Testosterone InjectionHere's what you need to know Testosterone replacement therapy is as much an art as it is a science. Sadly, many doctors are crappy artists. A "normal" testosterone reading means testosterone steroid injection dosage nothing. You need to have total testosterone, free testosterone, and bioavailable testosterone measured to get a reasonably accurate hormonal picture.
The Complete Guide to T Replacement | T Nation
Here's what you need to know Testosterone replacement therapy is as much an art as it is a science. Sadly, many doctors are crappy artists. A "normal" testosterone reading means almost nothing. You need to have total testosterone, free testosterone, and bioavailable testosterone measured to get a reasonably accurate hormonal picture.
Testosterone replacement therapy TRT should be given based on symptoms instead of blood values. If you have no energy, gain fat easily, have trouble putting on muscle, have a low libido, and suffer from depression, you may need TRT. You have the choice of injections, gels, creams, pellets, or supplements in treating low T.
However, testosterone injections give you the most bang for your buck. TRT causes very few negative side effects. TRT however, is contraindicated in men with existing prostate cancer. It can also cause an easily treatable condition where your blood thickens.
Some benefits of TRT happen quickly, while others take years. Libido can improve within weeks, as can depression, but loss of body fat and an increase in muscle takes months to plateau while continuing on at a lesser pace for years.
So you breathe a sigh of relief and mentally give your balls a slap on their backs for a job well done in kicking out a reading of But what does that number really mean? Testing for testosterone is rife with inconsistencies. Blood values of testosterone vary by the minute and the day. The only way to get a reasonably accurate reading would be to collect urine over a hour period and have the lab use it to measure testosterone and its metabolites.
Alternately, you could donate at least three blood samples from different times during the day. The lab would then pool the samples together and test that sample.
But nobody does it that way. It's more expensive, more time consuming, and more inconvenient. Besides, the doctor would think you were nuts for even suggesting it because, really, who are you to question him, you hapless mortal, and why are you worried so much about your T levels?
You should 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 you did pool multiple blood samples, it still wouldn't tell you much. For one thing, even though the results might indicate that you have a normal level of testosterone, it might not be normal for YOU.
Maybe you would've measured a high octane when you were in your twenties, but now you're sputtering along at a comparatively low octane and spend your days Facebooking, or it's offline equivalent, scrap booking. The only way you'd know what was normal for you is if you'd established a testosterone baseline reading before you turned But again, nobody does that.
Then there's the issue of steroid hormone binding globulin, or SHBG. The more SHBG you have, the more of your testosterone is bound up, leaving less of it free to do all the good stuff. So while your testosterone level may be , a good portion of it is locked up.
It can be maddening. It's like having a genie in a bottle that you can't uncork. That's why, at the very least, when trying to determine your T levels, doctors should ask the lab for your total testosterone levels, your "free" testosterone levels, and your "bioavailable" testosterone levels so you can get a little bit better of an idea of what your situation is. But, you guessed it, nobody does that, at least very few conventionally trained doctors. And we can't forget about estrogen, or more specifically, estradiol levels in men.
Your testosterone levels may read normal, but if estradiol levels are high, it could thwart testosterone in its efforts to make you the man you're supposed to be. As you can see, determining normal testosterone levels is a tricky beast. So, regardless of what your lab values are, and given the problematical nature of the lab tests, you have to instead rely on symptoms and the simple desire to be more than you are, hormonally speaking.
Do you have less energy? Have you experienced an inexplicable increase in body fat and have trouble losing it? How about a loss of muscle tone and an inability to make progress in your workouts?
Does your erection sometimes falter and wane? Do you think more about your lawn than lady parts? How about premature aging? Difficulty in concentration or memory? Or maybe a lack of "appropriate aggressiveness" where you don't take the initiative in matters of business or the heart? Maybe you're nervous, or always pissed off, ready to tear the head off the pudknocker in line in front of you who bought the last damn cinnamon roll? Any of these things could be indicative of low T, including, seemingly paradoxically, that last item on the list about undue anger levels.
Historically, low testosterone, or hypogonadism, has largely been a problem of middle age and beyond. Another study said that while 13 million men in the U. That's quite a chunk of human change, but consider that these statistics reflect only those men that were clinically deficient, i. It leaves out the millions — many who are young or relatively young — whose lab tests say they may be fine but based on their symptoms, are probably deficient. It also ignores the younger men who don't typically get their T levels tested.
Millions of them are likely deficient, too. Not because of old age, but because of environmental estrogens, pituitary and testicle stifling chemicals in general, and probably even a soft, cushy, modern, convenience-filled low-testosterone lifestyle. In fact, it's speculated that the testosterone levels of today's average man are roughly half of what his grandfather's were, at a comparative point in life.
Your first task is to find a progressive doctor, or at least one who isn't threatened by a patient who knows what he wants. Luckily, there are now plenty of low-testosterone treatment centers around the country.
Unfortunately, many of them are in it for quick dough and they aren't likely to be as informed on the topic as you'd like them to be. All the more reason for you to take charge. Once you find the right doc, describe your symptoms, confess your desire to get testosterone replacement therapy, and ask for lab work.
But make sure you get tests done in exactly the way specified below. For instance, if you don't ask for a "sensitive assay" estradiol test for males, they're going to measure your estradiol the same as if you were a ballerina from the Bolshoi ballet suffering from menstruation problems.
These tests will give a fairly good baseline reading of where you stand so that when you have follow-up blood testing done three to six months later, you can see if you're on the right dosage and whether you're suffering any insidious negative side effects. If you test out as deficient in testosterone, or if you have symptoms of low testosterone, you likely want to do something about it. There are definitely over-the-counter supplements designed for this very purpose.
And while effective, they're best used by healthy younger men who want a boost in T levels for bodybuilding purposes. They probably aren't the best choice for men who are clinically low and who've made the choice to undergo what's usually a lifetime commitment to testosterone replacement therapy, or TRT. Testosterone injections are the creme de la creme of TRT.
While it's true that testosterone gels see below create a more natural ebb and flow of testosterone, injections, provided they're administered properly, give you the most muscle-building, libido boosting, rock-your-world bang for the buck. You essentially have two injectable choices in America, testosterone enanthate and testosterone cypionate.
The half lives of these esters differ slightly, but it's not that big a deal, especially if your dosing is adequate and you've chosen a suitable injection method and schedule. For most men, mg. However, some men need less and some men need more, possibly up to mg. Beyond that amount and you're pretty much on a mild bodybuilding steroid cycle instead of testosterone replacement. Even if you're injecting weekly always on the same day , you still might suffer a bit of a low-testosterone lull as you get further away from injection day.
To remedy this, many men split their dosage in half and inject twice a week instead of once a week. Doing so keeps your blood levels of testosterone fairly stable. And while many men micromanage their hardest workouts to coincide with the peaks and troughs of their TRT, it's largely an unnecessary battle, especially when you're giving yourself two injections a week. Injections given that close together ensure that you're pretty much always riding a peak.
Additionally, you might want to consider subcutaneous injections rather than intramuscular injections. John Crisler, noted testosterone guru, insists that sub-q is much more effective, so much so that 80 mg. Plus, he adds, you don't poke your muscle bellies full of thousands of holes over the course of a lifetime of TRT. All you do is take a pinch of skin on your glute, thigh, or even belly, and inject a tiny needle into the fold at either a degree or degree angle.
Fully depress the plunger, release the skin, and you're good to go. Whether Crisler is right about the potency of sub-q injections isn't known for sure, but it has the ring of truth and it's worth a try. As mentioned above, testosterone gels provide a much more natural androgen rhythm and there's probably some argument to be made that mimicking the body's natural rhythms is the way to go.
However, many believe it doesn't have the same bang for the testosterone buck as injectable esters. Besides, gels have their drawbacks. You should only apply gels to freshly showered skin. You should refrain from swimming or working up a sweat for at least an hour.
Furthermore, you can't, under any circumstances, let a child or female especially a pregnant one come into contact with the treated area until it's absolutely dry. If you do decide to use gels, you must apply them once or in some cases, twice a day. Don't use your hands to apply the gel, though. Any gel on the hands doesn't soak in to the bloodstream. It's like applying gel onto an old catcher's mitt, which isn't very permeable.