I have heard of so many mistakes made by people taking testosterone replacement therapy. Some mistakes seriously affected their quality of life or caused men to stop taking testosterone prematurely. Here are some of the biggest bugs I’ve seen:
- Use of “street sources” of testosterone: I have met many men whose doctors do not endorse the use of testosterone, so they buy it on the black market or some kind in their gyms. This is illegal. Testosterone is classified as a controlled substance under the Anabolic Steroids Control Act of 1990 and has been assigned to Schedule III. It is regulated by the Drug Enforcement Agency (DEA). A doctor can legally prescribe it, but it is illegal to use it without a prescription. Please note that the purchase or use of Testosterone without the proper prescription may have legal consequences. The use of testosterone and its parent molecules (anabolic steroids) is illegal in the United States for those without a medical diagnosis that justifies their use (eg, anemia, wasting, hypogonadism). If after reading this book you still decide to get testosterone on the black market, be careful because you could be duped by informants who could tip off your purchase to the DEA. Also, importing testosterone even if you have a prescription is not legal. Bottom line: only use testosterone after a doctor gives you a prescription and don’t import it from other countries.
- The use of “street” testosterone is also dangerous. No one knows what those products may contain. Some so-called testosterone products may simply contain peanut oil, sesame oil, or grape seed oil. You also risk exposure to contaminants that could cause infection.
- Not having a doctor to keep track of your blood work is a sure way to get in trouble! If you have low testosterone, there are hundreds of doctors who will prescribe testosterone replacement therapy (see the Appendix section for directories). If you are using testosterone to increase muscle mass or to improve athletic performance even though you have normal testosterone levels, be smart and do as much research as you can. And please read the information in this book on how stopping testosterone can cause health problems (if you’re using black market testosterone, chances are your supply will eventually run out).
- Not exploring which testosterone option is best for you: Since there are a variety of options for testosterone replacement, it is important that you take the time to really find out what is best for you. Several factors are involved in deciding which would be the best testosterone replacement option for you. These include cost, insurance coverage, convenience, preference for daily versus weekly use, lack of time to adhere to a strict daily schedule, fears of needles, and the physician’s familiarity with different needles. products. For example, some health management organization (HMO) programs only pay for testosterone injections, since they are the cheapest option. However, some men have a phobia of needles and don’t like the weekly or bi-weekly injections that may require them to visit their doctors so often (some doctors don’t teach their patients to self-inject at home). Other men are prescribed daily gels even if their busy lives make it difficult for them to perfectly adhere to daily therapy. Some men without insurance or financial means decide not to seek help because they are unaware that there are patient assistance programs set up by manufacturers, or that compounding pharmacies can make cheap prescription gels and creams (details of this information are available at Appendix section). Each testosterone option has pros and cons that may be more suitable for one person than another, so read the next section on treatment options.
- Not using the correct dose: Men starting testosterone should have their blood testosterone levels rechecked two weeks to a month after starting therapy (depending on the testosterone formulation), just prior to administering the appropriate dose for that day or week. This is critical as these results are essential in deciding if the dosage is right for you. Total testosterone blood levels below 500 ng/dL that do not improve your sexual desire and energy should be increased to 500 to 1000 ng/dL by increasing injection frequency or dose. assume that most men respond to biweekly injections of 200 mg or 5 grams per day of gels. The reality is that many men require higher doses to achieve total testosterone levels above the normal mid-range. These men tend to discontinue testosterone early because they don’t perceive benefit at “average” doses. Incorrect frequency of injections is a common mistake and is actually worse than no treatment at all. See the following sections for more details on this.
- Cycling On and Off Testosterone: Testosterone replacement is a lifelong commitment in most cases. Once you start, you have to assume that you will stay on it unless you have an unmanageable side effect. Some patients think that “giving the body a rest” once every few weeks is a good thing. What they don’t know is that during the time you’re taking testosterone, your testicles stop producing it. When you stop replacement therapy, you are left with No testosterone in your system for weeks while your HPG hormone axis normalizes. Depression, weight loss, lack of motivation, and loss of sex drive can come on quickly and strongly. Some men never return to their normal hormonal axis after stopping testosterone (especially if they were hypogonadal to start with). Read more about this in the section titled “HPGA Dysfunction”.
- Stopping testosterone abruptly due to an unrelated signal: Some of us may be taking medications for other conditions along with testosterone. Sometimes new medications can increase cholesterol and triglycerides and/or liver enzymes (I call them “signals”). Some doctors prematurely blame testosterone rather than new medications someone might have started. I have seen people suffer from this poor judgment of their doctors. Weeks later, they learn that stopping testosterone did not improve any of these problems, but by then they feel tired, depressed, and asexual.
- Not knowing how to manage possible side effects: Fortunately, this will not happen to you after you finish reading this book. I know of men who discontinued testosterone due to swelling in the nipple area, acne, moodiness, perceived lack of benefit, hair loss, or a rise in prostate-specific antigen (PSA) due to prostate infection. Knowing how to manage these side effects is essential for long-term success. If you know what side effects may occur and how to manage them, you are less likely to stop therapy prematurely. You may just need to readjust the dose, change the delivery method, or take a medication to counteract the potential problem. Only the best doctors, who don’t overreact to a side effect, know how to do it.
- Having a lifestyle that is not “testosterone friendly”: If you smoke, drink more than two drinks a day, smoke too much marijuana, are overweight, don’t exercise, don’t control your blood sugar or lipids, and don’t show up for medical appointments, you don’t have testosterone. -friendly lifestyle. Studies have shown that these factors can influence your sexual function and long-term health. Excess alcohol can lower testosterone. Exercise can increase it if done correctly or decrease it if done excessively. You can read more about this later in this book.
- Not reading or staying “in network” with other patients: Being isolated about information makes you a less effective patient. There are online groups for men who talk about testosterone and other topics (see the Resources section). Sharing your experiences and learning from others are keys to being an empowered and proactive patient. It is the only way to maximize the benefits of whatever therapy you are using. Many of the practical “tricks” I have learned have been obtained through this method. The collective wisdom of others with similar problems is more powerful than simply trusting everything your doctor tells you or doesn’t tell you. Also, most doctors treat educated patients much better than those who are shy about sharing and asking questions.
- Not changing doctors when you have to: Changing doctors can be difficult, especially if you’re not an online patient who reads a lot about your condition. Many people have no choice and have to see a certain doctor in a health management organization (HMO) setting. But most of us have the option to seek out educated doctors who are not condescending and who treat you as an equal. Your doctor should be your partner in your health and not just an unquestioned authority. Although they are saving lives and have spent hundreds of hours in school and practice to do so, they are human beings who are exposed to myths and misconceptions similar to ours. I’ve heard the most irrational things from doctors about testosterone replacement that make me wonder how. unlucky as their patients may be. Be sure to do your homework and find a supportive doctor. your in your quest for optimal health. See the Resources section for directories of physicians trained in the management of testosterone replacement.
- Poor compliance: Forgetting when to inject or apply gels is a common complaint. Good time management and reminders are key. Find reminders that work for you. I use Google Calendar, which can be set up to send text messages to my phone as reminders. Avoid the yo-yo effect of poor compliance! Testosterone replacement is a lifelong and lifestyle commitment that should be carefully explored.