As I think I’ve said, I use the gel because it is applied every day and I never run out in my body. While the implants might be more convenient, especially for your Dad, he is likely to run out of TT BEFORE the next implant is inserted. That can be a real downer for him — well, so I’m told.
I think the pellets are probably a good solution for my dad, since he’s not likely to apply the gel consistently and is concerned about transferring it to other people. Also, you can’t shower after applying the gel; it’ll just wash off. Often, Dad doesn’t get around to showering until late in the day. So, having to apply the gel every morning might be a problem for him.
The doctor also said that the dosage delivered by the gel is a lot more variable than the pellets, and needs to be increased roughly 50% of the time after initial dosing. In other words, it may take longer with the gel to reach proper levels.
One thing I really like about the gel, however, is that it tends to cycle ones T levels over the course of the day in a roughly natural way (higher in the morning, when applied, and slowly diminishing thereafter). He’ll be trading off this potential benefit for consistency.
Also, I strongly recommend 3-monthly blood tests for Progesterone, Prolactin, Oestradiol, FSH, LH, Androstenedione, Total Testosterone, Free Testosterone, Sex Hormone Binding Globulin, Free Androgen Index and DHEAS. You should study up on each of these so you know what to expect and, if it is not right, what the doctor should do about it. Note, both LH and FSH will fall through the floor — that’s OK.
I’m not sure what the protocol will be, but I’ll certainly ask. T therapy is a big part of this doctor’s practice, so I expect he’s on top of things. It won’t hurt to double check, however.
Please, I might not know much about all this, but am happy to share what I do know. PM me or ask here anything you like. Nothing is too personal.
Thank you. I’ll continue to bend your ear; hopefully, not to the breaking point. :)
It was really interesting to see how this doc differed from Eugene Shippen (“The Testosterone Syndrome”). First, he didn’t seem overly concerned about estradiol. He said my dad’s breast tissue almost certainly was not caused by estrogen, since nearly all estrogen in men is produced from free T. No free T, no estrogen. So estrogen can’t be the culprit, he said. Still, I’m relieved that he will be testing estradiol both initially and on an ongoing basis.
He said he didn’t think the ratio of T/E was very important. He said the absolute numbers were more important than the ratio. Again, I’ll keep an eye on it and bring the issue up with him later if the ratio gets too low.
Since he wasn’t overly concerned about estrogen, I didn’t bother asking about aromatase inhibitors. Again, I’ll bring it up later if necessary.
The doc wasn’t really hot on HCG, either. He said there was little benefit, except for preventing testicular atrophy, which he didn’t think would be a problem in my father’s case. I would have felt better if he had asked my father if it was going to be a problem. The doctor was slightly brusque. He also said that pushing my father’s system to produce more T, when that system was already showing a lot of wear, was probably beating a dead horse. He didn’t use those words, but that was his point.
He wasn’t crazy about zinc, either. He slightly rolled his eyes when I mentioned it, saying that there was no data to support zinc being helpful for testosterone levels. I think I’ll check up on that detail.
While I have a few concerns about this doctor’s approach, I think we’re off to a good start. The best measure of the doctor’s success will be how my father responds.
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