The current forms of TRT in the us are injections and Transdermals:

Normally for Testosterone 100 mg a week of Depo Testosterone us normally used for full TRT sometimes a little more is required however this is normally the base.

As for the Transdermas Androderm which is the patch is available normally the 5 which deliveres 50 mg of testosterone and the 2.5 which deliver 25 mg of testosterone are the maximum used as this is the max recommended by the drug company however the patch is not as popular as the gels.

As for the gels Testim is used in a 1% solution which is 5 gm a tube which deliveres 50 mg of Testosterone no more than two are normally used 1 tube is normally adequate for most.

Also androgel is available and in the pump various mesaurements can be made I have heard 2.5 be most adequate for some guys however 5.0 7.5 etc are as well used which is 1% a gm so the formulation is very similar as Testim, androgel came out before testim to my knowledge and memory.

Also pellets can be used which you have to have a surgicial procedure done normally they are available in many doses.

Also depending on the Physician they can be compounded usually in a 10% Cream which can be compounded as 1 ML for 5% which is 50 mg a ml or gm, even 10% is available, this will take amore comprhensive Physician to be able to applicate, For example (name removed) is a good Physician which could administer such. It is available in various forms.

For those who may be sensitive to alc gel like testim or androgel.

Progesterone is also used from time to time in a lower level as this helps out as wel lalong with TRT.

Nebido is currently in the works and may be due to get approved by the FDA in the next few years however for some reason here in the USA we tend to use lower doses of Testosterone in comparison to some countires.

Also some Physicians will add clomid or something of the like to keep FSH levels up/

I know some people had some confusion in regards to TRT treatment.

*I would definatley recommend gels as they replicate consistant levels best of all provided your body absorbs them I would say they are the best to start out with some like the patch however can sometimes cause skin irritation.

When on TRT you always want your Lipid profile tested every 6 months normally as well as your CBC, Total Testosterone Free Testosterone Weekly Bioavailable and the like, you would also want to make sure your estogen is not too high as well or you may need to talk to your Physician baout an anti estrogen. Also FSH can be used to tell you if you still have your testicles the level of fertility you are at and LH will tell you if you are primary or secondary.

A Physician that treats at this level of expertise is not inexpensive and will cost you some good money as typicially insurance does not cover the costs however ocl i hear of some patients who are covered.

Just a brief discription of some answers for those who have had TRT in question and where I come from with it my personal opinions no medical advise intended

Just a couple of comments and these are just my personal 2 cents worth and I'm also not a doctor.

Most doctors would start at 200mg bi weekly with Depo Testosterone but most men feel less of a roller coaster effect if its done 7 to 10 days at 100mg to 150mg. Weight, etc all made finding the right dose difficult. Labs and how the patient reacts are very important to get it right. If the doctor tries to start you on 3 or (shudder) 4 week runs of Depo Testosterone decline! Its really a poor way to get your testosterone.

Clomid for long runs was not suggested. Its not tested for long term use and may (according to 2 doctors I worked with) cause damage to the centers that control hormone production causing more problems then it solves. For intact men who wish to procreate a safe run of 6 months with lots of sperm banking is the direction I would take it.

The starting dose for Androgel is 5gm not 2.5! The men who are started on 2.5 (I pity!) Its just not enough from everything I've read.

My Doctor said that Progesterone for men is not a great idea. If I remember why is ruins some of the effect of the Testosterone. In any event if you have enough of it don't add more.

Nebido is being used outside the US and the UK sites for hypogonadal men that I frequent are filled with men who hate it. Apparently its designed to last for many weeks to months. The only problem is that it doesn't work very well or at least not for as long as its designed to. I have hopes that it will not be approved in the USA until its proven to work correctly.

Anti-estrogen drugs are at best "questionable" with mainstream doctors. The primary issue is that none have been tested for long term use in men. The most popular one Arimidex is used by women with untreatable forms of cancer so its your safety that is a concern.

There are various herbs and such. Testing to see if they do "anything" is seriously warranted. *In my opinion.

Anyone starting on HRT should have labs done a couple of weeks after treatment starts or dose changes to judge how its working. An interview to see how the symptoms are going is vital! Anyone who "Starts" on HRT should be aware that after about 6 months on it your testicles will probably atrophy beyond repair. So don't start it without thinking of the consequences. Fertility will be impared at best. Ruined at worst. Once you sign up for lifetime HRT those Physicals become a MUST. This includes PSA tests to check for Prostate Cancer and a DRE (same reason) If your not going to get physicals DON'T start HRT! Your doctor will not write the scripts if he/she isn't sure its safe. And while HRT does not cause cancer it can make one that exists go wild like a brush fire.

I have used injectable testosterone undecanoate (the same thing as Nebido) and will say it's not as androgenic as other testosterones. In other words, it doesn't put the balls in you. If thats the case, the US government may approve it! The US government, and pretty much its citizens also, hate anything male, which is why less testosterone is the USA's motto; Your level has to be lower to get HRT, then if you do get it, you can only have a dab, etc. I bet anyone here, the US government will never approve something like Sustanon, a very androgenic form of HRT! Its a shame too, as Sustanon is probably closer to how Androgel feels than any other synthetic form of HRT, and Androgel being bio-identical to what balls produce. The side effects with Sustanon, such as increased cholesterol, are a bit more than other injectables, but can still be managed, as some people simply cannot afford Androgel. But as of now, in the USA, if you can't afford the bio-identical stuff, your best option is probably Testosterone Cypionate, but I would use it at 200mg/wk and along with an anti-estrogen, like Teslac is really good. One trick that I know, but good luck getting docs to listen, is to use say 2.5 grams per day of Androgel (if you can't afford the full dose) and then add an affordable injectable to it. The effects feel virtually identical to using the full dose of Androgel, but at a fraction of the cost.

I did a quick R&D on Teslac because this is the first I've heard of it. "Some have said it has even completely and permanently suppressed their estrogen content"

This is one thing you NEVER want to do. Men need a small dose of Estrogen for a lot of reasons. Outside of the health reasons the guys who have dialed their E2 down to zero reported to me that they lost the ability to Orgasm. They were very very unhappy (and close to insane) campers.

Like Arimidex Teslac is used by women for advanced cancer and thus is not tested at all in men and not (of course) for long term use. I would steer well away from any drugs like that unless my Doctor was on board and at least knew what I was taking and monitoring me.

You then have to ask yourself, how much of a permanent suppression was there of estrogen? The men you heard from may have been on boatloads of it. And for the permanent suppression, I can't imagine it has to be very much.

It will also increase your natural testosterone level, assuming you have balls, and keep them from shrinking from HRT. It has been used in men in the USA for a testosterone booster and for an estrogen lowering effect in men who take injectable testosterone. As long as it does not shut down estrogen too hard, it should be OK. ofcourse, too little estrogen will cause an increase in cholesterol, but a blood test will show all that up. My doctor put me on it along with testosterone propionate at 200mg/wk, and it made my balls start producing again, as they increased in size very noticeably. I found that at a low dose, the estrogen lowering effects were not near too much for me. Bodybuilders before a show, will sometimes take high doses of it, as they don't want any estrogen at all. But at clinical doses, it is used by doctors in the US. Its not a "woman's drug" as it is actually more closely related to testosterone than estrogen. The downside is, it's expensive, which leads us back to where we started from. So another anti-estrogen is Proviron. It will make your dick stay hard and increase energy. It's actually a male hormone, if that makes people feel more at ease than using the other anti-estrogens.

mrt (imported) wrote: Thu Nov 27, 2008 12:05 pm This is one thing you NEVER want to do. Men need a small dose of Estrogen for a lot of reasons. Outside of the health reasons the guys who have dialed their E2 down to zero reported to me that they lost the ability to Orgasm. They were very very unhappy (and close to insane) campers.

Like Arimidex Teslac is used by women for advanced cancer and thus is not tested at all in men and not (of course) for long term use. I would steer well away from any drugs like that unless my Doctor was on board and at least knew what I was taking and monitoring me.

Forget orgasm, you lose the ability to have erections without estrogen. I'm on Arimidex to control my E2 in conjunction with my T injections. When I started on T, my E2 was about 25, three months later it had shot up to 58 which is when i added a quarter of a tablet of Armidex 2x a week.

Batman

Ah, another good reason to approve Sustanon, is it will not raise estrogen near as bad as other injectables will. Then you can save more money not having to use the anti-Es. Thats one good thing about Nebido, is estrogen stays low on it, but as people are finding out, what looks good on paper, may not feel good in reality.

A most interesting thread, indeed. There have been a number of issues brought up which I need to discuss with my doctors.

Speed

At my most recent Dr. visit (blood labs to monitor effects of Testim) my Dr. said two things:

1) Testosterone supplements have not been shown to cause prostate cancer (which I had heard before); But if prostate cancer does develop eliminating T supplements and suppressing natural testosterone helps slow growth (or even stop growth) of prostate cancer........thereby helping to temporarily or permanently avoid surgery to remove the prostate in many cases.

2) He also said (which I had not heard) Recent studies are showing that, statistically, men who do get prostate cancer have very low natural testosterone level.

I don't know if there is any relationship to age in the studies.

Now if there is data to show rates of prostate cancer are higher in men of any age who have low testosterone level then there might be a link.

My Dr. prescribed Testim for me to bring my below healthy minimum T level up to low-normal. I have not tried other methods. This one is gooey, smelly, costly, but effective.

From what I am learning anyone who is getting a PSA test should have the testosterone levels checked also. Anyone born male, who is not transgendered, whether castrated or not, who has a below-minimum T level should at least consider maintaining a low-minimum T level by using a T supplement. Each passing year there seems to be more evidence that very low T levels are detrimental one one or more ways.

I concur that if you have prostate cancer, taking testosterone will accelerate it, depending on the type of tumor it is. And I also agree that if you don't have prostate cancer taking testosterone does not cause it. Because look how many millions of men have been taking quite large doses of testosterone, higher than HRT doses, and there is no increase of prostate cancer among them. In fact, they have less cancer!

That reminds me about the speculation of older people who take GH, as it has been proven time and again, that if you have a tumor, taking GH accelerates its growth. But it also seems if you don't have a tumor, taking GH replacement does not make you get one either.