Nope 38 posts is just because I am usually quite busy. However since I sold my business last month and the money is in, so as I am now semi retired I will have more time to play on the internet.
Just pushing your buttons newbie. I saw you attacking a fellow information seeker and thought I would engage. Now down to a more reasonable discussion. I do not claim to be any expert at all, quite the opposite. I am not opposed to TRT clinics or TRT at all, quite the opposite. However the ones I went to were sham operations. One wanted to put me on thyroid meds even though my numbers were well within normal and I had no symptoms as well as 100mgs of DHEA in adition to 200mgs of test weekly. The next one said use 200 mgs a week and none of the other stuff. From my reading I saw 200mgs was high. When my follow up bloodwork only included a T measurement and nothing else, and when he told me my sore breast and high BP were nothing, I decided to keep searching. There may be wonderful clinics, but the first rule "First do no harm" was not being practiced at either of these places. I then found an Endo recommended by a few guys in here that specializes in androgens.
Well I will agree that were irresponsible for not teaching you how to monitor yourself properly I wouldn't worry too much about elevated Hemo, although it increases risk factors it has never really caused a heart attack or stroke in direct relation to TRT. There are also things you can do to alleviate this, like getting a double RBC draw from Red Cross and this helps the cancer patients too.
For example, testosterone can increase the hematocrit, the percentage of red blood cells in the bloodstream. If the hematocrit goes up too high, we worry about the blood becoming too viscous or thick, possibly predisposing someone to stroke or clotting events. Although, frankly, in a review that I wrote in the New England Journal of Medicine* where we reviewed as much of this as we could, we found no cases of stroke or severe clotting related to testosterone therapy. Nevertheless, the risk exists, so we want to be careful about giving testosterone to men who already have a high hematocrit, such as those with chronic obstructive pulmonary disease, or those who have a red-blood-cell disorder.
http://www.harvardprostateknowledge.org/a-harvard-expert-shares-his-thoughts-on-testosterone-replacement-therapy
As for the blood pressure that is an issue for sure. There are also things you can do to help that though. It is mostly related to water retention and this "bloat" as most call it can be controlled with proper diet and water intake. Although scoring at 12-1300 in your trough is high, it is not uncommon for a healthy human being to produce that much naturally.
Keep in mind I am not saying you need 200mgs of testosterone a week, but someone like me who likes his T that high sometimes can do it if the proper precautions are taken. It may have been a bit higher dose than you needed, usually 125-150 a week will do it for most people. I know it seems high when trying to compare it to endogenous testosterone levels, but not all of that number is actually testosterone, ester weight accounts for about 31% of cypionate. On top of that trying to compare an endogenous secretion pattern to an IM injectable is almost impossible, it is like trying to fit a square peg in a round hole.
The endo wanted to determine if it was primary, secondary and any other underlying causes. After a complete blood work up determined it was secondary and just age related. He said we can go straight on T or I can try a clomid restart. The benefit being if the pituitary can be kick started and I can produce enough of my own T then it would be best to avoid having to medicate for the rest of my life. Not that there is anything wrong with that, but I agreed it would be best to see if it worked. Also there are many studies showing that clomid at low doses alone may be another option for T replacement. At 7 weeks now my T numbers are up to 680 and everything is great EXCEPT I have no libido which means low dose clomid is not going to be an option for me. After I come off it, if the T numbers go back to the low 300's which is where I started this all, then I will start T injections again at lower dosages and work up from there with following bloodwork rather than up to 200 weekly and having hematocrit and BP issues.
Here is the problem with Clomid, although it will usually bump your T a couple hundred points at doses as low as 8mg ED it usually stops working when discontinued, at least that is what I have seen from guys who have tried it. There is actually a nice long thread here where someone tried it for months and every time he came off, T would plummet.
The other side to it is since Clomid acts like an estrogen in some tissues and an anti-e in others it actually makes you feel like your on estrogen. Meaning it gives you those girly feelings that most secondary guys already have, so although it looks good on paper, for someone that is truly Hypo it does not solve there problems in the real world. Now on the contrary someone who has a healthy HPGA and is just suppressed from using AAS it does help. I personally have found an AI actually works much better, albeit it is not a wise choice IMHO for those on TRT cause it will not help BMD one bit.
The other negative is it is an oral and regardless of what anyone will tell you , it will eventually mess up your lipids during long term use and give a rise in transminase levels.
Lastly don't worry about exactly where your numbers fall so much when on TRT, not meaning negative ones, but where your testosterone and E and all that is. It is good to keep an eye on it but those who try to "dial it in" on paper are doing theirselves an injustice because these ranges are an average put together across the board. Thats like saying the per capita in America is 55k, its not a realistic number because the average was formed with that 5% that makes ungodly amounts of money. Symptoms need to be treated first, blood test second.
My point is this. I don't disagree that most in the medical field are not up to date in this thinking. A line I learned in law school also applies to med school. Half of all the doctors out there graduated in the bottom half of their class. The clinics wanted to bill me $250 a month and just give me T without proper follow up or initial testing to see if there are any other issues. I am happy to pay more than that, but I only pay for the best and these guys were far from. I think anyplaces that pushes T replacement without all the proper baseline tests is just in the business of selling T and not in the business of healing. They did not accept insurance because in this day and age of ignorance they can rake in the money until the rest of the medical establishment realizes how many people are suffering needlessly and T is not the devil. However rather than throw T right on the fire as you suggest, some of us are patient enough to exhaust all options first to avoid a lifetime of medicating. If IBMD wants to lose weight and exhaust his options by modifying his lifestyle, then god bless him, he should try. He is making great progress and should be commended, not belittled. Either of us may probably end up in the same place months from now, on T, but I am a patient man and willing to take the long road and open my mind instead of jump in feet first. You may see it as foolish but I am 49 with my FU money in the bank so it has served me well.
You know what you are right, he is making great progress and anyone that takes the time to figure out there nutritional intake should be commended. After all we are finding out that America is filled with Lazy fat asses that shovel BK down there throat like there is no tomorrow.
At the same time my point is that testosterone is not dangerous and if he wanted to try testosterone for a couple months and then come off and see if he can be natural again there is nothing wrong with that. People will say I am advising steroid cycles but I am not, it may just be the jumpstart he needs. Testosterone is not nearly as suppressive, especially for caucasians, as most think, and most guys that have the ability to regain normal HPGA function do so after discontinuing testosterone, even without the help of HCG and Clomid/Nolva
So my point is I assumed he made his decision to go all natural on the unfounded assumption that testosterone is bad for you, the fact is its not. It is much more harmless than half the shit you can buy at CVS.
What I hate to see is when guys go to the doctor and he wants to prove something, the Dr I mean, he wants to show that he can do it without medication. The fact is that most of the time it doesn't work, most of the time even if he gets his numbers in a comfortable range on paper, his libido, drive and erections are still in the dirt. It could take years to get it back. I just don't like putting guys through that agony when the chances of FULL recovery are minimal, especially the men that are past there 40's.
So my question is, if he could bounce back much quicker, with little negative risk and the same probability of recovering the HPGA after a short supplemental trial run of testosterone, why not save the guy the agony, let him have some fun, and fix it in a much shorter period of time?
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