Testosterone Replacement Therapy

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I’ve promoted hormone replacement therapy for men and women here and wanted to give you a personal update. Maybe it will help others as they age and decide to boost their testosterone. I started TRT with weekly injections and it worked well.

About a year and a half ago, I went to another provider and started testosterone pellet injections every six months. Much more convenient and Mrs Colt didn’t have to stick a needle in MY ass every week.

I’ve decided for two reasons to go back to weekly injections using a bio-identical testosterone. First, there’s too much variability of T levels during the six month span. Secondly, and ironically, TOO much testosterone can stunt libido! I experienced that for a couple of weeks twice when the testosterone pellets spiked.

Injections, while inconvenient, maintain a more consistent level of testosterone. This isn’t something younger members need to worry about, but you will get older so my goal is to share my experience so others can make a more informed decision when the time comes.

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For me, just avoiding to eat things that lower testosterone is enough. I don’t plan to ever do a treatment to add more testosterone to my body. I’m not criticizing you, you may well know what you need. I want to keep my body as natural as possible. But that’s just me. Good luck and I wish all the best to you.

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Avoiding testosterone reducing foods and additives makes sense. Medications can also reduce testosterone. I took statins briefly and later learned they reduce testosterone AND libido. Natural is best until a certain point when supplementation can improve the quality of life… muscle mass, libido, mood, and sleep. Eating healthy is always a good idea.

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“Natural” can also be a bit of a funny term when you consider how far from nature we all are.

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I’m maybe delusional, but actually, I don’t feel far from nature.

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I’ll leave it at a simple example to give you an idea of what I mean: We regularly travel at speeds undreamed of by people of earlier ages, speeds to which basically no living entity on this planet is adapted to.
Think “deer in headlights”: The poor things are trying to decide if whatever’s coming is close enough to expend the energy to flee, or if they’re still safe. And while they try to decide, they’ve already been hit.
We, on the other hand, are behind the wheel. And if not for some very clever technology, any crash in those machines would kill us, too.

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Ok thank you for clarifying.
I acknowledge these things but in my way of thinking they don’t separate me from nature.
Humans are creative and they’ll always create things, that’s their nature.
As far as I understand we’re not descendents of apes and when we got to the Earth we already spoke full human languages. I don’t see language and civilization as artificial but something we were already created with.
Maybe that’s why I don’t see human as apart from nature in the way other people see.

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Neo, I respect your desire to “keep my body as natural as possible”, however, if/when – I shall hope not – you enter “low testosterone” territory, you will find that a low testosterone condition has MASSIVE effects on both the mind and body.

I am speaking from personal experience – I have HAD TO (nothing to do with sex) use testosterone cream for about 25+ years because I have a low testosterone condition.

In my case, low testosterone caused effects that were very much “depression like”, plus low energy and a general feeling of being physically (and mentally) unwell.

A low testosterone condition can come on gradually or quickly. If it comes on gradually, the person may not realize that they have gone from being a vibrant energetic person to somebody who does not want to leave the house. If it comes on suddenly, the person (or their family) may think they need to get the person to a doctor as quickly as possible.

In my case (all with my regular doctor’s prescription and monitoring) I started with a very costly commercially packaged gel. I eventually discovered that testosterone cream was available from COMPOUNDING PHARMACIES at MUCH LOWER COST and with COMPLETE CUSTOMIZATION. The only “catches” (in the U.S.) is that: a) the compounded (or non-compounded) prescription products may not be covered by insurance (and not by Medicare); b) if it is potentially covered by insurance, the compounded dosage must be at least slightly different dosage than the pre-packaged commercial products.

The process of determining the necessary prescription dosage is likely to require a lot of experimentation and coordination between the patient, the doctor and the compounding pharmacy. And the patient MUST get into the driver’s seat and PUSH the process. There will be periodic blood tests to check levels – it is important to increase to the point the patient feels better, but to not go too far. In addition to the goal of raising blood testosterone levels from X to Y, there are two variables to control: a) the volume of cream per dose and b) the percentage of testosterone in the cream. The volume of cream is important because it is all about skin contact (spread and rub in on a non-hairy area); too little volume of cream and it is hard to be enough to spread and work in – too much volume and it is too much volume to absorb in a couple minutes. The higher the volume, the lower the percentage, and vice versa – to get to the goal increase. In my case, my prescription (for years) has been for DAILY 15 ml cream at 8.25% testosterone. It used to be dispensed in a NON-needle syringe, but the pharmacy a couple years ago changed to a pump-bottle; each squirt is exactly 5 ml so it is easier to deal with (the pumps come with different volume ratings).

Testosterone should only prescribed in response to a genuine medical condition. This is diagnosed by a blood test, usually done in response to the patient’s (or family’s) concerns about their physical and mental status. It is not always just the “low energy” comments recently seen in TV ads. However, low testosterone is NOT often the first condition that most physicians think of. For example, a patient who presents as depressed may actually be perfectly mentally fine, but just have very low testosterone. Treating the person for depression will likely do more harm and not help the problem.

Over the years I have encouraged several men who told me of their diminished physical or mental status to include the subject of testosterone in the conversation with their doctor. In some cases the tested very low and were greatly helped by prescribed testosterone.

Lastly, about this, absolutely only deal with your regular physician, in the context of a complete physical examination and testing. If you have multiple physician for multiple conditions, be sure that all of them are fully aware of the situation. Obtain the testosterone only from a “real” local pharmacy (where you can actually discuss this with a compounding pharmacist, NOT on the Internet) – and I suggest using a compounding pharmacy for much lower cost (same stuff, just no marketing and advertising costs built in).

Hopefully nobody reading this will ever need this information, but keep it in mind, just in case.

P.S. IMPORTANT: Testosterone is “gasoline on the fire” for cancers. If you have any cancer condition and/or high PSA levels, using testosterone may not be appropriate. In the case of elevated PSA levels that have been determined to not be related to cancer, both PSA and testosterone levels should be monitored in a coordinated fashion. Make sure any medical providers involved with any aspect are fully involved in the discussions.

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Great explanation and points about blood testing. Would injections work for you?

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Injections? I don’t know.

I do like the control and steadiness that daily cream gives me. Within a day or two I can actually feel the subtle difference if I am running a little low or a little high. And that allows me to increase or decrease a little bit if necessary.

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Just curious, if you’re willing to share, what do you try to keep your total testosterone at? Around 800?

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Colt… For clarity, and for those that may not be familiar with this, there are two types of testosterone numbers.

Also, when the term “normal” range is used, the test literature that was provided to me states that the “normal” range is based on "healty non-obese males with a BMI of less than 30 and between the ages of 19 and 39.

Men apparently need less testosterone in later years for physiological functions, such as muscle building, etc. Also, based on my experience, I believe that older men may have more sensitivity to lower/higher levels – within a day or two, I can actually feel differences if I use a little more or a little less cream. I believe that it is important for an older man to base their dosage on how they feel (physically and mentally) rather than on a “normal” range based on men decades younger than I am (mid-60s). What works best for me is far lower than the so-called “normal” range.

  • “Testosterone, Total, LC/MS” (“normal” range 264-916): Between 2019 and 2022, my number ranged from about 400 to about 600, with one strange outlier (bad test?) at about 800. However, from 2022 through current, my range has been about 175 to 385.

  • “Testosterone, Free” (“normal” range 6.6-18.1): Between 2019 and 2022, my number ranged from about 10.0 to about 14.0, with one strange outlier (bad test?) at about 25.0. However, from 2022 through current, my range has been about 5.0 to about 12.0.

For me, I don’t feel at all good (lackluster, unmotivated, unwell) if my levels go below about 160 / 5.0.

I feel “okay” (which is probably actually pretty good compared to how not-good other men I come into contact seem to feel) around 175 / 6.0.

I feel really good around 200-250 / 7.0-9.0.

However, if the numbers get more than about 20% higher than those “really good” ranges, then there are negatives for me. What I notice most is that I become much more goal-oriented (too much of a good thing, like low-grade mania), hard-driving (some might say I already don’t know any other way anyway), bull-in-a-china-shop, less considerate of others, and less patient. This shows up in unpleasant ways, such as when Mrs. AnalLover asks me a completely reasonable question, but I start answering before she is even done asking – and of course I get it all wrong and I cause upset. So, for me, it is really important to use enough cream, but not too much. To partially borrow a phrase, “If momma ain’t happy, ain’t nobody … getting laid.” So I am careful about dosage.

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I respectfully disagree with placing your trust entirely in the hands of a physician. Perhaps you have a good physician who is willing to explore causes and treatments. Most, in my opinion, are pill pushers. Western medicine treats symptoms instead of root causes. Even a functional medicine physician I see now pushed statins to shrink the arterial calcification I’ve accumulated over 69 years… many of those years, admittedly, not eating as healthy as I should have. My total cholesterol was 180 with high HDL and low LDL when she prescribed the statin. My total cholesterol is now 115, which I read is too low. The brain needs cholesterol and there are studies that link statins to Alzheimer’s. Despite my knowledge of some of this, I took the statin for five months. My bad as well.

With only 5+ years of TRT under my belt, I haven’t dialed my dosage in as you have. With pellets, my total T was over 1,200. With synthetic, injectable testosterone, my levels were at 600. I’m currently at a men’s clinic for shockwave therapy and a planned P-shot. Once my last round of pellets has worn off, I intend to use the men’s clinic and go back to injectable, bio-identical testosterone.

There are so many medications that cause ED… SSRI’s, various blood pressure meds, and statins. In western medicine, the depression caused by ED is treated with SSRI’s. That just exacerbated the ED. The only reason I maintain a relationship with a primary care physician is to ensure I have a doc with admitting rights to a hospital.

Like you, I need to dial in my optimal testosterone level. I’m not sure I can detect small differences as you can. I’ve actually read excessive levels can result in loss of libido. I’m in good health, eat healthy, lift heavy weights, and do my cardio. Once the horrific impact of the statin wears off, I can focus on optimum T levels. The shockwave treatments and P-shot should restore natural blood flow to my penis and improve the quality of my erection… something essential for anal penetration. Prior to the devastating effect of the statin, we enjoyed anal sex two or three times a week. Statin users beware!

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Thank you both @AnalLover and @Colt1911 for the information, it was quite a read. I probably have quite a few years on natural t and good erections ahead of me knocks on wood, but at some point this information might be very valuable indeed.

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Colt1911, I would never intentionally suggest “placing your trust entirely in the hands of a physician”. I am sorry if you got that impression.

However, the whole system of “Western medicine” (and insurance) requires a “provider’s” authorization for medications, treatments, diagnostic services and tests, etc. So, yes, a doctor is involved, but that does not mean that I am for a micro-second giving up control.

In the process of finding the right Testosterone dose for me, the doctor and I worked closely together, but I was “driving the train”.

I am a very strong believer that the patient (or a representative, if the patient is not able to properly represent themself), has to be fully informed, make conscious decisions, do their own “research”, and be “driving the train”.

Separately, I also feel strongly that patients are well served by bringing a close & trusted person with them to all medical appointments. In our case, my wife and I accompany each other to all medically-related appointments – even “intimate” appointments. There are no secrets. I am talking about “being in the room”, not just sitting out in the waiting room. We have found that a) we are both much better and more seriously treated by the staff and physician when we have the other accompany us to the appointment; b) many times the other has thought of important questions to ask; c) two note-takers are better than one.

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It’s such a complicated matter; I agree that one cannot blindly trust their physician, for various reasons, systemic and personal (they just might not be as informed on certain topics). On the other hand, unless you’re a physician yourself, you’ll probably not know a lot of basic (for a studied physician basic, that is) medical information needed to make an informed decision.

What makes matters even worse is that doing one’s own research requires a certain skill set, one that both you, @Colt1911 and you, @AnalLover possess. But how many people “do their own research” without knowing the first thing about how to do research?

This will be a wild detour from what’s been discussed so far, but …
These days, hybrid warfare includes informational campaigns, using established templates for conspiracy myths (QAnon recycles so much material from the protocols of the elders …), memes and classic disinformation (lies, propaganda) to erode a the confidence of populace in its institutions and their neighbors and colleagues. It seems weird to say as a skeptic, but we need more trust in institutions again.

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It is incumbent on the institutions to earn that trust. In the U.S. those institutions have failed us… and badly. In 1990, the food and drug administration banned the use of red dye #3 in cosmetics because of its link to cancer. For the next 35 years, the FDA allowed the use of red dye #3, a chemical known to cause cancer, in food. Left leaning individuals always blame capitalism and corporations, but what about the lazy, paid off regulators who allow the corporations to use dangerous chemicals in food? Shameful.

Let me draw the corrupt connection between US government bureaucracy and corporations. Government scientists in the FDA receive royalties for the pharmaceuticals they review. In some cases, these scientists assist in developing new drugs. Someone thought it would be a great idea to pay the regulators for their input. Incredibly, some in the U.S. refuse to see that as a conflict of interest. When the government officials charged with overseeing the safety and efficacy of the drugs are paid by the corporations that produce them, I can’t possibly trust anything they say or do. Below is a link to an article regarding this obvious conflict of interest.

Sadly, we’ll have to wait many years before we start hearing stories of the link between statins and Alzheimer’s. I have zero faith in these institutions. Their incoherent response to COVID should have been a huge wake up call, but these institutions are deeply entrenched in massive corruption and continue to abuse the power given them by an uncontrolled bureaucracy. Caveat empor. When it comes to your health, trust no one is safer than blind trust… at least until the corruption can be eliminated.

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Well yes, this is not an institution we should trust :grimacing:

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Gosh guys, I wished that I lived in the US, as I live in Australia. Here in Australia in regards to TRT, you just about have to be dead before you are officially prescribed by the medical profession on TRT… LOL! It makes me fuming sometimes at the thinking of the Australian government policies towards healthcare and for setting medical standards. It is almost like they want the Australian men to fall.

I have talked at length with Doctors, Urologists about what the US offers men like the P-shot, GAINSWave technology, and the such like. They look at me blank sometimes. Especially the Urologist’s as I get their thinking “That is how we do things around here. Who are you to tell/inform us on what to do?” Almost too lazy to do anything else… They all fall back on prescribing Viagra, Cialis :person_facepalming:

As many of you have shared, I resort to living, exercising, living healthy. I take daily Vitamin D, Zinc, Magnesium, Fish Oil, and the best till last, Shilajit. Shilajit is amazing for men their sexual health. I have Doctors blood test results on before, and after taking Shilajit in a 3 week period. The results on my testosterone levels, after taking Shilajit once a day, my testosterone went up by 50%. Plus with Shilajit my mental clarity is off the charts.

Being constrained by the Australian government and medical system in this country, that is how I address TRT.

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In the U.S., most insurance companies (I’m on my employer’s policy) won’t pay for TRT or ED treatment beyond meds. I pay for my TRT and ED treatments, exams, and bloodwork out of pocket.

Does the Australian system prevent any doc from prescribing testosterone? If so, that’s unfortunate. I understand your frustration as it really helps men as we age.

I would do exactly what you’re doing now… seeking out natural ways to increase your testosterone levels. In the U.S., treatment by providers outside of health insurance can offer lower rates than they charge the insurance companies because customers pay cash instead of battling with insurers to be paid.

As most of us in this group know all too well, sexuality is an important aspect of who we are and what kind of a partner we are. I know the day will come when it can’t happen, but I will do whatever I can to extend it as long as possible.

I wonder if you could find a reputable supplier outside the country that can ship you testosterone cream. A Reddit contributor indicated pharmacies can legally sell a testosterone cream slightly less concentrated than the prescription strength cream. I may look into the possibility it could be shipped to Australia. I’ll let you know what I learn.

Believe me, I understand your frustration.