Avoid these 10 mistakes
I have heard of so many mistakes being made by people taking testosterone replacement therapy. Some mistakes seriously impacted their quality of life, or resulted in men stopping testosterone prematurely. Here are a few of the biggest errors I’ve witnessed:
Using “street sources” of testosterone: I have met many men whose doctors do not support their use of testosterone or who have no insurance and access to testosterone replacement therapy, so they buy it on the black market or from dealers at their gyms or social circles. Testosterone is classified as a controlled substance under the Anabolic Steroids Control Act of 1990 and has been assigned to Schedule II or III (depending on the state) by the Drug Enforcement Agency (DEA). A doctor can legally prescribe it but it is illegal to use without a prescription. Be aware that the buying or the using of testosterone without a proper prescription may have legal consequences enforced by the DEA. The use of testosterone and its cousin molecules (anabolic steroids) is illegal in the United States for those without a medical diagnosis that justifies their use (e.g. anemia, wasting, hypogonadism). If you still decide to get testosterone in the black market, please be aware that you could set up by dealers who may act as informants who may alert the DEA of your purchase. Also, importing testosterone even if you have a prescription is not legal. The DEA and customs may intercept your package and, depending on the amount purchased, may press charges. So, be extra cautious. The media hype on testosterone and anabolics in athletes has unfortunately created a witch hunt by enforcement agencies.
Most people are unaware of the steps taken to compound a sterile injectable medication which is completely free of toxins and metals. Many black market steroid hormones have tested positive for toxic metals and are found to be either under-dosed or not containing any amount of the listed medication. Black market injectable medications typically are not made under the regulations of a pharmacy and can be lacking in critical steps needed to ensure patient safety. Physicians at Defy Medical personally investigate any pharmacy used to prescribe injectable hormones and nutrients. It is important to confirm that specific protocols are followed and that each batch of medication produced is independently tested to confirm potency, sterility, and absence of endo-toxins.
If you decide to use a street source of testosterone for muscle enhancing , at least educate yourself to ensure you maximize benefits and minimize side effects. There is a lot of confusing and misleading information about testosterone and ineffective testosterone boosters on the internet. Also, some men think the higher the dose, the better. Others ignore the risks of shutting down their body’s own production or do not know how to manage potential side effects.
Not exploring what testosterone option is best for you: Since there is an assortment of options for testosterone replacement (three injectable products, four gels, pellets, sublingual and gum film), it’s important that you take the time to really find out what’s best for you. Several factors are involved in deciding what would be the best testosterone replacement option for you. Among them are cost, insurance coverage, convenience, preference for daily versus weekly use, lack of time to stick to a strict daily schedule, fears of needles, and physician familiarity of the different products. For instance, some health management organizations (HMOs) programs only pay for testosterone injections since they are the cheapest option. However some men have needle-phobia and dislike weekly or weekly injections that may require them to go see their doctors that frequently (some doctors do not teach their patients to self inject at home). Other men are prescribed daily gels even if their busy lives make it difficult to be perfectly compliant to the daily therapy. Some men without insurance or financial means decide not to seek help since they do not know that there are patient assistance programs set up by manufacturers, or the fact that compounding pharmacies can make cheap gels and creams with a doctor prescription. Every testosterone option has advantages and disadvantages that may be more suitable for one person over another, so read the following section on treatment options. Testosterone: A Man’s Guide has details on each available option and how to ask your doctor the right educated questions. You can also learn more about the different TRT options, and which one might be best for you by contacting Defy Medical and scheduling a free consultation.
Not using the right dose: Men who start testosterone need to have their testosterone blood levels rechecked two weeks or one month after they start therapy (depending on the testosterone formulation), right before they administer the corresponding dose for that day or week. This is critical since these results are essential to deciding if the dose is right for you. Total testosterone blood levels under 500 ng/dL that are not improving your sexual desire and energy should be increased to 500 to 1,000 ng/dL by increasing the frequency of injection or the dose. Some doctors fail to retest after they get a patient started on testosterone since they assume most men respond to 200 mg bi-weekly injections or 5 grams per day of gels. The reality is that many men require higher doses to reach total testosterone levels above mid range of normal. Those men tend to stop testosterone early because they perceive no benefits at “average” doses. Incorrect frequency of injections is a common mistake and is actually worse than not getting treatment at all.
Cycling on and off testosterone: Testosterone replacement is a life-long commitment in most cases. Once you start you should assume that you will stay on it unless you have an unmanageable side effect. Some patients think that “giving the body a break” once every few weeks is a good thing. What they do not know is that during the time that you are taking testosterone, your testicles stop producing it. When you stop replacement therapy you are left with no testosterone in your system for weeks while your HPG hormonal axis normalizes. Depression, weight loss, lack of motivation, and loss of sex drive can appear rapidly and with a vengeance. A few men never have their hormonal axis return to normal after stopping testosterone. Do Not Stop testosterone replacement abruptly. Sometimes new medications can increase cholesterol and triglycerides and/or liver enzymes (I call these “signals”). Some doctors prematurely blame testosterone instead of the new medications that someone might have started. I have seen people suffer because of this poor judgment of their doctors. Weeks later, they learn that stopping testosterone did not improve any of these problems but by then they feel tired, depressed, and asexual.
HP Restoration Program- When there is a circumstance in which a patient must discontinue TRT, it is important that the testosterone is discontinued under a physician’s supervision. Defy Medical offers a program designed to restore both pituitary and testicular function, allowing for the production of your own testosterone. In some cases, men may be diagnosed with “hypogonadism” which means they will be incapable of producing adequate amounts of testosterone. The HP Restoration program can determine the type of hypogonadism so that a treatment plan can be customized to the individual.
Not having a doctor follow-up your blood work is a sure way to get in trouble! If you have low testosterone, there are hundreds of doctors who will prescribe testosterone replacement therapy. Some may be more educated or conservative than others. Also, there are some cash only clinics that provide TRT with some follow up program.
Not knowing how to manage potential side effects: Luckily, this will not happen to you after you finish reading this book. I know men who stopped testosterone due to swelling in their nipple area, acne, moodiness, perceived lack of benefit, hair loss, or a prostatic specific antigen (PSA) increase that was due to a prostatic infection. Knowing how to manage these side effects is essential to long-term success. If you know what side effects may occur and how to deal with them, you are less likely to prematurely stop therapy. You may just need to readjust the dose, change the delivery method, or take a medication to counteract the potential problem. Only the best physicians, who do not overreact to a side effect, know how to do this.
Having a life style that is not “testosterone friendly”: If you smoke, drink more than two drinks a day, smoke too much pot, are overweight, do not exercise, do not keep your blood sugar or lipids in control, and do not show up to doctor’s appointments, you do not have a testosterone-friendly lifestyle. Studies have shown that these factors may influence your sexual function and long-term health. Excessive alcohol can decrease testosterone. Exercise can increase it if done properly or decrease it if overdone. You can read more about this later in this book.
Not reading or staying “networked” with other patients: Being in isolation about information makes you a less effective patient. There are online groups of men who discuss testosterone and other issues, please visit (http://testosteronewisdom.com/resources.html) to learn more. Sharing your experiences and learning from others are keys to being an empowered and proactive patient. It’s the only way to maximize the benefits of any therapy you are using. Many of the practical “tricks” that I have learned have been obtained via this method. The collective wisdom of other people with similar issues is more powerful than just relying on everything your doctor tells, or does not tell you. Besides, most doctors treat educated patients a lot better than those who are timid about sharing and asking questions.
Not switching doctors when you have to: Changing doctors can be difficult, especially if you are not a networked patient who reads a lot about your condition. Many people do not have options and have to see a certain doctor in a health management organization (HMO) setting. But most of us have the option of searching for educated doctors who are not condescending and who treat you as an equal. Your doctor should be your partner in your health and not just an unquestioned authority. Although they are saving lives and have spent hundreds of hours in school and practice to do so, they are human beings who are exposed to myths and misconceptions similar to ours I have heard the most irrational things from doctors about testosterone replacement that make me question how unfortunate their patients may be. Be sure to do your homework and find a doctor who supports you in your search for optimum health.
Poor compliance: Forgetting when to inject or apply gels is a common complaint. Good time management and reminders are key. Find reminders that work for you. I use Google calendar which can be set up to send me text messages to my phone as reminders. Avoid the yo-yo effect that poor compliance causes! Testosterone replacement is a lifetime and life style commitment that should be explored with care.
Defy Medical is dedicated to being a leading concierge medical practice which focuses on both preventative and restorative therapies. We are committed to improve the health and wellness of the patients we serve across the country through personalized treatment and individual care. Defy provides access to affordable lab testing, medical support, and Testosterone Replacement Therapies to patients across the US. Our medical team will provide the monitoring necessary to maintain Testosterone levels within a specific range while managing any potential side effects.
Contact Defy Medical to learn more about Testosterone Replacement Therapy and an affordable Testosterone blood test which can be done anywhere in the US.
By Nelson Vergel
Author of the best-selling book “Testosterone: A Man’s Guide” and
Health Coach at Defy Medical