I am anticipating change. Today is the day that I receive 2400 mg of timed release bio-identical Testosterone pellets with Anastrozole (an estrogen inhibitor). I’m hoping for observable changes for my depression, weight gain, lethargy, and nonexistent libido.
The topical gels that I have been using over the past year have been ineffective. I was originally prescribed Androgel pump, then Testim gel; and in both cases I haven’t seen any effect of using these. In September 2015 (before starting the gel) I tested at 154 ng/dL, and in September 2016 was tested at 91 ng/dL. My body clearly isn’t absorbing the gel.
Based on my low T numbers, I’m receiving 2400 mg of Testosterone pellets with a goal of raising my numbers between 900-1200 ng/dL. Blood tests will be performed in approximately 6 weeks to determine actual levels for Testosterone and Estradiol so that any adjustments can be planned. Every four months I’ll be going back in for more pellets.
The Procedure
Lidocaine is used as a local numbing agent prior to insertion of the pellets (plan to wait for 10-15 minutes while the numbing takes effect). A small incision is made, and a pellet trocar (essentially a tube with a push rod) is inserted into the fatty tissue above the hip, and the pellets are fed through the tube into the fatty tissues (testosterone absorption is aided by fat). The tube is removed and steri-strips skin closures are applied. Those are covered with gauze and tape to complete the procedure. The whole procedure takes less than 30 minutes.
A video of the procedure (not me) can be seen on YouTube.
Following the procedure, some blood/drainage is expected. Bandages typically stay on for 4-5 days. There will be bruising and tenderness for up to 10 days while it heals.
The following supplements are suggested:
- Vitamin D3 gel caps (2000 iu) – take 4 daily for one month, then 3 daily. Vitamin D deficiencies are correlated to men with Testosterone deficiency.
- Iodine capsules (12.5 mg) – take one daily for one month, then 3 times weekly. Iodine helps increase testosterone levels.
- Myomin (500mg) – a natural estrogen blocker that may be used if estrogen numbers are higher than anticipated
It’s also important to note that anti-inflammatories (Aleve, Motrin and Ibuprofen) should be avoided because they block the effectiveness of the Testosterone. Alternative pain medications that can be taken include Aspirin, Tylenol and Excedrin.
Why am I doing this?
Last year I finally broke down and decided to seek medical help. After a few years of steady weight gain I was depressed, lethargic and uninterested in anything. My energy was gone, I had lost inspiration, and constantly felt depressed. I knew I needed to change the direction but could not be motivated. It was this apathy, and a long conversation with my wife, life partner and co-conspirator Angela that made me place a call.
Admittedly, I hadn’t seen a doctor in years. I no longer had a primary care physician, but started by scheduling an appointment with an endocrinologist to request a consultation. It was from that appointment that I learned I was diabetic, and had low testosterone. These two issues relate to each other because low T can lower metabolism and increase weight gain, which triggers diabetes.
I was placed on Metformin for the diabetes, and Androgel pump to improve T levels. There was a noticeable affect taking the Metformin (I was no longer exhausted at mid-day, I slept better, and my blood sugars were lower). I started the Androgel two weeks later, and didn’t experience any significant change (as in there was no change). After my health insurance plan changed their tier pricing for Androgel, I was essentially pushed to the Testim product as a replacement. Neither gel had a noticeable effect; apparently some men experience low absorption of gels, and this seemed to be my issue.
Dec Update: Numbers are Up
I received a call for the bloodwork I submitted on December 2, and the numbers are (finally) good:
- Testosterone: 864 (was 91) – target 1100-1500
- Estradiol: 21 – target under 40
The plan is to go back in on February 14 for another round of pellets, at the same dose. We will continue monitoring levels for progress.
From my standpoint it’s like a light switch was turned back on. I can feel the difference (lower stress, less depression) and the dysfunction is gone. I haven’t started exercising yet but there is a noticeable increase in my energy levels… meaning I need to get out and start running again!
2017 Update
Although the pellet treatment is working, I can’t continue to afford it. Pellets are not currently covered by my insurance (looking at you United Healthcare) and although alternate forms of T therapy are available from them, those don’t work. At $800 per session four or more times each year, numbers add up quickly.