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    optimizing testosterone therapy
    rickeroo posted:
    The following is my opinion and observations ONLY based on over 15 years of testosterone therapy. It's a life-long constant work-in-progress.

    Always maintain a healthy respect for, and a genuine fear of, the power of ANY hormone you are adding to your body. This is serious stuff. Learn what to expect and when. Know what LH, FSH, estradiol, and DHT are. Err on the side of under-dosing because overdosing by even a small amount may trigger some side-effects. Miss a dose ? Don't double-up to catch-up. Skip a dose one day a week, or so, and note how you feel. Be always mindful of possibly inadvertently contaminating your environment. Segregate your laundry from all others'.

    Start at a low dosage level based on the initial test and slowly increase it over a period of weeks, if not several months, till you reach your optimum daily dosage level based on your response rather than only the raw numbers from a lab test. A quick response at the beginning may mean that you're actually shocking your system at an overdose level that you don't want to maintain over any period of time. I've talked to dozens of men and several women and with EVERY one of them their doctor started them off at a high dosage level and then had to sharply reduce it because it triggered side-effect reactions. Worse with the women--acne and facial hair. Yuck ! At your optimized dosage you can probably blunt small effects of DHT,dihydrotestosterone, by taking about 180mg of saw palmetto extract daily.

    Avoid suggestions from athletes or body builders. They are taking large doses to "bulk up" and will have to go through a detox regimen when they decide to come back down. You're just trying to be "normal" in this environmentally estrogen-soaked, testosterone-suppressed world we live in---mostly from plasticizers.

    Avoid the patch. You can't adjust the dosage level to meet your needs, and it will probably itch and leave disk-shaped bruises that may last for months. Avoid injections. They tend to shock the system and are expensive. By far the best are gels (cream), and if you use a compounding pharmacy instead of Androgel, Testim, etc., you will probably spend less out-of-pocket than your copay if you went through your insurance carrier.

    Don't think you won't benefit from the therapy because your test results show you're only near or slightly under the bottom of the arbitrarily determined "normal range" of total testosterone. If you have the symptoms, then you need the therapy. Period.

    Seems like everybody focuses on the "total T" level and overlooks the important "free T", DHT, and estradiol levels. Having an endocrinologist periodically review your therapy isn't a waste of money.
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    Chris_WebMD_Staff responded:

    I just wanted to remind you all that these are experiences this poster is sharing and medical advice should only be used and taken into consideration given by your own doctor, as he/she has your health history and would know best for you.
    Thank you,
    Chrissy WebMD Community Staff

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