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Testosterone Replacement Therapy For Men: my experience

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 Posted 3/19/2014 12:21:16 PM
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Sorry, I meant HCG (human chorionic gonadotropin). I have now corrected it in my post.
Post #12295
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 Posted 3/24/2014 8:56:20 AM
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COQ10 (7/25/2011)
Nice post Kay...

I posted a thread on Propecia. Did you see that?

thanks


I betting you are fairly new to forum posting. It would be very nice if you could supply a link to that thread you referred to. I'm much more likely to take a look at it, if you make it just one click away.Smile
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 Posted 3/24/2014 10:29:22 AM
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gissim0 (2/9/2014)
Hi all. Im new here but have been on HRT for 7 years now.  Im 55 and am a solid believer.  my first experience was with implants.  I got way too much and didnt like it.  I then read all I could about it. My reading has made me conclude that ester injections are the way to go.  Bioidentical ones have a very short half life.  Patches are too low a dose and have to soak thru a fat layer, and fat converts testerone to estrogen.  Ive been giving myself IM 100 mg injections every week.  This is considered a very moderate dose which leaves my t level at  695 and a free t level of .98.  right in the windows.

About 3 months ago i had a PSA test.  No one mentioned the results so about 1 month later I just happened to ask.  The doctor looked and asked "am I reading this right?"  I looked and he was.  My PSA was 40.  After a few weeks of tests it was determined to be caused by an infection.  Ive been off T  for three months now as PSA has a half life of 3 weeks and they want to be positive there is no cancer.  I recall all the stiffness (not the good kind) and joint pain I originally had when I began.  I count the days until my next injections.


I had prostrate cancer and am still being treated for it. The first thing they like to do is give you drugs that stop all testosterone from being produced in your body. This will stop the development of the cancer, but this is only a stop gap while they apply the real treatment. In my case that was 45 days of radiation therapy using x-rays. I've completed the radiation therapy, but they want to keep me on the anti testosterone drugs for a full 2 years.

I can say with a great deal of confidence that a urologist can tell if you have prostrate cancer just by feeling your prostrate. By the time it enlarges and causes problems with urination, the tumors are large enough to feel.  My PSA was at 23 and I made the decision to get the biopsy. Sense the doctor was sure I had prostrate cancer he only took 9 cores instead of the usual 12-15 cores. From the biopsy they could determine my Gleason score where anything above a 5 is consider high and mine was an 8, meaning my prostrate cancer was fairly aggressive and needed treating.

Anyway I've had as close to zero T  as I can get for the last 7 months. I don't have any wood unless I really work at it, and I just don't feel like working at it. So what else can I say about that.

Does anybody have any comments about the bad drug commercials for androgen products to raise T levels? Also, is there anything that will help me while I endure my 2 years of low T? 





 
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 Posted 4/10/2014 7:51:10 AM
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http://askdrmyers.wordpress.com/tag/prostate-forum/

Dr Myers went through exactly what you're dealing with.    While undergoing hormone depletion he was sitting on a beach with beautiful women in bikinis walking by and his only thought was, "what a nice sunset that is".  I believe he is back to taking testosterone injections now that the cancer and prostate are gone.  I say that because he's mentioned his blood levels of testosterone are around 800.  If I'm right, then there's hope. 

kpo
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 Posted 5/30/2014 3:32:08 AM
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sbstrum (3/2/2012)
Just discovered the LE Forums and am pretty amazed at this incredible resource.   TRT (testosterone replacement therapy) can be administered logically, rationally, and with a scientific basis.  First main issues are what are the baseline test results? 

These should include baseline total and free  testosterone levels which are commercially available through many labs including LE lab. If you wish to be very scientific about this then you also want PSA, estradiol, DHT, fasting prolactin level.  The reason for this is that if there is occult  PC (prostate cancer)present, the  TRT (testosterone replacement therapy)will result in a serial increase in  PSA.  Also, as the  testosterone level increases, it will be metabolized via aromatase to Estradiol (E2) which if the level becomes significantly elevated will result in breast enlargement + nipple sensitivity etc. Therefore, monitoring E2 is important and there may be a need for the use of an aromatase enzyme inhibitor  e.g., Arimidex, Aromasin. 

Same issue with DHT since T  → DHT via the enzyme  5ARI (5-alpha reductase inhibitor), you should consider getting a baseline DHT level (blood) and rechecking DHT once you have good  testosterone levels.  If DHT is getting up there, then you may wish to discuss with your MD using Avodart or Proscar.  I prefer Avodart since more potent an inhibitor of 5AR.   Reason for checking prolactin is that E2 increase will increase prolactin and you do not wish this to occur since prolactin will increase nipple sensitivity and lower libido.  

These are some of the recommendations I would make.  

I am just looking at the forums to see how they operate so do not count on me watching the forum. 

Stephen B. Strum, MD


Hey, I just wish wished to bump this up. I completely missed we had Dr. Strum on this Forum and only wished he would have more time to write here. Myself, Kevin (kaypeeoh) and many other wrote quite a bit on prostate condition, testing and what we try to do to protect ourselves.

Btw, I just went across this recent test for PCa (Oncotype DX)

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 Posted 8/23/2014 6:56:32 AM
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Longtime Member (3/19/2014)
DHT cannot be converted to estrogen. There is evidence that estrogen, specifically estradiol, is more connected to prostate enlargement and cancer than DHT. A procedure developed in Israel involving shortening and opening the vessel by which testosterone exits the testes to the rest of the body was shown to reduce prostate problems, including cancer. Apparently it is the blockage of this vessel that contributes to the prostate problems (taller men, having a longer vessel, are more prone to these problems). I wonder if the DHT produced in the body from exogenous testosterone would have the same effect on the prostate, not having to pass through the vessel from the testes to the body.





Maybe it's the same people, but Gat and Gorem showed in older men that the main vein draining the prostate becomes incompetent, causing chronic congestion of the prostate.  By diverting the vein to the side the congestion clears.   The testes and prostate share a vein.  The congested prostate contains a lot of testosterone because of the shared vein.   Diverting the prostatic vein clears up BPH and seems to prevent prostate cancer.  




kaypeeoh
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 Posted 8/23/2014 11:47:37 PM
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kaypeeoh (8/23/2014)
...
Maybe it's the same people, but Gat and Gorem showed in older men that the main vein draining the prostate becomes incompetent, causing chronic congestion of the prostate.  By diverting the vein to the side the congestion clears.   The testes and prostate share a vein.  The congested prostate contains a lot of testosterone because of the shared vein.   Diverting the prostatic vein clears up BPH and seems to prevent prostate cancer.

kaypeeoh


Good to remind this interesting procedure Kevin. I pushed it quite a lot here in Switzerland but no longer hearing about it. A pity it has not encountered more favor.

PS
The full Gat&Goren procedure details to reverse BPH can be found here:
http://www.urology-hub.com/articles/reversal-benign-prostate-hyperplasia-super-selective-intraprostatic-androgen-deprivation-th


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 Posted 8/25/2014 6:30:17 AM
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I talked to an interventional radiologist--like Gat--but he had never heard of the procedure.   At the same time he said a similar procedure is done for varicoceles.   The root problem is weakening of the prostatic artery.  I've read that meditation can relieve the pressure of varicose veins in the lower legs.  

The raw testosterone flooding the prostate is converted to DHT within the prostate.  Drugs like Proscar prevent the conversion.  It's the DHT that leads to the problem of BPH and/or prostate cancer.   My theory:   Taking low doses of testosterone cypionate could reduce the amount of raw testosterone coming out of the testes via the feedback loop.  Men on testosterone treatments always note that the testes get smaller.  

A vegetarian diet could also reduce DHT.  It's thought that's because of the DIM in cruciferous veggies.  I've cut out dairy, pork and beef but haven't yet gone to a completely vegetarian diet.   My dad and granddad each had BPH and ultimately prostatic cancer.  So I wish this procedure would get more interest in the U.S.  I've asked the insurance company about it and they said it's too experimental to be covered. 

So I meditate, take DIM, avoid meat/dairy and take low-dose testosterone cypionate.   I've been doing this for a couple of years now.  I haven't had the nerve to go back to the urologist;  She was pushing green light laser.  As far as nocturia,  once or twice I week I need to use the toilet at 3AM but otherwise I have no prostate concerns. 

kpo
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 Posted 8/25/2014 6:57:57 AM
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kaypeeoh

Nice post, but you didn't say whether you've had any PSA tests and what they were in relation to your supplement and diet changes. The PSA tests over time is a pretty good indicator of what's happening to your prostrate and if you have that info please post it.
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 Posted 8/25/2014 8:09:54 AM
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Bad Robot (8/25/2014)
kaypeeoh

Nice post, but you didn't say whether you've had any PSA tests and what they were in relation to your supplement and diet changes. The PSA tests over time is a pretty good indicator of what's happening to your prostrate and if you have that info please post it.





When I was diagnosed with BPH several years ago the PSA was 0.2.  Over the years it's gone up to 0.3 then 0.35 but I haven't had it tested in the past two years. 

BTW, it's the prostatic vein, not the artery, that's involved in causing BPH.  I just noticed my mistake.

kpo
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