Talk to me about TRT

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    Talk to me about TRT


    I've been below bottom of scale on total testosterone since i was 35 (no prior steroid use, I was just a desk jockey who never exercised). I've hemmed + hawwed, and haven't followed through on looking at TRT yet. Estrogen was also high, but LH was ok (3 pregnancies since then). we're done having kids, i'm 40, and having to go pretty extreme to add some muscle. Also, I think I have thyroid issues (wasn't previously tested for it tho). my average waking body temp is 95.6, resting heart rate is 55. So I think I have a few things working agaist me reaching my fitness goals.

    I started looking at my healthcare plan, I have United. They do apparently as a prescription drug cover Testosterone enanthate or cypionate, with a $10 copay. And thats about all I know at this point. I've heard that many doctors like to prescribe Sustanon 250? but i don't know.

    Should I be making the jump? Any advice? my annual visit is due, so i'm both trying to figure what to talk to the dr about, as well as what blood tests to ask to be run. That way even if my current doctor is resistive about putting me on something, if I have all the blood tests already it will be easier to just bring those results to another dr. I'm on a PPO plan, so I dont need referrals or anything.

    Also, just as a point of interest for any of you on it, do you have to go to the dr office for them to inject or do you just do it at home?

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    Easy where I live it is hard to get a doc of any sorts to give out shots much less give you a script for self administration.. I am sure some doc locally does it, but none that I know of.. Every state will differ so your choices could be far better or worse than mine..

    I have had low test since I was in my early 20's.. I eventually juiced and stayed that route for a number of years.. off and on cycle etc.. My family doc would always tell me my overall test was fine.. ( it was 201).... Hello that is crap, but there again I had to have referals at the time and all he wanted to do was prescribe me Viagra..
    Insurance changed and I was able to see an endo, which I would reccomend that you do also.. They specialize in hormones are much more apt to give appropriate meds if needed.. My endo does not like shots, because of the yo yo.. Test is high for a few days then it starts to drop, then its high etc etc etc.. He insisted on using Androgel and shortly after gave me Evista ( Raloxifene) because of nip sensitivity.. IT worked well and gave me 18-21 healthy male test levels..

    I think you have seen me post where I had to take clomid to father children after being on HRT for a couple years but it worked out well and we have kido's now..

    I always wanted shots myself, but long term I think something like Androgel is probably better.. Simply because your blood levels are always steady and if you had any issue's you can discontinue use and your blood levels return to baseline in roughly 3 days..

    Gotta get back to work, but this will also get the thread back to the top my friend
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    Hmm interesting. the only problem i see with a gel is the contact issue. there are a few good pubmed articles about it. I have the wife + 2 daughters, plus an about to be born son. I'm a little concerned about both the physical contact with them (particularly pre-puberty girls) as well as even just clothing, etc contact.

    I guess tho first step is to find an endo in the area. Thank god I don't need referrals even for specialists.
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    Easy I had the same concerns,and my endo as well as my wifes OBGYN said as long as it was applied to an area that is not exposed to them.. ie the top of your quads, belly and shoulder area's and there was clothing between you and your kids and spouse it was not even an issue to be concerned with..

    They both also said that after hours had passed even direct contact from your spouse ( read sex ) still was not an issue..

    Here area few tips I learned along the way for topical use:

    1. always wash hands very well as soon as the application is done
    2. Make sure when appying it on your shoulders you dont come down to far and get it passed where your sleeve will cover when you move around.. You can put this on your traps as well to have a large enough application area.
    3. Apply it at bedtime.. This way the interaction between you and your family is limited at best.. Plus after an 8 hour sleep, any med on your skin that may be left is neglible.
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    Quote Originally Posted by EasyEJL View Post
    Hmm interesting. the only problem i see with a gel is the contact issue. there are a few good pubmed articles about it. I have the wife + 2 daughters, plus an about to be born son. I'm a little concerned about both the physical contact with them (particularly pre-puberty girls) as well as even just clothing, etc contact.

    I guess tho first step is to find an endo in the area. Thank god I don't need referrals even for specialists.
    Before you start therapy you should find out if you have a primary, or secondary condition. Your LH numbers are not necessarily that high. Three years ago I started a transdermal test therapy. Prior to that, my LH was 3.9. The cream brought my total T from 475 to 1711, along with DHT at 110 and E2 at 58. My doctor didn't seem concerned so I dumped him.

    My current physician started me on HGC therapy. He wasn't sure that I would respond well, but thought that at my age it was worth a try. We started at high doses and then trimmed back over time. My T levels never drifted below 1100 and free were always above 250. My own testosterone felt so much better than exogenous it was beyond compare. The natural rhythm was far superior the constant level of test I experienced on the cream. I hadn't felt that good since I was 20, and it showed - especially in the gym.

    It would be worth your while to find out if your gonads can still produce sufficient test. Eventually we all lose the ability and need exogenous, but if you can get 10 to 20 good years with your own it's certainly worth a try.
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    Hmm very true. my last test was

    Testosterone - 289ng/dl range 400-1200
    Estradiol 64 pg/ml range 12-56
    LH 3.9 u/l range 1.0-8.4
    FSH 1.0 u/l range 1.0-10.5

    so the same LH as you just enough to produce active swimmers apparently. with the other #s all out of whack. This was from ZRT blood spot testing (where you prick a finger and put droplets on a paper) rather than regular testing. I wanted to get an idea myself, this was from early december, and I wasn't due for a blood test till feb.

    The reason the thread title was "talk to me" was that I wanted to see what other people have experienced. I'm pretty well open to whatever will work. I just want to be able to talk to the endocrinologist and have some idea of what they suggest will feel like. I know from what i've read that there is a huge range in what endocrinologist prescribe for HRT. I noticed on my plan that either testosterone enanthate or cypionate are only a $10 copay, and androgel is a $30. Is there a brand name for HCG? I couldn't find it in the list of pricing under that.
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    Quote Originally Posted by EasyEJL View Post
    Hmm very true. my last test was

    Testosterone - 289ng/dl range 400-1200
    Estradiol 64 pg/ml range 12-56
    LH 3.9 u/l range 1.0-8.4
    FSH 1.0 u/l range 1.0-10.5

    so the same LH as you just enough to produce active swimmers apparently. with the other #s all out of whack. This was from ZRT blood spot testing (where you prick a finger and put droplets on a paper) rather than regular testing. I wanted to get an idea myself, this was from early december, and I wasn't due for a blood test till feb.

    The reason the thread title was "talk to me" was that I wanted to see what other people have experienced. I'm pretty well open to whatever will work. I just want to be able to talk to the endocrinologist and have some idea of what they suggest will feel like. I know from what i've read that there is a huge range in what endocrinologist prescribe for HRT. I noticed on my plan that either testosterone enanthate or cypionate are only a $10 copay, and androgel is a $30. Is there a brand name for HCG? I couldn't find it in the list of pricing under that.
    Novarel is popular, but other brands include Pregnyl, Ovidrel, Chorex and Profasi. You can also use a generic from a compounding pharmacy which will work just as well.
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    hmm looks like novarel is a $10 copay, so thats cool. Its nice how easy it is nowadays to look at stuff like that. That way when I do talk to the endo, I can try and work out something that will be inexpensive. 3 $10 a month meds is a bit different than 3 $35 a month ones.
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    Quote Originally Posted by EasyEJL View Post
    hmm looks like novarel is a $10 copay, so thats cool. Its nice how easy it is nowadays to look at stuff like that. That way when I do talk to the endo, I can try and work out something that will be inexpensive. 3 $10 a month meds is a bit different than 3 $35 a month ones.
    He may start you at a high dose, but eventually you should be able to get by on 1500 IUs per week. You shouldn't need more than one vial per month. Supposedly it stays good for 6 weeks, but I wouldn't chance it.
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    Quote Originally Posted by EasyEJL View Post
    hey jan, not wanting to derail this thread and crowd it with my questions for you can you post in my thread here as well?

    Talk to me about TRT


    Quote Originally Posted by EasyEJL View Post
    Hmm very true. my last test was

    Testosterone - 289ng/dl range 400-1200
    Estradiol 64 pg/ml range 12-56
    LH 3.9 u/l range 1.0-8.4
    FSH 1.0 u/l range 1.0-10.5

    so the same LH as you just enough to produce active swimmers apparently. with the other #s all out of whack. This was from ZRT blood spot testing (where you prick a finger and put droplets on a paper) rather than regular testing. I wanted to get an idea myself, this was from early december, and I wasn't due for a blood test till feb.

    The reason the thread title was "talk to me" was that I wanted to see what other people have experienced. I'm pretty well open to whatever will work. I just want to be able to talk to the endocrinologist and have some idea of what they suggest will feel like. I know from what i've read that there is a huge range in what endocrinologist prescribe for HRT. I noticed on my plan that either testosterone enanthate or cypionate are only a $10 copay, and androgel is a $30. Is there a brand name for HCG? I couldn't find it in the list of pricing under that.
    Assuming that the blood test is correct,
    start with getting your E2 to proper range.
    E2 is produced from T, if you slow down E2 production that should raise your TT. So you will find out if you have enough of natural test.
    -----------------------------------------------------------
    Assuming that your insurance is as good as mine (Medicare),
    this $3500 project will cost $6 out of pocket.
    Get this list on my post #44
    Jan's BloodTest April13/2007

    I have few more if you want to listen.
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    Happy to hear anything and everything I have United healthcare, their "Choice" plan. So its pretty solid overall. Its more or less a PPO.
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    Quote Originally Posted by EasyEJL View Post
    Happy to hear anything and everything I have United healthcare, their "Choice" plan. So its pretty solid overall. Its more or less a PPO.
    OK, then go to Genova Diagnostics and get

    NutrEval
    and
    Estroessence Complete 24 hr

    also read this:

    TESTOSTERONE NATION

    Country Life Betaine Hydrochloride with Pepsin -- 600 mg - 250 Tablets - Vitacost
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    Quote Originally Posted by EasyEJL View Post
    I started looking at my healthcare plan, I have United. They do apparently as a prescription drug cover Testosterone enanthate or cypionate, with a $10 copay. And thats about all I know at this point.
    Quote Originally Posted by EasyEJL View Post
    The reason the thread title was "talk to me" was that I wanted to see what other people have experienced. I'm pretty well open to whatever will work. I just want to be able to talk to the endocrinologist and have some idea of what they suggest will feel like. I know from what i've read that there is a huge range in what endocrinologist prescribe for HRT. I noticed on my plan that either testosterone enanthate or cypionate are only a $10 copay, and androgel is a $30. Is there a brand name for HCG? I couldn't find it in the list of pricing under that.
    Keep in mind that they may cover you and you may have a low(er) co pay but sometimes (depending upon your plan) they have an annual prescription coverage plan. IOW they will cover a fixed amount over a calender year.

    My United Health Care Plan has a $1000 calender years coverage limit.

    At 5g/day a 30 day supply of Androgel costs $250. At 10g/day a 300 day supply of Androgel costs $500.

    So, if like me, your prescription coverage is a $1000 max per calender year you have enough coverage for 4 months at 5g/day and 2 months at 10g/day of AndroGel.

    Obviously the AndroGel is too expensive at ~$165/g

    Even at cost your best bet is going with E or C. Personally I would have given up had I been stuck with AndroGel and my prescription plan. Injections twice a week is very convenient. hCG and Arimidex will obviously be additional cost.
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    is the "with pepsin" important on the betaine HCL? I tend to order from puritans pride, and they have 2 100 tab 400mg bottle for $5.30 or 5 bottles for $10.60. Don't really have to get it from them tho. I've been taking ZMK from millenium sport technologies, it seems to have a good ingredient profile.
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    Quote Originally Posted by EasyEJL View Post
    is the "with pepsin" important on the betaine HCL? I tend to order from puritans pride, and they have 2 100 tab 400mg bottle for $5.30 or 5 bottles for $10.60. Don't really have to get it from them tho. I've been taking ZMK from millenium sport technologies, it seems to have a good ingredient profile.
    Zinc Tally is not only a source of zinc, it is a way to check if you have enough.

    Check on T-nation in that article if pepsin makes a difference.
    Most of Betaine HCL's come with Pepsin.
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    I picked up some vitamin shoppe house brand at lunch time of the betaine, no zinc tally there. i'll order it from somewhere later
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    I like the concept of clomid at 25mg ED over test.

    There are some definitive threads on mindandmuscle re: clomid for TRT,Benson posted a lot about this.
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    Thanks colin, i'm going to go take a peek there. I wish the software interface was different there, I find great content there, but the interface makes it harder so I don't spend tons of time there.
  

  
 

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