I have heard of many mistakes made by people taking testosterone replacement therapy. Some mistakes seriously affected their quality of life or caused men to stop testosterone prematurely. These are some of the biggest mistakes I have ever witnessed:
- Using “street sources” of testosterone: I have met many men whose doctors do not support their use of testosterone, so they buy it on the black market or of some kind in their gyms. This is illegal. Testosterone is classified as a controlled substance under the Anabolic Steroid Control Act of 1990 and has been assigned to Schedule III. It is regulated by the Anti-Drug Agency (DEA). A doctor can legally prescribe it, but it is illegal to use it without a prescription. Be aware that buying or using testosterone without a proper prescription can have legal consequences. The use of testosterone and its raw molecules (anabolic steroids) is illegal in the United States for those who do not have a medical diagnosis that justifies its use (eg, anemia, emaciation, hypogonadism). If after reading this book you still decide to get testosterone on the black market, be aware that you could be misled by insiders who could alert the DEA to your purchase. Also, importing testosterone, even if you have a prescription, is not legal. Bottom line: only use testosterone after a doctor gives you a prescription and don’t import it from other countries.
- “Street” testosterone use is also dangerous. Nobody knows what those products may contain. Some of the so-called testosterone products may simply contain peanut, sesame, or grapeseed oil. You also run the risk of being exposed to contaminants that could cause an infection.
- Not having a doctor keep track of your blood tests is a surefire way to get in trouble! If you have low testosterone, there are hundreds of doctors who will prescribe testosterone replacement therapy (see the Appendix section for directories). If you are using testosterone to increase muscle mass or to improve athletic performance even though you have normal testosterone levels, be smart and do your best research. And please read the information in this book on how quitting testosterone can cause health problems (if you are using black market testosterone, its source will likely run out eventually).
- Not exploring which testosterone option is best for you: Since there are a variety of testosterone replacement options, it is important that you take the time to really discover what is best for you. Several factors go into deciding what would be the best testosterone replacement option for you. These include cost, insurance coverage, convenience, preference for daily versus weekly use, lack of time to stick to a strict daily schedule, fear of needles, and physician familiarity with different products. For example, some health management organization (HMO) programs only pay for testosterone injections, as they are the cheapest option. However, some men have a phobia of needles and dislike the weekly or biweekly injections that may require them to see their doctors as often (some doctors do not teach their patients to self-inject at home). Other men are prescribed daily gels even if their busy lives make it difficult to complete their daily therapy perfectly. Some men without insurance or financial means choose not to seek help because they do not know that there are patient assistance programs established by the manufacturers, or the fact that compounding pharmacies can make cheap gels and creams with a prescription (details in this information is available in the Appedix section). Each testosterone option has pros and cons that may be more suitable for one person than another, so read the next section on treatment options.
- Not using the correct dose: Men starting testosterone should recheck their blood testosterone levels two weeks to one month after starting therapy (depending on the testosterone formulation), just prior to administering the appropriate dose for that day or week. This is critical as these results are essential in deciding whether the dosage is right for you. Total blood testosterone levels below 500 ng / dL that do not improve your sex drive and energy should be increased to 500 to 1000 ng / dL by increasing the injection frequency or dose. It is assumed that most men respond to biweekly injections of 200 mg or 5 grams per day of gels. The reality is that many men require higher doses to achieve total testosterone levels above the mid-range than normal. These men tend to stop testosterone early because they see no benefit at “average” doses. Incorrect injection frequency is a common mistake and is actually worse than no treatment at all. See the following sections for more details on this.
- Activate and deactivate testosterone: Testosterone replacement is a lifetime commitment in most cases. Once you start, you have to assume that you will keep doing it unless you have an unmanageable side effect. Some patients think that “giving the body a break” once every few weeks is a good thing. What they don’t know is that during the time you are taking testosterone, your testicles stop producing it. When you stop replacement therapy, you are left with no testosterone in your system for weeks while your HPG hormone axis normalizes. Depression, weight loss, lack of motivation, and loss of sex drive can come on quickly and strongly. In some men, their hormonal axis never returns to normal after stopping testosterone (especially if they had hypogonadism at the start of the study). Read more details about this in the section titled “HPGA Dysfunction.”
- Stopping testosterone abruptly due to an unrelated signal: Some of us may be taking medications for other conditions along with testosterone. Sometimes new drugs can increase cholesterol and triglycerides and / or liver enzymes (I call them “signals”). Some doctors prematurely blame testosterone rather than new drugs someone might have started. I have seen people suffer because of this poor judgment of their doctors. Weeks later, they learn that stopping testosterone didn’t improve any of these problems, but by then they feel tired, depressed, and asexual.
- Not knowing how to handle possible side effects: Fortunately, this will not happen to you after you finish reading this book. I know men who stopped using testosterone due to swelling in the nipple area, acne, bad mood, perceived lack of benefit, hair loss, or an increase in prostate specific antigen (PSA) due to a prostate infection. Knowing how to manage these side effects is essential for long-term success. By knowing what side effects can occur and how to treat them, you are less likely to stop therapy prematurely. You may only need to readjust the dose, change the delivery method, or take a medication to counteract the potential problem. Only the best doctors, who do not overreact to a side effect, know how to do this.
- Living a lifestyle that is not “testosterone friendly”: If you smoke, drink more than two drinks a day, smoke too much marijuana, are overweight, do not exercise, do not control blood sugar or lipids and do not show up for doctor appointments, you do not have testosterone – friendly lifestyle . Studies have shown that these factors can influence your sexual function and long-term health. Too much alcohol can lower testosterone. Exercise can increase it if done correctly or decrease it if done excessively. You can read more about this later in this book.
- Not reading or staying “on the net” with other patients: Being isolated about information makes you a less effective patient. There are men’s groups online that talk about testosterone and other topics (see the Resources section). Sharing your experiences and learning from others are keys to being an empowered and proactive patient. It is the only way to maximize the benefits of whatever therapy you are using. Many of the practical “tricks” I have learned have been obtained using this method. The collective wisdom of other people with similar problems is more powerful than simply trusting everything your doctor does or does not say to you. Also, most doctors treat educated patients far better than shy patients when it comes to sharing and asking questions.
- Do not change doctors when you have to: Changing doctors can be difficult, especially if you are not a network patient who reads a lot about your condition. Many people have no options and must see a certain doctor in a health management organization (HMO) setting. But most of us have the option of looking for educated doctors who are not condescending and who treat you as an equal. Your doctor should be your partner in your health and not just an unquestionable authority. Although they are saving lives and have spent hundreds of hours in school and practicing to do so, they are human beings who are exposed to myths and misconceptions similar to ours. I have heard the most irrational things from doctors about testosterone replacement that I They make me wonder how unfortunate your patients may be. Make sure you do your homework and find a supportive doctor. you in your quest for optimal health. See the Resources section for directories of physicians trained in the management of testosterone replacement.
- Poor compliance: Forgetting when to inject or apply gels is a common complaint. Good time management and reminders are key. Find reminders that work for you. I use the Google calendar, which can be set to text my phone as reminders. Avoid the yo-yo effect that causes poor compliance! Testosterone replacement is a lifelong commitment and lifestyle that must be carefully explored.