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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by zuma on November 29, 2005, at 14:17:43
does anyone know the protocol for using testosterone injections to supplement antidepressants? dosage info, etc.?
Posted by jamestheyonger on November 29, 2005, at 18:22:09
In reply to testosterone w/ADs, posted by zuma on November 29, 2005, at 14:17:43
Provided tests prove out a low T level, supplement
T to bring T into normal level. Normal level
is a wide range so find the least amount ot T that brings on the most improvment. Perhaps 500-700 ng/dl would be a place to start.
Posted by jamestheyonger on November 30, 2005, at 12:08:38
In reply to Re: testosterone w/ADs, posted by jamestheyonger on November 29, 2005, at 18:22:09
> Perhaps 500-700 ng/dl would be a place to start.
If you are male, that is. The research I read indicates people are only supplementing T if it is low; it stands to reason that supplementing
T on someone who is normal would increase cancer risks (at least for males). In any case the research I have read indicates T in often low for males and females who are on AD's and/or depressed. I cannot find a study that nails it down as to the cause; is it the AD's or is it the depression (or both).There are several patches for T, this is the preferred method as they yield the smoothest levels. Shots (this is long acting T) tend to have a large peak in levels right after the injection. It is described as quite a rush. I would want to avoid this. There is a gel which is for daily use; it seems to me the patches would give easier smoother dosing. T is available via pills but there are some health risks with some of them.
I read that some people are starting with shots till the correct level is found that moving to a patch.
Posted by Declan on November 30, 2005, at 13:39:44
In reply to Re: testosterone w/ADs, posted by jamestheyonger on November 30, 2005, at 12:08:38
I've been told that patches result in skin irritation in warmer humid climates. The slow release capsules have been the best for me so far. Blood levels are more even. With the troches (dissolved in the buccal pocket), there was a 9 fold difference between the highest and lowest readings. Injections would be worse that way. You don't want to shut down your own production.
Declan
Posted by jamestheyonger on November 30, 2005, at 16:06:19
In reply to Re: testosterone w/ADs, posted by Declan on November 30, 2005, at 13:39:44
> The slow release capsules have been the best for me so far. Blood levels are more even.
What is the brand name ?
Posted by alohashirt on November 30, 2005, at 19:36:18
In reply to Re: testosterone w/ADs, posted by jamestheyonger on November 30, 2005, at 12:08:38
> > Perhaps 500-700 ng/dl would be a place to start.
>
> If you are male, that is. The research I read indicates people are only supplementing T if it is low; it stands to reason that supplementing
> T on someone who is normal would increase cancer risks (at least for males). In any case the research I have read indicates T in often low for males and females who are on AD's and/or depressed. I cannot find a study that nails it down as to the cause; is it the AD's or is it the depression (or both).
>
> There are several patches for T, this is the preferred method as they yield the smoothest levels. Shots (this is long acting T) tend to have a large peak in levels right after the injection. It is described as quite a rush. I would want to avoid this. There is a gel which is for daily use; it seems to me the patches would give easier smoother dosing. T is available via pills but there are some health risks with some of them.
>
> I read that some people are starting with shots till the correct level is found that moving to a patch.
>
The gel smells nasty, the patch is unreliable, even though it produces a hump I prefer a shot every ten to 14 days.
Posted by jamestheyonger on November 30, 2005, at 20:00:39
In reply to Re: testosterone w/ADs, posted by alohashirt on November 30, 2005, at 19:36:18
> the patch is unreliable,
How is it unreliable ? Falls off, irritates, uneven levels ?
Posted by zuma on November 30, 2005, at 21:00:59
In reply to Re: testosterone w/ADs, posted by alohashirt on November 30, 2005, at 19:36:18
> The gel smells nasty, the patch is unreliable, even though it produces a hump I prefer a shot every ten to 14 days.
>
>what dose do you inject with? and what was your T level before you started injecting?
Posted by Declan on December 1, 2005, at 1:03:33
In reply to Re: testosterone w/ADs, posted by jamestheyonger on November 30, 2005, at 16:06:19
No brand name that I'm aware of. It's bioidentical slow release testosterone, compounded at the pharmacy. Most I guess is dealt with by the liver, which is the drawback. I've tried troches and slow release capsules. There's also implants.
Declan
Posted by jamestheyonger on December 1, 2005, at 1:48:21
In reply to Re: testosterone w/ADs, posted by Declan on December 1, 2005, at 1:03:33
" Most I guess is dealt with by the liver, which is the drawback. I've tried troches and slow release capsules. There's also implants."
> DeclanYep, via the oral route requires higher doses, I have read, to get correct levels. The higher levels can have negative effects on the liver and lipids. The implant is not covered by my HMO,
otherwise it would be, I think, an excellent choice.Any idea on how this effected your lipid profile ? My ldl/hdl/triglyceride levels suck right now so I suspect they need to improve b4
my doc will play around with T.
Posted by Declan on December 1, 2005, at 12:24:19
In reply to Re: testosterone w/ADs, posted by jamestheyonger on December 1, 2005, at 1:48:21
My lipid profiles are really good, but I dunno if that's the T. I'd imagined it was diet, but now you mention it, increasing cholesterol may be the body's way of trying to correct low hormone levels. Then again I have my lipids tested regularly, maybe because of a negative effect from the capsules as you say. My doc's problem with the implants (apart fro their invasiveness) is that it's impossible to titrate doseage once they are in.
Declan
Posted by jamestheyonger on December 1, 2005, at 14:18:45
In reply to Re: testosterone w/ADs, posted by Declan on December 1, 2005, at 12:24:19
"My lipid profiles are really good, but I dunno if that's the T. I'd imagined it was diet, but now you mention it, increasing cholesterol may be the body's way of trying to correct low hormone levels."
There is a correlation between being overweight and higher estrogen in males. In males production of estrogen is how the body controls production of T. Fat is converted to estrogen. As estrogen goes up T goes down. A negative feedback loop. I would think increased cholesterol (note that is *sterol, the precursor to steroids) would increase estrogen either directly or via the fact
that those who are overweight tend to have worse lipid profiles.This is starting to look like an icky downward spiral. AD are associated with weight gain, weight gain is associated with increased estrogen
and lowered T, AD's or depression lowers T, lower T means more fat is created. Type-II diabetes/ metabolic syndrome follow.They revised what is called obese, I am ~20 lbs overweight and now considered obese. I get tested for Type-II diabetes this weekend; the icky glucose tolerance test.
http://www.lef.org/protocols/prtcl-130b.shtml#obe :
"A consistent finding in the scientific literature is that obese men have low testosterone and very high estrogen levels. Central or visceral obesity ("pot belly") is recognized as a risk factor for cardiovascular disease and Type-II diabetes. Research has shed light on subtle hormone imbalances of borderline character in obese men that often fall within the normal laboratory reference range. Boosting tes-tosterone levels seems to decrease the abdominal fat mass, reverse glucose intolerance, and reduce lipoprotein abnormalities in the serum. Further analysis has also disclosed a regulatory role for testosterone in counteracting visceral fat accumulation. Epidemiological data demonstrate that relatively low tes-tosterone levels are a risk factor for development of visceral obesity (7, 237).One study showed that serum estrone and estradiol were elevated twofold in one group of morbidly obese men. Fat cells synthesize the aromatase enzyme, causing male hormones to convert to estrogens (278). Fat tissues, especially in the abdomen, have been shown to literally "aromatize" testosterone and its precursor hormones into potent estrogens (80, 237-242).
Eating high-fat foods may reduce free testosterone levels according to one study that measured serum levels of sex steroid hormones after ingestion of different types of food. High-protein and high-carbohydrate meals had no effect on serum hormone levels, but a fat-containing meal reduced free testosterone levels for 4 hours (243).
Obese men have testosterone deficiency caused by the production of excess aromatase enzyme in fat cells and also from the fat they consume in their diet. The resulting hormone imbalance (too much estrogen and not enough free testosterone) in obese men partially explains why so many are impotent and have a wide range of premature degenerative diseases"
Posted by alohashirt on December 1, 2005, at 21:00:22
In reply to Re: testosterone w/ADs, posted by jamestheyonger on November 30, 2005, at 20:00:39
> > the patch is unreliable,
>
>
> How is it unreliable ? Falls off, irritates, uneven levels ?
>uneven (low) levels, irritates skin, needs to be taped on to stay on, if you are hairy it hurts when removed, dangerous if you have kids in your house (used patches can be dangerous to children.)
Posted by zuma on December 20, 2005, at 17:06:39
In reply to Re: testosterone w/ADs, posted by Declan on November 30, 2005, at 13:39:44
> I've been told that patches result in skin irritation in warmer humid climates. The slow release capsules have been the best for me so far. Blood levels are more even. With the troches (dissolved in the buccal pocket), there was a 9 fold difference between the highest and lowest readings. Injections would be worse that way. You don't want to shut down your own production.
> Declanjust a quick question, if the patch and pills are just as effective as injections, why do bodybuilders ONLY inject testosterone? they claim it's the only way it's effective.
Posted by ed_uk on December 21, 2005, at 12:52:00
In reply to Re: testosterone w/ADs, posted by zuma on December 20, 2005, at 17:06:39
>just a quick question, if the patch and pills are just as effective as injections, why do bodybuilders ONLY inject testosterone? they claim it's the only way it's effective.
....because they overdose, they don't take 'medicinal' doses. They'd have to apply about 30 patches all at once - not very convenient .......and VERY expensive.
Ed
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