Allergic to TRT? Dosing Schedule? - Reddit AMA #1, Part 5

Excerpt from our first Reddit AMA podcast video: Can someone be allergic to Testosterone? Other aspects of a TRT program? A bit of discussion on a dosing schedule included.

This editable transcript was computer generated and might contain errors. People can also change the text after it was created.

Garrett Soames: Yeah, I'll read it out. So Let's see, rde79 writes, Hey, I've been on TRT several years. Now when I first started, everything was great. I received all the positive benefits after a while TRT just stopped working instead of feeling good. I now feel rather terrible after injection. And for the next few days, my body feels achy sore. And I am tired pretty much no energy. It takes a good week or so before I start to feel better, This has happened over the last few years. During that time, I've switched protocols, this includes amount and frequency, reducing The dose has mitigated. Some of these problems. However, I don't get any benefits from TRT.

Garrett Soames:  Some other issues that surface post-injection are tinnitus and a stuffy nose. They both resolve about a week post injection. I've changed carrier oils. I've even tried the cream. Nothing has helped any idea as to what might be going on.

Brian Mckinley: Yeah. So he also goes on to say You know, we asked him a little bit of a follow-up because there's a lot there. We need a little bit more context and you know, he went to say that he's currently taking A testosterone Siphonate 100 milligrams once a week. And then listed off some multivitamins and some other medication that wouldn't be related to this TRT. Um so there's a couple of things going on there. Obviously, this man has tried a couple of different regimens and amounts and it kind of sounds like he's just kind of trying anything to see what might cause a change or what might not cause a change. But let's take a from a TRT. Centric. Look what could be going on with his dosing?

Brian Mckinley:  That might be causing any issues, so we're gonna look at that. So testosterone sniping, 100 milligrams a week. First off, let's say this right. Testosterone cyphenate. Testosterone ethanate. There's many testosterones that are out there and the difference between them is essentially only how many carbon chains are, kind of on the end of the molecule, which means, like how quickly your body, absorbs it and how much of it kind of gets into your body over time, which changes the half-life of product and half life of the product, is, how many days, or how much amount of time before half of what you inject or take is gone. And so, What you have is okay. Well if you're doing a hundred milligrams on this day, you know by the time you reach your half-life and for testosterone cyphenate that's about two to four days depending on the individual.

Brian Mckinley:  and, You'd be down to about half by that, right? So, You would never really want to take a substance like testosterone Siphonate. Where it's half. Life is about

Brian Mckinley:  Half of a week or so, and then take it weekly. Like that is not something we would ever advise someone to do. Because when you take any, any amount of outside testosterone, it shuts down your body's natural production, right? And so that's usually not a problem because the amount that you take is usually going to raise you up higher than what your battery's natural production is providing the first place, which is why you sought out TRT initially. And so, No big deal. But when you do it once a week, what can happen is? You have this big arch of like, Okay, I injected about day, you know, that day or later, it goes up really high and then it starts to come back down. Well, What can happen with that is? It can go lower than what you were before when you started. If you're taking too low of a dose or the frequency is a

Brian Mckinley:  But say incorrect for this medication we would always advise at least twice a week because the idea is buying that three and a half days, we want the next injection to occur so that you never dip below where you were naturally. And it's always this like nice little up bump up, bump up bump and it's a lot smoother. Your body loves smooth predictable, things. It hates it hates peaks and it hates crashes, throws everything off. So, your body's gonna be angry. If you're doing that, regardless of what milligrams are taking it's it's a roller coaster. We don't like that. So, even without the dosage, we would say that like this would cost someone to feel weird because their estrogen and their testosterone gonna shoot up, they're gonna have a lot of emotions. They're gonna have a lot of side effects. They're gonna have a lot of benefits, then, you know, if a week goes before your next injection, you're gonna bottom out, you're gonna feel a distinct difference there, it's not going to feel good.

Brian Mckinley:  and now if we take the dosage into account a hundred milligrams a week, Is typically. Below what we would normally prescribe as a starting therapeutic dose. Um, we shoot for maybe 140 milligrams a week for most patients, when we start out, that's just us, depending on their, their needs, their goals, and their current testosterone levels, that's usually gets people to where they need to be. And again, that's going to be broken up into two injections typically so maybe like 70 milligrams and so A hundred milligrams once a week is definitely enough to shut down your own testosterone production. Suppress it and then have yourself get very little benefits because the dose is so low and then all the negatives of having a crash course going on in your body. So, you know, just that alone without talking about the side effects, that is what I would change about the treatment program.

Brian Mckinley:  This other stuff that's going on, I'll let Garrett kind of talk about that because that's its own separate thing.

Garrett Soames: Yeah, right. So regardless you know like Brian said that dose and the dosing schedule are certainly way off so that's I think that's pretty clear. So it's it's possible you know that rde79 could literally just change up his dose and dosing schedule, he might benefit he certainly would benefit from at least twice a week. Maybe he might be one of those guys that benefits from the Daily like Sub Q injections.

Garrett Soames:  Again, we don't have full context so we don't know if he's tried those those routes but at the very least, we know. He needs to increases dose and increases frequency but those even doing that doesn't really explain some of these other symptoms, the body aches and stuff and feeling, sore and tired. I actually question whether or not his estrogen level, his as also taken a hit. If you think about it, you know, our natural estrogen production. We, it always starts to testosterone and then it's converted to estrogen. If he's if he's only injecting a hundred milligrams, he might be one of those low converters again on average, you can convert 1 milligram to four to six of total testosterone so maybe he has a low conversion and then he also maybe has high sex hormone by any globulins or, you know, high albumin levels. And so his free testosterone may be in the tanks anyways.

Garrett Soames: You know, so total Testoster, we don't know what it is there. And again, if he's not converting his low testosterone into estrogen, he's going to have symptoms of low estrogen as well. So we know low, estrogen symptoms, our body aches, joint aches, fatigue, low sex drive. You know, amongst another, you know, a bunch of other ones. So, all of the symptoms, he describes could literally just be from low estrogen, because he doesn't have enough testosterone to convert. So that's a possibility. The only thing that kind of throws me off,…

Brian Mckinley: Yeah.

Garrett Soames: you know is this tinnitus and the stuff he knows and it is for those who don't know is ringing in the ears.

Garrett Soames:  That's a little odd. You know, in my thought on that matter is, it's possible. You know, it's it's rare but it certainly can't occur. That it could be a different allergy even though he's tried different carrier oils. But there's no way he's allergic to the testosterone itself. Because again, if you were to have an electron microscope and look at natural produced testosterone and exogenous testosterone, they are, you know exactly the same So, the only thing that makes sense to me, otherwise might be actually a cortisol response. Normally, as testosterone goes up, cortisol goes down. And is testosterone goes down. Cortisol goes up. So they kind of alternate.

Garrett Soames:  however, in in an acute stress, response fight, or flight, both testosterone and cortisol both shoot up, you know, like if there were bear or something, your testosterone actually shoots up as well as your cortisol ready to fight or flight, Um, and so in living in a modern stressful society, a lot of people actually get problems with their adrenal glands and adrenal fatigue. So it's possible as he's injecting testosterone, he's been under so much stress so long That it's recognizing the testosterone rapid induction of testosterone as a stress response so his adrenal glands freak out and say, Oh, fight or flight. Here's a bunch of testosterone. Let's shoot up and and release cortisol at the same time. And all of those symptoms. He's describing could also be from this abnormal acute. Hormonal feedback response.

Garrett Soames:  From the adrenal glands, it would suggest that he lives a stressful life and that he needs to you. Do more yoga, he needs to take a vacation things like that, if that's if that's truly what's going on. But beyond that, you know again I hope this guy certainly finds some help. The first recommendation, as Brian said, the easiest thing would be to change the dose and the schedule increase the dose increase the frequency that may sort out 90% of these issues. He may again need some further testing, but again, I think we can say with confidence, it's not an allergy to the testosterone.

Brian Mckinley: Nice. Yeah. And you know a little bit of a wrap up on that one would probably be we would if that was someone who was our patient,

Brian Mckinley:  we would have a lot more context and maybe be able to give more of an exact cancer. We may be able to know. We may order like their free testosterone and kind of follow up on that. We may order an allergy panel and follow up on that. That's probably the course of action we would take. So, you know there there's some avenues there and we do hope for hope for the best. But that's just the advice that we can kind of get without, you know, being able to intervene as as their provider. But yeah, that covers I think what we're going to do for our video today. Thank you guys for watching this and you know this will probably be a full length video as it initially goes up. I'll chop it up and we'll have some probably short answers as well. You know, check our website out down below, We are Alpha MD, that's Alpha Md.org. We are an online, tier key company. We do you know in person video calls like this noise. Set up. Consultations are free.