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Old 04-27-2007, 04:01 PM   #1
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Low Testosterone questions, advice on treatment

Gels, Injections, HCG and Clomid, which to do for secondary hypogonadism?



Just got off Androgel, was on Testim. I was on Testim for 8+ weeks; went down in my last test which either indicates it may be shutting me down (with my "normal" testosterone production) in order to bring me back up which may or may not have been true; I don't know, I didn't wait to find because I felt terrible. Honestly, I am not sure how long I was on the gel, two, three months maybe. All I know is I felt worse then when I started in the last few weeks, which proved true with a lower result in my last test.


I talked to someone who was on Testim and he said he had a score of close to 1100ng. More erections, but he did not feel it helped him with his clarity or overall energy, although he was still in his 6 week or so.


When I was on Testim, I felt it worked for erections as well, sometimes had energy (although inconsistent), but felt like terrible again in about week 5 with no further progress, only digression.
I was on it for a total of 8 weeks before switching to Androgel.
Androgel: Started with three pumps...it seemed to dry fast, unlike the Testim. I got off it after about a week for a few reasons:
(1) Worried about touching people during the supposedly 3-6 hour "not touch period"...this is a problem since I touch people all the time and now that it is close to summer, short sleeve shirts, arms exposed, what would I do?

Maybe I didn't give it enough time, should have given it the full three months
I am not exactly sure how this works, anybody know?
Then again, I think I may have actually been on it for more than two months, closer, if not three months. I just can't remember, my brain is foggy all the time.


(2) If you are taking three pumps or one or two tubes: I wonder how much is really getting absorbed, especially considering that, some of it is left on your hands and then you have to wash it off.

(3) I want to explore an alternative treatment(s), with either HCG and Clomid or maybe shots.



I have questions about Testosterone Shots:
How much?

50mg, 100mg, more a week?

Does it go by age, body-frame, how you feel ???

Say you take 100mg a week, how high “may” it get your testosterone level in "ng", ex: 800-1100ng?

Also: from Day 1 to Day 7, How far do you fall after the initial shot?
How will you feel on day 6 and 7? testosterone level "may" be at ___?



HCG and Clomid:

I really want to try this type of approach just to see if I can get my levels elevated and stay elevated without testosterone replacement.

I don't see my Endo for another two weeks, so I will have to wait till then to see him in person and kindly suggest this "possible" approach; articles/reports from reliable sources will accompany my asking about this possible treatment.

I am hoping he will look into it, but just in case if he doesn't, how do I go about trying this alternative treatment?

Two Doctors were suggested on this board, Dr. Shippen and Dr. Crisler. Both are not covered by insurance and I am not sure how long it would take to get an appointment.
I did contact Crisler, but I would have to fly out to Michagen.
Shippen seems better, but not sure if I can get an appointment. I might try him, but have only found information where he is located, not the actual contact number.

Last edited by Bonds; 04-27-2007 at 04:09 PM.

 
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Old 04-27-2007, 08:49 PM   #2
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Re: Low Testosterone questions, advice on treatment

I hear Shippen is taking new patients again and my guess is the wait would be around 2 months. If you want to try HCG or clomid you may have to go to someone like Shippen or Crisler. There are some doctors that will give it but not many. If you tell your doc you need to be fertile he is more likely (if he is an endo) to give it temporarily.

If my memory serves right 3 pumps of androgel would be 7.5 g which is "supposed" to mean you absorb 7.5 mg per day. But everyone absorbs differently so who knows. The only way to know if your levels are right is to have them tested. Your doctor should be doing this for you anyway.

If you wash your hands well with androgel there is no problem touching people. Just dont rub them with your shoulders or wherever you apply it.

On T shot, I was taking 90 mg a week and got up to 1135 ng/dl, way too high. I cut back to 80 mg a week and on the recent test I was at 780 ng/dl, about where I want to be. I also take HCG 4 days a week in addition to the weekly T cyp shot. How much you take is really dependent on what levels you get your T to. If you are very big you may need a little more. I am 6'3" 220lb for a point of reference. I don't know how far my levels drop between shots. I take HCG for the 4 days before the Tcyp shot so that probably helps keep them up. I often feel the best for those 4 days of the week. I would not suggest shots less often than weekly. Many people do 2 a week.

If you go to Shppen he would likely try you on clomid for a week before your labwork. I don't know what Crisler does regarding clomid. There may also be other possibilities depending on what your problem is.

 
Old 04-28-2007, 07:42 AM   #3
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Re: Low Testosterone questions, advice on treatment

Just looked at the box of Androgel again, four (ounce) pumps = 5g. I think that is what it is saying since 10g is eight (ounce) pumps.

It costs me $58 for two bottles/pump device a month. If I needed to go up to 10g, that would be $116 a month.


The idea of gel(s) to keep you consistently high at around 850+ng seems like a great idea, but the greasy feeling of Testim from two tubes, one on each arm, kind of made it a pain. Not sure how much Testim would of been per month for two tubes (10g) a day.


Androgel at 5g (or four pumps, 2 on each arm) dried fast. If I needed eight pumps (10g) a day and it dried fast, I actually would not mind so much. I am just not sure about the $116 a month. I am also not sure how effective it would be since I did not give it enough time (which is a full three months before a test is required).


Have to talk to my Endo about this.


The only thing I was worried about the T-shots was the "Up and Down" feeling.
If I were up at 1000ng on day one, it would be terrible to decline during the week until the next shot. By day 7, you might be at??? (Very low), although I am not sure. Just say it was below 400ng, that would be hell. This is why I wondered what other experiences were when tested at the end of the week.
I wonder if I took a shot once a week if by the time I hit day 5 I could take oral pills {for day 6 and 7} then take my shot. Ex: Monday-Friday = T-shot, then on Saturday and Sunday, oral pills to keep me elevated, then on Monday, back to T-shot.
This might get complicated for the Doctors however, so it probably would not happen.


Not sure what to do. I have to go over all the facts, both positive and negative: like effectiveness, cost, and problems with use, ex. Gels and making sure you do not hug anyone with you exposed arms.



You wrote:
"On T shot, I was taking 90 mg a week and got up to 1135 ng/dl, way too high"

Why is that to high?
Is that where you started or ended up?
Just wondering because if you are at 1135 on day one, don't you decline from there until your next shot?

I talked to somebody that was taking two tubes of Testim and he said he was slightly above 1000ng when he was tested. He had only been on it for six weeks so I am not sure if he would eventual shut down, then go back up with only Testim in his sytem, which would be a more accurate reading for long term use, but anyway, he said he really didn't feel 1000ng. He had increased erections, some energy, but nothing where he felt was back to "normal" which he said the cognitive function of feeling "well" was not there, "yet." He did think that maybe in a few months it "may" work to its full potential.



What's the concerns with injections?
"Up and Down" effect?

What about cost? aren't the shots cheaper? I know some people say "Money shouldn't be a concern", but if I have to shell out $116 a month (for the gels), in my current situation, it is a concern. It will not be a concern in down the road when I am making money, but right now, health insurance is expensive enough.

Maybe I could take shots for right now and go on gels down the road. I will have to discuss this with my Endo since I know he wanted me on gels for longer, (about four months) to really feel the effectiveness. I have even read you should really give it up to six months.


I will see my Doctor in about a week so I will see.
If not, I will contact Dr. Shippen. Two month wait doesn't seem to bad considering if I could try HCG and Clomid to "possibly" get me back to normal without having to take any more drugs, I would be happy.


Question:

If HCG and Clomid work to increase your (or in this case MY) testosterone levels, could I just take them if it doesn't keep me elevated?
ex: HCG and Clomid treatment work, inceasing my Testosterone to 850ng, but it declines when I am off. Could I just take the HCG shots weekly from this point on? or does it not work like this?

Just wondering since I thought I read HCG shots are very small needles, unlike the T-shot needles which are about 1- 1 1/2 inches.



If you don't mind me asking:
Are you "shut down"?

Just wondering because you are on HCG.

How exactly does that work taking both Testosterone shots and HCG?

Last edited by Bonds; 04-28-2007 at 07:56 AM.

 
Old 04-28-2007, 11:24 AM   #4
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Re: Low Testosterone questions, advice on treatment

T cyp shots are cheap. I pay $60 (with no insurance) for about a 3 months supply of T cyp and needles. The up and down is not as bad as you think T cyp is absorbed slowly. In fact it will take you 2-3 weekly shots to get to a stable state, meaning with each of those shots the peak level you reach will be higher than the week before. The reason 1135 is too high is primarily that as T rises so does estradiol and mine got too high. I think it may be bad for your liver to have too high of levels also. Most people typically do not need to be that high to feel good, but a few do. Everyone is different.

If HCG or Clomid work, yes you can just take them. Typically you will use one or the other although both can be combined when trying to restart the HPTA. My HPTA is dead. My LH is so low it can't be measured. That is why I need the HCG to keep my testicles working. But I was on androgel for 4 years and my testicles atrophied in that time. So even though HCG does get them working now, they don't make enough T by themselves. THats why I supplement with T cyp shots. So some of my T comes from my testicles and some from T cyp. I have not known anyone who got T much higher than 500's for any sustained period on androgel, and that is at 10g a day. I was in the 500's when I took 10g a day.

 
Old 04-28-2007, 01:03 PM   #5
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Re: Low Testosterone questions, advice on treatment

WOW, T-Cyp shots are really cheap and it seems promising. No hassle either: one shot every week, plus HCG shots ???
I would take HCG with it? how often and needles are small?

First, I will call Shippen this week to see if I can get an appointment.

How do I get his phone number?

I have his location/address, but no phone number was provided.





Thank You very much for all your help.

 
Old 04-28-2007, 01:13 PM   #6
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Re: Low Testosterone questions, advice on treatment

I take the HCG Sat, Sun, Mon and Tue and take the T cyp on Wed. The HCG needle is very small, so small it will bend if you're not careful. It is pretty painless.

Sorry, not allowed to give contact info on this board but I'm sure you can find it with what you have.

 
Old 04-29-2007, 09:13 AM   #7
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Re: Low Testosterone questions, advice on treatment

The "T" injections are usually about 100mg weekly for less E2 conversion.
Less if also using HCG and/or Arimidex.

 
Old 04-30-2007, 10:10 AM   #8
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Re: Low Testosterone questions, advice on treatment

Endo response:

I am allowed to start injection, 100mg every two weeks.

Will this work or kill me?

He seemed not to know to much about injections or he hasn't dealt with it in a long time because he went right to the books to look it up.

He also said HCG is just like a Growth Hormone and it wouln't be effective for me; it has nothing to do with increasing testosterone.

I am currently looking up info to see what treatment exactly is, but I am not sure if he will take the suggestion of print-outs from the internet, even if they are from reliable sources; however, it can't hurt to try.


I will wait for a reply, but it seems that I am just going to have to crack my piggy bank open and go to a knowledgeable Doctor.
I just hoped I could have adequate treatment up until I get to see someone like Dr. Shippen.

 
Old 04-30-2007, 06:21 PM   #9
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Re: Low Testosterone questions, advice on treatment

I'd be leery with anyone who is at least fairly well versed in this issue. The repercussions of a wrong treatment could be unpleasant.

 
Old 04-30-2007, 08:38 PM   #10
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Re: Low Testosterone questions, advice on treatment

100 mg every 2 weeks is not enough.....I assume he's talking about T cypionate? Every 2 weeks is not often enough for shots. 50 mg/ week is not enough T for most people. Find another doctor if he doesn't know HCG is related to increasing T. Look up the "American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Hypogonadsims in Adult Male Patients". You will find HCG in this guideline. Maybe that will convince your doctor HCG is for raising T , it is not like growth hormone. Still don't count on him prescribing it. He obviously knows nothing about it. This is inexcusable for and Endo not to know this unless he is misleading you on purpose which is also inexcusable.

 
Old 05-01-2007, 03:06 AM   #11
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Re: Low Testosterone questions, advice on treatment

It appears to me that all the references in the **** guidelines refer to hcg usage for situations unlike what we usually discuss here (pre-puberty etc). I would love to use the document as ammunition with my endo, but I don't see the fit.

Am I missing something?

 
Old 05-02-2007, 07:56 AM   #12
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Re: Low Testosterone questions, advice on treatment

I think you will find in the guideline a statement about using HCG for fertility in adult males. The problem with using the guideline as an argument is 1. they only suggest using HCG where fertility is an issue and 2. the doses they suggest are way too high.

Anyman's suggested sources may be better to use as an argument.

 
Old 05-02-2007, 12:50 PM   #13
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Re: Low Testosterone questions, advice on treatment

thanks guys. I already have an appointment with Shippen (in a month) and was hoping for something that would help persuade my endo and I don't think Dr John's protocol will do it. That's why I was specifically asking for where the clinical guidelines said to do it.

I have been working with another Dr who was in Orlando last week and said there was some differing opinions there on HCG. I will have to try to get some further info.

 
Old 05-02-2007, 08:37 PM   #14
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Re: Low Testosterone questions, advice on treatment

Quote:
Originally Posted by hayfarmer View Post
I think you will find in the guideline a statement about using HCG for fertility in adult males. The problem with using the guideline as an argument is 1. they only suggest using HCG where fertility is an issue and 2. the doses they suggest are way too high.

Anyman's suggested sources may be better to use as an argument.
I spoke to three doctors about HCG and showed them the references for use in hypogonadal men. They all said the same thing. Long term use of HCG (or Clomid) is not tested thus they feel it is not safe. They suggested it might fry my brain. They all agreed that the max length of time to use it would be 6 months and then only if I was trying to make deposits for sperm banking purposes.

Thats my 2 cents worth!

 
Old 05-03-2007, 07:05 PM   #15
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Re: Low Testosterone questions, advice on treatment

Quote:
Originally Posted by james186 View Post
They all said the same thing. Long term use of HCG (or Clomid) is not tested thus they feel it is not safe.
Typical. They forget what low T can cause and see no problem with one's balls shrinking down to raisins. God forbid they actually broaden their horizons.....

 
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