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Ask the Experts about Fatigue and Anemia
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Testosterone Dosage
Jun 17, 2007

Dear Dr. Bob,

I'm a 38 year old male whose been positive for 6 years and not on any meds. T cells are above 500 and viral load below 15,000. Due to much fatigue and low sex drive I had my testosterone level tested which was 123. My doc prescribed 100mg testosterone cypionate weekly.

After 4 weeks of treatment my energy level is much better but still not much of a difference below the belt. Although, during my first week on testosterone I did have a spontaneous mid day woody just out of the blue! There hasn't been much more heat since. I would like to hope for an increase in my sex drive.

When should I return to have my testosterone retested and would it be best to go in the day before my injection.

Might my doc be able to increase my weekly dosage or injection frequency. Although I prefer the injections to the gels/patches (I would suppose they are messy and not as convenient as a weekly injection), could the gels/patches, because of their chemical make-up, be more successful in fueling my desire fire. Thanks for all your help!

Response from Dr. Frascino

Hello,

Since you are currently on the injectable formulation of testosterone replacement, the best time to check levels would be immediately prior to receiving a shot, when your testosterone level would be at its nadir (lowest point). I would suggest you check "free testosterone" for a more accurate assessment of your hypogonadal status.

As for injection versus gels or creams, the gels and creams actually have the advantage. First off they are neither messy nor inconvenient. They are self-applied once per day. The testosterone is absorbed quickly and completely. They are also more "physiologic." In other words, daily supplementation provides your system with testosterone on a continuous basis, which is what your system normally does naturally. Injections tend to give a walloping dose, sending testosterone levels sky high, which then gradually taper off and often fall below the desired range before the next dose is administered. Shots can also be painful, but then again, some folks may like that, so . . . .

You can read much more about testosterone replacement therapy for hypogonadism in the archives. Have a look.

Good luck.

Dr. Bob



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