T Nation

Need Help Understanding this New Low Testosterone Level

Hello everyone,
I need some guidance on this Testosterone Therapy that my family doctor started me on. He was hesitant on putting me on it last year (2-10-2015) when my level was at 258ng/dl. Then I got retested on 3-14-2016 and my T level was at 192 ng/dl. He then started me on Testosterone Cypiona 200mg/ML INJ. It said on the script box to inject 0.5 ML into the muscle once every two weeks. I had the pharmacist walk me thru on doing the injection since I had no idea on doing it. But he said to use 1 ML every two weeks is how the script breaks down. So the following two weeks I had to give myself my own injection which I was nervous and I couldn’t get the fluid into the syringe without the air like the pharmacist did. So I did the best I could, and then when I put the needle into the glut muscle, I didn’t realize how hard it was to do by myself. I ended up puling the needle out and putting it back in next to the first spot to see if the fluid would come out of the needle better. It didn’t seem like it was coming out. It was a total disaster. I finally was able to get it all in and had to hurry and get to work so I wasn’t late. Then I got my new refill vile and I had my friend that is on the same thing help me do it. Which went well. I then had the doc appointment and he doesn’t seem to be the type of doctor that puts people on the T Therapy. I asked him to help me understand on the dosage breakdown since the script box said 0.5 ML injection every two weeks, but the pharmacist said I should do 1 ML every two weeks. I thought the pharmacist was correct since my insurance refilled my script 30 days after starting on it. After talking with the doctor and his nurse that is in the room adding our discussion to the notes for the appointment, I was still confused because he was saying that I should get 4 doses out of one vile and it should last for 8 weeks, since I do the injection every two weeks. And after telling him how I only got two doses of 1 ML, out of the vial and then got a call from the pharmacy that my refill was ready to be picked up. He even had me confused and he finally said to just do the shot once a month, after I finished the second vial which I already had injected 1 ML out of the vial. So the next two injections I took the 0.5 ML to finish off the vial. I should be due for my next refill so I can take my next dose on Saturday. But now the pharmacy haven’t received the refill from the doctor yet. I had my next set of blood work I had done on Tues (6-16-2016) and I got the results of the T Level and it was at 191 pg/ml which is lower then the first two. I have my next appointment on 6-21-2016 which is next Tuesday.

I see a Rheumatologist for my Lupus, a Pain Management doctor, and my Physiatrist for my depression and anxiety and ADHD. And they say that I should see a specialty doctor. I feel with living with the depression, anxiety and no energy, memory loss is bad, no sex drive at all, and my pain, that I should see a doctor that treats hormone conditions to get better tested to see what is going on with me. What kind of doctor treats people on Testosterone Therapy. I need some help if anyone could give me some suggestions. I also started using a CPap at night for the past 2 years.

I take Ibuprofen, Morphine IR, Percocet, Diazepam, Zoloft, Flexeril, Vyvanse, Plaquenil, Vitamin D3-50 50000Units, Testosterone Cypiona 200MG/ML INJ, Miralax, Omega-3, Stress B Complex, One A Day Multivitamen

I’m on my phone and have more to say. I will respond more later. For now, stop injecting T before you disrupt your hpta axis more than it already has been and run from your Dr. He doesn’t know what he is doing.

Call all pharmacies in your area. Call standard pharmacies and ask for references to Drs who prescribe testosterone injections and also arimidex/anastrazole. Then call Compounding pharmacies and ask if they know of any drs who prescribe MALE patients hcg. See if any of the names overlap.

Call drs offices, explain your situation and get in for appointment and confirm insurance coverage.

You need to find a Dr willing to let you inject at least once per week at home, will monitor your estrogen levels and prescribe an aromatase inhibitor like arimidex/anastrazole if estrogen gets too high and also hcg to preserve your testes function and size.

You can simply get small insulin needles online (many States will not sell to you in person without prescription) and inject in your deltoid, quad or butt. No need to use the huge syringes.

Google and read about all terms I used that aren’t familiar to you.

Read everything you can in this trt forum.

Can you post your blood work results here?

Please read stickies in 2nd post of 1st forum topic.
Advice for new guys
Things that damage you hormones
Protocol gor injections
Finding a TRT doc

You should inject 50mg twice a week. Use #29 1/2" 0.5ml [50iu] insulin syringes and inject under skin, SC, or into muscle on upper outer leg.

You really need to read those stickies.

Thanks for the quick response Hostile,
I talked to my family doctors nurse today and she said that he will talk to me about my concerns at our appointment on Tues the 21st. He will I’m sure want to refer me to a different doctor about this. He has already said last year about being concerned about putting me on the T Therapy because of all the lawsuits that people put on doctors, which I can understand. I’m busy today to call any doctors. But I will keep reading more on this website about what you said. This is all new to me and this could be the problem I have been dealt with the past 20 years of depression and everything else on feeling down about myself. I’m sort of in a hurry myself right now but will be back on here tonight. I have always thought that my conditions I have was from after having a shunt inserted into my skull in my brain to drain thru the tube to my bladder, for a condition called “water on the brain” (Hydrocephalus) at age 16, and had it revised 5 times in 3 years. I’m now 43 with no more revisions thank god. I thought that having poor concentration, poor short term memory loss, poor energy, depression, and my well being has bought me down to where I feel like I cant do anything. I have always had a hard time on comprehending anything I read so I write a lot of notes on stuff but then I get overwhelmed with all the notes laying around. Then diagnosed with Lupus 18 years ago. And my L5-S1 disc has given me problems for the past 10 to 13 years. They want to do surgery but I’m scared to have it done. So my sister in-law is a PT, and she works with relaxation techniques and a procedure called Cranial Sacrum Therapy, which seems to help some, and stretching. That’s just a little more about me.
I will read about what you said and try to find it one here. There are two endocrinologist in my city, and they both have good ratings. If that’s who to see. I will have to call to ask them if they treat patients with T injections and my insurance. I have Medicare and Medicaid after I was put on SSDI about 5 years ago. Which I was approved in 4 months. I have one dream and that is to get better where I can find work that I can do full time. But with my conditions it don’t look to good though.
I have to get going. But what all type of blood work are you asking for? If you give me a list I can give you the results if I had them done. Or I can sent a list of everything I had done…

Thanks for your quick response KSman, I will also read about the stickies in the 2nd post. I’m just learning on how this forum works and where to look. But I am going to get the hang of it.

KSam, I started taking a trace mineral with Alfalfa, Kelp, and Dandelion in it.

I started reading on the website below about the 3 Herbal Trace Minerals. Could you read about these three and let me know if you know if they really can give false reports for my blood work or the meds I take. I have a list of my meds and blood work in my profile. Thanks, Rob

I haven’t been able to find a doctor that takes my insurance in my area. I only found one that is booked with appointments till August.
I had my doctor appointment with my doctor that started me on the T Therapy, again on 6-21-2016 for my follow up of my T Level I had done on 6-16-2016. I talked to him about doing a weekly injection, but he wants to do it every two weeks untill I see him in a month on7-26-2016. He wants me to take 1ML of Testosterone Cypiona 200Mg/ML INJ till I follow up with him on 7-26. I asked him about if there was any other blood work that needed done or if I should be taking anything else with the T. He said since the T Level only increased one number from before started the injections, that he wants to see me back in a month to see how the increase on the Cypiona will work.

I still want to send you the blood work you asked for in your last post to me. But with getting so much blood work that I get done for my Lupus and with what my family doctor orders, I wasn’t sure if you wanted me to post everything I had done the last month. Or is there a particular blood test your needing from me.
So for waiting so long to respond but I haven’t had the time and energy to get to it…

I’m sorry for not catching on to where you said to look at stickies. I’m logged in here on my cell. And I click on my picture and I then click on a drop down tab that shows my messages. Where do I go to get to the Stickies to read. I found the other day where Iif said “Things that damage your hormones”, and it had a small amount of info and it had a link to click on at the end. I don’t know if that is what I was suppose to read, and I couldn’t find the other three forum topic stickies. If I could get some kind of direction on how I get to those stickers will be appreciated. Then I can take time tonight to read them so I can get on the right track…Thanks.

Scan and upload if you can. I’d wait until August. This Dr is going to do more harm than good.

They have a website that my doctors started using a couple years ago that the patient can log in and it shows medical conditions, medications the patient takes, and any blood work, MRI’s, and surgeries. I will take a look at it when I wake up to check if I’m able to copy it to notepad and paste it on here that will show blood work, and vitals from each appointment. I had to work late and I just seen your message before going to bed…

I was looking online and found a couple doctors. I’m going to send the link for one of them to you so you can look at what she specialises in and if this could be a doctor I should use. Also It shows other doctors you can check out at the bottom of the page. I just really want to find the right one instead of going thru several of them while searching for the one I need. Here is the link to her page, https://www.healthgrades.com/physician/dr-vrinda-agrawal-gcx98

Thanks for taking your time to help me thru this and I will try to get the blood work from the site I log into.

I see nothing on her page indicating that she treats or specialized in hypogonadism or “andopause” as some refer to it occasionally in older men.

How did you locate this Dr? Through calling pharmacies?

My doctor did a Testosterone level last Thurs "Aug.18th. And my level jumped up to 650. And now he won’t refill for my new script till I see him Sept.13th. I read online that he should do a testosterone Free level as well which didn’t get done. It says if the estrogen becomes High that they may put you on a estrogen blocker. And I can’t get in to the endocrinologist that we have in town until October. So she just said she was going to talk to the doctor and see if he wanted to do something different before September or if I need to wait until then. She said that since it’s at 650 that it will be good until I see him next month. So I hope that I don’t feel worse not having it until then. Is there any other kind of blood work while being on testosterone therapy that your doctor should do besides the testosterone level and the free testosterone level?