how to diy testosterone replacement therapy

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    how to diy testosterone replacement therapy


    I was born with a f'd up pituitary gland and my body produces less T as a result, and I'm now 31 & thats catching up big time...libido & wood are both way too low, at least thats all I notice, may have bone density/muscle mass issues too. I'm in decent shape. I talked to a testosterone replacement thereapy clinic & they said it's like $4000 for the first visit and $1000.00/mo for their program. Well I'm self employed & can't afford insurance ($500/mo for the family) & I can't afford $1k/mo either, much less $4k upfront. So where I'm at is...trying to figure out all this sh!t on my own & based on my research I think cyp injections are going the be the best way to go. But I've got alot of questions. Maybe some of you can help me answer.

    1. How much should I take? Is there a guide to know about where your tt & freeT should be, based on age/weight, etc.? Are there any other things I need to be concerned about besides tt & freeT? (like Etrogen, etc...)

    2. I feel like to do it right, I should go to a lab & have my T tested on some kind of regular basis? If so, is there a way to do lowT labs for cheap? (perhaps a diy kit?) I looked online & only found places that were like $250/lab visit, still seems expensive to me.

    3. Are there any places to buy good quality cyp cheap? (online or offline, prescription/not) I found a place (offshore I'm sure) that'll give me 200mg/ml x 10ml for $100, is that good? Any recommendations would be great.

    4. How do you know if you need aromatize inhibitors, hcg, or 5alpha-reductase inhibitors?

    5. Is this the best forum for low T discussion? If there's a better place for me to post this thread, let me know.

    6. Is cyp the best solution for low T?

    7. Is there any good gameplan in this situation?

    My goal is simply to get my libido & hard wood back. Muscle gains would be an added bonus, but not as important as the libido.

    HELP!

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    I have low test like 187 My doctor has me on testosterone cypionate 200mg/ml I take .5 every 4 days, no insurance seems like I pay 44.00 I also take Anastrozole 1 pill every other day. I read where cypionate was the best test but I am new to this. Lol
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    Quote Originally Posted by testeez View Post
    So where I'm at is...trying to figure out all this sh!t on my own & based on my research I think cyp injections are going the be the best way to go. But I've got alot of questions. Maybe some of you can help me answer.
    on average, cyp injections are cheapest and simplest.

    Quote Originally Posted by testeez View Post
    1. How much should I take? Is there a guide to know about where your tt & freeT should be, based on age/weight, etc.? Are there any other things I need to be concerned about besides tt & freeT? (like Etrogen, etc...)
    generally speaking, somewhere between 100mg-150mg a week puts most men in range. Realistically you want TT + free to be at least over middle of range day after injection, and above bottom of range day before via blood test normal ranges.

    Quote Originally Posted by testeez View Post
    2. I feel like to do it right, I should go to a lab & have my T tested on some kind of regular basis? If so, is there a way to do lowT labs for cheap? (perhaps a diy kit?) I looked online & only found places that were like $250/lab visit, still seems expensive to me.
    its your health, $250 2x a year isn't horrifying. but i'll say more on this later

    Quote Originally Posted by testeez View Post
    3. Are there any places to buy good quality cyp cheap? (online or offline, prescription/not) I found a place (offshore I'm sure) that'll give me 200mg/ml x 10ml for $100, is that good? Any recommendations would be great.
    no, thats terrible. What you need to do is find a urologist locally, go visit him, pay for the visit out of pocket, get the blood tests via him (in that $250 range yes), and if you come back low then get him to prescibe cyp. Sams club/walmart sells 10ml vials for around $70

    Quote Originally Posted by testeez View Post
    4. How do you know if you need aromatize inhibitors, hcg, or 5alpha-reductase inhibitors?
    blood tests, or other issues. If you keep your doses in the normal range and you don't have huge amounts of bodyfat, you shouldn't need either. if you have really high bodyfat an AI might be useful at first.

    Quote Originally Posted by testeez View Post
    5. Is this the best forum for low T discussion? If there's a better place for me to post this thread, let me know.
    this is the forum area for testosterone for health vs cycling for muscle gains, so yes.

    Quote Originally Posted by testeez View Post
    6. Is cyp the best solution for low T?
    define best. Androgel 1.62% ends up giving you a closer to natural testosterone "flow" but you run contact risk with any women or children in your life.

    Quote Originally Posted by testeez View Post
    7. Is there any good gameplan in this situation?
    the only good gameplan is to work with a doctor. Even a general practicioner can prescribe testosterone (although most don't like to). But its pretty normal for urologists. An endocrinologist would be best given your thyroid issue although it will cost more.
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    Testosterone replacement therapy- Target Blood Test Limits


    Hematocrit under 53

    PSA under 3 (4 is max since doctors will not prescribe TRT at this number)

    Estradiol (ultrasensitive) between 20-50 pg/mL

    Blood pressure under 135/85

    Estimated Glomerular (eGFR) (kidney function) over 60

    Liver enzymes not elevated over 20 percent of top value of reference range

    TSH under 2.5

    Total Testosterone over 500 ng/dL

    Free Testosterone equal or above 2 percent of total

    If donating blood to bring hematocrit down, ferritin never under 30 ng/mL or micrograms/liter

    Free T3 (if hypothyroid and on treatment) in the upper quartile of range. (depending on range it can be 3.7- 4.2 pg/mL)


    HDL over 40 mg/dL



    OPTIMUM REQUIRED LAB WORK (Preferred but not mandatory)


    DiscountedLabs is the cheapest online lab test company in the US.

    1 ------- Estradiol- ultrasensitive via LC/MS test (not EIA!) [Quest Labs code 30289]
    (Labcorp code: 140244) (baseline, week 6 or 8, month 6)

    GOAL: 20-50 pg/mL

    2 ------- Testosterone, Free, Bio/Total (LC/MS/MS) (baseline, week 6-8, month 6, then yearly)

    GOAL: Total testosterone oer 500 ng/mL and free T 2 percent or more of total T.

    3 ------- DHEAs (baseline, month 6, month 12 (if supplementing))

    4 ------- Comprehensive Metabolic Panel w/EGFR (baseline, week 6-8, month 6 and then once a year)

    GOAL: Normal CBC including liver enzyme elevations under 20 percent and eGFR over 60

    5 ------- CBC w/ diff/PLT (baselines, week 6-8, month 6 and then once or twice per year)

    GOAL: Normal CBC

    6 ------- Lipid profile (fasting sample) (baselines, month 6, then once per year unless high)

    GOAL: Normal lipids

    7 ------- T3, free (for those with low thyroid symptoms)

    GOAL: Upper quartile free T3

    8 ------- T4, free (for those with low thyroid symptoms)

    Goal: Normal free T4

    9 ------- Ultrasensitive TSH (baseline, month 6, yearly after that depending on value and treatment)

    GOAL: TSH under 2.5

    10 -------- Prostatic Specific Antigen (PSA) (Baseline before testosterone treatment, 6-8 weeks after and then yearly)

    GOAL: PSA under 3

    11-------- LH and FSH (for men not on testosterone yet)- Used to diagnosed primary or secondary hypogonadism. Do not waste money testing your LH and FSH if you are on testosterone since they will be undetectable.

    For those with excessive fatigue: Saliva Cortisol + DHEA (4 specimens during one day) (you can wait for after 6 weeks on TRT). Ferritin is also a test that can be considered.

    GOAL: Normal cortisol graph and values along with proper cortisol/DHEA ratios


    Optional Tests:

    Vitamin D (25 (OH)D test)- Most people have low vitamin D, so spending money on this may be optional. Taking 5000 IU per day brings blood levels up to desired range in most people.

    Folate and Vitamin B-12- Low only if you suffer from malnutrition or malabsorption.
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    cool thread....in.....
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    Quote Originally Posted by muscletank View Post
    Testosterone replacement therapy- Target Blood Test Limits


    Hematocrit under 53

    PSA under 3 (4 is max since doctors will not prescribe TRT at this number)

    Estradiol (ultrasensitive) between 20-50 pg/mL

    Blood pressure under 135/85

    Estimated Glomerular (eGFR) (kidney function) over 60

    Liver enzymes not elevated over 20 percent of top value of reference range

    TSH under 2.5

    Total Testosterone over 500 ng/dL

    Free Testosterone equal or above 2 percent of total

    If donating blood to bring hematocrit down, ferritin never under 30 ng/mL or micrograms/liter

    Free T3 (if hypothyroid and on treatment) in the upper quartile of range. (depending on range it can be 3.7- 4.2 pg/mL)


    HDL over 40 mg/dL



    OPTIMUM REQUIRED LAB WORK (Preferred but not mandatory)


    DiscountedLabs is the cheapest online lab test company in the US.

    1 ------- Estradiol- ultrasensitive via LC/MS test (not EIA!) [Quest Labs code 30289]
    (Labcorp code: 140244) (baseline, week 6 or 8, month 6)

    GOAL: 20-50 pg/mL

    2 ------- Testosterone, Free, Bio/Total (LC/MS/MS) (baseline, week 6-8, month 6, then yearly)

    GOAL: Total testosterone oer 500 ng/mL and free T 2 percent or more of total T.

    3 ------- DHEAs (baseline, month 6, month 12 (if supplementing))

    4 ------- Comprehensive Metabolic Panel w/EGFR (baseline, week 6-8, month 6 and then once a year)

    GOAL: Normal CBC including liver enzyme elevations under 20 percent and eGFR over 60

    5 ------- CBC w/ diff/PLT (baselines, week 6-8, month 6 and then once or twice per year)

    GOAL: Normal CBC

    6 ------- Lipid profile (fasting sample) (baselines, month 6, then once per year unless high)

    GOAL: Normal lipids

    7 ------- T3, free (for those with low thyroid symptoms)

    GOAL: Upper quartile free T3

    8 ------- T4, free (for those with low thyroid symptoms)

    Goal: Normal free T4

    9 ------- Ultrasensitive TSH (baseline, month 6, yearly after that depending on value and treatment)

    GOAL: TSH under 2.5

    10 -------- Prostatic Specific Antigen (PSA) (Baseline before testosterone treatment, 6-8 weeks after and then yearly)

    GOAL: PSA under 3

    11-------- LH and FSH (for men not on testosterone yet)- Used to diagnosed primary or secondary hypogonadism. Do not waste money testing your LH and FSH if you are on testosterone since they will be undetectable.

    For those with excessive fatigue: Saliva Cortisol + DHEA (4 specimens during one day) (you can wait for after 6 weeks on TRT). Ferritin is also a test that can be considered.

    GOAL: Normal cortisol graph and values along with proper cortisol/DHEA ratios


    Optional Tests:

    Vitamin D (25 (OH)D test)- Most people have low vitamin D, so spending money on this may be optional. Taking 5000 IU per day brings blood levels up to desired range in most people.

    Folate and Vitamin B-12- Low only if you suffer from malnutrition or malabsorption.
    Great post. Bump for TRT users.
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    Thanks Kenpoengineer!
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    From the book "Testosterone: A Man's Guide" (Amazon)

    "The following suggestions for monitoring testosterone replacement are recommended by several physician groups and practices:

    1. You should be evaluated after the first month of therapy to measure your testosterone blood levels. If your doctor doesn’t ask, let him/her know about your quality of life. Make sure your doctor is aware of your energy level, mood, and sexual function, as well as any potential side effects (tender breasts, urinary flow decrease, frequent trips to the bathroom to urinate, moodiness, and acne).

    2. When using testosterone, your doctor will want to measure total blood testosterone levels right before the next corresponding injection or gel use after the first month (it takes a while for the blood levels to stabilize). If testosterone is >900 ng/ dl or <500 ng/dl, your doctor will adjust the amount or the frequency of your dose. I mentioned this earlier in the book but it bears repeating here: Some men need to have blood levels above 500 ng/dl to experience sexual function benefits from testosterone. It is important to be honest when your doctor asks you about your sexual performance. Do not let false pride, shame or machismo get in the way of a satisfying sexual and intimate life.


    3. Your doctor should check your hematocrit before starting testosterone, after 3 months and then every year after that. If your hematocrit is above 52%, you should donate some blood in a blood bank or get a doctor’s order for therapeutic phlebotomy if you cannot donate blood due to hepatitis or HIV (read the section “Checking for Increased Blood Thickness (Polycythemia)” or for more details. Usually, 4 units of blood can decrease hematocrit from 54 to 48 percent. Be careful with donating too frequently since your iron stores may drop which will cause severe fatigue.

    4. Be ready to have a digital rectal examination done and a prostatic specific antigen (PSA) blood test prior to starting testosterone, and after 3 months. Retesting every 6 months after that may not be unreasonable, especially in older men. A PSA above 4 ng/ml can be reason for concern and referral to an urologist. Testosterone replacement needs to be stopped if increases in PSA above normal are observed. Note: at the start of testosterone replacement in older men, when testosterone blood levels are rapidly rising, PSA may also increase. This is especially true when testosterone gels are employed, because they elevate DHT more relative to other options. Once testosterone levels have stabilized PSA drops back down to roughly baseline. It is important to allow “steady state” for testosterone fluctuations to stabilize before measuring PSA; a month or so should be sufficient. Also keep in mind that prostatic infections can also raise PSA, so it is important to see an urologist to rule this out before deciding to stop testosterone replacement due to high PSA.

    5. If you start experiencing breast tenderness, pain or growth, ask your doctor to measure your estradiol blood level using the sensitive assay (not the regular test used for women). Normal range for estradiol in men is 14–54 pg/ml (50–200 pmol/liter). Men who have high estradiol can be prescribed estrogen receptor inhibitors (more details in “Avoiding enlarged breasts (gynecomastia”)

    I would like to stress that there is no agreement between several medical guideline groups about the proper monitoring of TRT. And none of them include estradiol measurement. You can see how each guideline group recommends different schedules for monitoring testosterone, digital rectal exam, prostatic specific antigen, and hematocrit. It is no wonder that physicians in clinical practice are so confused about what is standard in testosterone replacement therapy monitoring."
  

  
 

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