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Messages - Josh

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Help us to help you / Re: Reference Range Map
« on: October 09, 2016, 09:21:34 PM »

Is that correct - 0.5 - 30nmol/L ? if correct that has got to be the lowest bottom end ever?!


Therapy Issues / Re: 4 Years of Nebido, switch to sustanon?
« on: July 27, 2016, 06:30:41 PM »
Hi Student,

Glad you have been having such good results.

I think the thing to do in this situation is talk to the consultant and insist that while you are willing to try a 5 week interval, there must be regular blood tests to see where levels are at and the ability to alter the frequency accordingly. As ever, keep a diary of how you are feeling so you can relay this to the consultant when and if you need to discuss altering the frequency.

From memory you have one of the best consultants so I imagine that conversation will be easy to have and well received.


Therapy Issues / Re: Clomid Query
« on: July 15, 2016, 11:29:42 AM »
Gels and injectables are life long things unless of course something comes along to 'fix' whatever the problem is leading to the need to use TRT.

As far as clomid is concerned, it does seem to be similar in the need for a life long treatment plan. I am not sure if there is much data on long term treatment outcomes and safety. Personally if it were a treatment option open to and offered to me, I would want to see some evidence of long term safety.


Research / Re: Low T and the heart
« on: June 24, 2016, 12:12:09 PM »
Another recent study published. :)


Therapy Issues / Re: Nebido Administration While Standing
« on: June 24, 2016, 11:54:04 AM »
I did try and tell mine and she said she doesn't have the time to administer it over 2 minutes as she only gets 6 minutes per patient. I assume maths wasn't her best subject!

Sent from my HTC 10 using Tapatalk

Worrying isnt it! Its why I prefer to self inject, then I know that the person administering the injection is reliable  ;D

News / Re: A momentous day
« on: June 24, 2016, 11:36:35 AM »
Does this mean EU guidelines are now redundant?

The EU guidelines for hypogonadism are, in my opinion, the best and most comprehensive guidelines there are at present. As guidelines they have never been anything more than a guide that doctors can follow or not, so they remain just that :)


Therapy Issues / Re: Nebido Administration While Standing
« on: June 19, 2016, 01:13:08 PM »
Seems to be fairly common that healthcare professionals administering Nebido believe it should be injected as quickly as possible and if the patient feels pain, tough. Basic training says that depot injections should be administered at a rate of 30sec per ml. Try telling a nurse that though!


Therapy Issues / Re: Nebido Administration While Standing
« on: June 19, 2016, 01:05:46 PM »

What on earth is a Harpy? :)

a rapacious monster described as having a woman's head and body and a bird's wings and claws or depicted as a bird of prey with a woman's face  :o

Hi Dave,

I can understand the viewpoint of the doctors - as far as I know there have been no long term effects studies carried out so it is rather a case of the unknown.

I will answer you concerns in order:

Am I corect in thinking I may be turning into primary hypogonadism by taking injectable It would not 'turn' into primary, however your testicles would not produce testosterone and long term this could lead to leydig cells becoming less efficient/unable to restart. From studies I have seen testicles can return to normal function after several years of TRT

Is nebido too strong for someone with baseline low normal levels i.e 10-11 nmol With the correct injection intervals it should be fine. My suggestion would be if this is a concern, maybe opt for something like Sustanon because its easier to adjust intervals with them being much closer together.

Is six months on injectable reversable By reversible I assume you mean will the testicles produce testosterone and sperm when clomid or HCG is given if injectables have been used for 6 months - in which case the answer is yes, there is high likelihood of natural testicle function in this scenario

Stimulating leydig cells with clomid and hcg is a no no in the UCLH endo team unless trying for kids . I dont mind trying stuff out once it gets rid of my dizzy head and moments of  lightheadedness. It would be worth it if it gets rid of this

With regards to my medical exemption certificate, will I effectively by void of free prescriptions because my hypopituitarism (secondary) becomes primary. Medical exemption is based on diagnosis, a different treatment type will not alter diagnosis. If you are secondary then treatment will may cause an effect similar to primary but it would not alter the underlying diagnosis.

Hope that helps


Therapy Issues / Re: Nebido Administration While Standing
« on: June 19, 2016, 09:39:24 AM »
I can see how it would be easier to lay down to administer. It makes it easier to ensure you dont contract muscles (although a needle and 4ml of oil based medication being injected into your muscle tends to serve as a reminder to not contract your muscles!) Also it is probably more comfortable with the length of time to inject.


Therapy Issues / Re: Nebido Administration While Standing
« on: June 13, 2016, 11:00:24 PM »
Hi Billy

Yes it's common to administer nebido while standing. Doing so should have no impact on treatment. Keep a note of how you are  feeling and compare with next time.


News / Re: testosterone levels
« on: June 12, 2016, 08:53:35 AM »
Hi Dave

Testosterone levels are generally at their highest after sleep, so yes if you work shifts your levels are likely to be at their highest at a different time to someone who is sleeping at night time.


Therapy Issues / Re: Testogel transference
« on: June 08, 2016, 02:28:48 PM »
I have read some case studies regarding transference and in every case contact was more direct, for example a wife applying gel for her husband and not washing her hands after.

In general as soon as the gel is dry the opportunity to transfer has gone. From dried gel traces of testosterone *might* leave the skin and then be picked up by another persons skin, however it would not be able to enter the other persons body without an appropriate vehicle (alcohol in the case of gels) and even if it did, there would have to be a LOT of contact, over a prolonged period of time.

So to answer your questions specifically:

- Is there any testosterone left on my skin 6+ hours after applying that could be transferred from brief contact? Yes there may be testosterone on the skin, it is highly unlikely to transfer to another persons skin in a way in which is could enter their system

- I was my hands after applying but would there be any transferred to the sink/taps or towel that could be further transferred to whoever touches it? Yes there may be tiny amounts on sink/taps/towels but the chances of these tiny amounts entering another persons system is minute

- I don't shower at night unless I've been to the gym in the evening, which with a newborn doesn't happen very often at the moment! Is there a risk of any of it rubbing off onto the bed sheets and then on to my girlfriend via the bed? It is generally on my skin for at least 10 hours before I go to bed. Again, yes tiny, tiny traces could be on the sheets but not in any form that could viably enter other persons body

- I've been applying it to my legs to lessen the chance of transference from contact with my arms/upper body which is more likely in bed. It seems to still be working even though advice is to apply to upper body. The gel is dry before I put clothes on but is there any chance of it coming through my trousers as the baby is often sat on my thighs? I think there is more chance of winning every lottery draw in a row for the next month. But seriously, the chances are beyond remote

I hope that reassures you :)


Diagnosis Problems / MOVED: 21 y/o Low LH and Low Test
« on: May 26, 2016, 11:05:49 AM »
This topic has been moved to Personal Diaries ( at the request of the topic creator.

Diagnosis Problems / Re: endo recommendation .. advice please
« on: April 24, 2016, 11:54:38 AM »
A doctor can write to your GP and recommend a treatment if they are private or NHS. The GP has to decide if they wish to take the recommendation and treat you, because they are responsible for that treatment.

A treatment recommendation from a private doctor can be viewed less favourably by *some* GP's, however if its a doctor with valid credentials and good reputation this will help. Some GP's will stick to only treatments they have experience of, some will be more flexible.


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