The PM seemed to work okay.
Sorry, I’m meant to say 80mg/week . 40 mg each shot.
Yes, I am self injecting but for the HCG the Doc gives me prefilled syringes.
What should I look for in my ALT/AST lab results?
Thanks.
I don’t see the pm. I will keep checking.
Thanks for your help.
Darn, I’ll try again.
Let’s try this again. Yes, I’m still seeing him and as you said, he does not like to use HCG or arimidex. Since my next follow up isn’t for another 5 months, I decided to look for another doc that might follow the T+HCG+arimidex protocol or at least willing.
I found the Agewell Men’s Institute in Alpharetta. http://www.agewellmensinstitute.com
770-559-5834
He takes insurance and uses t+HCG+arimidex. The only thing, they like you to come in each week so they can administer the shots and then after 6 weeks they will give you a month’s worth of prefilled syringes. I was able to get him to let me self-inject from the beginning. I just have to go in each week for the initial 6 weeks.
Give it a try. It?s a good second option.
Good luck
I will look into them. I really appreciate the help!!!
Sure, one other thing, this doctor is the one that doesn’t yet believe in Subq test shots. However, when I told him i was going to do it that way he was open to it and said to try but he added the disclaimer that he didn’t think it would work as well as IM. I think it’s just a matter of educating him. The one good thing about him is that he is flexible.
and
STABLE TESTOSTERONE LEVELS ACHIEVED
WITH SUBCUTANEOUS TESTOSTERONE
INJECTIONS
M.B. Greenspan, C.M. Chang
Division of Urology, Department of Surgery, McMaster University,
Hamilton, ON, Canada
Objectives: The preferred technique of androgen replacement
has been intramuscular (IM) testosterone, but wide
variations in testosterone levels are often seen. Subcutaneous
(SC) testosterone injection is a novel approach; however,
its physiological effects are unclear. We therefore investigated
the sustainability of stable testosterone levels using
SC therapy.
Patients and methods: Between May and
September 2005, we conducted a small pilot study involving
10 male patients with symptomatic late-onset hypogonadism.
Every patient had been stable on TE 200 mg IM for
41 year. Patients were instructed to self-inject with
testosterone ethanate (TE) 100 mg SC (DELATESTRYL
200 mg/cc, Theramed Corp, Canada) into the anterior
abdomen once weekly. Some patients were down-titrated
to 50 mg based on their total testosterone (T) at 4 weeks.
Informed consent was obtained as SC testosterone administration
is not officially approved by Health Canada.
T
levels were measured before and 24 hours after injection
during weeks 1, 2, 3, and 4, and 96 hours after injection
in week 6 and 8. At week 12, PSA, CBC, and T levels
were measured however; the week 12 data are still being
collected. Results: Prior to initiation of SC therapy, T
was 19.14+3.48 nmol/l, hemoglobin 15.8+1.3 g/dl, hematocrit
0.47+0.02, and PSA 1.05+0.65 ng/ml.
During
the first 4 weeks, there was a steady increase in
pre-injection T from 19.14+3.48 to 23.89+9.15 nmol/l
(p�0.1). However, after 8 weeks the post-injection T
(25.77+7.67 nmol/l) remained similar to that of week 1
(27.46+12.91 nmol/l). Patients tolerated this therapy with
no adverse effects.
Conclusions: A once-week SC injection
of 50â??100 mg of TE appears to achieve sustainable and
stable levels of physiological T. This technique offers
fewer physician visits and the use of smaller quantity of
medication, thus lower costs. However, the long term
clinical and physiological effects of this therapy need further
evaluation.
Quote:
Saudi Med J. 2006 Dec;27(12):1843-6
Subcutaneous administration of testosterone. A pilot study report.
Al-Futaisi AM, Al-Zakwani IS, Almahrezi AM, Morris D.
Department of Medicine, College of Medicine & Health Sciences, PO Box 35, Postal Code 123, Al-Khod, Sultanate of Oman. Tel. +968 99475401. Tel/Fax. +968 24413419. E-mail: alfutaisi@squ.edu.om.
OBJECTIVE: To investigate the effect of low doses of subcutaneous testosterone in hypogonadal men since the intramuscular route, which is the most widely used form of testosterone replacement therapy, is inconvenient to many patients.
METHODS: All men with primary and secondary hypogonadism attending the reproductive endocrine clinic at Royal Victoria Hospital, Montreal, Quebec, Canada, were invited to participate in the study.
Subjects were enrolled from January 2002 till December 2002. Patients were asked to self-administer weekly low doses of testosterone ethanate using 0.5 ml insulin syringe. RESULTS: A total of 22 patients were enrolled in the study. The mean trough was 14.48 +/- 3.14 nmol/L and peak total testosterone was 21.65 +/- 7.32 nmol/L. For the free testosterone the average trough was 59.94 +/- 20.60 pmol/L and the peak was 85.17 +/- 32.88 pmol/L. All of the patients delivered testosterone with ease and no local reactions were reported.
CONCLUSION: Therapy with weekly subcutaneous testosterone produced serum levels that were within the normal range in 100% of patients for both peak and trough levels. This is the first report, which demonstrated the efficacy of delivering weekly testosterone using this cheap, safe, and less painful subcutaneous route.
Thanks KSman. I’m going to take this ans some other information to him on my next appointment.
KSman, these were my liver test scores from 6/7/2012:
AST/SGOT 17 (0-37 U/L)
ALT/SGPT 19 (0-53 U/L)
Do they seem okay? Or should I have an updated test completed?
Thanks.
I’m thinking about ordering some LiquiDex since I seem to be an over-responder to the adex that I have. I tried 1/4 of 1mg of arimidex and it was too much. How much of the Liquidex would I take if the bottle is 30ml 1mg/ml?
Thanks.
Measure the drops per ml then do the math. If 28 drops per ml, 8 drops EOD = 1.0 mg/week, so 2 drops EOD would be 0.25 mg/week.
Thanks. I ordered the liquid form and will give it a try.
I’m thinking about switching to EOD injections from twice a week injections. Question, I’m moving up to 100mg/week from 80/mg week and was wondering if the following injection schedule would be correct for EOD.
Week 1:
Day 1 (Mon)- 24mg or 12 units
Day 2
Day 3 (Wend)- 26mg or 13 units
Day 4
Day 5 (Fri)- 24mg or 12 units
Day 6
Day 7 (Sun)- 26mg or 13 units
Week 2:
Day 1 (Tue)- 24mg
Day 2
Day 3 (Thur)- 26mg
Day 4
Day 5 (Sat) - 24mg
Day 6
Day 7 (Mon) - 26mg
Etc…
Or would I be better doing M-W-F each week with a larger dose on Friday?
Thanks!
That sounds like a good schedule to me. I a firm believer of not everyone will respond to the same treatment if it works for you go for it.
How did you manage to get Doc to let you inject from day one? Or have you taken things into you own hands ?
Thanks. The first doctor, after trying me on gels, typically has his patients self inject. However, he still recommends once a week IM. i told him I was doing SubQ and he said he had a few that do Subq but he can only recommend IM. He also said if it works then keep doing. The only problem with this doctor he doesn’t prescribe HCG or Amex. The second dr I found follwos the typical protocol as this site except he likes for you to come in weekly for the shot. I eventually talked him into letting me do my own shots.
My doctor called yesterday and told me my blood test results. No FT levels.
TT was 920 (prior level was in the low 300s and taken day of but before injection, this test was taken 24 hrs after my injection of 40mg)
E2 was 39 (high)
I’ll have the ranges in a few days. It was kind of funny because he wasn’t convinced that I could raise my levels by injecting Subq 2X a week. All he said after he told me my levels was that he was wrong about subq and apologized.
One question - I inject 2X a week for a total of 80mg of test cyp a week. I’m wondering what my levels would be after 2 days and 3 days if my level was 920 after 24 hrs of injection.
Thanks for all the great advice on this site, I was able to at least change one doctors opinion about his current TRT protocol.
To get a better measure of your average levels, test 1/2 between injections. How much levels drop depends on the person. EOD makes the variations very small.
You can point out to the doc that testosterone pellets are SC and gels are through the skin. It is not much of a misery.
Thanks KSman. When doing EOD would breaking my 80mg/week out in 3 shots (M-W-F) and then repeat the next week M-W-F be okay or is the following best:
Week 1:
Day 1 (Mon)- 10 units
Day 2
Day 3 (Wend)- 10 units
Day 4
Day 5 (Fri)- 10 units
Day 6
Day 7 (Sun)- 10 units
Week 2:
Day 1 (Tue)- 10 units
Day 2
Day 3 (Thur)- 10
Day 4
Day 5 (Sat) - 10
Day 6
Day 7 (Mon) - 10
I wouldn’t think M W F would be a bad thing. Maybe make the Friday injection slightly larger than the others to carry over two days. Tough to break 80 into 3 evenly but I’m guessing you have already figured how to do it. Sounds like you are in a good state at 920 you should be feeling better. My advice would to try the MWF if it works go with it. Everyone here seems to respond to different treatment schedules do what works for you. Hope it works out!!
I must admit I have been following your results as you seem to be making progress. The doc arena is difficult yo navigate and have managed to be successful in doing that. I trying to follow you lead and am interested in the details. Is doc writing script for all product involved or are you procuring yourself? Thanks for you help !!
Hi Mac79,
I appreciate the reply. Well, I’ve actually been bouncing between two doctors with two different “standard” protocols of treating low t. One gives me a prescription of test cyp for 6 months to self inject and that is all. He does not believe in HCG or adex. The other will do the test+hcg+adex but doesn’t believe in subq shots and thinks once a week is fine. I originally went to the second one because of the HCG and adex but he won’t write a script so have to go in for the syringes which pre-filled already for 2 weeks - 4 weeks of shots. I can give you some more info on the docs if you like. Good luck with your journey. It can be a little bumpy to start.