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CC_California-Raisins-Title-Plate…testicular shrinkage is one of the major reasons men come to me…

Most of my male clients come to me from franchise hormone replacement centers.  Usually, it is not too late to fix the damage that these “men’s clinics” have done.

One of the biggest complaints I hear is, ‘My testicles are much smaller.’

Your brain sends signals to your testicles that “tells” them to make testosterone.  When you are taking testosterone from an outside source, your body lets your brain know that you have plenty of testosterone and don’t require more.  Your brain will not send the signal to produce any because you have enough.

Over time, the testicles begin to atrophy from lack of function.  You know, ‘use it or lose it’.  This is known as testicular shrinkage and will happen to every man using testosterone unless he takes measures to prevent it.

Human Chorionic Gonadotropin (HCG) is an analog of that signal.  In women, HCG signals her ovaries to release egg(s) and move the egg(s) down the fallopian tube(s).  In men, HCG signals the testicles to produce sperm and testosterone.

If you think HCG is for weight loss, here’s two articles for you…
http://medicinecoach.com/lose-30-pounds-in-30-days/
http://medicinecoach.com/the-hcg-diet/

Men have come to me after being on testosterone for a decade or more without ever being offered HCG.  After learning about HCG and asking their doctor, they’re told, “you don’t need that” or “we don’t do that” or “that’s just what happens” or some other excuse for “I have no idea what I’m doing.”

HCG requires a prescription.  It is taken as a subcutaneous injection via an insulin needle.

When men have come to me with testicular shrinkage, they are put on a high dose usually taken twice a week.  The length of time for the testicles to return to normal size and function varies.  Some guys return to normal in 4-6 weeks, others have taken 4-6 months.  I’ve noticed that extremely high doses do not necessarily reduce the time to return to normal.

Fortunately, every client I’ve gained because of testicular atrophy has returned to normal size.  Those who have lost fertility have also returned to normal sperm count.

My testosterone clients are strongly encouraged to maintain testicular size, form, and function by using HCG.  The maintenance dose of HCG can vary greatly.  There are numerous dosing schedules that are effective.  When dosing my clients, not only do I consider their health, I also consider the costs of therapy.  The regimen my clients get is both effective and economically sensible.

If you are getting testosterone without the proper adjunctive therapies, please speak with your doctor about maintaining your long term health.  This includes prevention of testicular atrophy and well as keeping estrogen levels in check.


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vgeo5s5bokrawfz49zicNearly every franchise clinic supplying men with testosterone could possibly be doing more harm than good.  Many good-intentioned physicians are also most likely harming their male testosterone replacement therapy (TRT) patients.  It’s not their fault.  They simply are not educated on how to properly and safely support the man’s system while supplying testosterone.

There are a few different ways to get testosterone into the body.  Many physicians will write a prescription for a cream.  The cream is applied daily to the skin and the hormone is absorbed into the bloodstream.  There are two major problems with testosterone creams.  The first is cross contamination.  Only about 50% of the testosterone is actually absorbed through the man’s skin.  The remaining 50% gets on his clothes, his linens, his towels, his wife, his mother, his son, his daughter, and anyone and anything he comes in contact with.  To make matters worse, his clothes are mixed with his family’s clothes during the wash, contaminating everyone in the house.  For this reason, none on my male clients use testosterone cream.

The second issue with cream is the conversion of a large percentage of testosterone into estrogens as it passes through the skin.  Men make estrogens by converting testosterone into estrogens via the aromatase enzyme.  Males need estrogens, just a much smaller amount than females.  This conversion through the skin cannot be stopped or blocked.  The end result is an increase in testosterone but also a significant increase in estrogens.

Another way to administer testosterone is through a sublingual tablet or troche.  The tablet or troche is placed between the cheek and gum once or twice a day.  As it dissolves, the testosterone moves through the lining of the mouth and into the body.  This method is acceptable but the absorption is erratic.  Each person holds the tablet in their mouth for a different length of time before swallowing.  Testosterone does not survive in the digestive system and is destroyed before it ever reaches the bloodstream.  Food, drink and brushing your teeth can also alter absorption.

A third way to receive testosterone is via an implanted pellet.  This involves a surgical procedure to implant several testosterone pellets into the hip area.  The pellets dissolve over the course of 2 to 4 months, depending on the individual.  This process is expensive, painful, and has a higher risk of infection.  Also, I’ve seen several patients whose body rejected the implants and literally pushed them back out of the body.

The pellets dissolve based on surface area.  Freshly implanted pellets have the largest surface area and therefore release the most testosterone.  As time goes on, the surface area of the pellet gets smaller and smaller.  Therefore, the amount of testosterone being released gets lower and lower.  Eventually, the man feels worse than before he started therapy and makes an appointment for fresh pellets.  This procedure causes a tremendous increase in testosterone followed by a steady decrease of the course of several weeks.

Arguably the best way to administer testosterone is through intramuscular injection.  This is the way my clients receive their testosterone therapy.  A once a week injection provides a steady level of testosterone.  Once steady state is reached, the testosterone level remains stable with little fluctuations.

The injection is taken in the gluteus muscle.  This area shows the least amount of risk for hitting a larger blood vessel.  Some men inject in the thigh or shoulder.  I do not recommend this area as there are larger blood vessels that can be pierced by the needle.

Perhaps the greatest lack of understanding with TRT involves the adjunct medications that the man should be receiving.  As mentioned before, males make estrogens by converting testosterone.  Theoretically, the more testosterone in the body, the more estrogens are being manufactured.  Without blocking this conversion, the man’s ratio of testosterone to estrogens will continue to be unbalanced.  A once a week tablet of anastrazole is all that is required to inhibit this process and keep his estrogens at bay.

The subject of human chorionic gonadotropin (HCG) is one I am passionate about.  Our brain detects the level of testosterone in our body.  When the level is low, it sends out a signal to the testicles “telling” them to produce the needed testosterone.  Due to many different factors, the testicles are no longer producing the required testosterone and the man should start TRT.  When testosterone is returned to the proper level, the brain recognizes this and does not send out the signal to the testicles.

Like anything else on our body, lack of use causes atrophy and dysfunction.  Over time, the testicles shrink in size.  After a long period of time of not working at all, the testicular function ceases.  If the man decides to stop TRT, the testicles will no longer function to provide the necessary testosterone.  They will also be significantly smaller.

The body recognizes HCG as this signal from the brain to the testicles.  Since the brain is no longer sending that signal, it must be provided to avoid these issues.  HCG must be given as a subcutaneous injection, it cannot be swallowed and does not absorb through the skin or mucus membranes.  There are several different regimens for administering HCG with most of them being effective in keeping testicular function.  Too much HCG can cause desensitization, making the testicles resistant to the dosing.  Too little HCG will not be effective.

As with any specialized area of medicine, hormone replacement is very specific to the individual patient.  Simply adding a hormone here or there is not the answer.  Going to a well intentioned physician is not always a good option.  Hormone clinics are franchises like McDonalds that can pop up anywhere to make a quick buck and disappear.

Before starting your testosterone replacement therapy, be sure to study the subject and become educated.  This is your body and you want it to perform optimally.


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Viagra and Cialis and Trimix Oh My!!!!

by West Conner

I make an effort to always have fresh flowers in our house for my wife to enjoy.  After just two days in the vase, it’s easy to see which flowers have erectile dysfunction in this picture.
Erectile dysfunction is one of the services available with the Medicine Coach membership program.  As men age, many notice some […]

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Should I monitor DHT?

by West Conner

Dr. Conner,
Should I monitor DHT? Can I do anything to keep it low? Is it ever an issue? Do you recommend I continue to take saw palmetto or does the science not support its use?
Thanks
Mark
You can monitor DHT if you want to, but I don’t feel it’s necessary. Dihydrotestosterone (DHT) is a byproduct of testosterone. […]

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I am frustrated to say the least

by West Conner

I just had a thyroid test done my doctor says my levels are normal. But I have gained 12 pounds in 6 months and I am still tired all the time and have really dry skin. I contacted an endocrinologist but they told me that if my levels came back normal there was not much […]

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I have not had a period in 8 months.

by West Conner

Dr. Conner,
I am 43 years old and have not had a period in about 7-8 months. I began having very intense menopausal symptoms (e.g. hot flashes, difficulty with sleep, waking up sweating profusely, irritability, extreme mood swings, weight gain, etc.) shortly after I turned 43 (about 3 months ago). My boss, who is a psychiatrist, […]

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Inject testosterone while using HCG?

by West Conner

Dr. Conner,
I came across your page on HCG after doing a basic Google search. I was wondering; your article says that you should do one week on, three weeks off.  Does that boil down to once a month? Also, on the three weeks off, is it ok to inject testosterone from a vial?
Your response is […]

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My doctor refuses to help me…

by West Conner

I have researched and read all your material that you have on line and think I am a prime candidate for becoming a client. I have been on testosterone injections for 10 years now and my gonads have shrunk to prunes. I read about how injections of the three injections per month of HCG can […]

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