World Class Bodybuilding   Forum

BulkSupplements Egg Whites International A1Supplements.com i-Supplements Strength.com VitaSprings Myprotein Beyondsupplements
Go Back   World Class Bodybuilding Forum > Anabolic Steroid Discussion > Hormone Replacement Therapy

Shoutbox
Loading...


Hormone Replacement Therapy Learn and discuss more on Testosterone Therapy and Hormone Replacement The role testosterone plays in maintaining youthful Testosterone Levels, alleviating depression, as well as inducing fat loss in those who are unable to reduce body weight regardless of diet and exercise.




Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 09-30-2019, 08:01 AM
NavyChief's Avatar
NavyChief NavyChief Is Off Line
Community Veteran

 
Join Date: May 2014
Posts: 80
Thanks: 28
Thanked 39 Times in 26 Posts
Rep Power: 128
NavyChief has a brilliant futureNavyChief has a brilliant futureNavyChief has a brilliant futureNavyChief has a brilliant futureNavyChief has a brilliant futureNavyChief has a brilliant futureNavyChief has a brilliant futureNavyChief has a brilliant futureNavyChief has a brilliant futureNavyChief has a brilliant futureNavyChief has a brilliant future
How to monitor TRT dose

How to monitor TRT dose
Today, 01:00 PM
Thomas B. Repas, DO, FACP, FACE, CDE, is an endocrinologist, lipidologist and physician nutrition specialist in clinical practice at the Regional Medical Clinic Endocrinology and Diabetes Education Center in Rapid City, SD. Dr. Repas is the former chairman of the professional diabetes advisory committees of the Wyoming and the Wisconsin Diabetes Prevention and Control Programs. He is board certified in the areas of endocrinology, diabetes and metabolism, clinical lipidology, internal medicine and nutrition, and is also a certified diabetes educator.
How do you monitor and adjust testosterone replacement therapy dose?
June 8, 2011
A primary care colleague asked me this question recently. The answer depends on the form of testosterone therapy that has been prescribed. After confirming a patient has hypogonadism and treatable causes are ruled out, testosterone replacement therapy is initiated. Subsequent monitoring is done to confirm the dose is optimal.

Patients who are on intramuscular testosterone often have a nonphysiologic “saw tooth” pattern of testosterone levels which are higher than optimal soon after injection and decrease to lower than optimal before the next injection. This is why I tend to prefer transdermal preparations in most patients, except those who have financial limitations or who cannot apply the transdermal testosterone themselves.

After a patient has been on testosterone injections, I measure a trough testosterone on day of injection (before it is given) and a peak testosterone level about 24 to 48 hours after the injection. The goal is to keep the peak from being too high and the trough from being too low. This can be difficult in many patients. If a patient seems to be having too much variation in levels but cannot be switched to transdermal testosterone, I sometimes decrease the dose while increasing the frequency of injections. For example instead of 400 mg IM every month I might prescribe 100 to 150 mg IM every 7 to 10 days.

Transdermal testosterone patches are placed nightly. Patches keep testosterone levels stable and with less variation than injections. I usually test an early morning testosterone in patients on transdermal testosterone patches. The goal for the majority of patients is a total testosterone in at least the mid to normal range of 400 to 600 ng/dL. I aim for higher levels in younger patients and accept lower levels in older patients.

Transdermal testosterone patches do have a higher rate of dermatologic reactions compared with testosterone gel. These skin reactions can often be managed with corticosteroid creams. However, because of this adverse effect, my preference for transdermal testosterone replacement therapy is topical gel.

Patients on testosterone gel usually apply first thing in the morning after a shower. Testosterone levels may appear too low if obtained immediately before gel is applied and too high if it is measured within the hour or two afterwards. Therefore, I usually measure a total testosterone after levels have plateaued, about 6 to 8 hours after application. The goal is a total testosterone in at least the mid to normal range or higher.

If levels are too low in a patient on testosterone gel, often the explanation is poor application technique. I instruct patients on how to apply, and to apply over as large a surface area as possible to maximize absorption. As I wrote in a previous post, there is risk of exposing others. Patients on testosterone gel must take special precautions to avoid this.

Once the dose is optimized, I do not repeat levels very often, perhaps once a year, unless the patient is having symptoms or the dose is changed. Patients will also need a baseline CBC before treatment, at 3 months, 6 months and then annually thereafter. The risk for erythrocytosis seems to be greatest with testosterone injection therapy, but could occur with any form of testosterone if the dose is too high. Prostate-specific antigen and rectal exams are also advised in those aged older than 40 years.
Reply With Quote
Get your liquid egg whites here at EGG WHITES INTERNATIONAL

  #2  
Old 09-30-2019, 10:44 AM
A1food4u's Avatar
A1food4u A1food4u Is Off Line
Moderator


 
Join Date: Mar 2011
Location: between a soft and a hard place
Posts: 15,566
Thanks: 4,494
Thanked 3,705 Times in 2,947 Posts
Rep Power: 6641
A1food4u has a reputation beyond reputeA1food4u has a reputation beyond reputeA1food4u has a reputation beyond reputeA1food4u has a reputation beyond reputeA1food4u has a reputation beyond reputeA1food4u has a reputation beyond reputeA1food4u has a reputation beyond reputeA1food4u has a reputation beyond reputeA1food4u has a reputation beyond reputeA1food4u has a reputation beyond reputeA1food4u has a reputation beyond repute
good read..... thanks!
__________________
don't follow me... I'm lost
Reply With Quote
  #3  
Old 10-05-2019, 07:18 AM
jipped genes's Avatar
jipped genes jipped genes Is online now
Moderator

 
Join Date: Feb 2004
Posts: 21,536
Thanks: 447
Thanked 3,623 Times in 2,804 Posts
Rep Power: 5724
jipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond repute
Agree, thanks. I knew when they took blood but not why.

I am lucky, my trough is not pronounced and I am at 800 ng/dl +- with a fair dose.
Also my PSA has come back good every time. I do have a prob with SHBG which is borderline high. but that must be a different thread.
__________________
Doc "Do you do cardio"

Vandoo "Yes, I lift faster."
Reply With Quote
  #4  
Old 10-05-2019, 08:36 AM
Glycomann's Avatar
Glycomann Glycomann Is online now
Lumpy Moderator

 
Join Date: Nov 2009
Location: Chopping wood or laying pipe.
Posts: 10,944
Thanks: 1,145
Thanked 4,693 Times in 2,981 Posts
Rep Power: 2128
Glycomann has a reputation beyond reputeGlycomann has a reputation beyond reputeGlycomann has a reputation beyond reputeGlycomann has a reputation beyond reputeGlycomann has a reputation beyond reputeGlycomann has a reputation beyond reputeGlycomann has a reputation beyond reputeGlycomann has a reputation beyond reputeGlycomann has a reputation beyond reputeGlycomann has a reputation beyond reputeGlycomann has a reputation beyond repute
The gels didn't work at all for me. I couldn't get it over 300 ng/dL. Dr. Rand McClain says the therapeutic dose in men since the 1950s has been 800 ng/dL or higher. I can't find what literature he is talking about. Seems like all the modern literature is geared around the newer preparations and the degraded normal range we have now.
__________________
See Glycomann's articles http://www.worldclassbodybuilding.com/forums/f497/
Reply With Quote
  #5  
Old 10-06-2019, 07:36 AM
jipped genes's Avatar
jipped genes jipped genes Is online now
Moderator

 
Join Date: Feb 2004
Posts: 21,536
Thanks: 447
Thanked 3,623 Times in 2,804 Posts
Rep Power: 5724
jipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond reputejipped genes has a reputation beyond repute
Quote:
Originally Posted by Glycomann View Post
The gels didn't work at all for me. I couldn't get it over 300 ng/dL. Dr. Rand McClain says the therapeutic dose in men since the 1950s has been 800 ng/dL or higher. I can't find what literature he is talking about. Seems like all the modern literature is geared around the newer preparations and the degraded normal range we have now.
Yeah doc asked me if I wanted the androgel. I said hell no, give me the SHOT! Last quarter i was right at 779 ng/dl. Doc says we could not ask for a more stable patient. Like I said the SHBG is a prob but I feel pretty good otherwise.
__________________
Doc "Do you do cardio"

Vandoo "Yes, I lift faster."
Reply With Quote
Reply

Bookmarks


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump


All times are GMT -5. The time now is 06:33 AM.



Copyright ©2000 - 2019, Jelsoft Enterprises Ltd.
follow worldclassbodybuilding at facebook follow worldclassbodybuilding at pinterest follow worldclassbodybuilding at twitter