can’t discard my experiences for someone else’s opinion without data.
I only know what I know from personal conversations in person and experiences on these forums.
Here is an interesting read on pellets. Showing that re-implantation is done at hypogonadal levels of serum T. Take away what you will. I’m sure lots of guys do well on pellets, but it’s simply not the optimal way to administer testosterone for stability.
Guys that start TRT with pellets might feel good and stick with it. But without trying a more stable form of administration, they might not know if even more benefits or symptom relief could be had.
Another person still quoting TESTOPEL articles. No one is disagreeing about the issues with TESTOPEL.
Lets talk about BioTE. Thousands of certified clinics across the USA. Using the most conservative number of 1-2 NEW pellet patients per month gives a yield of at least 24,000 to 48,000 new pellet patients per year. Yet there is only a hand-full of negative comments on injectible boards like this one; or any boards that I could find.
That statement by the way, was kind of funny coming from you. Weren’t you the long-time member who had your hand slapped by a mod on another thread because you couldn’t support anything you were espousing with emperical evidence?
Better yet Systemlord, when you WERE on TRT, you held Defy Medical up to the level of a Deity. Why not talk to them – as they are now compounding their own T-pellets and are slowly pushing pellet insertion across their platform. If it has so many problems, why is DEFY doing it now?
Look at the percentage of posts on this board that are tied to body building. Pellet use is NOT for body builders.
All of this discussion is happening because one person with no knowledge or experience with pellets made a flippant statement that “pellet use should be avoided”.
Geez, I’m not claiming they are anything. I’m trying to say for every guy you talk to (or hear about on the internet, and that includes me because what I hear from pellet users is from those in my office looking to use injections), there are doctors out there (that I have spoken to in person) using them with good results. I don’t think you know these people, but I bet if you search around you can find a pellet forum somewhere extolling the benefits.
I don’t use pellets in the practice, for a lot of the reasons mentioned here. No argument. Injections first, then creams, then pellets, then gels. Orals? Never. It’s all my opinion, based on what I have been taught, what I experience both with patients and myself, what I hear from other doctors, and what I read.
Exactly. And because of this, protocol stickies recommending specific drugs, doses, routes of administration, etc, are simply not warranted. Further, because such stickies may generate a (false) impression in the mind of a naive reader that there is One Correct Protocol, they risk undermining the therapeutic relationship between the reader and his TRT provider if the provider employs a different protocol.
Thus, protocol stickies are not only unjustified by current science; they also are potentially harmful. Primum non nocere, everyone.
As a physician (note: not a TRT provider), I can attest that there are clinical scenarios for which the treatment could justifiably be called the One Correct Protocol. And it may be the case that, at some point in the future, clinical endocrinology will advance enough to justify such a protocol for TRT. But until that time arrives, protocol stickies are best avoided (as are individuals who claim to know the One Correct Protocol).
I could not disagree more! If we relay on current standards of practice for TRT in the medical community, we’d still be all injecting 200mg every 2 weeks. Or worse yet, they’d be putting us all on gells because the only source of education they are getting on this topic if from the big pharma companies that have profits to protect.
I was fortunate enough after months of searching to find an enlightened TRT specialist that put me on the road to recovery with a modern protocol to which I am happy to share as an alternative to what the relatively uneducated (in this matter) medical profession has to offer. However, I had to make a 200 mile round trip every time I visited him and he didn’t take insurance and charged an arm and a leg, but he was dam good at what he did. I am fortunate enough that I can afford this experience with those who want to take advantage of learning about alternative approaches.
We all have to keep in mind that the information we receive from the internet is unfiltered and we need to constantly challenge it. Open discussion like this provide a useful forum for advancing our knowledge through the experience of others.
Just to be clear, and if it wasn’t before then I apologize; this is not supposed to be a cookie cutter protocol thread, or a one size fits all. As I have stated several times it is a “beginner” protocol thread. Where guys can see what options are available, proper doses, proper frequencies, and the proper way to dial their protocol in for their specific needs. It is for the 100s of guys that come on here that we’re just prescribed patches, gels, or low dose protocols that aren’t working for them and don’t there are other options out there.
Unless there are extenuating circumstances, all beginner protocols should be fairly similar. It’s not rocket science. You get blood tests, then administer exogenous testosterone. Current research shows that some forms of exogenous testosterone are better than others for the majority of the population. So start with that protocol, and branch out if necessary. If things aren’t working, then make a change. But at least the guys here will have some information on where to start and an idea of what to do if things aren’t working quite right.
I will tell you what I do. Based on the patient’s history, past medical history, family history, social history, pertinent physical examination findings, lab results and their desires, needs and comfort level, I start them with 140-200mg once weekly. That is probably from 80-90% of them. The initial protocol is changed about 10-15% of the time.
I did not advocate against “open discussion”; I advocated against protocol stickies–which, if you think about it, epitomize the opposite of ‘open discussion.’
I think it’s an idea that sounds a lot better than it actually is. As someone who got slightly screwed up by reading the “stickies” that were once posted here, let me throw my vote in for no.
For one, I think the field is too fast moving and ethereal to confidently devote a sticky to “beginner’s” information. A beginner’s information sticky from three years ago would look totally different than one created today. Which means, regardless of intent, a disservice is being done. I mean, basic information like how to inject, what pellets are, what 200mg/ml means… that’s fine. But that’s not what we’re talking about.
Secondly, there is some degree of disagreement on almost every aspect of TRT (see: any random thread). That puts you behind the 8-ball from the start.
Third, a beginner’s sticky would not account well for individual differences, which I can attest are certainly variable, especially among the type of person that undoubtedly lands in this place. That is, one who is unsatisfied with their current treatment, which means they are significantly more likely to be an outlier of some kind. Outliers by definition do not get appropriate answers from information based on the mean, let alone information based on the mean that changes every 18 months. I don’t think it’s a good idea.
I think you have a good argument there, and not a lot I can disagree with. If it were a protocol thread, it would need to be maintained and updated with up to date information.
It would be nice to have a place to steer guys to. There are several posts daily of guys asking pretty much the same questions. “Where do I start?”, “what do I ask my doctor?”, “how long does it take?”, “why do I fee like crap on 70mg/week?”
Currently, these are all pretty much answered the same way: “your doctor is an idiot”, “drop the HCG and AI”, “increase your dose to at least 120mg/week”, “it takes 6+ weeks to feel the full benefits” etc. etc.
If there could be some sticky that addresses a lot of that, I think it would be quite valuable.
I take your points, and also your intention, which is efficiency and site friendliness.
The main issue to me is that stickies are a form of endorsement and carry serious weight, whereas one person’s comment is just that. In other words, those answers, even the repeated ones, are sometimes dead wrong - and for now the responsibility for accuracy or lack thereof rests mostly on that commenter’s head (and partly the recipient’s diligence and/or common sense).
Once something is stickied, however, it becomes “official”. And because of the nature of this beast (and as demonstrated by the last set of stickies) that creates its own set of headaches.
