I just made a post on TIPS on the topic of testosterone therapy. It's time that this subject get the attention it deserves. Some, like me, have had many years of experience with this and maybe we can be of help to the newbys. (Then again, maybe we have it all wrong.) Let's see where it goes----------
The women get much attention to their female hormone problems, but it seems that the men are just supposed to "suck it up". Well, I can attest to the fact that my quality of life has greatly improved since I faced up to the fact that I was lacking in testosterone and decided to do something about it. The fact that it is FDA classified as a CONTROLLED SUBSTANCE--SCHEDULE 3 (high potential for abuse) didn't make solving this problem any easier. Being in an HMO made it even more difficult since the doctors have to answer to their review board when they prescribe anything in SCHEDULE 3--especially when it isn't in their formulary (topical gel, not patch). Probably could have gotten a prescription for marijuana, or cocaine, easier if I'd complained of "pain and lack of appetite" (just kidding).
Low T is a pervasive, under-diagnosed problem and it seems most doctors haven't an easy way to deal with it.
The following is my opinion and observations ONLY based on over 15 years of testosterone therapy. It's a life-long constant work-in-progress.
Always maintain a healthy respect for, and a genuine fear of, the power of ANY hormone you are adding to your body. This is serious stuff. Learn what to expect and when. Know what LH, FSH, estradiol, and DHT are. Err on the side of under-dosing because overdosing by even a small amount may trigger some side-effects. Miss a dose ? Don't double-up to catch-up. Skip a dose one day a week, or so, and note how you feel. Be always mindful of possibly inadvertently contaminating your environment. Segregate your laundry from all others'.
Start at a low dosage level based on the initial test and slowly increase it over a period of weeks, if not several months, till you reach your optimum daily dosage level based on your response rather than only the raw numbers from a lab test. A quick response at the beginning may mean that you're actually shocking your system at an overdose level that you don't want to maintain over any period of time. I've talked to dozens of men and several women and with EVERY one of them their doctor started them off at a high dosage level and then had to sharply reduce it because it triggered side-effect reactions. Worse with the women--acne and facial hair. Yuck ! At your optimized dosage you can probably blunt small effects of DHT,dihydrotestosterone, by taking about 180mg of saw palmetto extract daily.
Avoid suggestions from athletes or body builders. They are taking large doses to "bulk up" and will have to go through a detox regimen when they decide to come back down. You're just trying to be "normal" in this environmentally estrogen-soaked, testosterone-suppressed world we live in---mostly from plasticizers.
Avoid the patch. You can't adjust the dosage level to meet your needs, and it will probably itch and leave disk-shaped bruises that may last for months. Avoid injections. They tend to shock the system and are expensive. By far the best are gels (cream), and if you use a compounding pharmacy instead of Androgel, Testim, etc., you will probably spend less out-of-pocket than your copay if you went through your insurance carrier.
Don't think you won't benefit from the therapy because your test results show you're only near or slightly under the bottom of the arbitrarily determined "normal range" of total testosterone. If you have the symptoms, then you need the therapy. Period.
Seems like everybody focuses on the "total T" level and overlooks the important "free T", DHT, and estradiol levels. Having an endocrinologist periodically review your therapy isn't a waste of money.View Thread
Your suggestions are overkill. Doctors haven't a problem prescribing hormone therapy for a thyroid hormone deficiency and even that doesn't require constant monitoring by an endocrinologist. I suspect that most doctors just don't trust their patients enough to properly handle T without cross-contaminating others, especially children. They are probably correct, so a better patch should be developed.
I wish the medical establishment would spend at least the same amount of time taking on the Plastics Council in ridding the environment of the pervasive estrogen-imitators as they do in discouraging T therapy. To much pushback from the politically powerful, heh ?View Thread
Whether you're needing a 5mg or 0.5mg daily dose, you will probably save a lot of money by using a local coumpounding pharmacy. Compare their price against Androgel, etc. before your get your prescription filled.View Thread
The opinions expressed in WebMD Communities are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of WebMD. Communities are not reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. WebMD does not endorse any specific product, service or treatment.
Do not consider Communities as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.