T-MALE

TESTOSTERONE


 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.

Knowledge is power


Question Index

What Are the Side Effects?

How It's Administered

Most Popular Testosterones: [Injectable, Gel, Patch, Buccal Tablets & Creams]

Costs of Testosterone

Drug Interactions

Health Tips

Pre-Existing Conditions to Report

How to Store Your Testosterone


 

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) 

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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 (from best to ok): 


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.


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Question: WHAT ARE THE MOST POPULAR TESTOSTERONES ? 


TESTOSTERONE DELIVERY SYSTEMS



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.
Addendum: A pharmacy here in Oklahoma City states that they can make transdermal patches on site. If you'd like more information, please write to me.


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 is 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
®


This is quite new though pharmacists have been making T cream for some time now. But I am told that pharmacists who compound T can compound the gel if they can obtain the formula.


Androgel or 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.


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 may 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: Information coming soon

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.

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

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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 $40.00


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




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


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.

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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

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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. 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!

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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. 

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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. 

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