Hey guys, Testosterone question.

Don’t settle for anything other than injections.

Thing is, Mr “I’m fine” doesn’t want anything Bc his ego somehow thinks needing it is unmanly, and he doesn’t want injections. Problem with that is 3 small kids. Transfer risk to them or me, the patch won’t stay on with his job and sweating, pills destroy the liver…

You’ve done your home work.

One of us has to, he is too busy ignoring reality with fantasy sports and telling me I’m not a dr and to quit trying to do the dr’s job. No consideration for the fact docs do get kickbacks on some medications, especially high cost heavily marketed ones like andro gel.

OP, I thought I would weigh in on the TRT pellets. I had low T for years and the gels/creams offered by my family Dr. Did not help. I believe they were either not getting the T level to where it needed to be for me or ineffective for some other reason. I found a Dr. That offered pellets. His strategy was to get me to the T levels of a teenager and keep me there. The pellets are supposed to last 5-6 months. They work for me. Huge difference. At the right T level, I don’t fall asleep in the afternoon, I sleep better at night, I am more energetic, much more positive mood and outlook on life, libido went through the roof (relatively speaking that is). With my metabolism the pellets only last between 4 and 5 months. We have been testing my Total T, Free T, and Estradiol throughout to catch when the pellets become ineffective. Of course I had already told the Dr. That they became ineffective after 4 months. But now he has the lab work proving it. Anyway, with the pellets, there is a local used on one of the hips. Then 2 rice sized pellets (my dose) are injected into the hip. First time it’s one hip, then 5 or 6 months later the other hip is injected. It is bruised and sore for about 3 or 4 days. After that if you run your hand over the spot and press you can feel the rice size pellets deep under the skin/fat/muscle. The first time I received the pellets, I noticed spontaneous erections and more frequent night time erections the very next day and night. The other symptoms resolved right after that. I noticed all of the changes/Improvements within 3 days.

Titleist (or anyone), I am curious about the injections. Where do you inject? How often? I think you wrote that you inject weekly. Is that a standard? What is the cost if insurance doesn’t cover it? (My insurance doesn’t cover it, and the pellets are $540 every time the pellets are inserted.) Could you share any other info that might contribute to my decision to seek the injection therapy? Thanks in advance for the info and your help.

Spartacus, I’m still in the research phase, but my understanding is creams and gels have terrible absorption rates, which could be why u had issues there. Also, everything I’ve read so far says the injections are the lowest cost option, with a rate of $40-$80 per month. That depends on dosage and whether you self administer tho of course. If they do the injections it’s typically done in the hip where the pellets are placed, but if you are self injecting it’s typically done in the upper outer thigh into the muscle.

BigBootyFan, how long after testosterone did u start HCG?

And Spartacus, you mentioned monitoring estradiol, I need to ask something important based on new information I stumbled on today. With testosterone injections, a common side effect is testicular shrinkage, it’s listed, and caused by the body not producing testosterone on its own when replacements are given, so naturally testes shrink. I don’t mean to get super personal, but I need to know if any of you experienced this side effect and if so, how long after starting testosterone therapy did you notice a difference in testicular size? I’m asking because I can’t find a clear answer online for how quickly the shrinkage starts after testosterone production is suppressed. This is critical for me to find out before tomorrow’s appointment when we planned to try to get him on testosterone therapy because my husbands levels have been critically low (under 200) since at least mid April. Almost 5 months and possibly longer if the mental symptoms and irritability were caused by this. The HCG got me questioning it and while reading about side effects of the testosterone shots and how most can be mitigated by aromatase suppression medications I started looking at what aromatase is. Hubs testicles have not showed any noticeable reduction in size, and at 5 months of extremely low production it would make sense they should since I assumed it happened within a few months of consistently low to non production. Aromatase is an enzyme the body produces when testosterone levels are too high and it converts what it seems as excess testosterone in to estrogen and causes a lot of symptoms like acne etc in men on testosterone replacement therapy, so they suggest an aromatase inhibitor to stop that from happening so you get the benefits of the testosterone. Since his testicles aren’t showing atrophy I’m wondering if maybe he is producing normal testosterone levels, but also an excess of aromatase and that is causing his symptoms. Hence why knowing what the timeline on shrinkage beginning is key to my theory. If that is the case, testosterone shots will actually make him worse instead of better. Also, high levels of estrogen are shown to cause inflammation in men, and since his pituitary problem was deemed idiopathic inflammation, if I’m right I might have just cracked the mystery the doctors couldn’t for what caused all hubs issues.

Thanks for the info on the injection costs and protocol.

As far as testes, I have not noticed any shrinkage. I have stayed at the 1” size (adult) on the orchidometer. Never remember being bigger since I was a teen and have remained at that size for the past 4 years I’ve been on the Pellet TRT according to the Dr. I remember the first time I read that testes size can shrink on TRT, I looked down at myself and thought Oh My they do look smaller, but it just happened that I was looking at a cold sack. The ambient room temperature and ones body temperature causes the sack to loosen when hot and tighten when cold, which happens to all men and that can make the testes appear bigger or smaller or sometimes tuck them into the body as happens often just prior to ejaculation during sex. Honestly though, with the health benefits I get from TRT, I would trade that for smaller testes if I actually had to. The things I do notice is body hair and acne. For about a month after the pellets I have a slightly higher tendency for acne. It’s nothing major and it seems to be more of a slight inflammation of body hair follicles, not even really pimples, and nothing on the face at all. During the entire time the pellets are working my body hair grows normal. But, when I get to the end of the pellets my body hair growth slows down big time. Normal for me is having small white hairs and thicker black hairs growing on my body. At the end of the pellets there is no black hair, just very fine white hair. Then after I get the pellets again the black hairs start back up and inevitably a few of the new black hairs show inflammation for a month or so. It’s like clock work, very predictable for me.

I started trt in April. I finished my first week of HCG today.

I noticed some testicular shrinkage so I needed to do something about it.

The HCG should help, they put him on clostrid today which is also supposed to raise levels of hormones to tell the testes to produce more testosterone, which reverses atrophy, but I’m ready to smack this dr because he doesn’t need that.

HCG could have a potential side effect. Enlargement of testicles and penis.

You probably meant clomid. What is your diet like? How is stress, work and does he exercise? These are worth looking into as well, if he gets on trt natural production of test will be history.

Yes that’s what I meant, sorry I’m so damn frustrated at the moment. Diet is so so, it’s not like we are gluten free vegetarians or anything, but I cook decently most of the time. Stress is through the roof considering he feels like crap, is tired all the time, and since this started in April he has been told it’s everything from a brain tumor to lymphoma before each was ruled out and the shrugged and said “well gee I just don’t know.” I want to go kick this dr in the teeth right now because hubs called back and told him after looking in to the clomid more he would rather avoid it, after that the dr pushed androgel, and when he told him no to that because of the children and risks of transfer that sonofabitch said “is that your decision or your wife’s?” Like yea, nice job doc, kick him while he’s already feeling emasculated and embarrassed he needs testosterone therapy. I am looking for a new endo for him after that. He’s terrified now he will be yoyo’ing all over the place and get worse.

Androgel and other similar products are known to be damn near as dangerous as radioactive material to touch to everyone else near you after application. That doc is full of shit and doesn’t want to do any work. Research is part of his job. At the rate this is going, any of his advice sounds suspect.

I second the finding another endocrinologist. Post haste.