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Should I use testosterone shots or pellets?

Testosterone can be delivered using many delivery platforms.  Injections, pellets, creams, gels, and patches are the most commonly used delivery methods.  There are definite benefits and drawbacks to each and we are going to evaluate them for you here. First, let's talk about using testosterone pellets.  The pellets are implanted into the subcutaneous dermal layer, typically in the upper hip area. This approach is very limiting for a few reasons.  First, it's a one size fits all approach. They are dosed by body weight and BMI calculations and leave no room for individualizing a patients levels based on his own natural, optimal level.  Another limitation is that the pellets bleed heavily early on after implantation, then fall well below optimal levels.  This below optimal state is constant until pellets are implanted again around four to six months from the previous insertion date. This roller coaster is exhausting and can sometimes be harder on the patient that being at a consistently low testosterone level, simply because of the consistency of the state of being. Below is a chart showing three different dosages of testosterone pellets over six months. You can see that if your levels repeated this up and down every six months, it would be quite a ride. Next, let's discuss creams and gels.  The topical approach is convenient for those who simply cannot inject themselves with testosterone.   Some of the drawbacks are that the creams can be messy and sticky.  Another issue is that there are many variables that affect the exact uptake of the testosterone.  If you are dehydrated, cold, or having any skin issues, the absorption can be off.  There are also dangers in applying the gel, then making any contact with another person with that skin within an hour.  These contact issues are real and have been the reason that many wives have been overdosed with testosterone due to their husband's irresponsible use. At Low T Nation, we prefer testosterone cypionate injections.  With the injections, we know exactly how much of the testosterone the patient is receiving.  It also only requires a weekly shot, so [...]

Atlantas Best Hormone Replacement Program

  • Testosterone Doctor in Atlanta

This is a letter we have just received from the wife of a new client who thinks that we are Atlanta’s best hormone replacement program.  Hope you enjoy!! My husband and I met in college through mutual friends. We were both very athletic and active, which is what drew me to him initially. We married two short years after meeting and began a family shortly after. I really felt like I had everything I’d ever wanted. About 5 years later I noticed that a month or two would go by without a single intimate event, but when I brought it up John dismissed it citing stress as the main contributor. Even more concerning was the changes I noticed in John’s* personality, he no longer wanted to be active with me and was beginning to put on weight. I knew he was stressed out from his job so I tried not to make it worse by pressing the issue, however everything coupled with his indifference to it all began a drive a wedge between us. I just missed the man I married. One day I was having lunch with an old college girlfriend of mine and I began to confide in her the issues John and I were having and she immediately recommended that we go to your place that had helped her husband resolve his low testosterone issues.  She vouched that you guys were indeed Atlanta’s best hormone replacement program. John doesn’t have low t I thought to myself, but then again I guess we really didn’t know, had he been checked recently? As she began to go down the list of symptoms, I felt as though she reading a synopsis of my life for the last 2 years, I couldn’t believe how well it described John’s characteristics as of late.  It was the first time in a long time that I had new hope for our marriage. So naturally, I rushed home, tidied up a bit and began to prepare one of his favorite meals in order to set the tone for a very important discussion.  I wanted to make […]

Picking the best Testosterone Doctor in Atlanta

  • Best testosterone replacement doctor in atlanta
How to choose the best Testosterone Doctor Here at Low T Nation, we truly believe that we have the best testosterone replacement clinic in Atlanta.  This is because our Atlanta Low T Doctors are all very specifically trained in Low Testosterone Therapy by the top organizations in the country.  One of the more frustrating aspects of our Low T Therapy is dealing with the misinformation and myths that many other doctors believe and give advice based on.  This well intended misguidance causes issues of confusion when their trusted health adviser gives them advice or warnings that are contrary to our standard of care. The first thing that men need to know about general practitioners and family doctors is that they did not learn the specifics of male testosterone replacement in medical school. This is the most important person, other that yourself, in ensuring that your testosterone replacement program is going to be a success.  If you're working with a doctor who has undergone additional training regarding male hormone replacement, then that's fantastic.  If you are working with an endocrinologist, that's also fantastic.  If you are considering using your family or general practitioner to manage your hormone replacement, you must determine if they have undergone the additional training necessary.  The video below will teach you 7 questions to ask and what the answers should be.  If your doctor cannot answer these questions correctly, find another doctor! If you have any questions about specific information or advice that your doctor has given you regarding testosterone replacement or anything related, feel; free to set a consultation with one of our practitioners.  We would be happy to discuss any issues you may have.

Estrogen management for men on testosterone replacement.

  • estrogen management in men on testosterone replacement
Estrogen management for men on testosterone replacement is absolutely critical to long term health.  Research is showing that estrogen levels are extremely correlated to heart disease.  This study shows that both high and low estrogen levels are almost equally dangerous when it comes to heart disease. High estrogen levels are also associated with increased blood clot and strokes and increased mortality.  Not to mention, all of the other obvious estrogen dominant side effects like weight gain, gynecomastia, sexual dysfunction, poor moods, and more. Low estrogen also causes more than just cardiovascular disease. Osteoporosis is a very serious issue in men with lower than normal estrogen levels.  So much so that this study proves a 650% increase in broken hips in research groups of men with the lowest estrogen levels as compared to men with healthy levels of testosterone. The mortality rates for men with broken hips and severe osteoporosis is also much higher than men with who do not suffer from these conditions.  Quality of life is also extremely improved when men have better bone health in their later years. Another vital aspect of managing estrogen involves keeping estrogen optimal in order to avoid the decrease in androgen receptors due to estrogen dominance.  This has been proven in several studies and will decrease the body's ability to bind to DHT and testosterone adequately.   Higher levels of estrogen have also been shown to increase SHBG which will in turn drastically reduce free testosterone levels.  This is just one more reason that your doctor must understand that keeping you in the optimal range of 20-30 pg/ml has a profound impact on your long term cardiovascular health, your bone health, your testosterone levels (and androgen receptor count) as well as moods and emotional state of being.  The importance of managing estrogen cannot be overstated.

Check out Low T Nation on Atlanta and Company!

  • Atlanta and Co Testosterone
Hey folks!  Check out our visit to Atlanta and Company  today to discuss Low Testosterone and Men's health topics.   Thanks to Atlanta and Company for allowing us the time today to hang out discuss Low T issues that men need to hear.   For more information on Low T and other men's health issues, please check out the rest of our website!

Low Testosterone Management: The Basics of Testosterone Replacement and the HPTA

  • The HPTA
Testosterone replacement management starts and ends with understanding the Hypothalamic, Pituitary, Testicular axis, the HPTA.  This is the fundamental supply and demand system that manages men's testosterone and sperm levels in their bodies.  Understanding this axis is crucial in determining whether a man's testosterone deficiencies are from primary or secondary hypogonadism.  This will in turn affect how to properly diagnose and prescribe that patient.  Without understanding the give and take involved in the hormone production, a doctor will either usually over prescribe, under prescribe or simply leave out the very vital co-travelers necessary to optimizing a man's hormonal health.  Watch this video on our Low T Nation youtube channel to learn the basics about how a man's hormones are monitored and stimulated when needed.  Also, how and when to add HCG and Clomid to ensure all testicular health and function processes are kept intact and healthy.

Testosterone Replacement with HCG

Low T Nation is a leading authority on Low Testosterone Therapy in Atlanta because our staff and Atlanta doctors are so knowledgeable about all of the various issues related to managing low testosterone.   Check out this video Brandon has recorded about Testosterone Replacement with HCG. HCG is very important when on TRT because it ensures your natural production of testosterone stays completely optimized.  Also, testicular function remains healthy.  Without HCG, many men suffer from testicular shrinkage and atrophy.  This is because the testicles remain in a dormant state due to inactivity.  Ensure your doctor is like our Testosterone Doctors in Atlanta and has been specifically trained on HRT.  This means they understands the subtle issues around HCG, Clomid, Estrogen, DHT and more.  Please don't hesitate to ask us any questions if have any regarding our philosophy on testosterone replacement with HCG.

Great Research on the Benefits of Testosterone Replacement

http://www.harvardprostateknowledge.org/a-harvard-expert-shares-his-thoughts-on-testosterone-replacement-therapy Testosterone’s impact on brain, bone, and muscle Cherrier MM, Asthana MD, Plymate S, et al. Testosterone Supplementation Improves Spatial and Verbal Memory in Healthy Older Men. Neurology 2001;57:80–88. PMID: 11445632. Isidori AM, Giannetta E, Greco EA, et al. Effects of Testosterone on Body Composition, Bone Metabolism and Serum Lipid Profile in Middle-aged Men: A Meta-analysis. Clinical Endocrinology2005;63:280–93. PMID:16117815. Liu PY, Swerdloff RS, Veldhuis JD. Clinical Review 171: The Rationale, Efficacy and Safety of Androgen Therapy in Older Men: Future Research and Current Practice Recommendations.Journal of Clinical Endocrinology and Metabolism 2004; 89:4789–96. PMID: 15472164. Moffat SD, Zonderman AB, Metter EJ, et al. Longitudinal Assessment of Serum Free Testosterone Concentration Predicts Memory Performance and Cognitive Status in Elderly Men.Journal of Clinical Endocrinology and Metabolism 2002;87:5001–7. PMID: 12414864. Wang C, Cunningham G, Dobs A, et al. Long-term Testosterone Gel (AndroGel) Treatment Maintains Beneficial Effects on Sexual Function and Mood, Lean and Fat Mass, and Bone Mineral Density in Hypogonadal Men. Journal of Clinical Endocrinology and Metabolism2004;89:2085–98. PMID: 15126525.

Testosterone Replacement Costs

  • Testosterone Replacement Costs
Testosterone replacement costs vary widely vary widely,  You need to understand where the hidden costs of the treatments are.  Check out the video for more information.  Make sure you listen to this video in order to understand costs of deductibles, office co-pays, pharmacy co-pays, lab splits, as well as time and energy spent on getting all of the various pieces together.

Testosterone Injections at Low T Nation

  • testosterone injections

At Low T Nation, we get asked all the time about which platform to deliver testosterone in a Low T program is the best. The most available and common testosterone replacement platforms are creams, pellets, injections, and patches. The best answer depends a lot on the person’s situation, but without any additional determining criteria, we at Low T Nation, prefer the injection based platform for a few reasons. The primary reason is that we know exactly how much testosterone a patient is getting in their system.  All of the other systems have a bit of room for error in understanding exact dosing.  The pellets have a time released mechanism that distributes the testosterone over months.  The creams can have evaporation and absorption issues to contend with.  The patches also become increasingly hard to tell exactly how much has been absorbed and how much is still in the patch. There are also other issues.  Creams have two additional drawbacks.  First being that there are known contact dangers.  It is very easy to pass the testosterone (even if the cream has been absorbed) to another person, hopefully not a wife or child.  The creams are also completely bio-available which means they have to be applied every day and on top of that, if you miss a day or two, you will feel down in the dumps again.  We don’t like the daily use and potential for normalizing back to pre-plan testosterone levels. The pellets tend to raise a patients testosterone levels to a level that is above the intended range far too often. This usually ends up causing issues with estrogen and DHT conversion at too high of a rate as compared to other delivery methods. The testosterone release also shows up like a bell curve with the pellets releasing quickly while the pellets are fairly new, then slowing dramatically as they age. The other issue with pellets is that the patient is usually either feeling better each day because of the increase or worse each day because of the falling levels of testosterone.  This therapy method for Low T is still a viable option […]

Testosterone Replacement Medications at Low T Nation

The testosterone replacement medications at Low T Nation are never a one size fits all prescription.  We evaluate each patient individually and treat that patient based on his individual physiology, health history, lifestyle and goals. An example of a standard program consists of: 100MG-200MG of Testosterone per week.  Usually cypionate delivered via IM injection. 500 units of HCG divided into 2 shots per week An estrogen blocker if required. Usually every 3.5-7 days.  Many men do not need this component of the therapy. Clomid is added to the prescription if the patient is currently family planning This plan is a generic example of a a basic starting point.  After about 2 months, the patient will come back in and have his lab work and symptom relief evaluated again to determine how well he is base lining with the initial prescription. Explanation of the drugs utilized by our practitioners Testosterone Cypionate is great vehicle to deliver the hormone because of it’s long-lasting half life.  The half life is about 7-8 days which suits our weekly injection schedule perfectly.  We only utilize bio-identical hormones from only the best compounding pharmacies with the highest accredidations.  This testosterone will have a man optimized in less than 7-8 weeks. Human Chorionic Gonadotropin (HCG) with Testosterone Replacement, is absolutely mandatory for all of our patients.  It maintains and optimizes testicular health and the output of testosterone.  If a patient is using a protocol which does not utilize HCG, that patient most likely is suffering from testicular atrophy and shrinkage and quite possible will suffer long lasting damage to his overall testosterone production capabilities.  HCG prevents any testicular degradation, optimizes a man’s natural production and therefore reduces the amount of the exogenous prescription required to keep him at an optimal level. Estrogen blockers are sometimes given to patients when their estradiol levels get out of hand.  We do not give this to most patients because estrogen is very cardio-protective in men.  We only use the estrogen blockers when a patient has a surplus and we then try to carefully and slowly dial it back so as not to bottom out the man’s […]

Low T Therapy and Low-Normal

  • Low T Therapy

One of the most frustrating aspects of Testosterone Replacement we hear from our Atlanta patients is that they’ve been tested by their doctor and the results said that they were “low-normal”.  This is extremely disappointing to the patient because they don’t usually ask for the test unless they are suffering from Low-T symptoms and they need relief.   Most of the laboratory ranges for Testosterone are somewhere between 350-1100.  The problem with the “low-normal” finding is that it takes the individualism out of the patient care and it says that you’re low-normal for the entire population of men that the lab range (350-1100) is trying to represent. The range is that wide because many healthy and fit men walk around the 400’s in the prime of their lives, while others walk around at over 1000. There is no way to look at a man and guess what his level should be at.  If a man’s bloodwork comes back with a Testosterone score of 375, it is indeed in the range, but it doesn’t account for the fact that he may be a individual who previously had a testosterone score of 800 in his prime.  This means that the patient in question is at about 45% of the testosterone he needs.  Do you see the issue here? Quality patient management in the testosterone replacement discipline cannot be performed from labwork alone.  In fact, at Low T Nation in Atlanta, we utilize a system of symptomatic qualifiers, lab results, and lifestyle factors to appropriately prescribe patients the right amount of testosterone for THEM.  Not for the entire range of all men who score extremely differently from one another.   We also employ a “start low, go slow” approach as well to make sure that a man that should be at 500 doesn’t end up at 1000 like in most other plans.

Compliance and Low Testosterone Therapy

Men, one of the most important things to keep in mind when on a testosterone replacement therapy is remaining compliant at all time. These programs are designed to optimize your body in ways that keep other systems and hormones in check as well.  When a patient falls out of compliance with HCG or Testosterone, other hormones and systems are affected as well.  This yo-yoing of multiple hormonal systems in the body can wreak havoc on a man’s state of mind and emotional well-being. Also, HCG compliance is absolutely crucial in optimizing overall testosterone levels as well as optimizing testicular health.  Patients who do not take their HCG routinely can experience testicular atrophy and shrinkage as well as lower testosterone levels across the duration of their therapy.  This actually negates the entire purpose of being on the therapy in the first place. So men, in closing, please do all you can to ensure that you are consistent with all of your prescriptions from Low T Nation.  A prescription calendar, appointments in your phone’s calendar or even apps like MediSafe Medication Reminder (APPLE,  ANDROID) will help you you more compliant, therefore healthier and happier!

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