This TRT Thing

[plix (imported)]

I've considered hypothyroidism, but the doctor does test the liver and thyroid on a regular basis and has never said anything is wrong. I would be curious as to my actual thyroid number though because being on the edge of the range is not necessarily optimum although most doctors will say it is fine. But there are many symtpoms of hypothyroidism that I just do not have. The only ones I do have are inability to lose weight, depression, fatigue, and low libido. There are so many others that people with hypothyroidism are supposed to have.

I actually have considered taking some thyroid medication (which I can easily buy from Inhouse) regardless of my thyroid status to see if it there is any improvement. But I'd be concerned about permanently shutting the thyroid down as occurs to the testicles with administration of T.

I did check out that group, and it does seem interesting. Wonder how familiar with and accepting they are of voulntary castration

I would love to be on nothing. But my main concern is the health risks. I find it difficult to believe that lack of hormones is all benefits and no risks. I am particularly concerned about diabetes, mainly since it causes just about every other health problem in existence.

I took generic depo-testosterone. I've always heard that the more frequent the injections the better. But I would imagine that everyone is different. I have never tried injecting less than weekly. I am a little farther from mac than you are hairless, at about 75 miles from him

Not long ago when I was getting frustrated with the T not working, I considered switching to a maintenance dose of E. I even went as far as ordering the E, which I still have. That would help reduce the health risks I believe, but my main concern there is feminization. I would hope that by sticking with a low dose feminization would be limited, but chances are there would be some.

This is not the first time that I have heard that exogenous T declines in effectiveness over time. I would think it is another one of those things that varies by person. Some people experience the decline, others do not. I would also imagine that presence or absence of the testicles would play some role in it. The testicles most likely do secrete other things that are important for a man's well-being.

Before I started this whole thing, I heard from multiple sources that estrogen in the MtF over time causes irreversible changes in certain chemical processes of the brain. I don't understand why those changes would be irreversible and why T would not re-masculinize those chemical processes, but I do suspect that my use of E in high doses for an extended time could have permanently damaged my male libido among other male methods of thought. After all, libido is primarily up to the brain. I cannot deny that I do have a strong libido when it comes to cuddling and snuggling, and this libido, which was not my libido before surgery, seemed to increase when I started T. So yes, I do think my use of estrogen could have a lot to do with this and could have permanently changed my experience of libido.

Basically I have read what everyone said, and I do feel that I am probably not helping myself much when it comes to trying to make this T thing work. Even if the E did not create permanent changes, which I believe it did, the consensus seems to be that the effectiveness of replacement T does decline over time. So is there really much point to doing this, which is really expensive and does not seem to be working? And if I were to stop doing it, should I risk using nothing or should I use a low level of E (far cheaper than T) and risk what could come with that?

[Beau Geste (imported)]

Just a couple of questions, Plix--

How well established is the connection between low testosterone and diabetes, and could any increased susceptibility to diabetes be counteracted by other drugs?

Did you experience the typical syndrome of hot flashes and "new eunuch's depression" (as opposed to common clinical depression) after orchiectomy? If not, it might be an indication that your body has a different "normal" hormone level than the average. If I recall correctly, you had gender identity questions from an early age, and that might be an indication of a difference in biochemistry, vis a vis the average for the general population.

The libido question is interesting. The usual assumption is that there are three "states" of the libido--attraction to males, attraction to females, and attraction to both sexes. But it seems conceivable that there are persons for whom the libido is normally in "off" position. Or perhaps there is another state which could be described as attraction to eunuchs. I think some women have reported feeling erotic excitement when they became aware that someone was a eunuch. I have read that, in India, there are numerous examples of liaisons--some lasting many years--between a man and a hijra. The hijras do present the appearance of women and they have had the external male genitalia excised--yet they clearly aren't biologically female.

[Eunuchist (imported)]

Or, more precisely: How well established is the causativ

e connection between low testosterone and diabetes, and could any increased susceptibility to diabetes be counteracted by

as little as watching your diet and lifestyle?

Most of the studies are in agreement that supplemental testosterone does not appear to have much effect on glucose tolerance and insulin levels (list of studies below). The few studies (in fact, I have only been able to locate one, though another one is still under way) that looked at direct intervention with hrt on diabetics did not notice improvement on any of the parameters; furthermore, even the authors of studies documenting a significant occurence of "low" t among diabetics do not generally reccomend hrt partly because of lack of any reliable evidence of it's effectiveness, and partly because their studies do not answer the classic question of "chicken or the egg" when it comes to low t. In fact, what their studies actually show is that most of these diabetics develop progressively low t only after becoming diabetic, and that the majority of men with diabetes do not have low t. This could as well indicate that hypogonadism in this case could be a part of a natural protective mechanism, by wich, in many diseases, the body tries to lower it's t levels in order to concentrate on healing, limiting further aggravation of the disease process (I will expand a little more on this issue in an upcoming post in another thread shortly).

The bottomline: If castration was truly an important risk factor in diabetes, the eunuchs would have eventually been noted for living significantly less than the average. However, the available evidence on castration strongly indicates the opposite. This, I believe, is hardly consistent with an increased susceptibility for such a deblilitating condition as Type II diabetes.

Check out one of my earlier posts on this issue: http://www.eunuch.org/vbulletin/showpos ... stcount=20

The most important risk factors that are thought to contribute to Type II diabetes (most of them modifiable):

http://www.phac-aspc.gc.ca/ccdpc-cpcmc/ ... index.html

[mrt (imported)]

Hi Plix:

I tried doing a GOOGLE search for

"effectiveness of replacement Testosterone declines over time"

The medical texts that I found all concluded that it is effective long term. As I'm fond of saying. I'm not an expert so if there is a study that supports this lets post a link.

One thing I've learned. If you don't "squeak" to your doctor when things are not right they assume everything is fine. You may have to really squeak loud to get the grease depending on how bad the doctor is. :-\

If your self medicating - don't! Get a good MD and some labs and work to finding the right balance. If you want to use Estrogens I still think you need to tell your Doctor. Better he/she knows and help guide you in a safe way.

[Hairless (imported)]

Plix, what are you trying to accomplish. In your profile, you say that you are a gay man. You don't seem to have any gender issues. Why were you taking the Estrogen? Was this to guard against hot flashes? What was your dosage and how long were you on it? This is probably where you got the touchy feelie sensation from, but it also added to the castrations loss of libido effects. You are worried about health risks as we all do. When we change the normal function of the body, something will suffer. I keep hearing about this eunuch calm, but if it does exist, we sure have to worry a lot to try and find it. I'm no expert either, but maybe with several of us thinking about this, we can come up with something. You have probably not been on E long enough and at a dosage that messed you up for good. To start with, what are you doing with HRT now. How much are you taking and how often. This is just a suggestion, but maybe worth a try. Try injecting 200mg every 2 weeks and stay at that for 2-3 months. Before it's time for your next shot or the day of, have your T level checked. This will give you your low reading. Do you know what your T was at before you got castrated? At that level how did you feel? I'm sorry, I don't remember what led you to get castrated. If your libido was too high, you want to shoot for a number that is quite a bit lower than you had. It's kind of funny with all the numbers we have floating around that my experience really shows YMMV. When I had my T checked, I thought I had an over active libido, but my number was 160. This is about half of a normal low reading. I think there are on line labs that can check your T that are not too costly if your doctors is too high. Maybe there are others here that can advise you on that. This process is going to take a while as it is trial and error, but it is that way going through a doctor also. You should also be on a vitamin and mineral program. It doesn't have to cost a fortune, but this will also help you feel better. My doctor has been very helpful getting me to where I feel great. There is no reason, that at your age, you can't also. If you want to PM me I can give you the list of supplements my doctor advised and tell you where I get them from. Have you had your bone density checked? Did your parents have any bone problems? This may not be an issue for you, but I take stuff for that also. My doctor likes the health store approach and stays away from the drugs when ever possible. Also are you getting some exercise. This will also help you with your energy level. You may have to force yourself at first, but it will make you feel better in the long run. Don't give up, we'll get this figured out.

[plix (imported)]

Perhaps the causative connection between low sex hormones and diabetes is not as established as it seems (at least not the former causing the latter). It would at least appear that other factors play a greater role.

I have never once experienced what I could say without a doubt was a hot flash, and my longest time off any hormones was about 3 months, which should be long enough to get them. The clinical depression that I have always had got neither better nor worse with castration. There was no "eunuch depression" - just the same depression I have always had.

I have noticed that during those times when some level of libido does seem to return, I become very uncomfortable. I seem to have a sort of psychological aversion to a male-type libido, which was not the case before surgery. I rather enjoyed it back then. But part of me does not want a libido to return, even though I am trying so hard to make that happen.

Squeaking doesn't work with this doctor, believe me. I've squeaked more than enough times. He is convinced that I still have gender issues and is trying to get me to go back of full doses of E. If I were to do E, it would be in a very low dose and only for the purpose of maintaining health.

I was castrated and originally took the E because I did at one time believe that I wanted to be female. I no longer believe that. The doses I took were doses that most likely put me well in the female range. I took them for over a year. At one time I was taking 4 mg oral E daily. Not as high as some take, but plenty high enough to be a full dose of E. I also did shots for a while, 20 mg every other week.

Not sure what I am doing with HRT now. Could do nothing, could do a low maintenance dose of E, could do T.

I could see how injecting T less frequently could be an improvement, at least toward the end of the cycle. When the injection occurs, T would spike which would cause E to spike as well. That would kill libido. But as the T levels declined into a more normal range, E would decline as well, and libido would pick up before the next shot.

I am not sure what my T level was before castration. At that time I felt pretty good, except for a non-related depression. I had a libido that would be typical for a 20 year-old man.

Both of my parents are still reasonably young, seeing as how I am pretty young myself. My mom actually does have osteo, but it is due to a medication she takes for crohns disease, not low E (she hasn't hit menopause yet). My dad has no bone problems AFAIK.

I tried to have my bone density checked after the surgery but was denied by the insurance I had at the time for not being a post-menopausal woman.

I am getting regular exercise.

I am only 22 and am not sure that I want to be playing this expensive TRT game for the rest of my life. From everything I have read from those who are on it, there are so many things other than T and even E that have to be in perfect balance for everything to work right. Unfortunately I screwed up my own natural regulatory system when I was castrated. Doing nothing or doing a small dose of E (which is much cheaper and requires much less maintenance than T) seems like it would be a lot easier on me and my body.

[Hairless (imported)]

I think your Dr. sucks. Maybe you need a different one. If your 75mi. from Mac, you must be around LA. There are many good doctors there. T is far from expensive. It costs less than $15 a shot including everything. I also think you are worrying too much about the other things the testicles make besides T and sperm. You are worrying about things that are not proven. Doctors that do the research seem to change their minds all the time. My doctor isn't concerned with all that stuff and he has me feeling fine. Like I said earlier, it takes time and tests to get it right. You might have to budget your money towards health issues more until you get this thing stabilized. As long as you are healthy, you should have no real concerns. The human body is made to run on either E or T and jumping from one to the other is not doing you any good. If you don't want to be female, there is no reason to be on E. I don't think the T was your problem, so if you get yourself back to pre-castrate levels, where you felt good and then deal with the depression, you'll be OK. Mrt can tell you a lot about feeling bad when the T is out of whack. He's written quite a bit about it.

[plix (imported)]

Don't worry, I know the doctor sucks I won't be going back to him regardless of what I decide to do.

I actually live a bit north of San Diego.

The only TRT doctor in my area I found on that board mentioned in this thread is in Orange County. Not a problem getting there. So I went to his site where he has the labs you must get for him listed. I calculated the costs of those labs, and it came out to about a thousand bucks. Keep in mind that is a thousand bucks per draw. Labs would probably need to be drawn every 3 months, and more often at first until things get stable. It would cost me a thousand bucks each time, meaning it is just not an option.

I do not deny that T itself is inexpensive (at least the shots), but it is the doctor visits ($350 for an initial consultation with this guy) and the labs especially that kill. A thousand bucks per draw is a lot of money, especially for us starving college students

Certainly there are eunuchs and others out there who take E for health reasons and have no desire to become female. In fact, one of them just posted on the subject today.

I agree that T was likely not my problem, at least not before the surgery. It was probably a combination of a clinical depression and a naturally feminine side to my personality that caused be to believe I wanted to be female. But my depression is quite complex in itself and will take many years of costly good quality private therapy to overcome. I do plan on getting some therapy for it when the time is right

I may have felt good with T back then, but I don't seem to feel good with it now. Could it be the depression that is actually making me feel not so great? Perhaps. But I do have that psychological discomfort with libido that is not sitting too well with me. I would just rather not deal with it at all instead of having to worry for the rest of my life whether everything is in perfect balance for things to work properly.

[Hairless (imported)]

Don't worry, I know the doctor sucks I won't be going back to him regardless of what I decide to do.

I actually live a bit north of San Diego.

The only TRT doctor in my area I found on that board mentioned in this thread is in Orange County. Not a problem getting there. So I went to his site where he has the labs you must get for him listed. I calculated the costs of those labs, and it came out to about a thousand bucks. Keep in mind that is a thousand bucks per draw. Labs would probably need to be drawn every 3 months, and more often at first until things get stable. It would cost me a thousand bucks each time, meaning it is just not an option.

I do not deny that T itself is inexpensive (at least the shots), but it is the doctor visits ($350 for an initial consultation with this guy) and the labs especially that kill. A thousand bucks per draw is a lot of money, especially for us starving college students

Certainly there are eunuchs and others out there who take E for health reasons and have no desire to become female. In fact, one of them just posted on the subject today.

I agree that T was likely not my problem, at least not before the surgery. It was probably a combination of a clinical depression and a naturally feminine side to my personality that caused be to believe I wanted to be female. But my depression is quite complex in itself and will take many years of costly good quality private therapy to overcome. I do plan on getting some therapy for it when the time is right

I may have felt good with T back then, but I don't seem to feel good with it now. Could it be the depression that is actually making me feel not so great? Perhaps. But I do have that psychological discomfort with libido that is not sitting too well with me. I would just rather not deal with it at all instead of having to worry for the rest of my life whether everything is in perfect balance for things to work properly.

I'm North of you then. Probably closer than Mac. Do you have, or can you get insurance through the college. I know it's not the best, but sometimes you can get a descent doctor. You shouldn't have to go to Orange county to find someone. San Diego has lots of fine doctors. I go to Beaver Medical Clinic in the Inland Empire and they have lots of doctors in all the different specialties. Maybe you can find something like that where you live. If it's something that your insurance doesn't cover, tell them you are paying out of pocket and ask for a discount. That lab in OC is way out of reason and so is the doctor. Are you in a state college or UC college or a JC. Some of their clinics aren't too bad.

Please don't obsess on the little things. Even in our natural state, there are very few if any people who are in balance. The main thing that you have lost is the testosterone and that can be regained and normalized in time. Did you read this on that link I gave you.

DEPO-TESTOSTERONE is for intramuscular use only. Dosage will vary depending upon the individual, the condition being treated, its severity, and prior androgen therapy. Because of the protracted action of DEPO-TESTOSTERONE injections more frequently than every two weeks are seldom required.

Eunuchism; Eunuchoidism - For complete replacement in eunuchs and eunuchoid patients, the usual dose of DEPO-TESTOSTERONE is 200 to 400 mg injected at intervals of three to four weeks. It is usually preferable to begin treatment with full therapeutic doses, which are later adjusted to individual requirements.

Priapism is a sign of excessive dosage and is an indication for temporary withdrawal of androgen therapy.

Impotence due to Testicular Deficiency; Male Climacteric - DEPO-TESTOSTERONE may be given every three to four weeks in doses ranging from 200 to 400 mg.

Oligospermia - To stimulate spermatogenesis when trial androgen therapy is indicated in subfertile males with oligospermia, recommended dosage of DEPO-TESTOSTERONE is: (1) 100 to 200 mg every three to six weeks for development and maintenance of testicular function; (2) 200 mg each week for six to ten weeks for suppression which may then be followed by rebound spermatogenesis following discontinuance of the injection.

Anabolic Effect; Osteoporosis - The dosage of DEPO-TESTOSTERONE for anabolic effect should be adjusted according to age, sex, and the condition of the individual patient. In the majority of cases, the dose will range from 200 to 400 mg injected every three to four weeks. In addition, an adequate diet should be provided and prolonged immobilization avoided whenever possible.

If you can get on a regular regime, after a few months, you should be fine.

If you need more info, do a Google search for,"testosterone replacement for eunuchs". There is lots of info there.

[plix (imported)]

I did look into insurance through school. It would cost me seven hundred something for the year. Not bad. And they can't deny me because it is a group plan. But they can and do exclude pre-existings for the 6 month period allowed by law. The policy starts on August 10, meaning I could get no coverage for visits, labs, meds, or anything else related to my T problems until February 10. The policy would be half over by then. Kind of worthless.

I could go to any lab. I just figured out using some prices that $1000 is probably going to be around what I pay at any lab for the 15 uncommon and expensive tests that are necessary for TRT.

That doctor's fee is not unreasonable for a first consultation. It's actually lower than I was expecting.

I would not want to go around to random doctors I know nothing about and risk giving them cash and discovering they cannot help me. I am only looking at well-known and respected TRT doctors who a good percentage of TRT patients go to.

I did read that information, and I don't see anything wrong with it. I just wonder what sort of difference it would really make. I have seen from many sources now that TRT is quite different from natural T, and that for some people it just does not work. After a year of playing with it using three different methods (patches, shots, gel) and many different dosing regimens one would begin to wonder if I am one of those people for whom it is just not going to work.