Dr made a prescription

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Im going to the Dr today to get the first shot. I have some medical literature Im taking with me to point out to him.

https://odprn.ca/wp-content/uploads/2014/12/111-TRT-Environmental-scan-final-dec-01.pdf
This is from 2014, if anyone has something current I would appreciate it.
Some excerpts..
"The target testosterone concentration is individualized but the goal is to achieve levels in the mid-normal range." ie around 18.6 nmol/dL (536ng/dL)
-the recommended dose ,from a table, is 200mg every 2 weeks
"Intramuscular testosterone esters (testosterone enanthate and cypionate) are long-acting preparations that are administered every 2-3 weeks, with peak concentrations occurring shortly after injection and gradually declining after 7-15 days. After IM injection of the testosterone ester, testosterone concentrations in serum rise into the supraphysiological range within 24-48 hours and gradually decline into the low-normal range over 2-3 weeks. However, resulting wide peak-to-trough fluctuations inserum testosterone levels may lead to instability in mood, libido and sexual function."
-Although the recommendation injections are still once every 2-3 weeks

The Dr said he is ok with me doing my own injections (he will teach my wife) so I can control that. Ill see what he says about upping the dose today...
 

jennerrator

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Im going to the Dr today to get the first shot. I have some medical literature Im taking with me to point out to him.

https://odprn.ca/wp-content/uploads/2014/12/111-TRT-Environmental-scan-final-dec-01.pdf
This is from 2014, if anyone has something current I would appreciate it.
Some excerpts..
"The target testosterone concentration is individualized but the goal is to achieve levels in the mid-normal range." ie around 18.6 nmol/dL (536ng/dL)
-the recommended dose ,from a table, is 200mg every 2 weeks
"Intramuscular testosterone esters (testosterone enanthate and cypionate) are long-acting preparations that are administered every 2-3 weeks, with peak concentrations occurring shortly after injection and gradually declining after 7-15 days. After IM injection of the testosterone ester, testosterone concentrations in serum rise into the supraphysiological range within 24-48 hours and gradually decline into the low-normal range over 2-3 weeks. However, resulting wide peak-to-trough fluctuations inserum testosterone levels may lead to instability in mood, libido and sexual function."
-Although the recommendation injections are still once every 2-3 weeks

The Dr said he is ok with me doing my own injections (he will teach my wife) so I can control that. Ill see what he says about upping the dose today...


Well...that's cool..you and I are doing the same amount!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!:32 (19):lol
 
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I decided not to wave medical studies in front of his face. I thought diplomacy would be the better course of action.

I did however ask about losing my own testosterone production when adding TRT. He didnt hesitate when he said I would NOT lose my natural production. He said the low levels of TRT would not stop my own production. He said I would have to take large amounts "like a pro bodybuilder" for the testes to quit producing.

I asked him about the low dose. He said the standard TRT protocol is to start at a lower dose and to increase the amount until I started feeling better and my levels came back to normal.
I asked if that meant the bare minimum. He said no, it will depend on how Im feeling, and if there are any side effect, and it would be "more of an open ended discussion" as time goes on.

So, overall I feel pretty good about the appointment.
I go back in a month for more blood work so well see what happens at 50mg every 2 weeks.
 
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I decided not to wave medical studies in front of his face. I thought diplomacy would be the better course of action.

I did however ask about losing my own testosterone production when adding TRT. He didnt hesitate when he said I would NOT lose my natural production. He said the low levels of TRT would not stop my own production. He said I would have to take large amounts "like a pro bodybuilder" for the testes to quit producing.

I asked him about the low dose. He said the standard TRT protocol is to start at a lower dose and to increase the amount until I started feeling better and my levels came back to normal.
I asked if that meant the bare minimum. He said no, it will depend on how Im feeling, and if there are any side effect, and it would be "more of an open ended discussion" as time goes on.

So, overall I feel pretty good about the appointment.
I go back in a month for more blood work so well see what happens at 50mg every 2 weeks.
You shouldn’t feel good about your doc being completely wrong about shutting down your production.
 

Gadawg

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Your doctor should be cutting hair. That's about the only thing Id let him near. He's not competent and you should correct him of his total inadequacy as you walk out the door.
 
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Anyone care to elaborate??

The pharmacist said the same thing independently. At lower levels the testosterone is additive. Worse case Ontario, they're not, and the TRT dose is increased.

The big one is that he will work with me until Im feeling good, on an open ended discussion with supporting bloodwork.

So how is this equate to 'new doc' ?
 
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Anyone care to elaborate??

The pharmacist said the same thing independently. At lower levels the testosterone is additive. Worse case Ontario, they're not, and the TRT dose is increased.

The big one is that he will work with me until Im feeling good, on an open ended discussion with supporting bloodwork.

So how is this equate to 'new doc' ?
Nothing to elaborate. When you introduce any testosterone that your body didn’t make, it shuts down your natural production. It’s not an additive. You will stop producing and you will be left with whatever you are injecting, which is about as much as a female needs.
 

Jin

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Nothing to elaborate. When you introduce any testosterone that your body didn’t make, it shuts down your natural production. It’s not an additive. You will stop producing and you will be left with whatever you are injecting, which is about as much as a female needs.

This is my understanding.
 
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Before I march into the Dr office and punch him in the face....

Is there anyone willing to make a guess where my blood work will be in 5 weeks?

If Im on the 'woman's dose' of 25 mg /week for 5 weeks, are you all saying my levels will drop then?

My average bloodwork level is 7.16 nmol/dL (206.5 ng/dL)

Based on what the Dr and pharmacist are saying I should expect an increase, but with the low dose I would expect it to be slight. Im going to guess 275. Who knows? I certainly don't.

Predictions?? Id like to know the rationale behind the statements to fire the Doctor.
 
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Before I march into the Dr office and punch him in the face....

Is there anyone willing to make a guess where my blood work will be in 5 weeks?

If Im on the 'woman's dose' of 25 mg /week for 5 weeks, are you all saying my levels will drop then?

My average bloodwork level is 7.16 nmol/dL (206.5 ng/dL)

Based on what the Dr and pharmacist are saying I should expect an increase, but with the low dose I would expect it to be slight. Im going to guess 275. Who knows? I certainly don't.

Predictions?? Id like to know the rationale behind the statements to fire the Doctor.
Bro do what makes you happy. Nobody knows what your levels will be, but if you look up, Jen said you and her are on the same dose. She’s a chick.

I pin 120mg a week and I sit at about 800 total. There’s guys that run 200mg a week and have lower test levels than I. Some pin less than I and have higher levels. We’re all different.

A quick google search will tell you that when you introduce artificial testosterone, you stop producing. Plain and simple.
 
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I agree with that, no one seems to know where the levels will be.

And I agree there is a point when natural production will shut down.

Not sure why Id fire the Dr just yet. Im not defending him either. Just need more info than Bro science and 'get new doc'
 
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I agree with that, no one seems to know where the levels will be.

And I agree there is a point when natural production will shut down.

Not sure why Id fire the Dr just yet. Im not defending him either. Just need more info than Bro science and 'get new doc'
Don’t know what to tell yah other than ride it out and see what’s up.
 

Gadawg

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I agree with that, no one seems to know where the levels will be.

And I agree there is a point when natural production will shut down.

Not sure why Id fire the Dr just yet. Im not defending him either. Just need more info than Bro science and 'get new doc'


This isn't "bro science". It's extremely basic science that is widely understood and documented
 
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PillarofBalance

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I agree with that, no one seems to know where the levels will be.

And I agree there is a point when natural production will shut down.

Not sure why Id fire the Dr just yet. Im not defending him either. Just need more info than Bro science and 'get new doc'

Negative feedback loop is anatomy and physiology 101, not broscience. Apparently you can't tell the difference?
 

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I need clarification on this “additive” testosterone thing.

I think i learned from Megatron that the HPTA is binary and I consider him an expert on TRT.

Can someone clarify this? Doc? Zilla? Megatron?

Negative feedback loop. Testosterone acts in the body the same way everything else is regulated.

"Exogenous administration of synthetic testosterone results in negative feedback on the hypothalamic-pituitary axis, inhibiting GnRH, leading to inhibition of FSH and LH production. As a result, intratesticular testosterone levels (ITT) and overall testosterone production decrease."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4708215/

OP, you need to get a new doc that knows wtf he is doing. You will probably feel 5-10x worse than you felt before the treatment if you play his sadistic game. Fukk that guy. If you still aren't willing to fire him, at least respectfully demand he refer you to an Endo or Urologist. Your GP is NOT going to take care of you. Period.
 
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I have been trying to find a reason to support the Dr and pharmacist, but I cannot.

Thanks Auto for the detail reply. The link is referring to male infertility, which is of course directly related.

I found another article that deals directly with the issue. Low testosterone, endogenous replacement, the negative feedback loop, and the HPTA of the endocrine system.

https://www.steroidal.com/testosterone/low-testosterone/

Its a good read that supports what everyone here is saying.

thank you
 
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Hey man we aren’t trying to be assoles, everyone’s trying to be helpful cuz a lot of us have been through it already
 
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I try to remain neutral and objective, but I still have a hard time believing the doctor can be so ill informed. Sometimes I think were just a bunch of hillbillies up here. The Doctor looked up sending me to the endo specialist at the first appointment. He said it would takes months to get an appointment, as its a non-emergency.

My brother, on the other side of Canada, was just prescribed 100mg of cyp once a month! Like I said before, its a great healthcare system if you're in a 911 situation, but not so much otherwise.

Anyway, I want to get started on a beginner cycle. Im following the advice (from here) to get settled on a trt program for 6 months before starting, and the process is painfully slow.

The doctor's sched:
another 50mg in 2 weeks
more bloodwork in 3 weeks.

Then he will most likely up the dose and repeat the process. Im going to keep up with this non-sense in the hopes he will keep increasing the prescription.

Ill keep posting the progress> I very much appreciate the advice.
Even if youre being a**holes. :32 (19):
 

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