The GOLDEN RULES of TOT excerpted from the upcoming TOT Bible found on Amazon.
5) Testosterone Optimization Therapy, done correctly, uses testosterone ONLY to establish a baseline for your blood work and correctly evaluate your vital biomarkers.This rule also applies to men of reproductive age and capacity. hCG should not be started with TOT until 6 weeks AFTER you establish baseline lab work. This allows your physician to properly understands what is happening to your endocrine system when exogenous testosterone is used by itself.
6) Aromatase Inhibitor (AI) medications are ONLY used when there is a CLINICAL NEED to do so, based on blood work and pronounced side eﬀects. AI’s can cause serious negative eﬀects to bone mineral density over time. When they are dosed, the MED (Minimum Effective Dose) principle should be applied, with the end goal of gradually eliminating AI use as soon as a therapeutic range of both testosterone and estrogen is established. This therapeutic range is said to be reached when there are no side effects and the patient feels happy and balanced. Starting a patient on hCG, testosterone and an AI at the same time is not only INEFFECTIVE, but also unnecessary FOR BIOMARKER EVALUATION. When therapy is initiated with all three of these medications, there is a total lack of understanding when it comes to identifying what each medication is doing in combination with the others. If anything, the patient is playing a “guess the problem” game with his endocrine system for months (usually years) because they can’t properly evaluate biomarkers. There is nothing good than can come from it, plain and simple.
7) The usage of medications to increase luteinizing hormone (LH) levels (hCG, hMG, clomiphene) and consequently raise testosterone levels without disrupting your body’s homeostatic mechanisms (HPTA/HPGA axes) should NORMALLY be the front line treatment with men who are of prime reproductive age (18-35 years old).
If a patient over 35 agrees to it, the usage of a LH stimulating medication alongside TOT is acceptable. The patient must be aware of the risks posed to fertility when using Testosterone, which are minimal. For men who wish to have children in the future, the ULTIMATE strategy involves having the patient attain a measured sperm count and freeze their sperm before they start TOT. This strategy allows men to have easy access to viable and motile sperm when they are ready to have children.
8) There is no such thing as a one-size-ﬁts-all TOT delivery system.
In our opinion, based on decades of experience and consultation with the top progressive physicians all around the world, injectable testosterone is the best way to optimize blood levels of testosterone in the fastest and most efﬁcient way possible. Some men will be needle-phobic (i.e. scared of needles), and in those instances, transdermal delivery is the best alternative strategy for maintaining lifelong patient adherence. Beyond those two delivery systems, EVERYTHING else is suboptimal with respect to the likelihood of potential issues and the added inconveniences to your daily lifestyle.
9) You must regularly perform blood work and become familiar with YOUR speciﬁc biomarkers to assess your overall health when undergoing TOT. You should understand the speciﬁc tests to run, the ranges you should be within for each biomarker, how often to run each test, and any exceptional circumstances to watch out for. Since TOT is a lifelong treatment, that means you’ll be regularly running these tests and tracking the results for the rest of your life. Phlebotomy (donating blood) should only happen when there is an elevation of platelet count (as clearly explained in this book), along with high levels of both hemoglobin (+20 g/dL) and hematocrit (+54%).
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I’m 50 and on 300 mg of t split biweekly . I take .5 mg anastrozole on injection day. My estrogen stays around 20-25. I have a heavy history of cancer in my family. So higher levels of estrogen worry me. My T level stays around 1100 ng
Patients taking Viagra are less likely to suffer a heart attack, new research claims.
Men taking the impotence drug were found to have a lower risk of having a heart attack or dying from heart failure than those not on the medication.
The findings mean Viagra could soon be used to treat hundreds of thousands of heart failure patients and even prevent fatal heart attacks, scientists say.
Experts from the University of Manchester studied 6,000 diabetic patients who had been given Viagra to treat erectile dysfunction.
The drug relaxes muscle cells in the blood vessels supplying the penis, allowing more blood to flow there.
This increased blood flow increases the likelihood of getting an erection.
Given the increasing reports of deaths in which the use of Viagra may be implicated, clinicians need to exercise caution when advising their patients with heart
Experts believe a key ingredient in Viagra called PDE5i, which relaxes blood vessels, also prevents damage to heart cells.
Heart failure is caused by the heart failing to pump enough blood around the body at the right pressure.
It most often occurs because the heart muscle has become too weak or stiff to work properly and is usually treated with medication which supports the heart.
Despite diabetics being prone to heart problems, the study participants did not suffer as many incidents as similar patients not on the drug.