T Nation

New to T Replacement, Questions

So… I am new to this whole thing. I was diagnosed 1 1/2 months ago with low t after fatigue and workout recovery problems over the last year. I have also gained about 10 lbs this year, although I workout daily (triathlon training only). I went to a urologist in Charlotte that is supposed to be the “man” for this. I was tested and my total t came back 210. I was never told of the other labs, and started on androgel 1.6, 2 pumps per morning.

After my insurance denied this, I switched to injections after 3 weeks. I stopped the gel cold turkey. I have had 2 shots the last 2 saturdays (1 and a half weeks total) of 100mg per shot IM. SO far, I notice very little. I may have a touch more energy each day. I had no sexual problems before, so nothing is changed there. I have gained 6 lbs in a month. It does not look like muscle. Either fat or bloating. I am in the process of switching urologists to a friend who specializes in fertility and t-replacement. I was unaware he handled this from the beginning.

A couple of things. First, he doesnt ever prescibe the shots. He likes the testim, or underarm new stuff. He feels the shots have too many swings, and get an addictive like profile, where more is needed over time vs. effect. He also is not happy that more tests were not performed prior to starting therapy. He wants me to stop cold for 10 days, then come in for an exam, and multitude of lab tests. I am not sure the labs are going to be accurate, since I will still have some effects of the last injection in my system.

I asked him about weight gain, and didnt really get a straight answer. Also, I asked about taking arimedex and was told he was not in favor of this, especially at first before we establish how things are going and check serial lab values for a few months. He did say if I was convinced I needed shots he would send me to his endocrinologist that can monitor things correctly and handle that.

Any ideas for this. I want to start losing weight and have energy. The last thing I want to do after 6 weeks is stop the replacement and start over on a new form of therapy which will start the waiting period over again. Thanks

Yeah, there should have been full tests before starting anything… you have no baseline to work with. 10 days seems tight, you will not have swung back to base yet… stopping cold turkey is going to slap you around, too. But both of those are mitigated a bunch by the fact that you were only on the shots for 2 weeks (the cream sucks, IMO, so I doubt it “changed” you much).

He’s right in not jumping into AI until he sees some labs.

Too bad he’s down on injections. He can control the swings by prescribing more frequent, smaller, doses (in your case 50mg twice a week), but he’d have to be ok with self-injections (should be, for pete’s sake, insulin users have to do that all the time).

Daily triathlon training might be taking its toll on you, too. More rest time might help.

As for weight… best to get all these tests and adjustments done, see how you are doing in a couple of months… and in the meantime, check your diet.

[quote]aness2323 wrote:
So… I am new to this whole thing. I was diagnosed 1 1/2 months ago with low t after fatigue and workout recovery problems over the last year. I have also gained about 10 lbs this year, although I workout daily (triathlon training only). I went to a urologist in Charlotte that is supposed to be the “man” for this. I was tested and my total t came back 210. I was never told of the other labs, and started on androgel 1.6, 2 pumps per morning.

After my insurance denied this, I switched to injections after 3 weeks. I stopped the gel cold turkey. I have had 2 shots the last 2 saturdays (1 and a half weeks total) of 100mg per shot IM. SO far, I notice very little. I may have a touch more energy each day. I had no sexual problems before, so nothing is changed there. I have gained 6 lbs in a month. It does not look like muscle. Either fat or bloating. I am in the process of switching urologists to a friend who specializes in fertility and t-replacement. I was unaware he handled this from the beginning.

A couple of things. First, he doesnt ever prescibe the shots. He likes the testim, or underarm new stuff. He feels the shots have too many swings, and get an addictive like profile, where more is needed over time vs. effect. He also is not happy that more tests were not performed prior to starting therapy. He wants me to stop cold for 10 days, then come in for an exam, and multitude of lab tests. I am not sure the labs are going to be accurate, since I will still have some effects of the last injection in my system.

I asked him about weight gain, and didnt really get a straight answer. Also, I asked about taking arimedex and was told he was not in favor of this, especially at first before we establish how things are going and check serial lab values for a few months. He did say if I was convinced I needed shots he would send me to his endocrinologist that can monitor things correctly and handle that.

Any ideas for this. I want to start losing weight and have energy. The last thing I want to do after 6 weeks is stop the replacement and start over on a new form of therapy which will start the waiting period over again. Thanks[/quote]

First question …Age.
second if <35-40 do you really need it or is HRT a symptoms of a deeper cause which if not addressed may need to other problems down the road. I see it all the time…

Sorry, I am 39 years old. Diet has been rough thd last few months. Also, starving in general and eating. 2500-3000 cal day. I can self inject. I work in healthcare field.

Good. Then you’ll know to get them to get a Thyroid assay, Vit D3, B12, FSH/LH, SHBG, and IGF-1 as well as the usual suspects (TT. FT. E2).

Hardasnails is correct, gotta have them look upstream at the thyroid and pit gland to make sure something else isn’t going on and the low-T is just a symptom, not the disease.

Sorry, I am 39 years old. Diet has been rough thd last few months. Also, starving in general and eating. 2500-3000 cal day. I can self inject. I work in healthcare field.

Sorry, I am 39 years old. Diet has been rough thd last few months. Also, starving in general and eating. 2500-3000 cal day. I can self inject. I work in healthcare field.

Also got some 27g needles. I was using 21g that they gave me

Not sure why the repeated post. Anyway. I want to start giving 50 mg twice a week. I was supposed to stop injections this coming sat. My appt and levels are gettting drawn on the 14th. I really dont want to stop taking it at this point, as its just now starting to work. I also dont know what its going to prove drawing levels after 9 days off t.

Wouldnt it be better to just take it as scheduled up until testing and get a good level check. Its going to be a set of numbers that show low t, but not as low as baseline. What would that even do? He already has a baseline t level before therapy. His side of it is, he wants to let the T get back down and check the other labs, Ie: thyroid, pituitary fxn, vit D etc. Anyone have any advice on how I should handle this next 10 days. SHould I just keep doing shots, should I switch now to 50mg and skip the halfway through the week dose, then continue on the 14th, or should I just stop now and see what the lab shows. Thanks, my head is swimming!

Good question. The doc is having you quit so he can get a wrong (at some level) test reading. He’s already planning on having you get on cream if the scores are low, but is setting you up for failure by having you in this sort of on, sort of off status.

If the shots seem to be working, what I’d do is this: Keep on the shots and find a new doc that really understands this stuff.

Biut that’s me… being bitter and all for getting jerked around by docs for 17+ years after suffering with this stuff but not knowing that was what was going on since I was a teen (another 18 years… I’m an old fart). 17 years of feeling like shit. I can’t get those back.

So the question. Is. If I stop after 10 days whst will my labs look like. Will there be an accurate fsh or lh level. Will my E2 still be elevated if it was on the shots? If no, I am going to just keep on the shots and get tested and say I forgot to stop. Next question. How do you go from 100 once a week t mg to EOD. My last shot was sat (100mg). I may post this separate. Thanks

So to reiterate, I was on androgel 2 weeks, then a month of shots (100mg per week). I quit cold turkey for 10 days at advice of new urologist. He wanted to get some more labs that were never performed. My total t came back at 68. I feel about the same as before starting anything. No sexual problems at all. More hungry after stopping for some reason. The new doc only prescribes axiron underarm gel. I told him I would try this for a few months and switch to shots with a new doc if this doesnt work. He worried me when he said he is looking for a level 350-500. Charlotte is so bad for getting treated for this. A lot of people are on gels and not ever getting retested, that I have talked to. I havent seen the rest of my labs, so I dont know what they show (although he texted me to say everything was normal except the t levels).

It sounds like this doctor got you in and out pretty quickly? What was your previous relationship with him? How did you find him was he a referral? The body is an amazing miracle that really does communicate with us. Especially when its out of balance.

Balance is the key to everything, and something inside you is a little out of balance. Im a firm supporter of T therapy and its done incredible things for many people. And, without proper administration it wont do any good. And how can it be administered properly if what is out of balance is not figured out first.

It depends on how serious you are about this and how far you want to take it but I would right away start keeping a journal of your diet, times you work out, eat, sleep, mood, everything you do for the next month or so and have this with you when you see this guy.

Pay attention to how much HE pays attention as these are critical bits of information. Lastly I would encourage a second opinion even a third. Seek out someone that looks at the whole picture, pays attention to not only what a series of test results tell him, but what YOU tell him. The best doctors are the ones that try their hardest to put themselves in our shoes in order to figure out whats been going on to throw us out of…balance.

Hope that helps.

Stop opening new posts, keep your case in one thread and stay there. We need that. This is not a chat room, it is better.

Endo’s are the worse, no, maybe it is the urologists. The specialists are the worst. Read the sticky about finding a TRT doc.

Read the advice for new guys sticky and the protocol for injections.

Im going to only post on this thread from here on out.

age 39
-height 6
-waist 33
-weight 180
-describe body and facial hair (athletic with most body fat around gut. Facial hair adequate
More fat on belly in last 4 months. Seems like more after starting Hrt as well)
-health conditions, symptoms [history] ( Other wise completely healthy)
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever (none)
-lab results with ranges (only current lab I have is TT 68)
-describe diet [some create substantial damage with starvation diets] (eat about 3000 day, balanced, sometimes eat like shit)
-describe training [some ruin there hormones by over training] (swim, bike, or run every day. Training 10-15 hours week)
-testes ache, ever, with a fever? (no)
-how have morning wood and nocturnal erections changed (not in a few years)

After androgel for a few weeks, then shots for 3 weeks, and switching doctors: I took 10 days of cold turkey stopping. My TT came back at 68. I immediatlely gave a shot of 50mg test cyp SQ. I started on the under arm axioron. I only started on this because of the new doc who is a freind of mine. The old doc was an absolute idiot and knew nothing. New doc is brilliant on certain things and a great surgeon (urologist). He claims that this whole protocal is BS and convinced me to try the axiron with nothing else. He only wants my t in the 350-600 range for tt., and is against shots, E2 blockers, and HCG. I have no idea how to switch docs without hurting his feelings, and at least he want to do frequent testing (monthly). I have good insurance and everything is covered so far. I wanted to see about going to antoher doc to get meds and still see my friend for labs, but know this would eventually lead to problems. I feel like shit, tired, grumpy, bloated, but have no sexual problems at all. Even at 68 I am still extremely interested in sex, and perform appropriately. I have been looking for docs in the Charlotte area. Most are at AAC’s and they want 300-400 a month. Most are just pushing roids legally as someone mentioned on here. Trying to push HGH as well. I will not do this unless I can use insurance. I found one doc, and made an appt., that will prescribe HCG and test injections, but am unsure about adex. I also do not know if I can get regular prescriptions for the T from him. His HCG is 220$ for 2 months supply. That doc also mentioned checking labs once a year. I am just not finding the perfect situation yet. I called some compounding pharmacy’s and got some doc’s numbers. All of them were shady and basically non-insurance wellness docs. The only option which is monitored with a caring doc is my friend, who doesnt know shit about the protocal on here, and wont do it. The amazing thing is about 10 people I work with are on T replacement. None of them have ever heard of adex or HCG. They all are either topical, or shots, and barely get retested. Charlotte docs, must suck. Suggestions?

Well, hCG has a shelf life of 4-6 weeks depending on who you ask, and I personally don’t keep mine around for more than 5. A 2 month supply would expire before you hit the end. Also $220 is too much. I live in a very high cost-of-living area, and my hCG is $80 a month.

What insurance do you have if you don’t mind me asking? You may have said it, but I kind of skimmed your posts =/

You won’t get HGH covered by insurance unless you have some disease that would require it. If you have to ask if you do, then you probably don’t. I personally wouldn’t add HGH to my TRT protocol as I don’t know how safe it is to be on for life, but that choice is up to you.

You can go to an AAC, and just tell them “no” to everything they suggest that isn’t the protocol you want to do. Tell them also that you are poor and anything they can do to help you out would be awesome. Pity works, believe me! Call a few places, say this, and see what they say. Worst case scenario is they say “nope”.

If you don’t want to do that then there’s two things I can suggest, and neither is going to be easy:

  1. Call your insurance company and ask them for a list of Primary Care doctors you can go see in your area. Go “interview” them: Tell them your situation and what you want. Print out the Protocol stuff here, as doctors sometimes like that you have a reason for what you want and not just looking for roids. If they won’t play ball, move on. If you run out of Primary’s to call, get a list of Endocrinologists from your insurance, and get some Primary to refer you. That’s what I did: Saw a Primary doc only one time to get a referral to an Endo after I got labs done from my oncologist. Lather, rinse, repeat with your list of Endo’s.

  2. Talk to those 10 people with whom you work and get their doctors’ numbers. Many doctors are willing to listen to new treatment ideas, and you know these docs prescribe testosterone, so they may be open to hCG and AIs. You may have to start out slow, like get the T script, wait a few weeks and get your E2 tested. If it’s high you tell them you want an AI. Later you can say that you feel like someone is kicking you in the balls 24/7. When they say there’s nothing they can do about it tell them that you’ve read a lot of stories online of guys who are on TRT who take hCG and that gets rid of the pain. Print out some stuff to take into said doctor and hope for the best.

Either way it’s going to be a process, so buckle up for the long-haul. Just remember - THE DOCTOR WORKS FOR YOU - not the other way around. Even if your insurance pays for your visits, that asshole in the white coat is making over $100 for 15 minutes of their time. If they want to keep making that, they need to listen to you. There are literally hundreds-of-thousands of doctors in the U.S. Why should you be making one of them money when they won’t help you?

You also need to get a ton of more labs done. Getting on TRT after only one test (Total Testosterone) is, to be as generous as possible, irresponsible. You have to find out what is causing your low T before medicating it. Otherwise you could be doing more harm than good and setting yourself for more problems later in life. I would recommend that after finding a new doctor you find a safe way to come off the stuff (not quitting cold-turkey) and wait the appropriate time (not ten days) for your system to have kicked back on and will provide accurate labs and therefore a proper diagnosis.

Read up on bodybuilder’s “post cycle therapy” for information on how to come off testosterone safely, and don’t attempt anything until you know what you are doing and have all the medications you will need.

Thanks for the info. My last post was confusing I guess. I have no interest in HGH, just saying how they were selling this. I have medcost preferred insurance. I hear you about the labs, but I sure want to get on some treatment for a while. This has been 2 months now and I feel worse than when I started. Once I find a new doc I will talk it over with them. Are the tests I just got while off for 10 days worthless. I figured the PSA, thyroid, LH, FSH, prolactin would still show something of interest. I had a baseline TT and free T before any tx. Just need to get all the results to post here.

Thanks for the info. My last post was confusing I guess. I have no interest in HGH, just saying how they were selling this. I have medcost preferred insurance. I hear you about the labs, but I sure want to get on some treatment for a while. This has been 2 months now and I feel worse than when I started. Once I find a new doc I will talk it over with them. Are the tests I just got while off for 10 days worthless. I figured the PSA, thyroid, LH, FSH, prolactin would still show something of interest. I had a baseline TT and free T before any tx. Just need to get all the results to post here.

Lab values from last tuesday, after being off of injections ( 100mg test cyp a week) for 10 days. I dont have ranges for these and am missing the free T for now.

hgb 14.6
hct 43%
fsh 1.1
LH 1.2
Prolactin 6.3
Psa .9
TT 68
TSH 1.3
Free T4 .89
E2 63

This is off of the shots for 10 days. I wonder what my E2 was on peak days. I feel very tired right now. I am 1 week on axiron, and meeting with a new doc today.