|
WHAT YOU NEED TO KNOW
If You Are Using This Miracle Drug for
The Purpose of Transitioning From Female to Male, There
are Things You Need to Know Both the Good and the Bad.
remember:
Knowledge is power
Question: ARE THERE ANY BAD
SIDE EFFECTS FROM TESTOSTERONE USE
?
Though some testosterone side-effects are often
desirable, there are other side effects that are not and
can be problematic if not life threatening.
1. Mild (USUALLY no impending need to report to a
doctor, but report if severe or if you are unsure):
Stinging Sweat or Skin prickling, Edema (water retention
in the body tissues), Increased Sweating, Increased Body
Odor, Mild Headaches, Thinning of Temporal Hair/Front
Hairline, Male Pattern Baldness, Increased Sex Drive,
Soreness at Injection Site, Skin break-outs or mild acne
(meaning rare flare-ups generally before the next
injection is due).
2. Mild to Moderately Severe (Call your doctor):
Moderate Depression, Some Mood Disturbances, Nausea,
Anxiety or Agitation, Hot Flashes (while the ovaries are
being shut down, menopause symptoms may arise), Flushing
of the Skin, Injection Site Reaction, Breast Tenderness
or Enlargement, Acne Vulgaris (cystic acne that
scars).
2a. Side -Effects that show up in lab testing or
clinic visit: Minor Elevation of Blood Pressure,
Minor Increases in LDL Cholesterol Levels, Mild
Decreases in HDL Cholesterol Levels, Slight Elevations
in Hematocrit and Hemoglobin Levels, Higher than Normal
Range Serum Testosterone Levels (average adult male T
levels are between 300 ng/dl - 1,000 ng/dl <depending
on the lab & doctor patient limits>). Much of
these can be contolled by weight loss, reduction in the
amount of Testosterone injected, or medications.
High LDL and Lower HDL can be remedied with the
supplement Niacin. Beware: Niacin will make you flush,
itch, sweat, and tingle all over if you take too much at
once. If you have a history of elevated cholesterol and
low HDL (good) cholesterol, ask your doctor about Niacin
therapy. If this is an option, he/she will instruct you
with how to use this supplement in order to be most
effective and to build a tolerance to the flushing,
itching effects. I buy Flush-Free Niacin from Wal-Mart.
Works great; no flushing, itching, or sweating.
3. Severe (Call your doctor immediately or
family/significant others, call on the patient's
behalf): Marked Depression, Severe Anxiety/Rages
(this is usually a pre-existing condition that is
exacerbated by the testosterone not caused by it),
Yellowing of the Skin or Eyes, Nausea, Vomiting, Fever,
Difficulty Breathing, Migraine Headaches, Flushing of
the Skin, Injection Site Reaction, Black, Tarry Stools
or Light-Colored Stools, Dark Yellow or Brown Urine,
Frequent or Difficulty Passing Urine, Stomach
Pain.
3a. Severe Side-Effects that show up in lab tests or
clinic visit: Large Increase in LDL Cholesterol
Levels, Drastic Decrease in HDL Cholesterol Levels, High
Blood Pressure, Liver Enzyme Elevation, Dangerous
Elevation of Hematocrit and Hemoglobin Levels (generally
anything over 18 on Hemo and 50 on Crit). Some of these
can be contolled by weight loss, reduction in the amount
of Testosterone injected, or medications. High LDL and
Lower HDL can be remedied with the supplement Niacin.
Beware: Niacin will make you flush, itch, sweat, and
tingle all over if you take too much at once. If you
have a history of elevated cholesterol and low HDL
(good) cholesterol, ask your doctor about Niacin
therapy. If this is an option, he/she will instruct you
with how to use this supplement in order to be most
effective and to build a tolerance to the flushing,
itching effects. I buy Flush-Free Niacin from Wal-Mart.
Works great; no flushing, itching, or sweating.
4. Very Severe but Not Common: Possible Liver
Tumors (extreme cases), Kidney or Liver Disease,
Suicidal Thoughts. (Report Immediately)
Back to the Top
Question: HOW IS TESTOSTERONE IS
ADMINISTERED ?
INTRAMUSCULAR * PATCHES * GELS *
BUCCAL TABS
1. The most tried and
true proven method is Injectable. Available in Name Brand and
Compounded versions. Testosterone is an IM Drug or an
Intramuscular Drug meant to be deposited (depot) deep
into the muscle tissue for slow release or slow
absorption rate into the body to be assimilated by the
liver and pituitary gland.
Preferred Injection Sites (all perfectly
acceptable depending on dosage; the larger the dosage,
the larger the muscle should be):
1a. Gluteus Maximus Muscle a.k.a. Glute Muscle a.k.a.
Butt Muscle a.k.a Upper Hip Quadrant.
1b. Thigh Muscle preferably the V.L. muscle or Vastus
Medialis, the muscle that runs along the outer edge or
posterior area of the right or left thigh.
1c. Deltoid Muscle a.k.a Upper Arm a.k.a Shoulder
Muscle.
Others are Patches, Creams & Gels.
WARNING: If you miss a dose, inject your normal dosage
as soon as possible but do not double up on dosages.
Back to the Top
Question: WHAT ARE THE MOST POPULAR
TESTOSTERONES ?
TESTOSTERONE DELIVERY SYSTEMS: Injection, Topical
and Buccal
1: COMPOUNDED & NAME BRAND INJECTABLE
TESTOSTERONE: CYPIONATE - ENANTHATE - DEPO-TESTOSTERONE® - DELATESTRYL®
If one wishes to save money, Compounded Testosterone is
a great alternative and the same high quality of the
name brand provided your pharmacist knows what he/she is
doing. Compounding Testosterone takes a lot of muscle
and it is mixed by a specific formula. Since the generic
market is non-existent now, on site compounding is the
best alternative to the higher priced name brand
testosterones.
The name brand cypionate tends to be more
expensive and is only available by manufacturers Watson
as Cypionate and Upjohn as Depo-Testosterone®. The name brand enanthate tends to
be very expensive and is only available in either 5 mL
or 15 mL vials by manufacturers Watson as Enanthate and
BTG Labs as Delatestryl®
2. TRANSDERMAL PATCHES: ANDRODERM® & TESTODERM®
Available in Name Brand Only: Androderm® and Testoderm®. These are round patches that are
applied directly to the skin preferably over a major
muscle. The underside of these patches have a pocket of
testosterone and alcohol covered by a porous film that
allows the preparation to 'leech' into the skin or
muscle.
There are several downsides to this particular method.
2a. Site Irritation: The adhesive that holds this
plastic patch to the skin can cause aggravating itching
and rashes.
NOTE: The patch is NOT meant for application to the
genital area. It was originally designed to be placed on
the scrotum but this is simply not the case anymore. In
addition, the patch can be used on Pre-op and Post-op
Transmen and one is not preferred over the other.
2b. Low Testosterone Levels: Despite rumors, the patch
has proven (so far) lousy at retaining higher serum
testosterone levels. Yes, they remain somewhat steady as
long as you don't place the patch over a fatty area
where the absorption rate is compromised. Also, they are
notorious for falling off when a person sweats. This
also compromises absorption rates. Many guys have
noticed a decrease in their body and facial hair and
reported hot flashes and moodiness on the patch.
WARNING: If you miss a dose, apply your normal number of
patches as soon as possible but do not double up on
dosages/patches.
3. TOPICAL GELS: TESTOSTERONE GEL / ANDROGEL®
Some pharmacies can compound a gel form
similar to AndroGel®
Androgel® or slang T Gel is primarily used
for men with Low T levels who already have some natural
serum T levels.
I am not sure how effective this prep will be with
transmen.
Addendum: Thanks to a guy who wrote in
01-03-06, I now have an answer to this question!
He wrote:" Hi Nick -
I have enjoyed your site and gotten great information
from it. I visited the T FAQ page and saw
the question regarding Androgel. That is what I am using
and I am now in my 6th month. When my endo tested my T
levels at like month 4, I was actually a little
too high (I think it was something like 582), so we
actually cut back from 5 g a day to 3/4 of that using
the pump. I was also getting moderately bad acne on my
back and less so on my face, but between the overly high
T level and the acne, my endo wanted to cut me back just
slightly. I have already had my voice change,
musculature changes, fat redistribution to some degree
and am seeing increased facial and body hair. In
short, my experience has been terrific and at this time
would stick with it over injectable."
I wrote back: "Thanks so much for
sending this! I don't blame you a bit; if the topical or
patch worked for me, I would be happy to give up the
injectable form myself! This information will be a great
addition to the site! Thanks again."
How the gel works: A daily application of
AndroGel, 5.0 grams, 7.5 grams, or 10. grams delivers 50
mg, 75 mg, or 100 mg of testosterone, respectively, per
day, to the skin's surface.
But note! Approximately 10% of the applied testosterone
dose is absorbed across skin of average permeability
during a 24-hour period.*
One would assume that guys who don't require as much T
as before when they had ovaries will benefit the most
but if the absorption rate proves sufficient and the
price becomes reasonable, the gel seems to work well in
those who still have working ovaries.
Though this product can be transferred to another person
by touch. Allow to dry before dressing. If you fear
transfer when having sex, avoid application within 4
hours of sexual contact and wipe the area prior to any
contact. Wash hands thoroughly after each application.
WARNING: If you miss a dose, apply as soon as
possible but do not double up on dosages.
4. TESTOSTERONE CREAMS:
The cream has been reported to work well
for many - can be compounded in various strengths as
prescribed by your physician. The cream form is applied
to the skin similar to that of AndroGel®.
Read the precautions above for AndroGel®
and other T gels that are compounded.
Though this product can be transferred
to another person by touch. Allow to dry before
dressing. If you fear transfer when having sex, avoid
application within 4 hours of sexual contact and wipe
the area prior to any contact. Wash hands thoroughly
after each application
5:
BUCCAL TABLETS: Striant®
The Food
& Drug Administration has approved a unique
treatment option for men requiring testosterone
replacement therapy. The first of its kind, Striant
mucoadhesive is a controlled- and sustained-release
buccal system from Columbia Laboratories, delivering
testosterone into the bloodstream via the gums and
cheeks.
It's a
white tablet with one curved side, which is the side
that adheres to the gum surface above the upper front
incisor where the gum meets the lip, releasing
testosterone as the buccal system hydrates and softens
in the presence of saliva. The absorbed testosterone
absorbs directly from the blood supply in the mouth into
the superior vena cava, avoiding first-pass metabolism
by the liver, a problem that has limited the efficacy of
oral testosterone. Each buccal system delivers 30 mg of
testosterone and should be applied morning and evening,
about 12 hours apart.
- The
dose of Striant is 30 mg twice daily (morning and
evening).
- Apply
Striant, curved side of the tablet against the gum
above the incisor tooth on either side of the
mouth, flat side against the cheek. Place a finger
on the outside of the upper lip to hold the tablet
in place for 30 seconds.
- Rotate
to alternate sides of the gums with each
application, regularly inspect gums, and notify
physician of any abnormality. Do not chew or
swallow the tablet, and take care not to dislodge
it.
- To
remove the remaining tablet, gently slide it
downward from the gum to the tooth to avoid
scratching the gum.
- Striant
should not be used by men with known or suspected
prostate cancer, known breast cancer, all women,
and those with hypersensitivity to ingredients.
- If a
tablet comes out or is swallowed, one can be
replaced if it is close to the next dosing. If
not, wait until next dosing time.
Personal
Experience with this drug: Rarely stayed in place,
caused moderate to severe sore throat pain, caused
site irritation. Swallowed a tab once when eating.
-Nick
WARNING: If you miss a dose, see
above bulleted area
Back to the Top
Question: WHAT IS THE AVERAGE COSTS
FOR THESE TESTOSTERONES ?
PRICE EXAMPLES
OF TESTOSTERONE:
COMPOUNDED and NAME BRAND TESTOSTERONES:
A 10 mL vial of 200 mg Enanthate (in sesame seed oil) or
Cypionate (in cotton seed oil) Compounded by hand as low
as $45.00 ¥
Compare to the price of a 10 mL 200mg Vial of name brand
Depo-Testosterone (Cypionate) $91.99 or 5 mL
200mg Vial Delatestryl (Enanthate) $83.88 ¶
Or
Compare to the price of a 10 mL 200mg
Vial of Cypionate by Watson $109.99 or 5 mL 200mg
Vial Enanthate by Watson $89.39§
¥Source: Compounded Testosterones on this
site: http://www.thetransitionalmale.com/PDP
¶ Source: Drugstore.com (7-2004) - § Source:
Walgreens
+++All prices subject to change
_____
NAME BRAND INJECTABLE TESTOSTERONES:
The price depends on what pharmacy you use and what part
of the country you are in as prescription drugs do not
have a set price, pharmacies can charge what they want.
_____
TRANSDERMAL
PATCHES: Testoderm® &
Androderm®
Testoderm®
Patch
If you are like most guys, you are on a budget and
this method is expensive. In order to have a low
normal serum Testosterone level, you need to apply
either a 4.0 mg Testoderm® Patches to the
skin daily or apply a 6.0 mg patch daily.
Continuous nominal delivery of 5 mg
testosterone for one day. 60 cm(2) system, 328 mg
testosterone USP, 1.2 mL alcohol USP
Contents:
Inactive Ingredients: ethylene vinyl
acetate copolymer, polyisobutylene, light mineral oil
adhesive, polyester film backing, alcohol,
silicone-coated polyester and hydroxypropyl cellulose.
Costs:
A box of 30 count 4.0 mg Testoderm
patches average $111.19 30-Day $231.93 90-Day¶
A box of 30 count 6.0 mg Testoderm
patches average $115.43 30-Day $330.37 90-Day¶
(clearly the better deal, but higher
dosage may not be right for you)
¶ Source: DrugStore.com (7-2004)
+++All prices subject to change
Androderm® Patch
If you are like most guys, you are on a
budget and may not have RX coverage; this method is
expensive. In order to have a low normal serum
Testosterone level, you need to apply either 2, 2.5 mg
Androderm® Patches to the skin daily or
apply 1, 5.0 mg patch daily. Androderm® Gel
consists of: Testosterone, ethanol (alcohol), purified
water, sodium hydroxide (salt), Carbomer 940 and
isopropyl myristate.**
A box of 60 count 2.5 mg Androderm
patches average $158.22 30-Day $297.97 90-Day¶
A box of 30 count 5.0 mg Androderm patches
average $162.85
30-Day $464.32 90-Day ¶
WARNING: If you miss a dose, apply your normal number
of patches as soon as possible but do not double up on
dosages/patches.
¶ Source: DrugStore.com (7-2004)
+++All prices subject to change
Call your pharmacy for up to date pricing
ANDRODERM® GEL:
75 GM Box (30 25MG Pkts) 1 BOX $169.83 3
BOXES $507.50 (90 days!) ¶
150 GM Box (30 50MG Pkts) 1 BOX $171.99 3
BOXES $509.95 (90 days!)¶
Sources:
* Unimed
** AndroGel pamphlet
** AndroGel pamphlet FAQ
¶ DrugStore.com (7-2004)
+++All prices subject to change
Call your pharmacy for up to date pricing
STRIANT - BUCCAL TABS:
If you
are like most guys, you are on a budget and may not have
RX coverage; this method is expensive. No definitive
price date available yet. Estimated to be well over $100
per month.
Call your pharmacy for up to date pricing
Back to the Top
Question: ARE THERE ANY
DRUG INTERACTIONS WHEN USING TESTOSTERONE ?
DRUG INTERACTIONS
Cyclosporine Cyclosporine is an agent widely used to
suppress the immune system, and is used primarily during
organ transplantation and as a treatment to psoriasis.
Human Growth Hormone a.k.a. hGH, known as somatotropin,
is the most abundant hormone secreted by the pituitary
gland. Available by prescription only. Used to treat
patients with growth hormone insufficiency due to
limited supply. However, presently growth hormone is
used in a wide range of indications such as Turner
Syndrome, Chronic Renal Insufficiency, and Growth
hormone deficiency in adults. This prep is often abused
by bodybuilders and has a high mortality rate when
abused.
Warfarin Anticoagulation drug, a blood thinner similar
to Coumadin, used in stroke and heart attack victims and
often diet changes to limit Vitamin K intake, which can
thicken blood.
Back to the Top
Question: DO YOU HAVE ANY
HEALTH TIPS FOR ME WHEN USING TESTOSTERONE ?
HEALTH TIPS
1. Supplement your dietary calcium intake throughout
your life as a basic rule if you don't drink or eat
enough dairy, if you have a dairy allergy, or if you are
lactose intolerant.
2. Limit your salt intake to reduce edema, lower blood
pressure, and prevent sclerosis of the arteries.
3. Drink plenty of water to reduce Hematocrit and
Hemoglobin levels from raising too high from the
Testosterone. Tip: If you are well hydrated prior to
having your blood drawn, you are more apt to have a more
accurate H&H level and serum T level. But do not
over-hydrate! Drinking 8, 16oz glasses of water per day
is usually the norm.
4. If you notice your HDL (good
cholesterol) going down after T use, there are
supplements you can take to raise them. once is Niacin
but it's best if you take Niacinamide, which stops all
flushing Niacin causes. (ask your doctor before taking
this over the counter vitamin!) Flushing meaning Niacin
causes your skin to flush red, tingle, itch, and feel
hot. It can be very disturbing if you don't know what to
expect. Niacinamide adds something extra to stop this
and the extra won't hurt you. It's a form of Calcium.
This supplement also helps lower Triglycerides and LDL
(bad) Cholesterol!
Also, take a supplement containing Omega-3
Fatty Acids is great for elevating HDL, benefiting your
heart and stripping plaque from your arteries, caused by
a poor diet high in fats or genetic propensity. I
suggest Flax Seed Oil. It contains 5 times more
Omega-3's than Fish Oil. A great place to find this oil
is at www.nutritionexpress.com I buy from
them all the time; affordable and fast!
Back to the Top
Question: ARE THERE ANY
PRE-EXISTING CONDITIONS I SHOULD DISCLOSE ?
PRE-EXISTING CONDITIONS TO REPORT TO YOUR
DOCTOR
BEFORE YOU START TESTOSTERONE THERAPY
Breast cancer, diabetes, heart or blood vessel disease,
high blood calcium levels, kidney disease, liver
disease, previous heart attack, an unusual or allergic
reaction to testosterone, other medicines, foods, dyes,
or preservatives.
Back to the Top
Question: HOW DO I STORE
MY TESTOSTERONE ?
STORING YOUR VIALS, PATCHES, CREAMS AND/OR GEL
PACKETS:
Store at room temperature between 59 and 86°F (15 and
30°C) . Protect from heat and light.
Back to the Top |
