Endo visit and 1st Cyp Shot

[Desmo996]

I had my 1st visit with my 2nd Endo today. This one seemed to be more comfortable with giving me shots, the last one just wanted to scare me away from the "Dangers of Steroids". I have mixed feelings about how the visit went.

I did switch from AndroGel to Test Cyp, but he wants to dose it at 300mgs every 3 weeks. This is going to give me a huge swing I think. I have about 3 months supply of AndroGel left, I was thinking about using it at 5mgs a day after the first 2 weeks. To help keep things balanced. I asked to get more frequent shots at a lower dose to keep from having my Test going up and down like a roller coaster, but he said that he would like to try this first. Is anyone else one a schedule like this and how is it working out for you? Also, I wasn't given a script, I have to go in to the office and a nurse will give me the shot every three weeks.

 

[pmgamer18]

It is like I have said for yrs. I have yet to see a good Endo. First the 300 mg shot will drive up your E2 big time at least it did for me. You will feel a rush or high because of the high dose. Then you will start back sliding we are all different so you may last one week or a week and half. If you were to read the AACE Guidelines they say to give shots every week. To keep from going on a roller coaster ride.
Here is what the Guidelines say "For complete androgen replacement, the regimen should be between 50 and 100 mg of testosterone enanthate or cypionate administered intramuscularly every 7 to 10 days. The use of 300 mg injections every 3 weeks is associated with wider fluctuations of testosterone levels and is generally inadequate to ensure a consistent clinical response."
Here is a link print it out and give it to the Dr. tell him you want to feel better not worse. And I tried mixing gels and shots it is a road to no good high E2.
http://www.aace.com/clin/guidelines/hypogonadism.pdf
Phil

 

[Desmo996]

Thanks Phil, I appreciate the feedback and info

 

[BigRagu]

yea 300 is going to send u on a emotional roller coaster......also as he said prob but yoru e2 and dht sky high............. try and get him to give u 100mg/week.......u will have to shoot more ofted.......but u get used to it.........

 

[SWALE]

Yes, it is completely wrong to dose TRT like that.

 

[Desmo996]

SWALE,
As a professional, how would you personally prefer a patient come to you with a request for a change in protocol? I personally don't want to offend the Endo, and end having to search yet again for another one. My experience so far on the 300mgs has not been real good, contrary to what I would have expected, and I really don't want to wait until my next appointment in Sept, to get my dosage adjusted. I could show him the paper that Phil linked to, or bring in your Recipe, but I have only had one appointment with this Endo, and he is the first to allow me to get the shots at all, so I don't want to rock the boat. Any suggestions?

Also,
Has anyone else on a higher dose of Test found it difficult to fall asleep and stay asleep? The first two nights were really restless for me, I slept fine last night, so I seem to be adjusting to it, or the effects are tapering off as the Test in my system slowly declines.

 

[mranak]

You need to find a new physician. I suggest GPs if you can't get to SWALE.

Will the endo let you do the injections yourself? If so, then get the script for 300mg tw (or whatever the term is for E3W) and inject 100mg qw until you find a new physician that can treat you properly. I don't like to suggest doing something that goes against what you have been prescribed, but we know that 300mg every three weeks is just totally inappropriate.

If you want, you could press (in a polite yet firm manner) the issue with this existing endo. Something like, "I communicate with many other HRT patients on the Internet and collectivly we know that depo-testosterone needs to be injected every 7 days. I understand that you have good success with your other patients E3W, but I'm only really interested in EW." He will probably say "no", but he might just shrug his shoulders and allow it.

 

[Desmo996]

My GP has given up on trying to manage my HRT, and has referred me to two different Endo's now. The first one was a waste of time, the second one is atleast willing to treat me. SWALE is on the other side of the the country from me, but I am saving up my Skymiles, as I am getting tired of the run around from the local Doctors.

So far my current Endo wants me to go into his office for the shots, this will only keep up until, he trusts me with a script, I am comfortable enough to do it myself or my insurance quits paying for it. So no script for me or I would just adjust the shots on my own to weekly.

I haven't received any feedback on the sleepless nights right after the shot. Maybe it was completely unrelated. Anyone?

 

[pmgamer18]

My GP has given up on trying to manage my HRT, and has referred me to two different Endo's now. The first one was a waste of time, the second one is atleast willing to treat me. SWALE is on the other side of the the country from me, but I am saving up my Skymiles, as I am getting tired of the run around from the local Doctors.

So far my current Endo wants me to go into his office for the shots, this will only keep up until, he trusts me with a script, I am comfortable enough to do it myself or my insurance quits paying for it. So no script for me or I would just adjust the shots on my own to weekly.

I haven't received any feedback on the sleepless nights right after the shot. Maybe it was completely unrelated. Anyone?

I think if you print this out and show him that the AACE recommends shots every 7 to 10 days. He will come around if he gets mad then you need to get a better Dr. I in my 21 yrs. have had no luck with Endo's and have seen a lot of Dr.'s. It is not as hard to find a good one today as it was 21 yrs. ago.
http://www.aace.com/clin/guidelines/hypogonadism.pdf

Phil

 

[jwtex]

SWALE,
As a professional, how would you personally prefer a patient come to you with a request for a change in protocol? I personally don't want to offend the Endo, and end having to search yet again for another one. My experience so far on the 300mgs has not been real good, contrary to what I would have expected, and I really don't want to wait until my next appointment in Sept, to get my dosage adjusted. I could show him the paper that Phil linked to, or bring in your Recipe, but I have only had one appointment with this Endo, and he is the first to allow me to get the shots at all, so I don't want to rock the boat. Any suggestions?

Also,
Has anyone else on a higher dose of Test found it difficult to fall asleep and stay asleep? The first two nights were really restless for me, I slept fine last night, so I seem to be adjusting to it, or the effects are tapering off as the Test in my system slowly declines.

I sleep the best right after my shot. I will fall asleep in 10 minutes and sleep through to 7 in the morning. Before TRT I slept about 4 to 5 hours, now a solid 7. Go figure. I guess we are all different.

 

[mranak]

My GP has given up on trying to manage my HRT...

I would try other GPs, personally. Finding an endo that is competent with TRT is very difficult. GPs usually don't know much either, but they are usually more open to suggestion.

Below is my experience with GPs regarding TRT. I only wrote it because I'm a bit bored. Feel free to ignore it unless you are also bored.

Personally, I got kind of lucky. I didn't know anything about hypogonadism but when I went to a random GP for some asthma problems, I asked about getting some medication (e.g. Viagra) for some ED issues I was having. He thought it might be a good idea to run a blood test and check out such things as my free testosterone and prolactin. The result was low but within the 'normal' range, but this particular physician realized that symptoms of hypogonadism and borderline low free testosterone were reason enough to give the patient (me) the option of TRT. Of course, I started reseraching on the Internet immediately and quickly found SWALES's "TRT: A Recipe for Success."

I changed physicians because of lab billing (my insuracne company only pays for labs if the labs are billed by the physicans office....a rule only setup so they don't have to pay for labs). I simply told the new physician that I was on testosterone cypionate x-mg/week. No way would the new physician have prescribed me such a regimen if I hadn't already been on this regimen.....he is one of those every-two-weeks kind of physicians that is used to giving the injections at his office. However, since I was already on this regimen, he was willing to give me a prescription to continue it. That said, he is really trying to get me to switch to doing the injections every two weeks. So now I am trying to politely (carefully) educate him (e.g. with charts that show the serum levels of testosterone over a two week period) without insulting him. He read SWALE's paper and said it was very good, but he seems to have missed some very important points.

 

[Desmo996]

I gave my GP a copy of SWALE's Recipe, but she still referred me to an Endo and has discontinued my scripts for AndroGel. So I am stuck with this Endo, looking for another one again, or flying to MI. For now, I am going to print out the pdf that pmgamer linked to and bring it with me to my next visit.

I can see why SWALE is dead set against this type of protocol, Other then a lack of sleep the first two nights, I did feel really good this first week, but I can tell it is fading as my serum levels taper off.