T Nation

New to Testosterone Replacement

Just a bit about me. I’m, 53 yrs old, 6’2", 210 lbs. Been lifting and running on a regular basis since high school. Don’t lift super heavy, but scored in the top 1% in my age group in strength (push-ups and sit ups) and aerobic capacity at a recent fitness test done at a university. No prescription meds. Eat what most people would consider a very clean diet.

Went to the family doctor with complaints of no sex drive, feeling tired, etc all the symptoms of low T. He told me up front he wasn’t a big fan of T replacement but sent me for a blood test. When the test results (LCMSMS method) came back my T was 228 on a reference range of 250-1100.

My free T % was 1.41 on a range of 1.5-2.2. After seeing the results my family doctor said he would be on T replacement if those were his numbers and sent me to a urologist.

Urologist examined me and put me on a program with a shot of testosterone CYP, 200 mg/ml every 2 weeks at his office and daily applications of Testim 1% gel (150 gm). I go back in 3 months for a blood test and exam.

Looking at these forums, I don’t recall seeing this exact procedure (shot every 2 weeks and daily gel). I’ve been on this for a week and a half and have been seeing signs that it’s doing something (morning wood, actually having some horny feelings).

Would like to get others thoughts on this course of treatment. Note, I have pretty good insurance and the prescription for the shot is $5 out of pocket and a month supply of the gel is $20 (Dr game me a card from Testin that will give me a rebate of up to $40 so it’s really free).

Read the “protocol for injections” sticky.
read this:

T injections every two weeks is very wrong. You need to self inject at least twice a week.

You apply how much T-gel?

T+AI+hCG

btw, your doc urologist is an idiot

“Would like to get others thoughts on this course of treatment. Note, I have pretty good insurance and the prescription for the shot is $5 out of pocket and a month supply of the gel is $20 (Dr game me a card from Testin that will give me a rebate of up to $40 so it’s really free).”

I don’t know why a doc would prescribe both injections and gel. It’s either one or the other. From what I know, injections should be small and frequent. Injecting once every 2 weeks is disastrous, and you can have abnormally low T values by the time of your injections.

I’ve been on 7.5 to 10 grams of Androgel per day for 8 years besides two 1-month stints on Clomid, and I feel great.

I’ve always had good insurance too. My cost has always been 25 to 50 bucks a month.

[quote]Bricknyce wrote:

I don’t know why a doc would prescribe both injections and gel. It’s either one or the other. From what I know, injections should be small and frequent. Injecting once every 2 weeks is disastrous, and you can have abnormally low T values by the time of your injections.

I’ve been on 7.5 to 10 grams of Androgel per day for 8 years besides two 1-month stints on Clomid, and I feel great.

I’ve always had good insurance too. My cost has always been 25 to 50 bucks a month. [/quote]

I just started treatment 2 weeks ago. You may have missed in my original post, I’m getting an injection every 2 weeks and applying Testin gel daily (50 mg T in a 5 gram tube). I’m assuming the gel will help keep levels somewhat stable between injections. I have another blood test and visit with the doctor in 2.5 months. My initial blood test results were very low (below the scale). Doctor may change dosing/method as levels come up.

I didn’t miss your post. I read the whole thing. T level is kept steady by applying Testim everyday or through injecting more frequently than twice per week. It’s either/or.

[quote]Bricknyce wrote:
I didn’t miss your post. I read the whole thing. T level is kept steady by applying Testim everyday or through injecting more frequently than twice per week. It’s either/or. [/quote]

I believe I saw in another post you’ve been on TRT for 8 years. Have you been on straight Testim the entire time or were you on something else earlier?

[quote]KSman wrote:
Read the “protocol for injections” sticky.
read this:

T injections every two weeks is very wrong. You need to self inject at least twice a week.

You apply how much T-gel?

T+AI+hCG

btw, your doc urologist is an idiot[/quote]

Thanks for the book reference, have it on order. I’m using Testin gel daily (50 mg T in a 5 gram tube), with an injection at the doctor’s office every 2 weeks.

[quote]john2009 wrote:

[quote]Bricknyce wrote:
I didn’t miss your post. I read the whole thing. T level is kept steady by applying Testim everyday or through injecting more frequently than twice per week. It’s either/or. [/quote]

I believe I saw in another post you’ve been on TRT for 8 years. Have you been on straight Testim the entire time or were you on something else earlier? [/quote]

I used Clomid for one month, and have been on Androgel since then.

The only other one-month stint on Clomid occurred when I neglected seeing my doctor for almost a year. My T value reached 1500 ng/dl on 10 grams per day. I wasn’t feeling well and I hadn’t overdue for a visit. So I knew something was wrong. 1500 ng/dl is an abnormally high value. He gave me half a tab of Clomid for a month to “turn my pituitary back on”, so to speak. And it did. My LH and FSH returned to normal. I went back on 7.5 grams of Androgel. I now use 10 grams with no problem. I’m still puzzled as to why 10 grams did that at that time.

Had a follow on question to this. I was feeling tired (turns out was probably a cold/flu) and was wondering if my estrogen levels were getting high on the treatment doctor had me on (shot of testosterone CYP, 200 mg/ml every 2 weeks at his office and Testin gel daily 50 mg T in a 5 gram tube). He sent me for a morning blood test 12 days after my last injection and probably 8 hrs after I last applied the Testim. Results came back:

T: 827 on a scale of 250-1100
Free T: 3.2% on a 1.5-2.2% scale

Nurse who called said the T looked good and doctor was taking me off the injections due to the high FT. As I got the test results in a phone message, I don’t know if they tested for estrogen, but from my limited understanding, I don’t believe the FT would be that high if there was an estrogen issue. I’m feeling pretty good now, have more energy, sexual desire and seem to have less muscle soreness after working out. I have a follow up appointment with the urologist in 2 months. I’ll have a work physical before that with blood work. Is there anything I should be watching for?

“Is there anything I should be watching for?”

Why not just keep this in MEDICAL PROFESSIONALS’ hands?

john2009, you need to test serum E2

What were the doc’s instructions about T-gel before the lab work?

[quote]Bricknyce wrote:
“Is there anything I should be watching for?”

Why not just keep this in MEDICAL PROFESSIONALS’ hands? [/quote]

Rest assured and not offense to anyone but I trust a doctor that sees me in person, has my test results, etc more than anyone on an Internet forum. Was just asking the question to help my own knowledge and possibly lead to some additional targeted research on my part.

How much research has to go into this once you get the appropriate treatment? I’ve been on this for 8 years and stopped all research once I got the right doctor. All I do now is go for an appointment to talk my doc and get a blood test done once every six months.

[quote]KSman wrote:
john2009, you need to test serum E2

What were the doc’s instructions about T-gel before the lab work?[/quote]

Didn’t have any specific instructions. As I think about it a bit more, my blood draw was actually closer to 12 hours after I used the Testim. Thanks for the advice on serum E2. I’ll have to have a blood test in 2 months for my follow up appointment and will ask him to order it in addition to the T tests.

[quote]Bricknyce wrote:
How much research has to go into this once you get the appropriate treatment? I’ve been on this for 8 years and stopped all research once I got the right doctor. All I do now is go for an appointment to talk my doc and get a blood test done once every six months. [/quote]

I’m glad you found something that works. I’ve been doing this for 1 month, and I’m feeling better, just trying to determine if things are working as they should. I’ve seen several posts here and other places where people have problems and apparently there is some trial and error involved to get the right course of treatment.

[quote]john2009 wrote:

[quote]Bricknyce wrote:
How much research has to go into this once you get the appropriate treatment? I’ve been on this for 8 years and stopped all research once I got the right doctor. All I do now is go for an appointment to talk my doc and get a blood test done once every six months. [/quote]

I’m glad you found something that works. I’ve been doing this for 1 month, and I’m feeling better, just trying to determine if things are working as they should. I’ve seen several posts here and other places where people have problems and apparently there is some trial and error involved to get the right course of treatment. [/quote]

Fair point.

I just started Testim one week ago today. I’m a 30yo healthy male and by healthy I mean I eat right and work out regularly. I’m 6ft. 180lb. I wasn’t feeling as sexually aroused and energetic, etc. as I though i should so that’s what prompted the visit to the urologist. After one week on Testim, I’m feeling only a minor improvement.

I’m interested in hearing more of what I can expect as I continue on with treatment. I’m hoping it will cause me to grow more chest/ab hair. If anyone has any stories of it causing more chest hair growth, etc I would really appreciate reading about the story and how long it took before you began to notice the new hair and how much, etc.

All other Testim related advice welcome. By the way, I get a lot of compliments on the smell! lol

Are you really that interested in growing more chest and abdominal hair?

I got quite hairy through my 20s and I believe this is because of Androgel. I started using it at 23 and now I’m 30.

I’ve been on Testim for about 4 months. Don’t notice any difference in body hair, but my beard tends to grow in more in places where it didn’t before. I put it on at night, so nobody’s smelling it on me during the day.

John2009, did you read the protocol for injections sticky at the top of the page?