Complete Guide to Substitution Therapy testosterone for men

Here is what you should know …

1. Testosterone replacement therapy can be called not only science, but the whole art. Unfortunately, most doctors artists come out so-so.
2. The “normal” testosterone is an illusion. No definition general, free and bioavailable testosterone you do not get holistic picture.
3. Hormone replacement therapy (HRT) with testosterone is prescribed based on symptoms, not blood tests. If you feel powerlessness, easily gain fat, with difficulty achieve muscle gain, your libido is low and you suffer from depression, then you may need HRT.
4. Low testosterone is treated with injections, gels, creams, capsules and nutritional supplements. With this injection of testosterone most effective.
5. HRT testosterone is not full of side effects. the main thing contraindication is prostate cancer. Also such therapy is capable of lead to a thickening of the blood, but this condition lends itself easily treatment.
6. Some HRT results appear quickly, but on playback others may take years. From low libido you get rid of a couple of weeks, as well as depression. But dropping excess fat and muscle gain will begin gradually, pass in a few months the plateau will continue for years in slow pace.

• Testosterone hormone replacement therapy
  • Are your testicles doing their job?
  • “Normal” testosterone is a dummy
  • Other team members: SHBG and estradiol
  • Signs of Low Testosterone
  • Take tests wisely
• What drugs are used in replacement therapy testosterone?
  • 1. Injection
  • 2. Testosterone gels
  • 3. Other forms of release
• HRT, your testicles and hCG
• Potential side effects of HRT
  • What about gynecomastia and heart attacks?
• The effect of hormone replacement therapy with testosterone

Testosterone hormone replacement therapy

Are your testicles doing their job?

So, as a result of a blood test for testosterone, you see a figure 600 nanograms per deciliter (ng / dl). You know that the “norm” ranges from 200-1100 ng / dl. You breathe a sigh of relief, and mentally give “five” to your testicles that could “squeeze” normal rate. But what is this really talking about numeral?

“Normal” testosterone is a dummy

Unfortunately, a testosterone score of 600 ng / dl does not mean absolutely nothing. In a laboratory blood test per level a lot of testosterone inaccuracies. Its concentration in the blood is continuous is changing. The only way to get at least some reliable data will be handed over to the laboratory collected during days urine to measure the amount of testosterone and its metabolites. Alternatively, you can take a minimum of three blood samples per different time of day. In the laboratory they will be connected together, and there will be test.

However, practically no one does this. It is more expensive, longer and troublesome. Also, if you offer this to the doctor, he will take you. for the madman. And really, who are you to doubt him competencies, are you a miserable mortal? And what are you so worried about your testosterone? You should be content with useless blood tests, approximate indicators of testosterone, and supposedly functioning testicles, like most representatives of the human herd on the planet.

And even if you donate a few blood samples, this is not a reason to draw any conclusions. First of all, because “normal” testosterone may not be normal for YOU.

Perhaps when you were 20 with something, your testosterone and rolls over, giving out 1100 ng / dl. However now when you are having difficulty scored a minimum of 600 ng / dl, you study Facebook all day long and other sites, collecting information. If you defined your testosterone background when you turned 30, now you could judge the “normality” of the results. But then again, this no one does.

Other team members: SHBG and estradiol

Another source of problems is globulin binding sex steroids, or SHBG. It is a glycoprotein that literally binds sex hormones, including about 60% of your testosterone. Over the years, this figure is growing.

The higher your SHG level, the more your testosterone linked, which reduces the amount of free hormone capable do your job. Therefore, let your testosterone be equal to 600, the lion’s share of it is connected. That’s just terrible. As if you have gin in a bottle, but you are not able to uncork it.

That is why, in attempts to calculate the level of testosterone, the doctor should at least assign analysis to general, free and bioavailable testosterone to understand at least a little situation. But, you guessed it, no one does this, unless that a couple of doctors of the classical school.

We must not forget about estrogen, or rather – about the level of estradiol in men. Your testosterone may be normal, but increased levels of estradiol will prevent any attempts testosterone to make of you the man with whom you could to be.

As you can tell, determining testosterone levels is rather laborious and insidious occupation. Therefore regardless laboratory test results, given their ambiguity, focus on symptoms and a simple desire to be better with hormonal point of view.

Signs of Low Testosterone

Do you know a breakdown? Have you ever unreasonably gained fat which subsequently could not get rid of? How about a loss muscle tone and lack of training progress? Do u you have problems with erection? Do you think about your lawn more often than about female charms?

What can you say about premature aging? Problems with concentration and memory? Depression? Or maybe you have a flaw “healthy aggression” when you do not take initiative in business heartfelt?

Maybe you are too irritable, always cocked, and ready tear my head to the fat in front of you in the line who bought last cinnamon roll? Any of these conditions may testify to reduced testosterone, including, however paradoxically, and the last item on the list is about unjustified anger.

Historically low testosterone, or hypogonadism, has been characteristic the period of the Middle Ages and subsequent eras. According to the data In 2006 studies, 39% of men over 45 suffered from this problem. According to another survey of 13 million men living in the United States, had a testosterone deficiency, and only 10% of them passed treatment.

There is a change. However, do not forget that these statistics includes only men whose testosterone deficiency has confirmed clinical examination, i.e. laboratory test results. Therefore, millions of men remain, mostly young or relatively young – whose analyzes are within normal limits, but their well-being suggests a clear hormonal imbalance.

Also excluded are young people who do not check at all your testosterone. Millions of such people can also experience lack of this hormone. The reason does not always lie in aging. organism. Rather, it is due to the influence of estrogen from the surrounding environment, inhibition of pituitary and testicular functions by chemicals in overall, as well as well-fed, comfortable, modern, surrounded all sorts of amenities a lifestyle where there is no room for splashes testosterone.

Rumor has it that the testosterone level of modern the average man is about half that of his grandfather at the same age and living conditions.

Take tests wisely

Your first task is to find a progressively minded doctor, or a specialist who is at least not afraid of purposeful Patients. Fortunately, in any country there are now enough centers for the fight against testosterone deficiency. But most of them, no matter how regrettably, they were hastily organized, and did not differ in high competence in the matter. This is an additional incentive to understand topic yourself.

Having found a good doctor, describe your condition to him, express desire to undergo testosterone replacement therapy and ask Assign you analyzes. But be sure to go through the procedure laboratory tests as indicated below. (For example, if you don’t indicate that you need a specifically “sensitive” analysis on estradiol for men, then laboratory assistants measure it to you as if you ballet dancer from the Bolshoi cycle).

You need the following tests:

• Testosterone total
• Testosterone, bioavailable
• Testosterone free
• Estradiol (sensitive analysis)
• SHGG
• Follicle-stimulating hormone (FSH)
• Luteinizing hormone (LH)
• Dihydrotestosterone (DHT)
• Complete blood count (KLA)
• Prostate Specific Antigen (PSA)
• Blood chemistry
• Integrated metabolic panel

The performance of these analyzes will serve as a reference point. WITH with them you will compare the results of the survey after three or six months to judge the correct dosage of drugs and manifestation of any hidden side effects.

What drugs are used in replacement therapy testosterone?

Route of administration	Drug name	Dosage
Oral	Andriol	120-200 mg daily
	Metadren	10-30 mg daily
	Halotestin	5-20 mg daily
Injection	Nebido	1000 mg every 3 months
	Delasteryl	200-400 mg every 4 weeks
	Depot Testerone	200-400 mg every 4 weeks
Transdermal	Andromen	10-15 mg per day
	Androgel	75-100 mg per day
	Testoderm	2.5-7.5 mg per day
Subcutaneous	Testosterone implants	1200 mg for six months

If you have a testosterone deficiency or are being tortured symptoms of its manifestation, you probably want to get rid of him. To this end, a huge range of additives has been developed. (Alpha Male® and Tribex® are most effective). They are very effective, and are recommended for healthy guys who want to increase their level testosterone for progress in bodybuilding. Obviously such drugs will not be the best choice for patients with clinical lack of testosterone, who decided to take the path hormone replacement therapy with testosterone (HRT) long in a life.

1. Injection

Testosterone injections are an elite means of HRT. Though testosterone gels (see below) are indeed consistent with natural fluctuations in testosterone in the body, injection, with proper use, allow you to build muscle more intensively, provide a libido jump and give many more benefits.

There are two types of testosterone injections in America: testosterone enanthate and testosterone cypionate. These esters have a little different half-lives, but it’s not so important, especially if you adhere to an adequate dosage and appropriate method and application schedule.

Most men have enough of 100 mg of each drug per week. But some may require a smaller or larger dose, about 200 mg per week. If you stab more, then it will not be testosterone replacement therapy, and a facilitated steroid cycle for bodybuilders.

Even with weekly administration (always on the same day), you you can still suffer from signs of low testosterone, increasing every new day after the injection. To avoid this many men divide the dose in half and administer it twice a week. So your testosterone level will be more or less stable throughout all week.

Most athletes also tune their hardest training for hormonal “ups and downs” during HRT. But these are unnecessary troubles, especially if you inject testosterone twice in Week. Such a short interval between injections will provide you constant testosterone rise.

In addition, instead of intramuscular, you can also do subcutaneous injections. Dr. John Chrisler, recognized testosterone guru insists greater subcutaneous efficacy injection, since 80 g of testosterone administered in this way corresponds to 100 g of the drug injected into the muscle. Also he notes that you don’t have to riddle with muscle belly hundreds of holes during an extended HRT.

All you need to do is pinch your skin on your buttock, thigh or even stomach and insert a tiny needle into this fold at an angle of 45 or 90 degrees. Press the piston all the way, release the skin, and you’re done. Is Chrysler right about this benefit of subcutaneous injections, or not – it is not known for sure. But the share of truth here is definitely there, so it’s worth a try.

2. Testosterone gels

As mentioned above, testosterone gels support natural androgen rhythm, and it can be assumed that imitation natural rhythms of the human body will give the best result. However many consider that they are inferior to injections in their effectiveness.

Moreover, gels have their drawbacks. They need to be applied only on freshly washed skin. For at least an hour you can’t swim and sweat. Also, in no case should you allow children and women (especially pregnant) to touch the treated area of ​​the skin until completely absorbed.

After choosing a gel, you will have to apply it alone (in extreme cases, two) once a day. But to smear it with hands is not recommended. Gel, remaining in the hands will not enter the bloodstream. It’s the same as smear an old impervious baseball glove. Instead of this squeeze the gel onto the forearms and rub them against each other. So you do not lose a drop.

3. Other forms of release

Other forms of testosterone medications, including creams, capsules and sublingual tablets are not worth talking about. Creams can prove to be very effective, but they have a lot of dirt and they absorb worse than gels. Capsules and tablets are either completely useless, either impractical. Besides guessing their exact dosage is almost impossible.

There are also other proven treatment protocols. effectiveness in the fight against secondary hypogonadism (in which the hypothalamus for some reason does not give a signal to the pituitary gland to produce LH and FSH, which in turn cause the testes to produce testosterone), for example, selective estrogen receptor modulators (SERM).

The two most common of these are clomid (clomiphene) and Nolvadex (tamoxifen). They stimulate the production of LH by the pituitary gland, which activates the testes. A detailed description of these protocols is not included in the objectives of this article.

HRT, your testicles and hCG

The greatest concern regarding HRT is related to infertility and drying out the testicles. Indeed, HRT reduces the amount of sperm produced, but it’s foolish to think that a replacement dose will save you from fatherhood. In most cases, the testes are reduced, and sperm volume is reduced. But this phenomenon is easily prevented with using concurrent use of human chorionic gonadotropin (HCG).

This drug duplicates the effect of LH, so your testicles will continue to function. They will still produce sperm and testosterone, so no atrophy will occur. Also LH receptors are located throughout the body, and hCG binds to this system. Funny, but still, thanks to this man, undergoing HRT or hCG therapy, assure their excellent well-being.

HCG is injected subcutaneously with insulin syringes and is easy to reach. by prescription. The recommended starting dose is 100 IU per day. With time, you can increase the daily dosage or vice versa, work hard 200 or 500 IU twice a week.

Potential side effects of HRT

During HRT, several bad things can happen. One of they only threaten you if you have discovered prostate cancer.

Notable is the absence of any evidence that HRT provokes prostate cancer, even after careful study specialists of thousands of studies and medical records. But for some hormone replacement therapy still unknown to us tends to aggravate the condition of those suffering from this disease. therefore it is necessary to undergo digital rectal examination annually, continuing to monitor prostate-specific antigens (PSA).

HRT can also lead to polycythemia (increased production the body of red blood cells). Instead of flowing freely through the veins, your blood thickens and moves with jerks, like soft ice cream from the machine Dairy Queen. It is clear that because of this, heart attacks and strokes occur when blood vessels become clogged clots.

Therefore, you should control your hemoglobin and hematocrit. When hemoglobin is higher than 18.0, or the hematocrit increases to 50.0, then you should adjust your dosage of testosterone, pass blood to donate to the Red Cross, or go through the procedure like this called therapeutic phlebotomy (conventional phlebotomy in doctor’s office).

What about gynecomastia and heart attacks?

Fearful gynecomastia has never been seen in men, undergoing hormone replacement therapy with testosterone. Gynecomastia, or breast tissue growth in men, diagnosed solely in receiving significant dosage of testosterone (1000-3000 mg per week) or its analogues. Hair loss is possible, but everything usually normalizes to 30 years. If if you lived to your age without losing your hair, it’s very doubtful that HRT will make you bald.

Other popular heart testosterone horror stories attacks and other troubles – vile slander. On the contrary men with low testosterone are more susceptible to different sores, including heart problems, diabetes, dementia and many other disorders typically associated with old age, death, and decrepitude.

The effect of hormone replacement therapy with testosterone

Testosterone affects the body in the most wonderful way, but not right away. Despite the improvement in well-being, bordering on inspiration, which appears shortly after the start of therapy, many physiological processes start only after some time.

1. Sexual benefits. Fully they start manifest in the third week of therapy, after which from 19-21 weeks there is a plateau effect.
2. Depression. If you have depression, it will begin to recede somewhere weeks from 6, but a full recovery takes more time.
3. Anxiety, sociability and stimulation of the cerebral cortex (controlling attention and even creativity). Improvement occurs from week 3, and the plateau effect manifests itself in three months therapy.
4. Insulin sensitivity. Increases in a few days, providing tangible results (loss of excess fat) in 3-12 months, and often lasts for years.
5. Muscle gain. It does not so much depend on the optimal level. testosterone, how much from genetics, diet, lifestyle and training. However, by and large, testosterone therapy is positive affects the muscles in a month. So intense the trend will last a year, after which its pace will slow down and it will continue for several more years.
6. High quality of life. There is one of the intangible benefits called life satisfaction. Often it consists of the totality of all the positive features of the optimal level testosterone, both physiological and psychological. Her it is impossible to measure, as, however, and overestimate. Simply try to find a doctor who understands this.