I have been feeling pretty tired the last few months,  also have noticed a change in the way my muscle mass changes in response to working out along with a slight drop in libido. It's still there but not the same as before.  So I asked my neighbor who's a doc and he wanted to run some tests.


I came back with low testosterone and very low Vit D.  Testosterone was only 160 when he said it should be 400-800 and 400 was considered low.

he said it's likely related to stress and my travel schedule and work which lately has been insane.  Also not sleeping well.

He outlined a couple of options.  1 is a testosterone gel but he said that's a lifetime option. Once you start, you can't stop.  that doesn't sound good.

another one is something called "novarel" or HCG.  He said it helps stimulate your body to produce it's own.  This sounds like a better option since it sounds like I can come off it if my schedule goes back to normal or I start getting some sleep..


I'm not sure though. Anyone else gone through this?  it's not bad,  I feel fine I just don't feel quite "normal".  Any reason not to use the Novarel/HCG stuff?

The first injection I did I was scared af. It wasn't a good experience. I used to go Im it hurt and I hit nerves/veins a time or two and said fuck that. Switches over to sub q in the top of thigh with small needle. no issues.

I still don't love needles but I easily do it, and more or less conquered my fears. You can too I'm pulling for you

The worst part of that isn't the lightening bolt it sends down the leg causing a person to jump and pull the needle out.  It is knowing that you have to try the exact same thing again with a duller needle.  That is why I switched to my deltoids.  There might be a pinch feeling at times but no lightening bolts.  

I've done that a few times.  I learned to move closer to the side of my thigh and haven't hit anything in a long time.  

So I have always wondered what to do if I pull it out.  Do I clean the needle with alcohol and try again or do I just have to throw it away and start over with a new one?  I hate to throw away good T but wasn't sure what to do and I didn't have needles I could swap out (using 1/2" 27GA).

I’ve never tried to inject into my thigh but it sounds like maybe not the best place.  I hear a fair number of complaints about hitting nerves and such.  
Deltoids were alright but I had a lot of soreness post-injection.  
Since I switched to ventroglute I haven’t had a single bad stick.  I guess it’s one of the most commonly recommended locations for IM injection because there aren’t many nerves or veins in the area.

Honestly switch to a smaller needle. I think I use 1/2 inch 28 gauge or so.

The trick is learning to backpin, ie fill the larger needle with t. Remove the plunger from a smaller needle and fill from back. Push air out, and then you have a sharp as its gonna get small needle to inject with.

If you have a bad injection, pull out the needle trade the T into a new syringe and start over. You want that bitch sharp and straight.

Try it before you knock it.  You can grab a section of fat (I've got thick thighs so it works )

However make sure you leg is straight/rested and go in at a slight angle. I can tell when I get the placement semi off and the needle is resting on the muscle or going slight IM instead of subq.

Ah, I’m doing IM rather than sub q.  The complaints I’ve heard are related to IM specifically.  I can see how it would be convenient for sub q, depending on how you’re built.

If you swabbed with alcohol before hand then you should be fine just reusing it.  If you didn't then you could swab the needle with alcohol.  I've never had a problem just stabbing myself again, in the leg or dealts.  Not exactly sure what I've hit in the dealt but it causes 10x the pain of the other days.  It is rare, maybe 2-3 times a year.  I'll withdraw the needle and move it over a bit.

Hopefully you get symptom relief.

Who are these people?  The only negative I experienced was my Estradiol was super high, its under control now and I have no negatives.  All positives, it's worth it for men.

The positives have vastly outweighed the negatives for me.  The TRT fixed my symptoms that drove me to get my levels checked in the first place.  Greatly improved mood, energy, overall enjoyment of life.  Like a switch was flipped.
Plus it's provided the additional benefits of remarkable results in the gym, and improved libido.  Granted, I made some serious diet and lifestyle changes at the same time I started TRT but I cut fat and put on about 15# of muscle over the course of 6 months.  Huge increases in strength and my physique really transformed.

The negatives I've experienced are minor.  Slight increase in body hair on my back and shoulders.  Same with acne.  Nothing major but I'm getting the occasional pimple on my back that wasn't present before I started TRT.  I don't know about blood pressure but I've had a few labs since I started and nothing was out of the ordinary.  

You're gonna like it.

For the newcomers:

https://www.ar15.com/forums/general/Low-Testosterone-What-are-the-options-UPDATE-Testosterone-megathread/5-827650/?r=94973254&page=361&anc=94973254#i94973254

All of this! I’ve been on it three months and like he said it was like a switch was flipped. Mood, sex drive, and energy all improved greatly!

So I’ve dipped into this thread a few times.  I’ve been on Xyosted now for the past two years.  Overall great results.  No more feeling tired all the time, plenty of energy, all the positives.  Although as of late, I am noticing the down side of ball shrinkage.  Seems that I should’ve read further to see that I should have added HCG to the mix.  I see my doc next month, hopefully when I talk to him, I can get it prescribed. That being said, I’m seeing all sorts of different stuff about whether docs will prescribe it or not. Hoping to get some guidance on if HCG is the right thing to add and the best way to get my doc to add it to my mix.

Anybody else getting Xyosted from Sterling Specialty pharmacy?

Cash price is $150, it says.

Just got my results. Thoughts?

Test - 348
Free T  - 12.7
Estradiol  - 21.6
Hemoglobin A1c - 5.3
HGB - 15.2
HCT - 43.8

Couple things, what’s scale and range of the Free T being measured? Pg/ml? Ng/dl? If later measurement much better than first.

How old are you and mostly how do you feel? I’d consider SHBG and full thyroid panel also just so you have a baseline at least. Good to know all that if you’re feeling “tired” etc.

12.7 pg/mL

I am 36. I feel tired and unmotivated. I have a decent side hustle and I cant just get motivated to get out and do it. Some memory issues over past few years too.

I believe these are thyroid numbers

TSH - 2.64 uIU/mL

I get to join this mega thread. I don't have time to read 390 pages . I have been dragging lately and at the doc I had my testosterone checked it was low as was my vitiman D and iron was at the bottom of okay. I have vitaminD and testosterone with needles. I hate shots and insurance will not pay the doc to give a shot. What is the shot solution ?

Ice pack before the jab would help.

Auto injector might help if your just nervous.

@whiskerz

Auto injector for sure. The Union Medico one. I ordered one from Spark Hormone Therapy here in the US. It’s a handy little device. I have only used mine a few times now but it certainly helps remove a lot of potential human error and it’s just the push of a button to get a proper jab. You still have to push the plunger but that’s the easy part for me. I would highly recommend it for a newb like myself. There is a lot of info about these on YouTube and Reddit.

I just started that 2 weeks ago, I was using cypionate and was getting strange shard soreness/pain in my muscles so trying Xyosted now. My urologist said people tend to have better results with it and honestly i dont feel a thing only negative is it cost more than cypionate

Man up and stick the needle in.  Get a 27 gauge insulin needle.

I mean what would you do if you needed insulin injection 2 or 3 times a day to live?

AI and cardio disease


For the guys who use AIs.  You don't need them and they are not good for you.

This.  It's not that bad, just get over the psychological part of it.

Easy for me to say though, I've always been the type to watch others give me the shot and have found it interesting.  So giving them myself was a bit trippy at first, but wasn't bad.

Self injecting is a piece of cake once you get over any anxiety about it.  I was quite weirded out at first but I got over it quick once I started and realized how much of a not big deal it is.  I talked about this a bit a few posts back but I'll go into a little more detail on what works well for me.

I do intramuscular (IM) injection because that's what was recommended to me and it just seems like a better plan to me.  A lot of guys seem to do subcutaneous (subq) and have good results.  The needles are shorter so it could be less intimidating.

I use syringes with Luer Lock needles for easy needle swapping.  22g needle to draw the T from the vial, and 25g 1" needle to inject.  Depending on body fat and injection location you might need a longer needle.  1mL syringes are small in diameter so it's easier to push down the plunger on the small needle.  I recommend buying high quality injection needles from BD or another reputable maker since the cheap ones have mixed reviews on quality and maybe the occasional less than razor sharp point.  Anything that helps to minimize scarring is a good idea.  That's why it's best to draw the T from the vial with one needle, then swap to a fresh one since piercing the rubber stopper dulls the point of the needle.  The needles you use to draw with can be cheapies.

I inject in the vertrogluteal muscle which is sort of on the side of your hip.  This is probably the most commonly recommended IM site because I guess there aren't a lot of nerves or blood vessels in the area.  There are a lot of bad videos on YT about how to locate the VG muscle for injection.  Some unclear, some plain wrong.  The best tip I found was actually in the comments of a video.  Look at the side of your hip sorta just behind and below your pelvic bone crest.  Point your toe and act like you're grinding out a cigarette with your toe by twisting your heel back and forth.  Your VG muscle should flex and be pretty obvious.  Then just lean against a counter or something with your opposite side to allow the muscle to relax, and inject in the center of it.  I've done this dozens upon dozens of times and I've never had a bad stick.  Half the time I can't even really feel it.  The other half of the time it would be more accurate to call it minor discomfort rather than pain.

Good luck.

@TheRadBaron

I am interested in the Ventrogluteal. I see it mentioned a lot. I am just not 100% sure I can find it LOL. Tomorrow I will spend some time trying the technique you mentioned. I am on about week 3 of TRT so still a noob.


Question. Any of you guys ever miss a shot day? if so, what is your protocol for that?

Also, anyone ever fly with their TRT meds/supplies? I have a flight coming up and am very curious about this. I am not checking a bag, just a carry on backpack.

Just inject the next day.  Long esters really don't matter if you miss a day.

Keep in carry on.   TSA doesn't care.

10-4 Thank you Sir. That is exactly what I wanted to hear

That data is for old women!

I agree and disagree! When I take Anastrozole it crashes my Estrogen which is not good. I did a test run not taking Anastrozole for about 1 year and my "E" was stable at around 60pg/ml. The doctor wants me at 30pg/ml, I've never been able to hit that number. It's like a moving target. I never had any issues running at 60pg/ml FYI.

FWIW I usually run about 1100-1200 total T and 29 Free T. (9.5%BF)

Some men need an AI though. Having a high BF% will skyrocket Estrogen while on T and HCG or some form of LH/FSH stimulator.

I might ask my doctor about an AI with a shorter half-life or lower my T dose slightly. (The half-life of anastrozole is 50 hours, letrozole 48 hours, and exemestane 24 hours.)


This is a decent article to back up your statement!!
https://themenshealthclinic.co.uk/aromatase-inhibitors-no-more-no-less/

HCG works great for me! The cost of HCG has skyrocketed though. FDA BS!!! You can still get it from Canada (canshipmeds) with a prescription.

I switched over to Gonadorelin due to price and an added benefit of stimulating FSH.

Gonadorelin is a synthetic gonadotropin releasing hormone that, like HCG, increases luteinizing hormone (LH), but also activates follicle stimulating hormone (FSH) which is something HCG does not do. Gonadorelin does so by stimulating the pituitary gland which is vital in the manufacturing of testosterone in the testicles. That stimulation provides a “double kick” in regard to potential testosterone production which replicates what occurs during puberty when the body is at its height in regard to secretion of hormones for growth and sexual development. In doing so, Gonadorelin can reverse testicular atrophy and even increase seminal volume – which would be considered a huge advantage to a lot of men.

HCG has a side benefit of increasing all gonadal function which helps with everything you mentioned.  It only mimics LH but that is enough for all functions to increase when it is added.  That's why the studies show that TRT plus HCG can maintain fertility and prevent testicular atrophy.  It doesn't work in all situations, other factors come in to play as well.  

I'm not familiar with Gonadorelin but after a quick search it looks like that is what specialists are switching to since the FDA screwed over everyone with their new rules on HCG.  Something that stimulates the pituitary instead of only the testicles would produce a better result but only if it is able to safely and effectively do that.  The body likes everything to be in balance, increasing one thing throws something else off.  Also, just like with TRT if someone prostate cancer the extra T will speed it up.  What conditions might be affected by stimulating the pituitary more?  It controls more than just LH and FSH production.  It might do more beneficial things or it could cause other problems.  Time will tell as more people start to use it.

After asking and asking for help the past couple years (low but not insurance low) I went and ordered some online.  Took my 1st shot Tuesday, shot was easy..ass ached for day and half. Hopefully things turn around in next month.

Your ass will get used to it.  Be sure and rotate injection sites.

Just looking into this thread for the first time. So I’ll spend time going through it all before asking questions that have likely been answered.

I’m wondering if anyone has experience with Wittmer Rejuvenation. I’ve heard good things so I did an intake with them and have a preliminary meeting scheduled for early next week.

Wondering about cost as well.

I'm paying $212/ month.  Not covered by insurance. My doctor prescribes how I'm feeling but watches the numbers. Hard to find Doctors like this.

I don't know anything about Whittmer.

I use defy.  Paid around $2500 for the first year.  That was with more blood work because of being a new patient.  

They now send me an RX for blood work that I use my insurance for and I source my own Testosterone and nandrolone.  My yearly cost for the clinic is now about $250 to monitor my T levels and health.

I use a local mens clinic.

Appointments are about $150 every 3 months until dialed in then every 6 months.

Labs are free through work/insurance.

Test is $30-40 for 10ml vials through goodrx.

Syringes from amazon.

I use my regular doc, writes script, get 10ml of 200mg/ml Test from Walgereens using GoodRx for about $40 a refill. Based on typical dosage thats 10 weeks worth. So about $17 a month / $208 a year.

Thanks for all the feedback.

Not sure if my PCP will be on board or not. If he is, great. Blood test last week came in at 352. I know that a lot of doctors won’t play ball if the numbers are within the reference range, even if it’s on the low end. 352 is average for an 85 year old. I’m in my 50s.

Do the clinics offer anything beyond simply prescribing when PCPs will not? I was under the impression that they are more diligent about monitoring and adjusting for estrogen impacts and supplementing with HCG and AI if necessary, where PCPs might not be as comprehensive.

Am I just buying the sales pitch or is there something to that?

My doc initially wouldn't prescribe me so I went to a clinic. Once I was on a regular dose I was able to convince him to take it over saving me a bunch of money. My urologist has also offered to treat if needed.

I guess it’s my turn…

Been feeing awfully tired the past couple of years.  Strength in the gym is about the same but recovery takes longer.  Sex drive is still super high and no erectile issues though.  I asked my dr for a testosterone check with my annual physical last week and I was surprised by the results.

Given these results do you all think I’m a candidate?

36 year old male
5’8”
174 lbs
Weight lift 5 days a week.

282 ng/dL Total Testosterone (Normal range 250 - 1,100 ng/dL)
75.4 pg/mL Free (Normal range 35.0 - 155.0 pg/mL)

I feel you man. you have never met a bigger bitch about needles than me. I have fainted giving blood before.   I can't STAND needles.  


here's how I learned to do this and it's not a big deal.

1.  Draw with an 18G needle, then switch to a 25G needle. I get 18G needles from the doc/amazon on top of the normal 25. G needles. I Keep an 18G needle with my testosterone and I use it for several draws.  Doc said this is fine as the T has alchohol in it. I have never had a problem. Open 25G syringe, remove needle, put 18G on. Sterilize top of T, insert, draw, replace cap on 18G, remove it, replace wtih 25G needle.

2. Chose location site. I have huge thighs, so I have the meat for it, but a year ago I switched to hip. it's harder physically cause I have to reach way back to my upper butt cheek, but i rarely have issues like bleeding or other problems.

3. Sterilize chosen site. I use a cotton ball and soak with alcohol and I sterilize a huge area on my general zone. Either top of thigh or top of ass cheek. Really hose it down, just in case.

4. gently pick site by "testing".  What I do is I very gently move the needle around till I find a dead zone. If you touch your skin you'll find areas that you feel IMMEDIATELY, avoid those, and other areas that you can't feel or can barely feel. I move the needle around till I find a dead spot. Once i find somewhere that doesn't hurt, push the needle in, but I don't plunge it in, I push it in SLOWLY. I find if I plunge it in, I get pain, hit nerves.  If I just apply gentle pressure, it will just slowly sink in with very little pain. If you get a lot of pain, back it out and find another spot. i also find a very gentle motion of the needle helps it cut in. just wiggle the syringe a little and it will cut its way in.

5. Mistakes; if you have to reset more then 2 or 3 times, you'll notice the needle gets dull, just pull the needle and put a new one on to the existing syringe.  try again. I rarely have to probe more then 2-3 places before i find somewhere where it goes in and i barely feel it. Sometimes I can't feel it. I think there are gaps between nerves and if you can find a gap, there's hardly any pain.

6. Inject, but slowly. The T is thick so squeeze it in, but take breaks. it takes me 30 seconds to get it all in there (1ml a week for me. If it's 1/2mil you might take 10 seconds to get it in there). After injecting, leave the needle in for a couple seconds. If you pull it immediately, some of the T will come back out the hole.   after a few seconds, withdraw and wipe the area with the alcohol cotton ball.  You are finished.

Tips:
- Draw with 18G, inject with 25
- Reuse 18G draw needle if you want. I have used the same one for months before.  It only ever goes in the bottle of T
- If T is thick, put in bowl of warm water or in your pocket for a while to heat it up. I stopped doing this a long time ago but it does help thin it out
- probe different areas and find a dead zone, insert and inject slowly
- top of thigh or top of butt cheek. But cheek is harder but less pain. You are kinda doing it blind unless you are very flexible.

Order 27 gauge insulin needles,  draw and pin in ventroglutes or delts.