Title : The Complete Guide to T replacement
link : The Complete Guide to T replacement
The Complete Guide to T replacement
by the TC Luoma T-Nation
replacement therapy testosterone 101
This is what you need to know ...
- The testosterone replacement therapy is both an art and a science. Unfortunately, many doctors are fucking artists.
- A "normal" testosterone reading means almost nothing. You need to have total testosterone, free testosterone and measured to obtain a fairly accurate picture bioavailable hormone testosterone.
- The testosterone replacement therapy (TRT) should be given based on symptoms rather than blood levels. If you have no energy, increased fat easily, has trouble putting on muscle, have low libido, and suffer from depression, you may need TRT.
- You have the option of injections, creams, gels, pills or supplements to treat low testosterone levels, however, testosterone injections will give you the most bang for your buck.
- TRT makes very few negative side effects. TRT however, it is contraindicated in men with existing prostate cancer. It can also cause an easily treatable condition where the blood thickens.
- Some of the benefits of TRT happen quickly, while others take years. Libido may improve within weeks, as depression can, but the loss of body fat and increased muscle takes months on the plateau while continuing at the slowest pace in years.
Are your balls doing their job?
So just received the results of your blood and testosterone graphics out of 600 nanograms per deciliter (ng / dl) of blood. You know it's "normal" somewhere between the range of 200 to 1100 ng / dl. So breathe a sigh of relief and mentally give your balls a pat on the back for a job well done in kicking out a reading of 600. But what that number really mean?
"normal" testosterone Media Zilch
Unfortunately, that reading of 600 ng / dl means almost nothing. Tests for testosterone is riddled with inconsistencies. Blood testosterone levels vary by time and day. The only way to get a reasonably accurate reading would collect urine over a period of 24 hours and has the laboratory used to measure testosterone and its metabolites. Alternatively, you could donate at least three blood samples of different times during the day. The laboratory samples would then join together and test that sample.
But nobody does it that way. It is more expensive, more time consuming and more uncomfortable. In addition, the doctor might think you were nuts for even suggesting because, really, who are you to question him, that miserable mortal, and why you care so much about your testosterone levels? You must be content with vague blood readings, average testosterone levels, and at least quasi-functional balls like the rest of the sheep on the planet.
And even if it did pool multiple blood samples, still would not say much. On the one hand, although the results could indicate that you have a normal level of testosterone, it may not be normal for you.
Perhaps he has measured a high-octane 1100 when he was in his twenties, but now are sputtering along at a rate relatively low octane 600 and spend your days Facebooking, or equivalent online booking scrap. The only way you know what is normal for you is that if you had set a reading of basal testosterone before age 30. But again, nobody does.
The other players: SHBG and estradiol
Then there is the question of globulin steroid hormones, or SHBG. It is a glycoprotein that literally binds sex hormones, including, on average, about 60% of their testosterone, and that percentage continues to rise as you get older.
The more SHBG have, the more of your testosterone is linked, leaving less freedom to do all good things. So while your testosterone level may be 600, much of it is locked. It can be maddening. It's like have a genie in a bottle that can not be uncorked.
That's why, at least when it comes to determine their testosterone levels, doctors should ask the laboratory for levels of total testosterone, levels of "free "testosterone, and testosterone levels" bioavailable "so it can be a little bit better of an idea of what your situation. However, you guessed it, no one does, at least, very few doctors trained conventionally.
And we can not forget about estrogen, or more specifically, estradiol levels in men. Their testosterone levels can read normal, but if estradiol levels are high, could thwart testosterone in their efforts to make the man you're supposed to be.
As you can see, the determination of normal testosterone levels is a difficult beast. Therefore, regardless of what your lab values are and, given the problematic nature of laboratory tests, you have to rely on symptoms instead and the simple desire to be more than they are, hormonally speaking.
Symptoms of low T
Do you have less energy? It has experienced an unexplained increase in body fat and have difficulty losing? How about a loss of muscle tone and inability to advance their training? Does your erection decay times and decreasing? Do you think more about the turf female parts?
What about premature aging? Difficulty in concentration or memory? Depression? Or maybe a lack of "adequate aggression" which does not take the initiative in business matters or heart?
Perhaps you are nervous, or always angry, ready to head off the online pudknocker front of you that bought the last damn cinnamon roll? Any of these things could be indicative of low T, including, apparently, paradoxically, the last item in the list on the levels of undue anger.
Historically, low levels of testosterone or hypogonadism, has been largely a problem of age and beyond. A 2006 study reported that 39% of men over 45 suffer from it. Another study indicated that while 13 million men in the US they may be deficient in testosterone, less than 10% get treatment for him.
That's a big part of human change, but consider that these statistics reflect only those men who were clinically deficient, ie, lab tests indicated they were low. Leaving aside the millions - many of whom are young or relatively young -. Whose laboratory tests indicate that these might be fine, but on the basis of their symptoms, are probably deficient
also ignores the younger men who do not usually get tested their testosterone levels . Millions of them are probably poor, too. Not because of old age, but due to environmental estrogens, pituitary and testicular suffocating chemicals in general, and probably even a comfortable modern style, soft and sweet life filled with low testosterone convenience.
Indeed, it is speculated that testosterone levels average man today are roughly half of what was his grandfather, in a comparative point in life .
Get lab work right Done
Your first task is to find a progressive doctor, or at least one that is not threatened by a patient who knows what he wants. Fortunately, now there are a lot of treatment centers low testosterone throughout the country. Unfortunately, many of them are in it for the quick pasta and are not likely to be as informed on the subject as you want them to be. All the more reason to take over.
Once you find the right document, describe their symptoms, confesses his desire to receive testosterone replacement therapy, and order lab work. But be sure to get tests done exactly the way specified below. (For example, if you do not ask for an analysis of estradiol "sensitive assay" for men, which will measure your estradiol same as if it were a ballet dancer Bolshoi suffering from menstrual problems.)
Question for this laboratory work:
- testosterone, total
- the bioavailable testosterone
- testosterone, free
- estradiol (sensitive assay)
- Steroid hormone globulin
- follicle stimulating hormone (FSH)
- luteinizing hormone (LH)
- dihydrotestosterone (DHT)
- The complete blood count (CBC)
- prostate-specific antigen (PSA)
- chemical Group blood
- metabolic Panel
These tests give you a pretty good read reference where it is so that when you have the blood test monitoring carried out between three and six months later, you can see if you are in the correct and if you are suffering insidious negative side effects dose.
What are your options for replacing T?
If tests like testosterone deficient, or if you have symptoms of testosterone deficiency, you probably want to do something about it. There are definitely over-the-counter supplements designed for this purpose. (Alfa Male® and Tribex® are the most powerful.) And while effective, are the most used by healthy younger men who want increased levels of T bodybuilding purposes. They are probably the best option for men who are clinically low and has decided to submit to what is usually a lifelong commitment to testosterone replacement therapy or TRT.
1. Testosterone injections
Testosterone injections are the cream of the cream of the TRT. While it is true that testosterone gels (see below) to create a more natural flow and the flow of testosterone injections, provided they are managed properly, will give most of bodybuilding, libido boost, explosion of rock-su -world of the ball.
essentially has two options in America injectables, testosterone enanthate and testosterone cypionate. The half-lives of these esters differ slightly, but not a big deal, especially if the dosage is appropriate and you have chosen a suitable injection method and an outline.
For most men, 100 mg. a week of any ester is sufficient for effective TRT. However, some men need less and some men need more, possibly up to 200 mg. one week. Beyond that amount and that is quite a mild steroid cycle instead bodybuilding testosterone replacement.
Even if you are injecting a week (always on the same day), you may still suffer a little calm under testosterone as further from the days of the injection. To remedy this, many men divide their dose in half and injected twice a week instead of once a week. So you can keep your blood testosterone levels fairly stable.
And while many men micromanage their toughest workouts to match the peaks and valleys of the TRT, which is largely an unnecessary battle, especially when they are giving two injections a week. Injections given that together ensure it is almost always mounted a peak.
In addition, you may want to consider subcutaneous injection instead of intramuscular injections. Dr. John Crisler said testosterone guru, insists that the sub-q is much more effective, so much so that 80 mg. Testosterone is injected under the skin is equal to 100 mg. injected intramuscularly. He adds, do not push your muscle bellies filled with thousands of holes throughout the life of the TRT.
Everything we do is take a pinch of skin on the buttock, thigh, or stomach, and inject a small needle into the fold, either 45 degrees or an angle 90 degrees. fully depress the plunger, release the skin, and you're good to go. Whether Crisler is right about the power of sub-Q injections is not known with certainty, but it has the ring of truth and worth a try.
2. testosterone gels
As mentioned above, testosterone gels offer a natural more androgen pace and is likely to be some argument to affirm that mimic the natural rhythms of the body is the way to go. However, many believe that it does not have the same return on investment in the form of injectable testosterone esters.
In addition, the gels have their drawbacks. should only be applied gels freshly showered skin. You should refrain from swimming or working up a sweat for at least one hour. Moreover, it can, under any circumstances, do not let a child or woman (especially pregnant) come into contact with the treated area until it is completely dry.
If you choose to use gels, you must apply once (or, in some cases twice) a day. Do not use your hands to apply the gel, however. Any gel on hands does not enter the bloodstream. It's like applying gel on the glove of a former receiver, which is not very permeable. Instead, squeeze the gel on the forearms and rub. That way you will not lose any.
3. Everything else
Almost everything else, including creams, pills and sublingual drops, is not much worth discussing. Granted, creams can be effective, but are disordered and penetrate the skin, and gels. Pellets and drops, however, are ineffective or impractical and precise dosing quite impossible.
There are, however, other protocols that have proven effective in the treatment of secondary hypogonadism (where the hypothalamus, for whatever reason, is not telling the pituitary to produce LH and FSH, which in turn cause the testes produce T), as selective estrogen receptor modulators or SERMs.
Two of the most commonly known are the Clomid (clomiphene) and Nolvadex (tamoxifen). They just fool the pituitary production of LH which tells the testicles to get to work. The exact protocols are beyond the scope of this article, however.
TRT, testicles, and HCG
One of the greatest fears about the making of the TRT is infertility and balls contraction. While TRT reduces the number of sperm that a man produces, it would be absurd to think that the replacement dose has rendered safe from becoming a dad. In many cases, however, the testicles shrink and sperm count will be reduced, but this effect can be easily prevented by simultaneous administration of human chorionic gonadotropin, or HCG.
HCG
The drug mimics LH so that your testicles are not closed. They still produce sperm and testosterone still going to produce, so the contraction will occur. In addition, there LH receptors throughout the body, and HCG adheres to these receptors entire system. Anecdotally, at least, this makes men in the TRT therapy HCG and say they feel very good.
HCG is administered subcutaneously through an insulin needle and is easily accessible to your doctor through several compounding pharmacies across the country. The recommended initial dose is generally about 100 IU per day, working up high daily doses or, alternatively, 250 or 500, given twice a week.
The potential negative side effects of TRT
There are a small number of bad things that can happen when the TRT. One is only a problem if you have prostate cancer before starting treatment TRT.
Note that there is absolutely no evidence - even after the researchers have collected thousands of studies and patient records - that TRT may cause prostate cancer. However, for some reasons not fully understand, however, the TRT may worsen prostate cancer. It is therefore important to have a digital rectal examination (DRE) annually, while monitoring prostate specific antigen (PSA).
TRT can also cause a condition called polycythemia, which simply means that testosterone treatment has caused the body to produce too many red blood cells. Instead of freely flowing through their veins, the blood thickens and jets along as the material leaving the queen of dairy soft serve machine and understandably can cause heart attacks and strokes when the pipes are clogged.
This is why it is important to track both hemoglobin and hematocrit. If the hemoglobin is greater than 18.0, or hematocrit exceeds about 50.0, may need to adjust your dose of testosterone, donate some blood to the Red Cross, or undergo what is called therapeutic phlebotomy (one simple blood in a doctor's office).
What about Gyno and heart attacks?
-feared Gynecomastia is almost unknown in men receiving TRT. Gynecomastia, or the growth of male breast tissue, which is seen almost exclusively in men taking pro-bodybuilder levels of testosterone (1000-3000 mg. Per week) or testosterone analogues. Hair loss is a possibility, but appears to have stabilized in the 30 If you've gotten this far without losing their hair, it is very doubtful that the TRT will make things worse.
The rest of the things you may have heard about testosterone causing heart attacks or any other bad thing is horrible, very bad. In any case, men with low testosterone levels are more prone to a number of diseases, including heart disease, diabetes, dementia, and almost everything else usually associated with old age, death or decrepitude in mens.
What to expect from therapy testosterone replacement
Testosterone makes for interesting body things, but usually not happen overnight. While you may start to feel pretty good, almost euphoric, after beginning therapy, the various physiological benefits have varying amounts of time.
- sexual benefits. These kick in fully in about 3 weeks and the plateau between weeks 19 and 21.
- Depression. If it is a factor, depression often begins to lift in about 6 weeks, but the maximum benefits take longer.
- Anxiety, sociability and stimulation of the cerebral cortex (the part that controls attention and even creativity). These begin to improve in about 3 weeks, plateauing approximately 3 months after starting therapy.
- insulin sensitivity. Begins to increase in just a few days, (less body fat) increasingly evident effects of 3 to 12 months, but often continue for years.
- Increased muscle. This depends not only on having adequate levels of highly testosterone, but genetics, diet, lifestyle, and training. However, in general terms, testosterone therapy can positively affect muscle in just one month, peak at about one year, and then continue at a slower pace for some time.
- The good life. And then there is the intangible benefit known as enjoyment of life. This is what often get when you combine all the benefits of testosterone, physiological and psychological, into one. You really can not be measured, but it is oh-so valuable. Just make sure you find a doctor who understands that.
Source: https://www.t-nation.com/steroids/complete-guide-to-t-replacement
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