Question Are stagble levels of T a good idea? [Archive]

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crazycrew

01-20-2010, 09:50 PM

I brought this over from another forum because I thought it is a relevent question that needs an answer.

Andrologia. 2008 Feb;40(1):44-8.

Effects of testosterone gel followed by parenteral testosterone undecanoate on sexual dysfunction and on features of the metabolic syndrome.

Saad F, Gooren L, Haider A, Yassin A.
Department of Men's Healthcare, Bayer-Schering, Berlin, Germany. farid.saad@bayerhealthcare.com

The effects of administration of testosterone (T) gel, resulting in plasma T levels in the low range of reference values, followed by testosterone undecanoate (TU), producing plasma T levels in the mid-normal range, were measured in 27 hypogonadal men aged 47-74 years. T gel had positive effects on the International Index of Erectile Function, the Aging Males' Symptoms Scale and International Prostate Symptoms Score and on the metabolic syndrome. The improvement was larger when TU was administered and plasma T levels were higher. The reduction in waist circumference and plasma cholesterol were larger with TU than with T gel, while the increases in plasma high-density lipoprotein and sex hormone binding globulin (an indicator of the severity of the metabolic syndrome) were larger with TU than with T gel. Both T gel and TU appeared safe on prostate parameters. Plasma haemoglobin and haematocrit were elevated but remained in the normal range.

The assumption that treatment with T is adequate when achieved plasma levels of T are within the reference range is no longer tenable. Some androgen-dependent biological functions require higher plasma T levels than others, and, moreover, these thresholds differ among men.
PMID: 18211301 [PubMed - in process]

Dr Gordon said to me in an e-mail

In my opinion stable levels of T is the last thing you want. It's not physiologic and doesn't work. Stable levels of T lead to tissue desensitization and lack of stimulation. That's why topical T preparations work so poorly, if at all. With women I have to make certain that serum T levels are very low at the time of an injection.

Your opinions.

JanSz

01-20-2010, 09:58 PM

Have you noted this words:
2008 Feb;
.....
Dr Gordon said to me in an e-mail
.....
That's why topical T preparations work so poorly, if at all.
.....
With women I have to make certain that serum T levels are very low at the time of an injection.
========================

women----injection

...

Bulldog

01-20-2010, 10:13 PM

Dr Gordon said to me in an e-mail

In my opinion stable levels of T is the last thing you want. It's not physiologic and doesn't work. Stable levels of T lead to tissue desensitization and lack of stimulation. That's why topical T preparations work so poorly, if at all. With women I have to make certain that serum T levels are very low at the time of an injection.

I know Dr. Gordon is a proponent of injected T esters, but how variable does he keep his patients levels using injected T esters? Wouldn't topical T preparations be MUCH more variable that any injected T ester? Isn't that why Dr. John likes T gel so much? I'm confused by Dr. Gordon's bolded statement above regarding variability and topical T preparations. Does anyone know what kind of protocol he starts his patients on using injected T esters? I'm curious what he believes is the best way to start out.

JanSz

01-20-2010, 10:25 PM

I know Dr. Gordon is a proponent of injected T esters, but how variable does he keep his patients levels using injected T esters? Wouldn't topical T preparations be MUCH more variable that any injected T ester? Isn't that why Dr. John likes T gel so much? I'm confused by Dr. Gordon's bolded statement above regarding variability and topical T preparations. Does anyone know what kind of protocol he starts his patients on using injected T esters? I'm curious what he believes is the best way to start out.

On his presentation on Secretropin I seen one of his patients at TT=1880
He had higher SHBG levels
but
I think his BAT levels were just right.

..

Noted, dr Gordon uses T injections for women.
..

agoraphobe

01-20-2010, 10:35 PM

i was curious at that lecture dr john did where dr gordon said he doesn't use topicals, it's interesting to learn he flat out doesn't believe in them.

GirlyMan

01-20-2010, 11:03 PM

Did they measure estradiole levels? I think that ratio may be quite relevant, if not prominent ... at least in terms of the ADAM test.

crazycrew

01-20-2010, 11:12 PM

On his presentation on Secretropin I seen one of his patients at TT=1880
He had higher SHBG levels
but
I think his BAT levels were just right.

..

..
Which is a good argument for me to up my dose dramaticly. Should have results of latest BW in a day or two. We'll see.

Still, I have heard very credible discussions about the benefits of normal cycle rhythms over a constant level of T. But what is a "normal" cycle and is it even monitorable? I will probably be switching to an every third day routine soon.

MarkLA

01-21-2010, 02:48 AM

"Normal" has T peaking in the early AM and then declining the rest of the day until it rises again early AM.

http://www.vrp.com/graphics/Male_diurnal_test_rhythm.gif

crazycrew

01-21-2010, 09:58 AM

"Dr Gordon said to me in an e-mail

In my opinion stable levels of T is the last thing you want. It's not physiologic and doesn't work. Stable levels of T lead to tissue desensitization and lack of stimulation. That's why topical T preparations work so poorly, if at all. With women I have to make certain that serum T levels are very low at the time of an injection."

This email was sent to him 2 days ago by the way.

crazycrew

01-21-2010, 10:02 AM

"Normal" has T peaking in the early AM and then declining the rest of the day until it rises again early AM.

http://www.vrp.com/graphics/Male_diurnal_test_rhythm.gif

This should indicate that to mimic normal rhytmms would be impossible. So given the half life if IM test wouldn't twice a week or every third day give you a rhythm cycle that stays within the "normal" test ranges?

Bulldog

01-21-2010, 10:14 AM

This should indicate that to mimic normal rhytmms would be impossible. So given the half life if IM test wouldn't twice a week or every third day give you a rhythm cycle that stays within the "normal" test ranges?

No, the more frequently you administer Test Cyp the flatter the levels would be.

crazycrew

01-21-2010, 10:20 AM

No, the more frequently you administer Test Cyp the flatter the levels would be.

Exactly, Isn't this why Dr Gordon and Dr J recommend weekly doses when using IM; for the cycle effect that you lose on gels?

Bulldog

01-21-2010, 10:35 AM

Exactly, Isn't this why Dr Gordon and Dr J recommend weekly doses when using IM; for the cycle effect that you lose on gels?

I believe so.

I'm still waiting for my last labs so I can compare my levels 3 days after my shot and 5 days after my shot to see how much variation there is. Unfortunately I can't do any testing later than 5 days after my shot because my local lab is not open on the weekends.

seekonk

01-21-2010, 10:35 AM

crazycrew

01-21-2010, 10:40 AM

Now I'm confused.

.

Welcome to my world Bro.:confused1:

Bulldog

01-21-2010, 10:40 AM

Now I'm confused.

I thought topicals caused levels that were less stable during the course of the day, but he seems to be contradicting this.

That is what confused me also. I'm not sure why he thinks that is true.

LowT

01-21-2010, 01:14 PM

"Normal" has T peaking in the early AM and then declining the rest of the day until it rises again early AM.

http://www.vrp.com/graphics/Male_diurnal_test_rhythm.gif

It seems to me that a topical would be the opposite of this graph. Morning application would cause levels to rise through the day and peak in the afternoon after which point levels would decline quite a bit through the night.

Presumably test levels rise during the night as part of the body's repair process and to prepare for waking.

Bulldog

01-21-2010, 01:23 PM

It seems to me that a topical would be the opposite of this graph. Morning application would cause levels to rise through the day and peak in the afternoon after which point levels would decline quite a bit through the night.

Presumably test levels rise during the night as part of the body's repair process and to prepare for waking.

That may be ture. However, at least it is still a DAILY cycle of high and low testosterone. With injected T esters you are on a WEEKLY cycle of high and low at best, and if you inject more than once per week the cycle gets flatter and flatter the more frequently you inject.

It would be nice if there were an injected T ester that had a one day half life (for daily injections) and could be injected SubQ (for those of us who cannot absorb T gel).

hebsie

01-21-2010, 01:32 PM

That may be ture. However, at least it is still a DAILY cycle of high and low testosterone. With injected T esters you are on a WEEKLY cycle of high and low at best, and if you inject more than once per week the cycle gets flatter and flatter the more frequently you inject.

It would be nice if there were an injected T ester that had a one day half life (for daily injections) and could be injected SubQ (for those of us who cannot absorb T gel).

...well there is Test Propionate, but I've heard negative things about using it for TRT/HRT

Bulldog

01-21-2010, 01:49 PM

...well there is Test Propionate, but I've heard negative things about using it for TRT/HRT

I have heard the same thing about Test Propionate. I guess I should have qualified my wish with ".....that works well for TRT".

crazycrew

01-21-2010, 04:26 PM

It seems to me that a topical would be the opposite of this graph. Morning application would cause levels to rise through the day and peak in the afternoon after which point levels would decline quite a bit through the night.

Presumably test levels rise during the night as part of the body's repair process and to prepare for waking.

Dr Gordon said
" In my opinion stable levels of T is the last thing you want. It's not physiologic and doesn't work. Stable levels of T lead to tissue desensitization and lack of stimulation. That's why topical T preparations work so poorly, if at all.."

Dr Gordons point is that gel applications do not "cycle" at all but rather have a stable and relatively flat lined rythm.

Bulldog

01-21-2010, 04:45 PM

Dr Gordon said
" In my opinion stable levels of T is the last thing you want. It's not physiologic and doesn't work. Stable levels of T lead to tissue desensitization and lack of stimulation. That's why topical T preparations work so poorly, if at all.."

Dr Gordons point is that gel applications do not "cycle" at all but rather have a stable and relatively flat lined rythm.

I don't think that is true. You should get a spike to peak T level somewhere between 2-4 hours after TD application and then a steady decrease back to baseline. You won't get that kind of cycle every day by administering the testosterone any other way.

crazycrew

01-21-2010, 04:49 PM

I have my doubts too but I was going by what the man said. Could it be he thinks it has much less of a cyclical effect than a natural cycle

Bulldog

01-21-2010, 06:02 PM

I have my doubts too but I was going by what the man said. Could it could be he thinks it has much less of a cyclical effect than a natural cycle

That's probably true. But injected T esters have even less of a cyclical effect, so I don't understand why he prefers them over TD application.

JanSz

01-21-2010, 10:29 PM

seekonk

01-22-2010, 11:39 AM

Hourly side by side

To me it looks like:

The variability is comparable. There is a difference of roughly 200 ng/dL between peak and trough in both graphs. In this respect, the topical simulates natural release in young men.

The timing and duration of the peaks differ. With the topical, the buildup to peak is much more rapid. Don't know whether this matters.

(2) could possibly be improved by splitting the dose, putting some on before bed and some more during middle of the night bathroom break.