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I see a urologist too. He's the 1 who told me I need to be on TRT.

I went to him after my previous endo did the labs and told me that

my T was low on them but that I don't need TRT. So when the

urologist saw the labs he said 100% I need TRT. I then went to

another endo to get a 2nd opinion on that b/c I felt uncomfortable

that the previous endo (who is the reviewr for the AACE guidelines)

and this urologist were looking at the same labs, yet the endo who

is supposedly the expert told me i don't need trt and the urologist

told me I absolutely need it. so when i went to the new endo i

explained the whole situation to him, and he told me that it can't

hurt trying it but that he doesn't think it's going to take care of

my symptoms. Now, as I previously posted, he's telling me to stick

with it for a few more months and then discontinue if no

improvement. I just emailed him today asking why he's saying that

the Androgel is working as it should if my T levels are in the low-

normal range. I'll let y'all know what he says. I did fell great

for almost 2 weeks when I first started the Androgel, which leads me

to blv that if my levels were much higher, as they likely were

during that time period, then maybe this trt could actually help my

mood symptoms.

> >

> > It's great advice but it's easier said than done. I've spent

hours

> > and hours reading this site and researching this stuff, but when

I'm

> > functioning at such a low capacity it's nearly impossible for me

to

> > actually absorb most of it, and then when I do go to the Dr. I'm

so

> > disconnected that I can't assert myself anyway.

> >

> >

>

> You're correct. It isn't easy. It is time-consuming, costly,

> inconvenient, and mind-bendingly frustrating. I don't think you

need

> to necessarily see an endocrinologist. A urologist might be as

good

> or better. Unfortunately, doc shopping is about the only good

weapon

> we have. You may need to make some notes for yourself to carry

into a

> consultation so you can fall back on them in case you get

confused.

> The initial goal is to ask enough questions to see if the doc is

even

> a possibility. If the answers aren't promising, cut it off and

don't

> waste time and energy. You might be able to call the office and

find

> out how many men are currently under the doc's care for

hypogonadism.

>

> I hope you'll take a close look at the anti-aging clinic website

> before committing yourself. It looks like it might be rather

costly.

> Initial labs ~$600

> Initial consult $695

> Program maintenance fee $50/month

> Followup labs 2 to 3 times/year $100 - $300

> Medication $75 to $200/month

>

> Plus they seem to emphasize compounded transdermal products which I

> don't think will do you much good since you've already failed on

> transdermals. I always find it troubling when a doctor steers you

to

> their own pharmacy instead of letting you choose for yourself.

> Assuming you have the money, it might be fine. The good side is

that

> they'll probably have a positive or at least non-negative view of

> testosterone therapy and that's a considerable benefit.

>

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Try this link.

http://www.tuneupyourt.com/

load it then hit Frind A Dr. then put in your state. Make sure you call them

first some Dr.'s that sined up are not good. A lot of guys have found a good

Dr. doing this call them and ask how many men does the Dr. treat for low T and

does he test for high Estradiol if one is high does he use Arimidex to keep

there Estradiol down and ask if the Dr. uses HCG to treat men that are

secondary. You will know when you have found a good one.

Phil

jonnyblog <jonnyblog@...> wrote:

New York

> > >

> > > Jonny,

> > >

> > > > Been there done that. THese are the " Top Doctors " who don't

> take

> > > > insurance and charge 500 bucks a visit who tell me this.

> > >

> > > This has been my approach, which seems to be working:

> > > 1. Educate yourself until you know all aspects of TRT. Know

the

> best

> > > treatments, the proper lab tests, etc. I personally have spent

> > > probably 80+ hours on this.

> > > 2. Utilize the incredible knowledge and experience that can be

> found

> > > in this group.

> > > 3. Find a doctor who is under your insurance plan and who is

> > > cooperative. I approached my doctor with exactly what I

wanted,

> and

> > > he has prescribed it every time. I am doing self-injections of

> T cyp,

> > > Arimidex, and HCG.

> > >

> > > Eugene

> > >

> >

> > Great advice. Glad the group was helpful. That's precisely why I

> > contribute some of my time here.

> >

> > Brad

> >

>

>

>

>

>

>

>

>

>

>

>

>

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I say go back to your Urologist he sounds like he knows what he is talking

about. What happens when you go on gels is your levels go up on top of what

they were befor the gels. Then your brain sees this and stops sending the

messages to your Testis to make T when this happens your T levels go back down

some times it goes lower then what you were before starting the gel. This is

why Androgel says in the insert to get tested after 2 week on the gel and if

your still low to up the dose. Your on 10 grams if I remember right and your

levels are this low you need to try shots go back to the Urologist and tell him

you should have listened to him.

Phil

jonnyblog <jonnyblog@...> wrote:

I see a urologist too. He's the 1 who told me I need to be on TRT.

I went to him after my previous endo did the labs and told me that

my T was low on them but that I don't need TRT. So when the

urologist saw the labs he said 100% I need TRT. I then went to

another endo to get a 2nd opinion on that b/c I felt uncomfortable

that the previous endo (who is the reviewr for the AACE guidelines)

and this urologist were looking at the same labs, yet the endo who

is supposedly the expert told me i don't need trt and the urologist

told me I absolutely need it. so when i went to the new endo i

explained the whole situation to him, and he told me that it can't

hurt trying it but that he doesn't think it's going to take care of

my symptoms. Now, as I previously posted, he's telling me to stick

with it for a few more months and then discontinue if no

improvement. I just emailed him today asking why he's saying that

the Androgel is working as it should if my T levels are in the low-

normal range. I'll let y'all know what he says. I did fell great

for almost 2 weeks when I first started the Androgel, which leads me

to blv that if my levels were much higher, as they likely were

during that time period, then maybe this trt could actually help my

mood symptoms.

> >

> > It's great advice but it's easier said than done. I've spent

hours

> > and hours reading this site and researching this stuff, but when

I'm

> > functioning at such a low capacity it's nearly impossible for me

to

> > actually absorb most of it, and then when I do go to the Dr. I'm

so

> > disconnected that I can't assert myself anyway.

> >

> >

>

> You're correct. It isn't easy. It is time-consuming, costly,

> inconvenient, and mind-bendingly frustrating. I don't think you

need

> to necessarily see an endocrinologist. A urologist might be as

good

> or better. Unfortunately, doc shopping is about the only good

weapon

> we have. You may need to make some notes for yourself to carry

into a

> consultation so you can fall back on them in case you get

confused.

> The initial goal is to ask enough questions to see if the doc is

even

> a possibility. If the answers aren't promising, cut it off and

don't

> waste time and energy. You might be able to call the office and

find

> out how many men are currently under the doc's care for

hypogonadism.

>

> I hope you'll take a close look at the anti-aging clinic website

> before committing yourself. It looks like it might be rather

costly.

> Initial labs ~$600

> Initial consult $695

> Program maintenance fee $50/month

> Followup labs 2 to 3 times/year $100 - $300

> Medication $75 to $200/month

>

> Plus they seem to emphasize compounded transdermal products which I

> don't think will do you much good since you've already failed on

> transdermals. I always find it troubling when a doctor steers you

to

> their own pharmacy instead of letting you choose for yourself.

> Assuming you have the money, it might be fine. The good side is

that

> they'll probably have a positive or at least non-negative view of

> testosterone therapy and that's a considerable benefit.

>

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>

> I see a urologist too. He's the 1 who told me I need to be on TRT.

> I went to him after my previous endo did the labs and told me that

> my T was low on them but that I don't need TRT. So when the

> urologist saw the labs he said 100% I need TRT. I then went to

> another endo to get a 2nd opinion on that b/c I felt uncomfortable

> that the previous endo (who is the reviewr for the AACE guidelines)

> and this urologist were looking at the same labs, yet the endo who

> is supposedly the expert told me i don't need trt and the urologist

> told me I absolutely need it. so when i went to the new endo i

> explained the whole situation to him, and he told me that it can't

> hurt trying it but that he doesn't think it's going to take care of

> my symptoms. Now, as I previously posted, he's telling me to stick

> with it for a few more months and then discontinue if no

> improvement. I just emailed him today asking why he's saying that

> the Androgel is working as it should if my T levels are in the low-

> normal range. I'll let y'all know what he says. I did fell great

> for almost 2 weeks when I first started the Androgel, which leads me

> to blv that if my levels were much higher, as they likely were

> during that time period, then maybe this trt could actually help my

> mood symptoms.

>

I think you have a good reason to be optimistic that some or all of

your symptoms will be improved when you get your t level up. If the

AG was in the middle of the range or so, I'd say yeah, wait it out a

few months. But the level is too low. Waiting ain't gonna change

that. And he's not going to escalate your dose even after some

months. He's just going to discontinue your treatment. Apart from

getting copies of your medical records, I see no reason to see that

guy again. Go back to the uro. Show him your labs and explain that

the AG isn't effective in getting your levels up. Ask him to try you

on injections. If it works well, learn to give them to yourself.

My level when diagnosed was 415ng/dl. I felt terrible. Within a week

or so of starting testosterone, I felt much better. The idea that

1ng/dl over the lower limit of the ref range is enough is just a big

pile of crap.

Wing up your energy and call the uro for an appointment asap.

Brad

Brad

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yblog,

You said something very interesting in one of your

posts... " I feel like my personality has been stolen from

me. " That is so suspicious for antidepressent medication

side effects. Your complaints sound very familiar to those

expressed by others I've encountered who take anti-D's.

Since the drugs do cause varying degrees of sexual

dysfunction and are even related occasionally to lower

T levels....Could you speak to you perscribing Doc about

slowly coming off them for a time? Some folks can't. They

need them. It can be dangerous to just stop the meds so

don't even think of trying it without medical supervision.

I definately had depression problems while hyopgonadal. I

tried effexor for 2 years. It did little. My wife, who's a weed

eater uses nothing but homeopathic/natural remedies. She

convinced me to talk to her Doc about weening off the

effexor and trying a simple 50mg. dose of 5HTP twice a

day. What an amazing relief that was! It didn't solve my low

T problem but it did help a lot with anxiety and depression.

Since getting back onto Androgel, I have no need for even the

5HTP now. Being hypo does cause an aray of S/S, including

depression. Within a week I stopped taking the 5H and haven't

looked back. I will say getting through the rough spots was eased

quite a bit by my wife's suggestion. In fact it is she who does

all the research for me since she's a whiz at it. My Uro was

suprised that I wanted my E2 checked but he didn't refuse

at all. He just said no one ever asks for E2 monitoring and

thought my wife was pretty on the ball. My Uro will do about

anything I ask as long as I rationalize my request. Since

keeping E2 within reason lessons the risk of prostate cancer,

in my case the recurrence of....that was all he needed to hear.

Every Doc I encountered at least asked if I felt like I were

depressed. I hadn't felt depressed or anxious using the 5HTP.

What I felt was exhausted, sore joints/muscles, virtually no

libido and generally lousey all over all the time. I began by

using 5gms and felt 100% better than I did but that wasn't

to say I felt 100%. Anything was better than lousey!

Now I use 5gms.in the morning and 5gms around 3-4 in the

afternoon. Been on this routine for 2 weeks now and boy, do

I feel better! I use DIM to keep my E2 under control. So far

so good. Feeling better than I have in a decade.

It's impossible to perfectly balance body chemistry but it

can be kept in better harmony. I couldn't function on a low

of 197-240 but my free was also in the basement too. I

responded to 5 but 10 is more like it for a 49 year old.

I'm not going to check my levels again unless there's a

concern until November. The goal was to function in a

healthy way and so far that goal is being met. I hope you

find the right mix that'll work for you soon.

Be safe,

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I think maybe I have some better advice for you, which is based on what

you've already been told here. Make a list of the doctors in your area,

and call each one and ask if they will offer the treatment you want IF

you test out as hypogonadal. Don't accept a doctor who won't treat you

the way you want. I go to a doctor 1200 miles away because he gives me

the treatment I want (I do weekly t-cyp + hCG). It is a thousand

thousand times worth it - TRT has changed my life. Not to mention which

NOBODY pushes me around anymore. You won't believe how much easier it

makes it to speak up.

Regards,

Louis Nardozi

>> 2d. Re: Need Help with Labs

>> Posted by: " jonnyblog " jonnyblog@... jonnyblog

>> Date: Mon Jun 26, 2006 2:15 pm (PDT)

>>

>> The endo I saw before this 1, who wouldn't agree that I needed to treat my

Low-T, is 1 of the Dr.s whose name is listed as a Reviewer on that AACE link

(http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf)

>> These were the results from the labs that he based his decision on done back

in Feb. and March. Now, are you going to tell me that he knows enough about

Low-T for the AACE to hire him to review their own guidelines, but he was so

misinformed in telling me that I don't have Low-T problems? Maybe he knows

something about all these #s that indicates that My T is not a factor in my

symptoms and that's why I'm still feeling crappy eventhough I got another " top "

endo who agreed to treat me???? Something just doesn't make sense here, and it

seems crazy for me to now go to another endo. I am going to go see these guys

(http://www.antiagingnyc.com/about_us.htm), maybe they'll have a different

strategy that will be more helpful.

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Great Post but I feel very strong about going that long with out testing.

In all the 22 yrs. I have been on TRT I have been tested every 4 to 6 weeks.

Things can go wrong that you will not feel like your blood getting thick, your

liver needs to be watched and DHT can go off the top of the range on gels. I do

get my blood work payed for 100% and for the guys that have to pay then at least

every 90 days have blood work done.

Phil

Vickie or <plp40@...> wrote:

yblog,

You said something very interesting in one of your

posts... " I feel like my personality has been stolen from

me. " That is so suspicious for antidepressent medication

side effects. Your complaints sound very familiar to those

expressed by others I've encountered who take anti-D's.

Since the drugs do cause varying degrees of sexual

dysfunction and are even related occasionally to lower

T levels....Could you speak to you perscribing Doc about

slowly coming off them for a time? Some folks can't. They

need them. It can be dangerous to just stop the meds so

don't even think of trying it without medical supervision.

I definately had depression problems while hyopgonadal. I

tried effexor for 2 years. It did little. My wife, who's a weed

eater uses nothing but homeopathic/natural remedies. She

convinced me to talk to her Doc about weening off the

effexor and trying a simple 50mg. dose of 5HTP twice a

day. What an amazing relief that was! It didn't solve my low

T problem but it did help a lot with anxiety and depression.

Since getting back onto Androgel, I have no need for even the

5HTP now. Being hypo does cause an aray of S/S, including

depression. Within a week I stopped taking the 5H and haven't

looked back. I will say getting through the rough spots was eased

quite a bit by my wife's suggestion. In fact it is she who does

all the research for me since she's a whiz at it. My Uro was

suprised that I wanted my E2 checked but he didn't refuse

at all. He just said no one ever asks for E2 monitoring and

thought my wife was pretty on the ball. My Uro will do about

anything I ask as long as I rationalize my request. Since

keeping E2 within reason lessons the risk of prostate cancer,

in my case the recurrence of....that was all he needed to hear.

Every Doc I encountered at least asked if I felt like I were

depressed. I hadn't felt depressed or anxious using the 5HTP.

What I felt was exhausted, sore joints/muscles, virtually no

libido and generally lousey all over all the time. I began by

using 5gms and felt 100% better than I did but that wasn't

to say I felt 100%. Anything was better than lousey!

Now I use 5gms.in the morning and 5gms around 3-4 in the

afternoon. Been on this routine for 2 weeks now and boy, do

I feel better! I use DIM to keep my E2 under control. So far

so good. Feeling better than I have in a decade.

It's impossible to perfectly balance body chemistry but it

can be kept in better harmony. I couldn't function on a low

of 197-240 but my free was also in the basement too. I

responded to 5 but 10 is more like it for a 49 year old.

I'm not going to check my levels again unless there's a

concern until November. The goal was to function in a

healthy way and so far that goal is being met. I hope you

find the right mix that'll work for you soon.

Be safe,

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Guest guest

Phil,

I am 49 years old and my body has had cancer

twice. This body isn't going to ever be in perfect

balance! Chasing a perfect balance is like chasing

a rainbow...there is no pot of gold in the end. I desire

a good quality of life with a body chemistry that is

in good harmony, not perfect balance....since there

is no such thing! If I find I feel poorly or something

has gone haywire, then I'll go sooner, but I won't be

a slave to test results. Hormones go up and down,

sometimes dramatically in the same 24 hours. While

morning wood may be a few people's way of knowing

their E2 is off, the actual fact of the matter is...morning

wood primarily has to do with bladder fullness, not with

nocturnal erections. Gauging morning erections by how

much of an invasive drug to use sounds like playing with

fire to this coward! You are certainly one to take a challenge.

What works for me is to not be a slave to tests or what

others say is normal. What works for one won't necessarily

work for everyone. In fact labs are age and or size related

in many cases. Life styles, stressors, so may things skew

tests from one day to the next. Comorbidities make a difference

in results...there are a lot of reasons why people are different.

Different is why some will and some won't take to transdermals

for example. Oddly, most TCa patients do well on transdermals.

Wonder why that is?

I would encourage all men to seek a good Urologist who deals

with ED and male disorders then follow up with an Endo. It may

be wise to stick to Doc's directly involved with larger hospitals

rather than small town independent Doc's. They are likely to

be the most up to date on things. nyblog's Doc isn't wrong.

He does need to give it time. 3 months is nothing if it gets things

done. Instead of spending 30+ years sticking needles into tissues

that eventually stop absorbing the drug because tissues turn fibrous,

he needs to try his Doc's idea first. Long term use of shots can

cause tissues to become scarred and fibrous thus reducing the

effectiveness of injectables. That complication was one of reasons

the transdermals were developed. It is also the reason I plan on

using transdermals unless / until they become ineffective. That

can only be determined in time. Air and time are free!

Be safe,

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One thing, I want to sound off about doing the whole baseline thing.

Phil will agree with me on this one that the baseline for T is not

accurate if the patient has been on HRT any length of time. Unless

the H/P axis is restarted using clomid or HcG after meds are stopped

the results fall off the scale. Removing the meds only crashes the

patient since it may take as long as a year for the body to react IF

it does at all. I've been here before - t levels dropped from 560 to

95. Depression and side effects at this level are VERY real! There

are plenty of body builders who've done a cycle of steriods and their

pituitary cease LH and FSH forever. If a doc tells me to stop the

meds it tells me one or two things (or both) - 1- he doesn't know

anything about HRT or 2- he doesn't want to treat me and hope I won't

return.

And that's all I have to say about that.

L

> I think maybe I have some better advice for you, which is based

on what

> you've already been told here. Make a list of the doctors in your

area,

> and call each one and ask if they will offer the treatment you want

IF

> you test out as hypogonadal. Don't accept a doctor who won't treat

you

> the way you want. I go to a doctor 1200 miles away because he gives

me

> the treatment I want (I do weekly t-cyp + hCG). It is a thousand

> thousand times worth it - TRT has changed my life. Not to mention

which

> NOBODY pushes me around anymore. You won't believe how much easier

it

> makes it to speak up.

>

> Regards,

> Louis Nardozi

>

>

> >> 2d. Re: Need Help with Labs

> >> Posted by: " jonnyblog " jonnyblog@... jonnyblog

> >> Date: Mon Jun 26, 2006 2:15 pm (PDT)

> >>

> >> The endo I saw before this 1, who wouldn't agree that I needed

to treat my Low-T, is 1 of the Dr.s whose name is listed as a

Reviewer on that AACE link

(http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf)

> >> These were the results from the labs that he based his decision

on done back in Feb. and March. Now, are you going to tell me that he

knows enough about Low-T for the AACE to hire him to review their own

guidelines, but he was so misinformed in telling me that I don't have

Low-T problems? Maybe he knows something about all these #s that

indicates that My T is not a factor in my symptoms and that's why I'm

still feeling crappy eventhough I got another " top " endo who agreed

to treat me???? Something just doesn't make sense here, and it seems

crazy for me to now go to another endo. I am going to go see these

guys (http://www.antiagingnyc.com/about_us.htm), maybe they'll have a

different strategy that will be more helpful.

>

>

>

>

>

>

>

>

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Guest guest

Yep I am with you on this one.

Phil

patrolbase19 <patrolbase19@...> wrote:

One thing, I want to sound off about doing the whole baseline thing.

Phil will agree with me on this one that the baseline for T is not

accurate if the patient has been on HRT any length of time. Unless

the H/P axis is restarted using clomid or HcG after meds are stopped

the results fall off the scale. Removing the meds only crashes the

patient since it may take as long as a year for the body to react IF

it does at all. I've been here before - t levels dropped from 560 to

95. Depression and side effects at this level are VERY real! There

are plenty of body builders who've done a cycle of steriods and their

pituitary cease LH and FSH forever. If a doc tells me to stop the

meds it tells me one or two things (or both) - 1- he doesn't know

anything about HRT or 2- he doesn't want to treat me and hope I won't

return.

And that's all I have to say about that.

L

> I think maybe I have some better advice for you, which is based

on what

> you've already been told here. Make a list of the doctors in your

area,

> and call each one and ask if they will offer the treatment you want

IF

> you test out as hypogonadal. Don't accept a doctor who won't treat

you

> the way you want. I go to a doctor 1200 miles away because he gives

me

> the treatment I want (I do weekly t-cyp + hCG). It is a thousand

> thousand times worth it - TRT has changed my life. Not to mention

which

> NOBODY pushes me around anymore. You won't believe how much easier

it

> makes it to speak up.

>

> Regards,

> Louis Nardozi

>

>

> >> 2d. Re: Need Help with Labs

> >> Posted by: " jonnyblog " jonnyblog@... jonnyblog

> >> Date: Mon Jun 26, 2006 2:15 pm (PDT)

> >>

> >> The endo I saw before this 1, who wouldn't agree that I needed

to treat my Low-T, is 1 of the Dr.s whose name is listed as a

Reviewer on that AACE link

(http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf)

> >> These were the results from the labs that he based his decision

on done back in Feb. and March. Now, are you going to tell me that he

knows enough about Low-T for the AACE to hire him to review their own

guidelines, but he was so misinformed in telling me that I don't have

Low-T problems? Maybe he knows something about all these #s that

indicates that My T is not a factor in my symptoms and that's why I'm

still feeling crappy eventhough I got another " top " endo who agreed

to treat me???? Something just doesn't make sense here, and it seems

crazy for me to now go to another endo. I am going to go see these

guys (http://www.antiagingnyc.com/about_us.htm), maybe they'll have a

different strategy that will be more helpful.

>

>

>

>

>

>

>

>

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Guest guest

nice to hear a voice of reason. i'm sure this is what my Dr.s have

in mind. I guess I'll stick it out a little longer and then

commadeer the situation when all else fails.

>

> Phil,

>

> I am 49 years old and my body has had cancer

> twice. This body isn't going to ever be in perfect

> balance! Chasing a perfect balance is like chasing

> a rainbow...there is no pot of gold in the end. I desire

> a good quality of life with a body chemistry that is

> in good harmony, not perfect balance....since there

> is no such thing! If I find I feel poorly or something

> has gone haywire, then I'll go sooner, but I won't be

> a slave to test results. Hormones go up and down,

> sometimes dramatically in the same 24 hours. While

> morning wood may be a few people's way of knowing

> their E2 is off, the actual fact of the matter is...morning

> wood primarily has to do with bladder fullness, not with

> nocturnal erections. Gauging morning erections by how

> much of an invasive drug to use sounds like playing with

> fire to this coward! You are certainly one to take a challenge.

>

> What works for me is to not be a slave to tests or what

> others say is normal. What works for one won't necessarily

> work for everyone. In fact labs are age and or size related

> in many cases. Life styles, stressors, so may things skew

> tests from one day to the next. Comorbidities make a difference

> in results...there are a lot of reasons why people are different.

> Different is why some will and some won't take to transdermals

> for example. Oddly, most TCa patients do well on transdermals.

> Wonder why that is?

>

> I would encourage all men to seek a good Urologist who deals

> with ED and male disorders then follow up with an Endo. It may

> be wise to stick to Doc's directly involved with larger hospitals

> rather than small town independent Doc's. They are likely to

> be the most up to date on things. nyblog's Doc isn't wrong.

> He does need to give it time. 3 months is nothing if it gets

things

> done. Instead of spending 30+ years sticking needles into tissues

> that eventually stop absorbing the drug because tissues turn

fibrous,

> he needs to try his Doc's idea first. Long term use of shots can

> cause tissues to become scarred and fibrous thus reducing the

> effectiveness of injectables. That complication was one of reasons

> the transdermals were developed. It is also the reason I plan on

> using transdermals unless / until they become ineffective. That

> can only be determined in time. Air and time are free!

> Be safe,

>

>

>

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