Re: Androgel Failure, Injections -- Questions and Ideas

[Guest guest]

:

Just curious have you ever tried a compounded testosterone cream. When I was

using a

10% cream and putting it on the inside of my wrists, I could get 1100 plus

levels of total T.

However, when I was on two packets of 5 gm androgel per day, I was lucky to get

half that

level. In addition, the creams were much gentler on my skin, and my out of

pocket cost

was roughly the same. However, my new health plan views compounding pharmacy

drugs

as experimentla medicine, so they do not contribute to the cost of the creams.

This clearly

has more to do with big pharmacuitical companies and their proffits more so than

affordable treatment that really works.

Given your other health condition, what does your doctor think of using

implantable

pellets? Some people consider this to be old fashioned HRT, but after having

been on

pellets, I must say that it works well. The release rate is very steady--more

so than any

other form of TRT, and you dont get as much aromitizatoin to DHT and E2 compared

to

putting androgel on your shoulders and arms.

[Guest guest]

Question:

    I have been moving the around androgel around the body.  I started on the

shoulder but absorption was poor.   I heard that body fat hinders absorption. 

So I have tried my lean inner thigh, and backside of the knee to the ankle.

  Any wisdom or success from trying other areas?

Justus

Re: Androgel Failure, Injections -- Questions and Ideas

:

Just curious have you ever tried a compounded testosterone cream. When I was

using a

10% cream and putting it on the inside of my wrists, I could get 1100 plus

levels of total T.

However, when I was on two packets of 5 gm androgel per day, I was lucky to get

half that

level. In addition, the creams were much gentler on my skin, and my out of

pocket cost

was roughly the same. However, my new health plan views compounding pharmacy

drugs

as experimentla medicine, so they do not contribute to the cost of the creams.

This clearly

has more to do with big pharmacuitical companies and their proffits more so than

affordable treatment that really works.

Given your other health condition, what does your doctor think of using

implantable

pellets? Some people consider this to be old fashioned HRT, but after having

been on

pellets, I must say that it works well. The release rate is very steady--more so

than any

other form of TRT, and you dont get as much aromitizatoin to DHT and E2 compared

to

putting androgel on your shoulders and arms.

[Guest guest]

Can you try Clomid or get the compounded creams they dan make this 2x's stronger

then 10 grams of gel.

Have your Dr. call this link you put the cream on your forearms and no where

near as big of an area to cover. I was on 10% testo cream with 50mgs of DHEA in

it doing I think 150mgs a day. My levels were always good to bad when the gels

come out my health care would not pay for it anymore.

Co-Moderator

Phil

> From: Fadden <fadden@...>

> Subject: Androgel Failure, Injections -- Questions and Ideas

>

> Date: Monday, October 13, 2008, 12:29 AM

> Many of us have experienced the gradual failure of Androgel

> to

> maintain serum levels of testosterone after years of use.

> I am now

> experiencing that problem after having used Androgel

> successfully for

> over 5 years. In the last two years my T levels have

> declined from

> around 800 ng/dl on 6 pumps (7.5 GM) Androgel daily, to

> around 250

> ng/dl on 8 pumps (10 GM daily). My doctor has now

> prescribed 12

> pumps (15 GM) but I am doubtful that's going to give

> any better

> results. Even on 12 pumps I feel lousy, so I'm sure my

> T is still

> low.

>

> Now the obvious answer would be to go to injections.

> However I have

> a history of endocarditis (bacterial infection of the heart

> valves)

> which was caused by a gangrenous gallbladder. My

> endocarditis was

> not caused by the injections; but a history of endocarditis

> makes

> intramuscular injections a bit risky, since any infection

> could

> spread the the heart and be fatal.

>

> I did do injections for about 10 years (before my

> endocarditis

> episode) and we are considering going back to them, but due

> to the

> risk in my case I might want to try other approaches first.

>

> Questions:

>

> 1. Has anyone on Androgel who has found their levels

> declining been

> able to get the levels back up by changing the site of

> application? For example, I am now doing belly and

> shoulders. Would it help to apply the Androgel to my

> thighs instead?

>

> 2. Has anyone whose Androgel failed gotten good results

> from

> anything other than i.m. testosterone, eg. patches, buccal

> (Straint)

> or even HCG alone? (HCG injections would not pose as much

> risk for

> me as they are not intramuscular.)

>

> If it makes any difference, my hypogonadism is tertiary: my

>

> hypothalamus doesn't put out GnRH, hence no LH/FSH,

> hence no

> Testosterone. Without treatment my T levels are below 100

> ng/dl.

>

> 3. Has anyone doing testosterone injections had an

> infection from

> them? I noticed that Groh mentioned he developed

> cellulitis. I

> did injections for 10 years without any problem, but

> it's a little

> more risky for me now. (It's not risky for most guys,

> just possibly

> those of us who have had endocarditis.)

>

> Finally, I thought I'd share a theory I have about why

> Androgel may

> stop working. I know some guys have mentioned skin

> thickening -- and

> that could be one cause. But I have not noticed a change

> in skin

> quality, so that led me to some other ideas. I should

> mention that I

> have a degree in Biochemistry and even published a paper or

> two on

> drug metabolism (before my own health fell apart), so

> I'm on somewhat

> familiar ground.

>

> What I think might be happening is this: Skin cells

> contain the

> various enzymes that metabolism and break down

> testosterone:

> aromatase, 5-alpha-reductase and others down the line that

> convert T

> to estrogen or DHT and then to inactive compounds.

> Furthermore it

> appears that these enzymes may be inducible. That is to

> say

> exposure to T may increase the activity of the enzymes that

> break it

> down. Now when you put Androgel on your skin you are

> exposing the

> skin cells to concentrated levels of T that are possibly

> thousands of

> times higher than normal. It may be that in time this

> induces the

> skin cells to have an exaggerated ability to break down

> testosterone. Thus the testosterone in the Androgel is

> destroyed by

> the action of the skin cells before it can penetrate to the

>

> bloodstream.

>

> Nice theory perhaps, but it doesn't necessarily solve

> the

> problem. Maybe one could apply Androgel with some kind of

> topical

> aromatase inhibitor and 5-alpha-reductase inhibitor in high

>

> concentrations, but I'm not sure that's practical.

> So that brings

> me back to the idea of changing application sites. Or the

> alternative of injections.

>

> Any comments would be appreciated.

>

> Thanks,

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

Compounded testosterone cream is an excellent suggestion. I did not

realize compounding pharmacies made a 10% cream. At that strength

some of it may actually get through my skin. How much of the cream

did you use per day?

The cost is a drawback, as insurance probably won't pay for it, but

I've got to get my T levels back even if I go broke. I can't believe

how tired I am.

As for the pellets, I read an article that cited a 0.6-4.0% rate of

infection at the site of the pellet implantation. So I am not sure

that would be an improvement over injections as far as infection

risk.

If Nebido ever comes on the market in the US, that might be good for

me as one only needs to inject it every 10 weeks or so.

Thanks for the reply,

At 04:11 AM 10/13/2008, sbryant511 wrote:

>Just curious have you ever tried a compounded testosterone cream.

>When I was using a

>10% cream and putting it on the inside of my wrists, I could get

>1100 plus levels of total T.

>However, when I was on two packets of 5 gm androgel per day, I was

>lucky to get half that

>level. In addition, the creams were much gentler on my skin, and my

>out of pocket cost

>was roughly the same. However, my new health plan views compounding

>pharmacy drugs

>as experimentla medicine, so they do not contribute to the cost of

>the creams. This clearly

>has more to do with big pharmacuitical companies and their proffits

>more so than

>affordable treatment that really works.

>

>Given your other health condition, what does your doctor think of

>using implantable

>pellets? Some people consider this to be old fashioned HRT, but

>after having been on

>pellets, I must say that it works well. The release rate is very

>steady--more so than any

>other form of TRT, and you dont get as much aromitizatoin to DHT and

>E2 compared to

>putting androgel on your shoulders and arms.

[Guest guest]

Justus,

Did you get any better levels from thigh and leg application than you

did with the shoulder?

At 06:03 AM 10/13/2008, Verily Light wrote:

>Question:

>

> I have been moving the around androgel around the body. I

> started on the shoulder but absorption was poor. I heard that

> body fat hinders absorption. So I have tried my lean inner thigh,

> and backside of the knee to the ankle.

>

> Any wisdom or success from trying other areas?

[Guest guest]

Gel sort of worked for me. I don't have labs to validate that,

but it was too expensive for me, even with insurance covering

some of it. It costs $60 for 10 ml of 200mg/ml depot testosterone

from Strohecker's in Portland, including shipping. For me, that

is less than a dollar a day. I get a hell of a lot more out of TRT

than I would the small cup of drip coffee that would buy me.

As long as you are using sterile syringes and using alcohol

swabs on the vial and the injection site, infection risk is very low.

I don't mind poking myself twice a week for that. The 10% cream

is about $400 for 3 months with a volume discount from my

compounding pharmacy.

It is too bad we can't use a DMSO delivery system to deliver

esterfied testosterone directly through the skin. We probably

can, but there is no research or documentation on it. Probably

the makers of syringes would lobby against that as an option.

-Mike

>

>

>

> Many of us have experienced the gradual failure of Androgel to

> maintain serum levels of testosterone after years of use. I am now

> experiencing that problem after having used Androgel successfully for

> over 5 years. In the last two years my T levels have declined from

> around 800 ng/dl on 6 pumps (7.5 GM) Androgel daily, to around 250

> ng/dl on 8 pumps (10 GM daily). My doctor has now prescribed 12

> pumps (15 GM) but I am doubtful that's going to give any better

> results. Even on 12 pumps I feel lousy, so I'm sure my T is still

> low.

>

> Now the obvious answer would be to go to injections. However I have

> a history of endocarditis (bacterial infection of the heart valves)

> which was caused by a gangrenous gallbladder. My endocarditis was

> not caused by the injections; but a history of endocarditis makes

> intramuscular injections a bit risky, since any infection could

> spread the the heart and be fatal.

>

> I did do injections for about 10 years (before my endocarditis

> episode) and we are considering going back to them, but due to the

> risk in my case I might want to try other approaches first.

>

> Questions:

>

> 1. Has anyone on Androgel who has found their levels declining been

> able to get the levels back up by changing the site of

> application? For example, I am now doing belly and

> shoulders. Would it help to apply the Androgel to my thighs instead?

>

> 2. Has anyone whose Androgel failed gotten good results from

> anything other than i.m. testosterone, eg. patches, buccal (Straint)

> or even HCG alone? (HCG injections would not pose as much risk for

> me as they are not intramuscular.)

>

> If it makes any difference, my hypogonadism is tertiary: my

> hypothalamus doesn't put out GnRH, hence no LH/FSH, hence no

> Testosterone. Without treatment my T levels are below 100 ng/dl.

>

> 3. Has anyone doing testosterone injections had an infection from

> them? I noticed that Groh mentioned he developed cellulitis. I

> did injections for 10 years without any problem, but it's a little

> more risky for me now. (It's not risky for most guys, just possibly

> those of us who have had endocarditis.)

>

> Finally, I thought I'd share a theory I have about why Androgel may

> stop working. I know some guys have mentioned skin thickening -- and

> that could be one cause. But I have not noticed a change in skin

> quality, so that led me to some other ideas. I should mention that I

> have a degree in Biochemistry and even published a paper or two on

> drug metabolism (before my own health fell apart), so I'm on somewhat

> familiar ground.

>

> What I think might be happening is this: Skin cells contain the

> various enzymes that metabolism and break down testosterone:

> aromatase, 5-alpha-reductase and others down the line that convert T

> to estrogen or DHT and then to inactive compounds. Furthermore it

> appears that these enzymes may be inducible. That is to say

> exposure to T may increase the activity of the enzymes that break it

> down. Now when you put Androgel on your skin you are exposing the

> skin cells to concentrated levels of T that are possibly thousands of

> times higher than normal. It may be that in time this induces the

> skin cells to have an exaggerated ability to break down

> testosterone. Thus the testosterone in the Androgel is destroyed by

> the action of the skin cells before it can penetrate to the

> bloodstream.

>

> Nice theory perhaps, but it doesn't necessarily solve the

> problem. Maybe one could apply Androgel with some kind of topical

> aromatase inhibitor and 5-alpha-reductase inhibitor in high

> concentrations, but I'm not sure that's practical. So that brings

> me back to the idea of changing application sites. Or the

> alternative of injections.

>

> Any comments would be appreciated.

>

> Thanks,

>

>

>

[Guest guest]

Phil,

The compounded cream is definitely something for me to look at. You

mentioned a link, but I don't see one in your post. If you could

direct me to a link that would be great. (There is a link on the

group page to the Signature Compounding Pharmacy, but the link no

longer leads to the pharmacy page.)

Clomid is also very interesting to me. It would be nice to get my

testes to make their own T as they used to once upon a time. And a

pill is easy to take. My main concern about Clomid regards the

vision problems that sometimes occur. I already have poor sight in

one eye due to amblyopia. Don't want to risk making things worse. I

wish I had a better idea how common (or how rare) these eye problems

are with Clomid. Some things I read give me the impression that it

is an extremely rare side effect, but other sources seem to say it's

not so rare. Also in most cases eye problems seem to resolve after

stopping Clomid, but not always. If I had a better idea of the

degree of risk it would be easier to decide whether to chance it.

By the way, Phil I am glad you were one of those who answered my post

for this reason: I'm mostly a lurker here, but this gives me the

opportunity to commend you on the work you do keeping this list

going. You have the gratitude and respect of a lot of guys out here.

At 01:10 PM 10/13/2008, philip georgian wrote:

>Can you try Clomid or get the compounded creams they dan make this

>2x's stronger then 10 grams of gel.

>Have your Dr. call this link you put the cream on your forearms and

>no where near as big of an area to cover. I was on 10% testo cream

>with 50mgs of DHEA in it doing I think 150mgs a day. My levels were

>always good to bad when the gels come out my health care would not

>pay for it anymore.

>

>Co-Moderator

>Phil

[Guest guest]

,

The way they did this for me was I would start at what 15 grams of Androgel

would be do labs every 4 to 6 weeks and every time you refill It have them make

it stronger until you get the levels you need. Also you don't get the high

levels of DHT like you would with gels you us a smaller area to put on the

cream. The cream is cheap less then the cost of shots. And less converson into

Estradiol.

Nebido is not what they say it is the guys I talk to in the UK don't like it it

is only good for 3 to 5 weeks not 12 like the clam. I feel pellets are the

highest cost of TRT there is and you can't find a good Dr. that will give you

enough pellets to last 3 to 4 months. And you still might have a problem then

need to inplant the pellets under your skin.

Co-Moderator

Phil

> >Just curious have you ever tried a compounded

> testosterone cream.

> >When I was using a

> >10% cream and putting it on the inside of my wrists, I

> could get

> >1100 plus levels of total T.

> >However, when I was on two packets of 5 gm androgel per

> day, I was

> >lucky to get half that

> >level. In addition, the creams were much gentler on my

> skin, and my

> >out of pocket cost

> >was roughly the same. However, my new health plan views

> compounding

> >pharmacy drugs

> >as experimentla medicine, so they do not contribute to

> the cost of

> >the creams. This clearly

> >has more to do with big pharmacuitical companies and

> their proffits

> >more so than

> >affordable treatment that really works.

> >

> >Given your other health condition, what does your

> doctor think of

> >using implantable

> >pellets? Some people consider this to be old fashioned

> HRT, but

> >after having been on

> >pellets, I must say that it works well. The release

> rate is very

> >steady--more so than any

> >other form of TRT, and you dont get as much

> aromitizatoin to DHT and

> >E2 compared to

> >putting androgel on your shoulders and arms.

>

>

> ------------------------------------

>

>

[Guest guest]

Mike I do DMSO to try to help with my low iron levels did labs after using it

and my dam Iron levels went down. So the DMSO did not work.

Co-Moderator

Phil

> From: Mike Lawson <mlawson66@...>

> Subject: Re: Androgel Failure, Injections -- Questions and

Ideas

>

> Date: Monday, October 13, 2008, 4:33 PM

> Gel sort of worked for me. I don't have labs to

> validate that,

> but it was too expensive for me, even with insurance

> covering

> some of it. It costs $60 for 10 ml of 200mg/ml depot

> testosterone

> from Strohecker's in Portland, including shipping. For

> me, that

> is less than a dollar a day. I get a hell of a lot more

> out of TRT

> than I would the small cup of drip coffee that would buy

> me.

> As long as you are using sterile syringes and using alcohol

> swabs on the vial and the injection site, infection risk is

> very low.

> I don't mind poking myself twice a week for that. The

> 10% cream

> is about $400 for 3 months with a volume discount from my

> compounding pharmacy.

>

> It is too bad we can't use a DMSO delivery system to

> deliver

> esterfied testosterone directly through the skin. We

> probably

> can, but there is no research or documentation on it.

> Probably

> the makers of syringes would lobby against that as an

> option.

>

> -Mike

>

>

> >

> >

> >

> > Many of us have experienced the gradual failure of

> Androgel to

> > maintain serum levels of testosterone after years of

> use. I am now

> > experiencing that problem after having used Androgel

> successfully for

> > over 5 years. In the last two years my T levels have

> declined from

> > around 800 ng/dl on 6 pumps (7.5 GM) Androgel daily,

> to around 250

> > ng/dl on 8 pumps (10 GM daily). My doctor has now

> prescribed 12

> > pumps (15 GM) but I am doubtful that's going to

> give any better

> > results. Even on 12 pumps I feel lousy, so I'm

> sure my T is still

> > low.

> >

> > Now the obvious answer would be to go to injections.

> However I have

> > a history of endocarditis (bacterial infection of the

> heart valves)

> > which was caused by a gangrenous gallbladder. My

> endocarditis was

> > not caused by the injections; but a history of

> endocarditis makes

> > intramuscular injections a bit risky, since any

> infection could

> > spread the the heart and be fatal.

> >

> > I did do injections for about 10 years (before my

> endocarditis

> > episode) and we are considering going back to them,

> but due to the

> > risk in my case I might want to try other approaches

> first.

> >

> > Questions:

> >

> > 1. Has anyone on Androgel who has found their levels

> declining been

> > able to get the levels back up by changing the site of

>

> > application? For example, I am now doing belly and

> > shoulders. Would it help to apply the Androgel to my

> thighs instead?

> >

> > 2. Has anyone whose Androgel failed gotten good

> results from

> > anything other than i.m. testosterone, eg. patches,

> buccal (Straint)

> > or even HCG alone? (HCG injections would not pose as

> much risk for

> > me as they are not intramuscular.)

> >

> > If it makes any difference, my hypogonadism is

> tertiary: my

> > hypothalamus doesn't put out GnRH, hence no

> LH/FSH, hence no

> > Testosterone. Without treatment my T levels are below

> 100 ng/dl.

> >

> > 3. Has anyone doing testosterone injections had an

> infection from

> > them? I noticed that Groh mentioned he developed

> cellulitis. I

> > did injections for 10 years without any problem, but

> it's a little

> > more risky for me now. (It's not risky for most

> guys, just possibly

> > those of us who have had endocarditis.)

> >

> > Finally, I thought I'd share a theory I have about

> why Androgel may

> > stop working. I know some guys have mentioned skin

> thickening -- and

> > that could be one cause. But I have not noticed a

> change in skin

> > quality, so that led me to some other ideas. I should

> mention that I

> > have a degree in Biochemistry and even published a

> paper or two on

> > drug metabolism (before my own health fell apart), so

> I'm on somewhat

> > familiar ground.

> >

> > What I think might be happening is this: Skin cells

> contain the

> > various enzymes that metabolism and break down

> testosterone:

> > aromatase, 5-alpha-reductase and others down the line

> that convert T

> > to estrogen or DHT and then to inactive compounds.

> Furthermore it

> > appears that these enzymes may be inducible. That is

> to say

> > exposure to T may increase the activity of the enzymes

> that break it

> > down. Now when you put Androgel on your skin you are

> exposing the

> > skin cells to concentrated levels of T that are

> possibly thousands of

> > times higher than normal. It may be that in time this

> induces the

> > skin cells to have an exaggerated ability to break

> down

> > testosterone. Thus the testosterone in the Androgel

> is destroyed by

> > the action of the skin cells before it can penetrate

> to the

> > bloodstream.

> >

> > Nice theory perhaps, but it doesn't necessarily

> solve the

> > problem. Maybe one could apply Androgel with some

> kind of topical

> > aromatase inhibitor and 5-alpha-reductase inhibitor in

> high

> > concentrations, but I'm not sure that's

> practical. So that brings

> > me back to the idea of changing application sites. Or

> the

> > alternative of injections.

> >

> > Any comments would be appreciated.

> >

> > Thanks,

> >

> >

> >

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

,

Thanks it feels good to hear that. Yes you need to try clomid even if you have

been on TRT with your testis shut down for yrs. they will come back on line

right away. Mine did with I added HCG to my T shots after 23 yrs. my testis

were the size of small grapes now they are full again. I am sorry some times I

do that post about a link and forget to put it in.

http://www.collegepharmacy.com/menshealth/andropause.asp

College Pharmacy is dam good and will work with your Dr. even help him and talk

you if you have a problem. As for Clomid keep an eye out for the sides we have

guys hear that do only clomid.

Co-Moderator

Phil

>

> >Can you try Clomid or get the compounded creams they

> dan make this

> >2x's stronger then 10 grams of gel.

> >Have your Dr. call this link you put the cream on your

> forearms and

> >no where near as big of an area to cover. I was on 10%

> testo cream

> >with 50mgs of DHEA in it doing I think 150mgs a day. My

> levels were

> >always good to bad when the gels come out my health

> care would not

> >pay for it anymore.

> >

> >Co-Moderator

> >Phil

>

>

> ------------------------------------

>

>

[Guest guest]

Maybe iron is too big to transport in that way.

I know that DMSO will transport B12, and I've

read studies about it being used to transport

estradiol, so I'm sure that it would work

with esterfied testosterone, but I'm not sure

about the oil that it is suspended in, and I

don't want to get on some watch list by

ordering the powder for an expirement...

Sorry it didn't work for the iron. I'm still

using it for B12 and it seems to work for

that. If I'm sick or something, I'll also do

a B12 shot. It seems to help. That's what

my old doc would do when I was growing

up.

Do you also have B12 anemia, or just iron?

They are both nasty. I'm finally getting

ahead of the iron problem. In addition

to the supplements, I cook in cast iron.

Anything slightly acidic will grab iron right

off of the pot and get it into your system.

There's a statistic to support that, but

I'd have to dig for it.

Well, I hope you get that iron level

and your thyroid levels up where they need

to be for you to feel good.

-Mike

> > >

> > >

> > >

> > > Many of us have experienced the gradual failure of

> > Androgel to

> > > maintain serum levels of testosterone after years of

> > use. I am now

> > > experiencing that problem after having used Androgel

> > successfully for

> > > over 5 years. In the last two years my T levels have

> > declined from

> > > around 800 ng/dl on 6 pumps (7.5 GM) Androgel daily,

> > to around 250

> > > ng/dl on 8 pumps (10 GM daily). My doctor has now

> > prescribed 12

> > > pumps (15 GM) but I am doubtful that's going to

> > give any better

> > > results. Even on 12 pumps I feel lousy, so I'm

> > sure my T is still

> > > low.

> > >

> > > Now the obvious answer would be to go to injections.

> > However I have

> > > a history of endocarditis (bacterial infection of the

> > heart valves)

> > > which was caused by a gangrenous gallbladder. My

> > endocarditis was

> > > not caused by the injections; but a history of

> > endocarditis makes

> > > intramuscular injections a bit risky, since any

> > infection could

> > > spread the the heart and be fatal.

> > >

> > > I did do injections for about 10 years (before my

> > endocarditis

> > > episode) and we are considering going back to them,

> > but due to the

> > > risk in my case I might want to try other approaches

> > first.

> > >

> > > Questions:

> > >

> > > 1. Has anyone on Androgel who has found their levels

> > declining been

> > > able to get the levels back up by changing the site of

> >

> > > application? For example, I am now doing belly and

> > > shoulders. Would it help to apply the Androgel to my

> > thighs instead?

> > >

> > > 2. Has anyone whose Androgel failed gotten good

> > results from

> > > anything other than i.m. testosterone, eg. patches,

> > buccal (Straint)

> > > or even HCG alone? (HCG injections would not pose as

> > much risk for

> > > me as they are not intramuscular.)

> > >

> > > If it makes any difference, my hypogonadism is

> > tertiary: my

> > > hypothalamus doesn't put out GnRH, hence no

> > LH/FSH, hence no

> > > Testosterone. Without treatment my T levels are below

> > 100 ng/dl.

> > >

> > > 3. Has anyone doing testosterone injections had an

> > infection from

> > > them? I noticed that Groh mentioned he developed

> > cellulitis. I

> > > did injections for 10 years without any problem, but

> > it's a little

> > > more risky for me now. (It's not risky for most

> > guys, just possibly

> > > those of us who have had endocarditis.)

> > >

> > > Finally, I thought I'd share a theory I have about

> > why Androgel may

> > > stop working. I know some guys have mentioned skin

> > thickening -- and

> > > that could be one cause. But I have not noticed a

> > change in skin

> > > quality, so that led me to some other ideas. I should

> > mention that I

> > > have a degree in Biochemistry and even published a

> > paper or two on

> > > drug metabolism (before my own health fell apart), so

> > I'm on somewhat

> > > familiar ground.

> > >

> > > What I think might be happening is this: Skin cells

> > contain the

> > > various enzymes that metabolism and break down

> > testosterone:

> > > aromatase, 5-alpha-reductase and others down the line

> > that convert T

> > > to estrogen or DHT and then to inactive compounds.

> > Furthermore it

> > > appears that these enzymes may be inducible. That is

> > to say

> > > exposure to T may increase the activity of the enzymes

> > that break it

> > > down. Now when you put Androgel on your skin you are

> > exposing the

> > > skin cells to concentrated levels of T that are

> > possibly thousands of

> > > times higher than normal. It may be that in time this

> > induces the

> > > skin cells to have an exaggerated ability to break

> > down

> > > testosterone. Thus the testosterone in the Androgel

> > is destroyed by

> > > the action of the skin cells before it can penetrate

> > to the

> > > bloodstream.

> > >

> > > Nice theory perhaps, but it doesn't necessarily

> > solve the

> > > problem. Maybe one could apply Androgel with some

> > kind of topical

> > > aromatase inhibitor and 5-alpha-reductase inhibitor in

> > high

> > > concentrations, but I'm not sure that's

> > practical. So that brings

> > > me back to the idea of changing application sites. Or

> > the

> > > alternative of injections.

> > >

> > > Any comments would be appreciated.

> > >

> > > Thanks,

> > >

> > >

> > >

> >

> >

> >

> >

> > ------------------------------------

> >

> >

[Guest guest]

I agree, Phil does an awesome job here!

About the clomid, the side effects are very dose dependent. 25 mg is much safer

than 50.

You can also do some things to help protect your optic nerve. Lutein, and other

antioxidants will help with this too.

Clomid has helped me a lot and so has HCG.

If you are really worried, you can take it in cycles. That would further

reduce your risk.

-Mike

> >

> > >Can you try Clomid or get the compounded creams they

> > dan make this

> > >2x's stronger then 10 grams of gel.

> > >Have your Dr. call this link you put the cream on your

> > forearms and

> > >no where near as big of an area to cover. I was on 10%

> > testo cream

> > >with 50mgs of DHEA in it doing I think 150mgs a day. My

> > levels were

> > >always good to bad when the gels come out my health

> > care would not

> > >pay for it anymore.

> > >

> > >Co-Moderator

> > >Phil

> >

> >

> > ------------------------------------

> >

> >

[Guest guest]

,

 

Using my lower leg is the best for me.  It is night and day for me.  I would

never go back to arms or shoulders.  Lower legs and underside of the knee and

ankle make feel like I have 2 times the T in my system.   I don't get muscle

pain after a long day nor do I get that 'I forgot my wallet feeling' either. And

especially I don't myself withering.

 

I feel whole! I feel complete.  I feel fully stable.  Not just mentally but

physically.  

 

Justus

Re: Re: Androgel Failure, Injections -- Questions and

Ideas

Justus,

Did you get any better levels from thigh and leg application than you

did with the shoulder?

At 06:03 AM 10/13/2008, Verily Light wrote:

>Question:

>

> I have been moving the around androgel around the body. I

> started on the shoulder but absorption was poor. I heard that

> body fat hinders absorption. So I have tried my lean inner thigh,

> and backside of the knee to the ankle.

>

> Any wisdom or success from trying other areas?

[Guest guest]

Hello Group , I am P from Staten Island NY. xxy-47 I have been doing

self injections since I am thirteen yrs old. I am thirty nine now and every

time I inject it in my butt it still hurts. The Dr. told me I can also inject

it

in my leg. One day I will try that.

JP

**************New MapQuest Local shows what's happening at your destination.

Dining, Movies, Events, News & more. Try it out

(http://local.mapquest.com/?ncid=emlcntnew00000002)

[Guest guest]

I'm not as flexible as I was as a youngster. I don't know about

getting right behind the knee. I can certainly reach my calves.

Any luck there?

>

> >Question:

> >

> > I have been moving the around androgel around the body. I

> > started on the shoulder but absorption was poor. I heard that

> > body fat hinders absorption. So I have tried my lean inner thigh,

> > and backside of the knee to the ankle.

> >

> > Any wisdom or success from trying other areas?

>

>

>

>

>

>

>

[Guest guest]

Wups, I'm not awake yet. If this was about gel application, I withdraw the

question. If it is about injection sites, I would very much like to know.

Thanks,

-Mike

>

> >Question:

> >

> > I have been moving the around androgel around the body. I

> > started on the shoulder but absorption was poor. I heard that

> > body fat hinders absorption. So I have tried my lean inner thigh,

> > and backside of the knee to the ankle.

> >

> > Any wisdom or success from trying other areas?

>

>

>

>

>

>

>

[Guest guest]

Years ago when I first got sick my family Dr. at the time told me I am anemic

and put me on some strong Iron pills after doing them for months and my levels

not coming up very high. He wanted to give me Iron shots so I went to see a

Blood Dr. but this guy was foreign and I could not understand a thing he said.

Anyway he redid my labs and told me I don't have low iron. Now 23 yrs later I

test my Ferritin and it came back below normal. My Dr. put me on this brand of

Iron pills doing 2 a day.

Ferrous Fumarate 324 mg - 106 mg Elemental Iron , Croscarmellose Sodium ,

Magnesium Stearate , Microcystalline Cellulose , Pharmaceutical Glaze ,

Pregelatinized Starch , Sodium Lauryl Sulfate , Sodium Starch Glycolate , Silica

, Stearic Acid , Talc

When I went to do labs my Dr. told me to stop them 5 to 7 days before doing the

labs or the test will show high. This is when I realized the Blood Dr. I had

seen did not tell me to do this and this my Dr. says is why he said my labs were

good and I don't have low Iron. So now I feel my Iron has been low all these

yr.'s.

It might be that the DMSO did not work because 2 months before I tried DMSO my

Dr. lowered my dose of Iron pills from 2 to one a day and my Ferritin and Total

Iron levels started coming down. Maybe I was not on enough for he DMSO to free

up. I am back on 2 pills a day as of last Tue. when my labs come back lower.

I am sure my B-12 has been low but don't have labs that show it my Dr. did test

my Folate RBC 2 months ago and it came back below normal and I read this can

cause low Iron. And I was on Folaic Acid when I first tested it. My Dr. told

me my body in not converting the Folaic Acid and I need to take the converted

brand. I got this Thorne Research - Folacal and my labs last Tue come back up

in the mid range. But I read it can take months on this to feel the effects of

it working.

I am going to mix up more DMSO today what can it hurt and use it 2 x's a week.

Here is what the Phd. says about DMSO and Anemia from this link.

http://www.krysalis.net/anemia.htm

=========================================================================

The combination of DMSO, the DMSO-B12 + folic acid solution, along with iron as

a separate oral supplement, should provide a multi-dimensional treatment of

anemia that would be more effective than iron alone. The DMSO would provide

immediate relief by directly assisting with oxygen transport and a longer-term

benefit of helping with the transport of iron from the intestine to the bone

marrow. The DMSO-B12 + folic acid solution will provide the B12 and folic acid

necessary for proper maturation of red blood cells. Iron supplements will insure

sufficient iron to make hemoglobin. A good multi-vitamin supplement such as

SPARX is recommended to ensure a complete vitamin balance.

Co-Moderator

Phil

> From: Mike Lawson <mlawson66@...>

> Subject: Re: Androgel Failure, Injections -- Questions and

Ideas

>

> Date: Monday, October 13, 2008, 8:35 PM

> Maybe iron is too big to transport in that way.

>

> I know that DMSO will transport B12, and I've

> read studies about it being used to transport

> estradiol, so I'm sure that it would work

> with esterfied testosterone, but I'm not sure

> about the oil that it is suspended in, and I

> don't want to get on some watch list by

> ordering the powder for an expirement...

>

> Sorry it didn't work for the iron. I'm still

> using it for B12 and it seems to work for

> that. If I'm sick or something, I'll also do

> a B12 shot. It seems to help. That's what

> my old doc would do when I was growing

> up.

>

> Do you also have B12 anemia, or just iron?

> They are both nasty. I'm finally getting

> ahead of the iron problem. In addition

> to the supplements, I cook in cast iron.

> Anything slightly acidic will grab iron right

> off of the pot and get it into your system.

>

> There's a statistic to support that, but

> I'd have to dig for it.

>

> Well, I hope you get that iron level

> and your thyroid levels up where they need

> to be for you to feel good.

>

> -Mike

>

>

>

> > > >

> > > >

> > > >

> > > > Many of us have experienced the gradual

> failure of

> > > Androgel to

> > > > maintain serum levels of testosterone after

> years of

> > > use. I am now

> > > > experiencing that problem after having used

> Androgel

> > > successfully for

> > > > over 5 years. In the last two years my T

> levels have

> > > declined from

> > > > around 800 ng/dl on 6 pumps (7.5 GM)

> Androgel daily,

> > > to around 250

> > > > ng/dl on 8 pumps (10 GM daily). My doctor

> has now

> > > prescribed 12

> > > > pumps (15 GM) but I am doubtful that's

> going to

> > > give any better

> > > > results. Even on 12 pumps I feel lousy, so

> I'm

> > > sure my T is still

> > > > low.

> > > >

> > > > Now the obvious answer would be to go to

> injections.

> > > However I have

> > > > a history of endocarditis (bacterial

> infection of the

> > > heart valves)

> > > > which was caused by a gangrenous

> gallbladder. My

> > > endocarditis was

> > > > not caused by the injections; but a history

> of

> > > endocarditis makes

> > > > intramuscular injections a bit risky, since

> any

> > > infection could

> > > > spread the the heart and be fatal.

> > > >

> > > > I did do injections for about 10 years

> (before my

> > > endocarditis

> > > > episode) and we are considering going back

> to them,

> > > but due to the

> > > > risk in my case I might want to try other

> approaches

> > > first.

> > > >

> > > > Questions:

> > > >

> > > > 1. Has anyone on Androgel who has found

> their levels

> > > declining been

> > > > able to get the levels back up by changing

> the site of

> > >

> > > > application? For example, I am now doing

> belly and

> > > > shoulders. Would it help to apply the

> Androgel to my

> > > thighs instead?

> > > >

> > > > 2. Has anyone whose Androgel failed gotten

> good

> > > results from

> > > > anything other than i.m. testosterone, eg.

> patches,

> > > buccal (Straint)

> > > > or even HCG alone? (HCG injections would

> not pose as

> > > much risk for

> > > > me as they are not intramuscular.)

> > > >

> > > > If it makes any difference, my hypogonadism

> is

> > > tertiary: my

> > > > hypothalamus doesn't put out GnRH, hence

> no

> > > LH/FSH, hence no

> > > > Testosterone. Without treatment my T levels

> are below

> > > 100 ng/dl.

> > > >

> > > > 3. Has anyone doing testosterone injections

> had an

> > > infection from

> > > > them? I noticed that Groh mentioned he

> developed

> > > cellulitis. I

> > > > did injections for 10 years without any

> problem, but

> > > it's a little

> > > > more risky for me now. (It's not risky

> for most

> > > guys, just possibly

> > > > those of us who have had endocarditis.)

> > > >

> > > > Finally, I thought I'd share a theory I

> have about

> > > why Androgel may

> > > > stop working. I know some guys have

> mentioned skin

> > > thickening -- and

> > > > that could be one cause. But I have not

> noticed a

> > > change in skin

> > > > quality, so that led me to some other ideas.

> I should

> > > mention that I

> > > > have a degree in Biochemistry and even

> published a

> > > paper or two on

> > > > drug metabolism (before my own health fell

> apart), so

> > > I'm on somewhat

> > > > familiar ground.

> > > >

> > > > What I think might be happening is this:

> Skin cells

> > > contain the

> > > > various enzymes that metabolism and break

> down

> > > testosterone:

> > > > aromatase, 5-alpha-reductase and others down

> the line

> > > that convert T

> > > > to estrogen or DHT and then to inactive

> compounds.

> > > Furthermore it

> > > > appears that these enzymes may be inducible.

> That is

> > > to say

> > > > exposure to T may increase the activity of

> the enzymes

> > > that break it

> > > > down. Now when you put Androgel on your

> skin you are

> > > exposing the

> > > > skin cells to concentrated levels of T that

> are

> > > possibly thousands of

> > > > times higher than normal. It may be that in

> time this

> > > induces the

> > > > skin cells to have an exaggerated ability to

> break

> > > down

> > > > testosterone. Thus the testosterone in the

> Androgel

> > > is destroyed by

> > > > the action of the skin cells before it can

> penetrate

> > > to the

> > > > bloodstream.

> > > >

> > > > Nice theory perhaps, but it doesn't

> necessarily

> > > solve the

> > > > problem. Maybe one could apply Androgel

> with some

> > > kind of topical

> > > > aromatase inhibitor and 5-alpha-reductase

> inhibitor in

> > > high

> > > > concentrations, but I'm not sure

> that's

> > > practical. So that brings

> > > > me back to the idea of changing application

> sites. Or

> > > the

> > > > alternative of injections.

> > > >

> > > > Any comments would be appreciated.

> > > >

> > > > Thanks,

> > > >

> > > >

> > > >

> > >

> > >

> > >

> > >

> > > ------------------------------------

> > >

> > >

[Guest guest]

offten do you do the shot in your rear. I pray it's every week. I do my T

shots into my thigh every 3 days this keeps me leveled and holds down my

Estradiol levels not doing a big shot every week keep estradiol down. I use a

27g 1ml x 1/2 " lg. needle and have no pain to get the oil out of the vial I just

pull the plunger all the way down and hold it. It takes about a min. or two the

get my dose. I have no pain doing this and my levels are great.

Co-Moderator

Phil

> From: jvpfish@... <jvpfish@...>

> Subject: Re: Re: Androgel Failure, Injections -- Questions and

Ideas

>

> Date: Tuesday, October 14, 2008, 10:37 AM

> Hello Group , I am P from Staten Island NY. xxy-47 I

> have been doing

> self injections since I am thirteen yrs old. I am thirty

> nine now and every

> time I inject it in my butt it still hurts. The Dr. told me

> I can also inject it

> in my leg. One day I will try that.

> JP

> **************New MapQuest Local shows what's happening

> at your destination.

> Dining, Movies, Events, News & more. Try it out

> (http://local.mapquest.com/?ncid=emlcntnew00000002)

>

>

>

[Guest guest]

I'm on AndroGel 7.5 daily and am open to any ideas to make it more

effective, that is, yield higher levels (I seem to test at 350-400

total T at this dosage). Have you been tested since starting to apply

to the calf and behind the knee? If so, how much of an increase did

you see by doing this? Does this mean you do not apply any gel at all

to the shoulders? Finally, how do you deal with leg hair? My endo had

warned me off applying to any hairy parts as the hair would pick up

too much of the gel. Thanks!

>

> ,

> �

> Using my lower leg is the best for me.� It is night and day for me.�

I would never go back to arms or shoulders.� Lower legs and underside

of the knee and ankle make feel like I have 2 times the T in my

system.�� I don't get muscle pain after a long day nor do I get that

'I forgot my wallet feeling' either. And especially I don't myself

withering.

> �

> I feel whole!�I feel complete.� I feel fully stable.� Not just

mentally but physically.��

> �

> Justus

[Guest guest]

With levels this low I would just switch to shots do them your self read TRT: A

Recipe for Success in this is the best way to do TRT. Your not getting the gel

through your skin. Start at 100mgs every week for shots and the shots are a lot

less in cost then gels.

Co-Moderator

Phil

Co-Moderator

Phil

> From: a_hohmann <a_hohmann@...>

> Subject: Re: Androgel Failure, Injections -- Questions and

Ideas

>

> Date: Tuesday, October 14, 2008, 11:54 AM

> I'm on AndroGel 7.5 daily and am open to any ideas to

> make it more

> effective, that is, yield higher levels (I seem to test at

> 350-400

> total T at this dosage). Have you been tested since

> starting to apply

> to the calf and behind the knee? If so, how much of an

> increase did

> you see by doing this? Does this mean you do not apply any

> gel at all

> to the shoulders? Finally, how do you deal with leg hair?

> My endo had

> warned me off applying to any hairy parts as the hair would

> pick up

> too much of the gel. Thanks!

>

>

>

>

> >

> > ,

> > �

> > Using my lower leg is the best for me.� It is

> night and day for me.�

> I would never go back to arms or shoulders.� Lower

> legs and underside

> of the knee and ankle make feel like I have 2 times the T

> in my

> system.�� I don't get muscle pain after a

> long day nor do I get that

> 'I forgot my wallet feeling' either. And especially

> I don't myself

> withering.

> > �

> > I feel whole!�I feel complete.� I feel fully

> stable.� Not just

> mentally but physically.��

> > �

> > Justus

>

>

> ------------------------------------

>

>

[Guest guest]

I actually feel rather good - certainly better than I've felt in a very long

time. Morning

erections every day, good energy, E2 at 26, etc. So I've been reluctant to

switch to

injectables as the gel seems to be working and is very convenient and keeps me

feeling

very consistent from day to day. My original question, however, remains one of

wanting to

know if applying gel to areas such as the poster mentioned - behind the knees

and on the

calves - makes a material difference.

> > >

> > > ,

> > > �

> > > Using my lower leg is the best for me.� It is

> > night and day for me.�

> > I would never go back to arms or shoulders.� Lower

> > legs and underside

> > of the knee and ankle make feel like I have 2 times the T

> > in my

> > system.�� I don't get muscle pain after a

> > long day nor do I get that

> > 'I forgot my wallet feeling' either. And especially

> > I don't myself

> > withering.

> > > �

> > > I feel whole!�I feel complete.� I feel fully

> > stable.� Not just

> > mentally but physically.��

> > > �

> > > Justus

> >

> >

> > ------------------------------------

> >

> >

[Guest guest]

yes,  I have great success with my calves.  I have good circulation and the T

hits the system quickly.  Give it a try.  

Re: Androgel Failure, Injections -- Questions and Ideas

I'm not as flexible as I was as a youngster. I don't know about

getting right behind the knee. I can certainly reach my calves.

Any luck there?

>

> >Question:

> >

> > I have been moving the around androgel around the body. I

> > started on the shoulder but absorption was poor. I heard that

> > body fat hinders absorption. So I have tried my lean inner thigh,

> > and backside of the knee to the ankle.

> >

> > Any wisdom or success from trying other areas?

>

>

>

>

>

>

>

[Guest guest]

,

 

  Tests for me put me in the upper 1/3.  I  doubled my labs.   I will test again

in  2 weeks to see if this truly consistent with my body.  Phil taught me to

have 3-4 consistent months of testing..     I do not apply to the shoulders at

all.    Hairy parts are gone.   Since I have hypo and am bald.   I deleted hair

elsewhere.   This could be a positive factor in absorption.    The other thing I

do is slow down with rubbing in the gel.   I apply less pressure and use a wider

strokes.  I also am very conscious to make sure that I get as much wet in at one

place before it dries.   And I continue to lightly rub even after it appears to

dry.   

Re: Androgel Failure, Injections -- Questions and Ideas

I'm on AndroGel 7.5 daily and am open to any ideas to make it more

effective, that is, yield higher levels (I seem to test at 350-400

total T at this dosage). Have you been tested since starting to apply

to the calf and behind the knee? If so, how much of an increase did

you see by doing this? Does this mean you do not apply any gel at all

to the shoulders? Finally, how do you deal with leg hair? My endo had

warned me off applying to any hairy parts as the hair would pick up

too much of the gel. Thanks!

>

> ,

> �

> Using my lower leg is the best for me.� It is night and day for me.�

I would never go back to arms or shoulders.� Lower legs and underside

of the knee and ankle make feel like I have 2 times the T in my

system.�� I don't get muscle pain after a long day nor do I get that

'I forgot my wallet feeling' either. And especially I don't myself

withering.

> �

> I feel whole!�I feel complete.� I feel fully stable.� Not just

mentally but physically.��

> �

> Justus

[Guest guest]

Thanks for the suggestions. This just goes to show just how very limited the

" official "

AndroGel directions are with respect to which areas can be used. I'll give it a

try. I want to

make the most of the gel, even though I actually feel good.

>

> ,

>  

>   Tests for me put me in the upper 1/3.  I  doubled my labs.   I will test

again in  2 weeks

to see if this truly consistent with my body.  Phil taught me to have 3-4

consistent months

of testing..     I do not apply to the shoulders at all.    Hairy parts are

gone.   Since I have

hypo and am bald.   I deleted hair elsewhere.   This could be a positive factor

in

absorption.    The other thing I do is slow down with rubbing in the gel.   I

apply less

pressure and use a wider strokes.  I also am very conscious to make sure that I

get as

much wet in at one place before it dries.   And I continue to lightly rub even

after it

appears to dry.   

>

>

>

> Re: Androgel Failure, Injections -- Questions and

Ideas

>

>

> I'm on AndroGel 7.5 daily and am open to any ideas to make it more

> effective, that is, yield higher levels (I seem to test at 350-400

> total T at this dosage). Have you been tested since starting to apply

> to the calf and behind the knee? If so, how much of an increase did

> you see by doing this? Does this mean you do not apply any gel at all

> to the shoulders? Finally, how do you deal with leg hair? My endo had

> warned me off applying to any hairy parts as the hair would pick up

> too much of the gel. Thanks!

>

>

[Guest guest]

Okay I have to pipe up. First sky I am sorry about your experiences, I

know if you had asked me 2 days ago I would be agreeing with you but I

have finally been pushed over the edge. I am now self medicating with

topical hydrocortisone and it feels like my brain is on for the first

time in weeks and haven't been bedridden or stuck in the bath. F*ck

the doctors, their only use is writing scripts, labs, being an

outsider with knowledge you might not have. Even if we are opposed we

shouldn't surrender, the only way out is through it. If doctors won't

preform the only useful things then I will find another way.

In terms of your options of HRT, read on. I am on and loving pellets,

so that is my bias.

Oral- You can either cause a 17-alpha-methyl alteration to make the

liver ignore it and likewise kill your liver. Alternatively the

testosterone undecanoate rely on a very unstable route of adsorption

through the lymph system. This only works with high fat meals taken

with the drug, if not it goes to the liver and is deactivated and

possibly harms the liver. More info can be found here but suffice to

say this technology is not new and has been used in other T products

with limited success. The drug is available in Canada and Europe;

theoretically could be imported.

http://www.bodybuilding.com/fun/catandriol.htm

A mix of oral and topical is the mucus membrane patch or sublingual

drops. You may find good success with compounded drops but it requires

repeat dosing and care not to swallow it. I wouldn't recommend the

mucus membrane patch because it doesn't allow any dosage changes, may

be swallowed, doesn't stay on well and causes irritation in some. It

is expensive and I believe it can be found in most countries but don't

know for sure. I know little about the conversions with these methods.

Injections may be right for you but I am not comfortable making any

judgments here. You would do best with a product made with PLGA

microspheres that is being researched. It is the only chance of long

term injections currently on the horizon. The other mixed esters and

undecanoate is able to maintain levels at best for 6-8 weeks and often

less with significant highs and lows throughout. However if you can

handle the swings the current options are the esters and that might

theoretically lower your risks. If you chose injections pay attention

to what ester is used i.e. longer ones that is your guide to longer

lifetimes in the body.

Topical options would be an immediate switch to the 10% cream (not

versa gel) formulation. Androgel's makers shot themselves in the foot

with alcohol and the 1% formulation. That caused the main problems

with their product. I couldn't breath through the fumes. Then remember

the more vascular the better absorption. Same goes for thinner skin.

So neck, behind ears, armpits, elbow, wrists, groin, back of knees and

genitals. Take care with genitals may cause elevated PSA, prostate

cancer risk, BPH, urinary problems etc. It must be covered by clothing

in day to day life and you must be willing to shave the hair off the

area. The other options would be an occlusive dressing like tegaderm

over the area which would increase absorption.

Also while most formulations use pure crystallized testosterone, you

may benefit from using an esterfied testosterone to make it last

longer in your system. I would imagine propionate with its 3 day life

would make the topical levels extremely stable; just a personal

opinion because the swings killed me. I was so low by the next day on

androgel that I couldn't remember to put it on. If however you need

the cyclic nature of base testosterone then feel free to use it. So to

recap give up the androgel and switch to 10% testosterone base or

propionate cream and rub a dab on your inner and upper thigh adding

more until you feel right; then get tested after 3 days for base and a

week for propionate. Follow up consists of the doing that for as long

as it works. If you decide to try all of these options at once you

should start with a very small amount and work up dosing no more then

every 8 hours. You are going to get some very fast absorption that

way. Phil or one of the doctors what happens if you adjust the

androgens too rapidly?

Pellets is your last option. I love pellets but they do have a risk of

infection especially if not made and implanted under strict

conditions. It isn't just infections where the pellets face problems.

If you implant more then two they rub against each and the tissue;

three or more will cause buckling, breaking and overlapping with the

same damage causing an inflammatory process that can cause a rejection

process both bad things. They also don't encapsulate like other

implants in the body and migrate. These factors are very well

understood in the modification community. They need to be located in

an area where they can be felt and is vascular fatty area. They aren't

easily adjusted and require minor surgery for implanting and removal.

Currently it is hard to get true custom pellets however maybe you have

a good compounder. We would also do well to consider enclosing the

implants in a soft silicone shell to eliminate the edges. Testicle

implants have been forwarded as a good option allowing a lengthly

lifetime of 5 years in some cases. Since the surface area is

controlled the dosage is also controlled so you would do best to

determine your correct dosage prior to going to advanced options. It

would eliminate the swings in serum levels that even pellets despite

their lifetime have at the beginning and end.

They respond to temperature so if you do anything to change your

temperature that will effect how much you get. This means a lot

because it mimics the natural swings of the testicles. Through the

overall swings are quite small. I like them and I this is by far the

best method though I haven't tried the oral, sublingual or mucus

membrane patch.

The final point I would like to make is there are very good body

modification artists who have been doing implants only for years with

much better success then many of the studied implanters. They aren't

nearly as expensive as doctors with a lot more knowledge to boot. They

also might be found while a doctor with experience can't be. Be very

careful who you pick. If you don't know what is right then you might

be very wrong. I am a medic and can identify poor surgical technique

and sterile environment, you make your own call.

trannyboy