T Nation

Finally Started TRT, Have Some Questions

Over 35 Lifter
#1

Well, after a bunch of testing and a process of doctor research, I have started TRT.

My pre-treatment levels were as follows:

FSH: 8.69
LH: 5.4
Estradiol: 31.4
Testosterone: 279.1
Free Testosterone: 4.06

I am almost 48 years old.

My doctor started me on Androgel at 5 grams daily. He did not discuss his goals in terms of the levels I should reach. he will be testing E levels at each visit and is prepared to adjust and treat that as needed.

Based on my own research, I am thinking that I should work towards getting my T level to about 600 and my Free T to 25. Is this reasonable? If so, it strikes me as unlikely that I am going to get there on the lowest dose I see on the Androgel box.

We discussed weekly shots (self-administered), but he noted that one did not get a steady level with shots. My wife, an MD, agreed with this based on her own experience with patients getting this treatment.

Can some of the experts here offer some advice on dosage levels and the shots vs gel issue? I have only been on for about 10 days, so I can’t really go back and tell him that I want to triple my dose. Do I wait for my fist blood test, which will be in about 3 weeks?

Thanks in advance for the help.

#2

We can all save you a lot of trouble. You might need a new Dr to do this but we’re all doing this to some degree. Everyone’s protocol is a little different but here’s mine:

-50mg of T cyp every three days injected SC
-250IU of HCG injected every three days SC
-1/4mg of Adex every other day

That dose of T cyp and Adex are a good starting point. This puts me in the upper 1/4 range in T and free T. E2 27.

If you really want to use a transdermal use a compounded T cream. Way better and more pleasant to use than Androgel. 75mg of T cream put me over the top of range high on total T. The only thing I didn’t like about it was it left a slight oily residue. MUCH better than Androgel though.

Androgel is a very weak T gel. I think for it’s intended purpose it works ok and that is to put you “within the normal range”. Basically if your T was zero it’s better than nothing. For getting T in the upper range of normal it’s totally useless. Pluse do you really want to smear 100mg of Androgel all over your body every day for the rest of your life?

T cyp, per the label, is supposed to be injected IM. I read some research where it was being injected SC so I gave that a shot. I’m finding I really like it injected that way. No pain, scarring, and labs are the same. It’s a great way to go but your Dr won’t have a clue.

I think you’ll always notice a little swing in how you feel with weekly injections. Plus it’s a little hard to fine tune E2 with weekly injections.

Basically I wouldn’t attempt to reinvent the wheel. The above protocol works well and you’ll just have to tweak it to your body. Many of us started off going down the Androgel road and it’s not a pleasant road to travel down.

#3

[quote]brentf13 wrote:
We can all save you a lot of trouble. You might need a new Dr to do this but we’re all doing this to some degree. Everyone’s protocol is a little different but here’s mine:

-50mg of T cyp every three days injected SC
-250IU of HCG injected every three days SC
-1/4mg of Adex every other day

That dose of T cyp and Adex are a good starting point. This puts me in the upper 1/4 range in T and free T. E2 27.

If you really want to use a transdermal use a compounded T cream. Way better and more pleasant to use than Androgel. 75mg of T cream put me over the top of range high on total T. The only thing I didn’t like about it was it left a slight oily residue. MUCH better than Androgel though.

Androgel is a very weak T gel. I think for it’s intended purpose it works ok and that is to put you “within the normal range”. Basically if your T was zero it’s better than nothing. For getting T in the upper range of normal it’s totally useless. Pluse do you really want to smear 100mg of Androgel all over your body every day for the rest of your life?

T cyp, per the label, is supposed to be injected IM. I read some research where it was being injected SC so I gave that a shot. I’m finding I really like it injected that way. No pain, scarring, and labs are the same. It’s a great way to go but your Dr won’t have a clue.

I think you’ll always notice a little swing in how you feel with weekly injections. Plus it’s a little hard to fine tune E2 with weekly injections.

Basically I wouldn’t attempt to reinvent the wheel. The above protocol works well and you’ll just have to tweak it to your body. Many of us started off going down the Androgel road and it’s not a pleasant road to travel down.[/quote]

x2 … 2 billion that is.

#4

Interesting post, I started TRT two weeks ago. Doc (nationally known anti-aging Doc that we are fortunate to have in Indianapolis) has me doing 150 mg compounded cream daily (also the cream contains addl. 25 mg DHEA), then three shots total of 200 mg test. cyp. spaced two weeks apart (only during the first 6 weeks of treatment). He told me he personally follows this protocol and that shots are usually not necessary past the first 6 weeks. I was also borderline hypothyroid (hereditary) and started on 1 gn. armour daily.

It is AMAZING to me how much better I feel in this short time frame, plus, my lifts are going through the roof and I’ve already gained 6 pounds with no change in waist measurement. (also almost 48 yrs. old) Initial levels of T were similar, 200 total (low) and 14 free (midrange "normal) everything else in range except thyroid low end of range.

I have not seen this protocol here or elsewhere, would be interested in comments about it…lot of very knowledgeable people on here, very willing to assist.

thanks!!!

#5

Well, I spoke with my doctor today and am pretty disappointed. In asking him questions about his goals, he stated his objective is to get me to “low normal” which, he feels, is 300 total T and 10 of free T.

This is crazy low and I am quite sure he will not work with me to get to my own goals of 600 total and 20-25 free.

I wrote to Crisler and hope that he will do a phone consult. Renewman is too expensive and I am scared of the FL companies. Has anyone worked with these folks:

http://francisholisticmedicalcenter.com/index.htm

Thanks in advance…

#6

I’m a patient of Dr Crisler’s and I think it’s worth it if you’re going to be on treatment for life. You have to see him in person once and then the rest is over the phone. Once you’re dialed in it’s cheap.

#7

Don’t waste your time go to Dr Crisler

#8

I would love to go see Dr. Crisler, but can’t swing a trip from New England to Michigan, at least right now. It seems that there is no way to work with him other than traveling there, correct?

I have spoken with the people at Renewman and they have a doctor that is only 45 minutes away.

I checked my health insurance and RX coverage and they will reimburse out of network purchases, so this might actually work. I do wonder how safe these people are – granted, there is an MD involved, but there are also a lot of variables in play in terms of levels etc.

I would be interested in hearing from people who actually use Renewman and what their experience has been. I am not interested in getting to crazy levels or obsessing over all this. I just want to improve how I feel and be safe in doing so.

If there are other suggestions, that would be great. But hearing frm current Renewman users would be a big help.

Thanks.

#9

Crisler is way cheaper than Renewman.

#10

[quote]brentf13 wrote:
Crisler is way cheaper than Renewman. [/quote]

Can you explain this please? Is this based on experience with both? What numbers are you using as your basis?

Thanks.

#11

I talked to Renewman and Crisler’s office and compared prices. Crisler was way cheaper long term and I would rather deal with him. I think TRT is costing me about $30 a month. Crisler writes my prescriptions and sends them to my local pharmacy. Insurance has been covering the meds without a problem.

#12

[quote]brentf13 wrote:
I talked to Renewman and Crisler’s office and compared prices. Crisler was way cheaper long term and I would rather deal with him. I think TRT is costing me about $30 a month. Crisler writes my prescriptions and sends them to my local pharmacy. Insurance has been covering the meds without a problem. [/quote]

That’s good to know. How often a year do you have to see Crisler?

#13

[quote]brentf13 wrote:
I talked to Renewman and Crisler’s office and compared prices. Crisler was way cheaper long term and I would rather deal with him. I think TRT is costing me about $30 a month. Crisler writes my prescriptions and sends them to my local pharmacy. Insurance has been covering the meds without a problem. [/quote]

Exactly

#14

[quote]Elaikases wrote:
brentf13 wrote:
I talked to Renewman and Crisler’s office and compared prices. Crisler was way cheaper long term and I would rather deal with him. I think TRT is costing me about $30 a month. Crisler writes my prescriptions and sends them to my local pharmacy. Insurance has been covering the meds without a problem.

That’s good to know. How often a year do you have to see Crisler?

[/quote]

You only have to go see him ONCE - Ever.

Thats the beauty of it.

After that you can, if you want, conduct office visits virtually via phone and fax, going over bloodwork and whatever else may arise.

This visits are twice a year at 60 dollars a piece.

You can always go see him in person as well if you wanted to.

#15

He also provides the option of no visit if you use your MD to consult.

For Those Who Want To Become My Patient

In order for Dr. Crisler to dispense medical advice or treatment you must be a part of our practice. There are three ways to become a patient:

  1. If you are local you may simply schedule an appointment.
  2. If you are out of state, you may schedule a day trip.
  3. If you don’t want to make the trip, you may have your primary care provider consult with Dr. Crisler. Additional information below.
#16

Do you have more details on how to arrange having your PCP consult with Dr. Crisler? This sounds like a good possibility.

#17

[quote]thr61 wrote:
Do you have more details on how to arrange having your PCP consult with Dr. Crisler? This sounds like a good possibility.[/quote]

Sure, go to this link and you can read the entire instructions.

musclechatroom.com/forum/showthread.php?t=74

#18

I believe that Dr. Crisler will be willing to consult directly with your doctor for free. Your doctor would have to shrink his ego enough to call Dr. Crisler, though. That’s a hurdle to jump over.

There might be a D.O. (physician that is a doctor of osteopathy rather than an M.D.) in your network that may be more openminded about this. Many go down the path of endocrinologists, who should understand this stuff. My doctor is a urologist, and I suspect he knows at least as much as Dr. Crisler. Truly a pearl of great price that I found in this local doctor who is in network. Doctor number 8 on my quest to get affordable TRT.

Good luck man.

#19

[quote]CrazyCrew wrote:
thr61 wrote:
Do you have more details on how to arrange having your PCP consult with Dr. Crisler? This sounds like a good possibility.

Sure, go to this link and you can read the entire instructions.

musclechatroom.com/forum/showthread.php?t=74[/quote]

In order to treat you virtually without an in house initial consultation, Dr. Crisler will need to go through your primary care physician. This can be done by having your doctor call and confer with Dr. Crisler about your situation. If your doctor is willing, you may be able to set up a conference call so that you could be a part of the initial consultation.

Is what it says, btw.