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Dx Testosterone Therapy: Andropause (Low-T):

Summary: "How To" Use Testosterone Therapy in Men:
While there are commercial testosterone products of gels (Androgel), patches (Androderm), under arm lotions (Axiron), and buccal products (Striant), we use exclusively testosterone cypionate injections and compounded testosterone pellets. The reason is that topical testosterone are converted to estradiol and in time will negate any of the beneficial effecdts of teststerone by raising Sex Hormone Binding Globulin (SHBG). The starting dose is 80-100 mg intramuscularly once per week. The total dose of androgens is usually limited to less than 200mg per week with some men using two (2) injections weekly. The dose of testosterone pellets in our practice is limited to 600-800mg every 6-8 weeks as the pellets may prove to be almost twice as potent as the injections.
Men who experience breast tenderness are prescribed /anastrozole 1mg daily.

 Aging on the Male Reproductive System

The Merck Manual states:
"Beginning at about age 20, the production of testosterone (the main male sex hormone) in men usually begins to decrease an average of 1 to 2% per year. The period in later in life when testosterone production has decreased enough to cause significant symptoms is sometimes described as male menopause or andropause. However, the gradual hormone decline in men differs greatly from what women experience in menopause, during which female hormones almost always decline rapidly over just a few years. The rate of testosterone decline varies greatly among men. Some men in their 70s have testosterone levels that match those of the average man in his 30s.

Whether young or old, men with low testosterone levels may develop certain characteristics associated with aging, including decreased libido, decreased muscle mass, increased abdominal fat, thin bones that easily fracture (osteoporosis), decreased energy level, slowed thinking, and a low blood count (anemia). Low testosterone levels also increase the risk of coronary artery disease."

Medications Used in the Treatment:
1. Testosterone topical: Androgel®, Testim®, Axiron®, Androderm®, Fortesta®
2. injection: testosterone cyprionate, delatestryl, tesosterone enanthate
3. Testosterone pellets: Tesopel®,compounded
4. Testosterone buccal: Striant®
5. Injection: Deca-Durabolin®/ nandrolone
6. Oral Testosterone: Oxandrin®, methytestosterone, Testred®, Methitest®
7. Oral: Danocrine®/ Danazol
8. Oral or injection: Winstrol®/ Stanozolol

Testimonial It is no longer unusual for a man in his young 20's to be seen in the doctor's office with complaints of poor sexual performance, lack of energy, work ethic and being unable to make gains while working out hard in the gym. Travison's research focuses on 1) men today have 15% lower levels of testosterone than their fathers at the same age, and 30% less than their grandfathers; and the Editor's research shows a rapid increase in Sex Hormone Binding Globulin that ties up the testosterone, preventing Low-T from doing its anabolic, power, sex drive, performance functions. Both problems Low-T and high SHBG need to be addressed add corrected to resolve the CAUSE of the problems.

*[Editor] Mulligan in 2006 made note that almost 40% of men had low testosterone; those with low testosterone had increased incidence of hypertesion, hyperlipidemia, diabetes, obesity, prostate disease, asthma and chronic obstructive pulmonary disease.

New F.D.A. Laws have approved specific compounding pharmacies to manufacture unique products at such low prices that a buyer can purchase one year (12-months) of these compounded products with their extra ingredients for the cost of just two or three months of the F.D.A. and state supervised approved testosterone products!

The True Cost of these medications can be seen by Clicking Through the E-store for pricing and purchase options of testosterone on the Webpages. Testosterone cream at 20mg/ml (2%) contains more testosterone than the 1.62% milligrams (of testosterone) in a 5ml packaged of Androgel®:
Compound cost $88.00; Androgel 1.62% is priced over $400.00 per month.
*200mg Compounded Testosterone pellets have almost three times more milligrams of testosterone than the 75mg in Testopel®: compounded is priced at $46.00 for 200mg; Testopel $88 for 75mg and they are both made with the same machinery.

*Compounding pharmacies can make testosterone cream/ gels, to different milligrams of testosterone than in Androgel®, Testim®, Androderm® -- to specifications and individual patient needs--and--
compounded can add anastrozole (estrogen blocker) and zinc so patients may need less medications.

*[Editor] The following information is gleaned from the published article from K.C. Channer, M.D. of which we are in full agreement. The United Kingdom is restricted to only testosterone while other countries have the same F.D.A. approved other potent anabolic steroids. The [Editors] combine formulations of testosterone, Nandrolone, Oxandrolone, Stanozolol and others to maximize anabolic effects.

Salient Points of the Article Entitled "Testosterone and Cardiovascular Disease in men"; Asian J Androl 2012 May; 14(3):428-435
* Men are more at risk of developing and dying from Coronary Artery Disease [usually 10 years earlier than women]..and gender-specific effects of [testosterone] are implicated.
*Testosterone declines with age: "Total testosterone fell at a rate of 0.11 nmol/year, but the fall in free testosterone was more impressive and due, at least in part, to the significant rise of sex hormone binding globulin with age. "
*Testosterone dilates the coronary and penile arteries
*Testosterone replacement acting as a vasodilator, is an anti-ischemic agent.
*Low testosterone correlates with earlier death and disease
*In summary, hypo-testosteronemia (Low-T) is associated with raised pro-inflammatory cytokines (tumour-necrosis factor-α and interleukin 6) and reduced anti-inflammatory cytokines (interleukin 10) which are, in turn associated with pro-atherosclerotic and inflammatory states. Additionally, low testosterone is associated with raised fibrinogen and hypercoagulable states, theoretically, promoting atherosclerosis and atherosclerotic plaque instability and thus acute coronary syndromes.

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