Testosterone replacement therapy

[+ Funguy]

@Funguy

It seems like HRT is something that certain doctors do “on the side”. All the doctors I’ve seen so far are either PCP, urologists, cardiologists, etc. it also seems like the patient spends a little time taking to ‘the’ doctor and more time taking to PA’s or even what seems like non-medically trained people.

 

Can you comment on the HRT ‘industry’ and how you think people could best go about finding the right practice?

 

By the way, a few of the people I’ve seen have been on HRT for 10+ years. How important do you think that is in choosing a provider ?

 

You do raise some interesting points but I can only speak for myself and the way I do things.

First of all HRT is relatively new. Many years ago Pain Mgmt was in the same place HRT is now.

 

Most present day pain specialists are/were anesthesiologists. HRT is still in relative infancy and therefore often a side specialty of other specialists. I came to the party about 6-8 years ago. I had retired from Pediatrics 20 years ago at age 50 - back issues requiring major surgery and I just burned out in pain. Surgeries and intense rehab for 2 years and it was time to get back to work. Retirement allowed me to pick and choose when I wanted to work and what I wanted to do. First I started back in pediatrics, was asked to manage an anti-aging skin care office and then finally the anti-aging with HRT. Now I do all 3 and it's far more fun than burning out again. Because HRT is coming into it's own there are soooooo many different ways things are done.

 

As I said before, I will only comment on the way I do things. First of all, any visits are doctor-related. No PA's and no non-medical employees. You see me or my partner, period. We have a yearly fee and ALL visits are included, whether you come in weekly, monthly, twice a year or whatever. We don't want patients to feel it will keep costing them visit by visit. Calls, email, etc are included. No extra costs incurred. Right now I am unaware of any other office in my area which runs this way. Every one else is by the visit.

We present different methods of replacement for the patient to choose from depending on lifestyle, tho we have our preferences. Examples include for instance in T replacent: topical, injectable. We steer patients away from pellets for various reasons, discuss alternative injection schedules, different types of topical. Monitoring is done with reason, not weekly or even monthly but when needed.

 

Therefore it really is necessary for the patient to be comfortable with the style of the office. The length of time a physician has been doing this specialty is less important than his knowledge and the patient's comfort. There are private offices, clinics, docs which do this on the side as part of their regular practice, etc. Again, it is the knowledge that is important.

 

As to finding the right home for the patient - unfortunately, I think it's still hit or miss. I have many patients who come to me from other docs who do things COMPLETELY differently than I do. I put it to the patient to decide what makes more sense from a practical viewpoint and then plug in the specifics for the patient. We always check blood levels - no labs, no refills! It's that simple.

 

I could go on and on but you get the idea - logical presentation to the patient, use of the most simple methods rather than trying to combine all meds into one pill for everyone, and availability. That's really the key to satisfied patients - can they get ahold of you when they need to.

 

In some metropolitan areas offices are numerous and in some areas nonexistant.

I have patients literally from all over the country, Europe, and Asia. A lot of Facetime and Skype is used, we use a compounding pharmacy which can send meds anywhere in this country and nonresidents make arrangements which are workable.

 

I hope this lengthy post answers your questions.

[Bearofdistinction]

I’ve been on full hormone replacement therapy for 24 years post surgery for a non-functioning pituitary adenoma. It gave me my life back at 34 years old. Energy, metabolism, libido, spiritual changes came rapidly and maintenance has been a breeze. I inject 80 mg of testosterone cypionate weekly. The only downside is my gonads went! They are about 1/2” in diameter! Really hard for my partners to find when I’m close to cumming.

 

Small price to pay === just tie them together with a neon-glow ribbon

[Rudynate]

Small price to pay === just tie them together with a neon-glow ribbon

 

There are solutions for that. It doesn't sound like your practitioner is up to date.

Edited August 25, 2018 by Rudynate

[instudiocity]

There are solutions for that. It doesn't sound like your practitioner is up to date.

When I had my dog neutered, I bought him a pair of neuticals one size larger.

 

But I don’t know what my doctor could prescribe other than neuticals for me. He’s a prof at UCLA Medical Center.

[+ Funguy]

Small price to pay === just tie them together with a neon-glow ribbon

 

@Rudynate is correct, there are usually solutions for this issue. However, after 24 years (which puts your age at approximately 58?) it is doubtful that slipping in some Hcg will work to stimulate your testes to begin functioning and therefore increase in size. If that is the only negative you can point to at this time, by your description you are blessed with very successful treatment.

[instudiocity]

@Rudynate is correct, there are usually solutions for this issue. However, after 24 years (which puts your age at approximately 58?) it is doubtful that slipping in some Hcg will work to stimulate your testes to begin functioning and therefore increase in size. If that is the only negative you can point to at this time, by your description you are blessed with very successful treatment.

Did Hgh, diabetes interfered.

[+ Funguy]

Did Hgh, diabetes interfered.

 

HGH is not a problem. Diabetes should not affect testicular size but will contribute to any ED.

[Rudynate]

Hcg and hgh are different hormones.

[+ Funguy]

Human chorionic gonadotropin vs. Human growth hormone.

[instudiocity]

HGH is not a problem. Diabetes should not affect testicular size but will contribute to any ED.

You saw the part about non-functioning pituitary?

[+ Funguy]

Yes - sorry for the delay.

Can understand the Hgh as it is mediated by the Pituitary. Not quite certain how the diabetes (DM or DI?) interfered and impacted the size of the testes.

[Rudynate]

Yes - sorry for the delay.

Can understand the Hgh as it is mediated by the Pituitary. Not quite certain how the diabetes (DM or DI?) interfered and impacted the size of the testes.

 

Hgh can cause elevated blood glucose.

[Derrick Rigg]

Mix the test enth., tren, eq., and gh and you got one great bodybuilding cycle.

[Deadlift1]

Human chorionic gonadotropin vs. Human growth hormone.

I just added daily HCG injections to my topical T therapy. I feel it gives a mini turbo boost in mood to the T. Is it a placebo effect? Does HCG enhance the muscle building effects of the T therapy?

I'm also curious about the drug Sermorelin. It seems to be a popular add on for some. What is your opinion on its use?

Edited August 27, 2018 by Deadlift1

[+ Funguy]

Hi Deadlift1:

 

Several comments - you mention that you are on topical T. That is my favorite method of administration BUT it must be of sufficient strength to raise the T. Preparations such as Androgel (6.25%) don't do it. My patients are put on a 20% cream twice a day (made at compounding pharmacy.)

Free T needs to be checked occasionally just to make sure you are in the right range.

 

Daily HCG injections are probably overkill. I recommend to my patients who want to use HCG for exactly the reason you mentioned that using it 3 days in a row is sufficient. It now is available as 500 mg troches (oral gummies) with excellent absorption so those not wanting to inject have that option. As far as placebo effect - it probably is NOT acting as a placebo but really is working and does enhance muscle building.

 

Last - Sermorelin. This is a synthetic Growth Hormone Releasing Factor. If you produce enough HGH it is fine for helping to release it. BUT, if you do not produce enough, no amount of releasing factor will help that. So, to see if it is a good option, have your IGF-1 measured.

[Deadlift1]

I am using the Androgel 6.25 and so far it has worked well for me. I also lift heavy weight. Sometimes my free T levels fluctuate as if my natural production kicks in every now and then. I did experience some acne in the very first year. My red blood cell count does increase but I donate blood every other month. I have given up red meat and it seems to have helped. I know when my T levels are optimal as morning erections return. My PSA has been normal for the 5 years i have been using. As i mentioned before the T with the HCG gives me a nice feeling of well being. I think it reduces anxiety to a degree. At times it does feel like i joined a club for life. If I were to start all over again today, i would go to a specialist like Dr. fun guy. But at the time I started there were very few around as he stated.

 

fun guy I read that a common dosing of HCG is 700 iu per week. Two shots a week (350 iu) for those who inject T and seven (100iu) for those who administer T topically. Whats your take?

 

And thanks again for your help.

Edited August 28, 2018 by Deadlift1

[Rudynate]

I haven't used it in quite a while, but I used hCG at a dose of 250 IU twice weekly. I do T shots twice weekly and I used to do the hCG the day before the T shot. I was under the care of a very early HRT doc in Michigan.

[+ tristanbaldwin]

I didn't do a TON of anabolic steroids back in my heydey; but I did just enough that it probably permanently lowered by natural count(coupled with my increasing age into the 30's)...that my count was low enough to warrant Testosterone Replacement Therapy. 1 shot a week, 200 mg strength....and man. What a difference it is. Energy wise, vitality wise, sexual wise.

 

Your only mistake with TRT is waiting even ONE SECOND LONGER to research, before going to your doctor to get it. Your keys should already be in your hand.

 

YOLO.

[+ g56whiz]

The purveyor of my Trimix is a Male Medical practice that also provides TRT. Some time ago they celebrated the movement of their practice to a new and larger facility with a cook out to which they invited clients. It was easy to see which were clearly the TRT clients although I suspect some were ED clients as well. It was also easy to see that the all male staff enjoyed a unique employee benefit: none had scrawny arms. [swoon]

[Rudynate]

The purveyor of my Trimix is a Male Medical practice that also provides TRT. Some time ago they celebrated the movement of their practice to a new and larger facility with a cook out to which they invited clients. It was easy to see which were clearly the TRT clients although I suspect some were ED clients as well. It was also easy to see that the all male staff enjoyed a unique employee benefit: none had scrawny arms. [swoon]

 

 

Unfortunately TRT doesnt do much for ED.

[+ Funguy]

Unfortunately TRT doesnt do much for ED.

 

Finally, someone who understands!

[+ g56whiz]

Unfortunately TRT doesnt do much for ED.

 

True enough. But it was clear from some of the conversations I overheard that some of the Muscle Mary’s on TRT were also using Trimix.

[Rudynate]

True enough. But it was clear from some of the conversations I overheard that some of the Muscle Mary’s on TRT were also using Trimix.

 

 

I have encountered quite a few guys who use trimix. The one time I tried it, it didn't work very well. Just made my dick burn and didn't give me a boner.