Right now there are tens of thousands of men in the United States (not just Irvine, CA) with low testosterone who are not being treated. They are going to their doctor with all the signs of low testosterone but are being told that their levels are normal and that nothing can be done about it. They can not lose weight, their energy levels are low, they are dragging themselves to the gym reluctantly, their sex life is in the toilet and they mental focus and motivation is all but gone.
This is a huge quality of life issue for men and their doctors typically respond by saying “you are just getting old Sean.” Testosterone is the main hormone we optimize for men in anti-aging medicine. Here are the essentials of what you need to know about getting treatment for low testosterone.
1. What form of testosterone should you use?
If you are a man that is younger than 40 and still wants to have children then we can boost your testosterone levels by giving you something called HCG (human chorionic gonadotropin). This is an injection that you do nightly. HCG will increase your testosterone levels by telling them to make more testosterone naturally vs actually taking testosterone.
HCG will also keep your sperm counts evaluated which is important for any man that still wants kids. If we were to give that same man testosterone (vs HCG) then it will definitely boost his testosterone levels but can in theory suppress his sperm counts and make it harder for him to have kids. For most men I see in my practice this is not an issue so we give them testosterone. But I do have a few dozen men less than 40 who use either HCG by itself or HCG every other day with daily testosterone cream.
There are a few good published studies that if you give men testosterone and have them use HCG every other day that they will maintain adequate sperm production.
If you are not concerned about having children then you can either use a topical cream or injectable testosterone. As a general rule we want to try and mimic normal physiology as much as possible when replacing hormones. That is, we would give you smaller amounts of testosterone daily vs giving you an injection once or twice per week. The creams tend to have a better protective effect on your heart than do the injections.
The problem with the creams are that you can transfer the cream to your wife or girlfriend for up to 4 hours after you apply (if there is skin to skin contact). So that blocks off 4 hours out of your day that have to avoid sexual contact.
For me this is not an issue because I simply apply it right before I go to work each day and by the time I get home its fine. The second issue is that about 30% of men simply do not absorb the creams that well. When we recheck their levels they either stay the same or actually go down. So for these men we switch them to injectable testosterone. The dose we typically use for creams is 200mg/gram and have them use 1 gram per day.
FYI: androgen is 10mg/gram which is why it never works and I never use it. It simply is not high enough a dose.
2. What is the best injectable testosterone?
I have found through years of experience that using testosterone cypionate in grape seed oil in a dose of 200mg/ml and have patients inject 0.4ml every 4 days gives them optimal levels and they will generally feel amazing. The cypionate forms tend to provide optimal levels over a period of a week.
Many men that come to my office will tell me their doctors had them inject once per month or every other week. They would go on to say for the first week they felt great and then they absolutely crashed. The reason why they crash is because by day 8 their levels start to plummet again.
3. What are the downsides of using testosterone?
The reality is that there are very few downsides to using testosterone. What we see clinically is that 2% of men (1/50) will see an increase in male pattern baldness (which is easily treatable). Some men will notice that their testicles will decrease in size slightly (because of loss of sperm production). For 99% of men this is not an issue and they could care less.
I have and a few patients who wanted to use HCG in addition to keep their testicles large but most men and women could care less about the size of the testicles. A very small percentage of men will notice that they get some acne but this is more of an issue with women than in men.
Lastly, in men with higher percentages of body fat, they may notice that their nipples are tender and their breasts can become sore. This is because they are over converting testosterone to estradiol. For those men we simply lower the dose until they get lean.
The reality of using testosterone is that men who have levels in the upper 25% of the normal range have a 25-30% reduction in dying from all causes (including cancer and heart disease).
Here is great link to Dr. Neal Rouzier explaining the anti-aging effects of testosterone in men: https://www.youtube.com/watch?v=HYW5yIxPA18
In addition, within weeks of getting treatment they start waking up with erections again, their sex life improves, the weight starts coming off, their workouts improve dramatically and their mood and focus are back to what they had when they were in their 20’s.
To have your levels checked and evaluate by Dr. Sean Breen simply call us at 877-721-0047 or visit us on the web at www.DoctorBreen.com