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Category Archives: Testosterone

TRT (Testosterone Replacement Therapy) – My Journey 2019 …

Posted: March 5, 2020 at 1:44 pm

328 ng/dl.

Finally, I had received the lab results to confirm what I had suspected all along: Low Testosterone.

The last few months, Ive noticed my quality of life dropping. Not a sudden drop but rather slowly going downhill.

The reason I got this Testosterone blood test in the first place was because the symptoms of Low Testosterone became almost unbearable.

I am not exaggerating when I say that I would take a 200mg caffeine pill and then have a window of about an hour during which I would function OK.

OK doesnt mean optimal and it simply meant I was getting a bit of work done. Either that or I could use that hour to go to the gym.

Either way, after that hour, it was GAME OVER.

When I say, GAME OVER, I mean it.

I would spend the rest of the day lying in bed watching YouTube videos or sleeping. I would always be in a state in which I couldnt focus on anything, was super tired but not tired enough to actually go to sleep.

Nothing would get me out of that state.

The diet I was (and am currently) following was very healthy already. I was taking additional supplements such as a multivitamin, Vitamin C, Magnesium

There was no obvious reason for me to feel that way. I was working out regularly; on paper (blood test), I looked healthy (except Low T).

I also noticed that taking stimulants (caffeine) started to work less and less to the point at which sometimes I would take 300mg caffeine and go right to sleep.

The day after I got the lab test back, I knew I had to take action.

Still, going on Testosterone Replacement Therapy isnt an easy decision. It (usually) is a lifetime commitment.

In the years prior to that, I had given it a thought but eventually decided against starting TRT. After all, things were not THAT bad.

This time, it was different. I had reached my personal threshold.

I had a few realization in the following days:

This was the primary reason for me to start TRT.

Every day that I am performing at 30%, I am literally wasting my potential in terms of income, making progress in the gym and enjoyment of life.

I knew that I was in this low energy state (feeling like a 105 year old) for the last 2 years, yet, still I was ableto build an entirely passive online business from scratch netting me over $10,000+ per month.

I was thinking, Holy cow! I have achieved that while feeling like absolute crap, whats possible if I perform at my best?

Testosterone Levels are only going to drop as I age.

Meaning, TRT is inevitable anyway if I want to feel energetic and reap all the benefits of optimal testosterone levels.

Looking at it this way, I realized the question was not whether or not I should start Testosterone Replacement Therapy, but rather when.

I dont think Ill ever be happy being average.

Whether thats in regards to lifestyle, online business or my physique.

I just cant talk myself into being average (trust me, I have tried). I want to tap my full potential.

To be clear, I dont want to be a massive bodybuilder, but I am not OK with having an average body with little muscle mass either.

Prior to starting TRT, I had also met with a professional bodybuilder to hear what he has to say and find out what (in his opinion) is possible as a natural athlete. (I trust his opinion; he himself looks great and has coached hundreds of naturals and enhanced athletes.)

This is when I learned that a truly great physique (top 1%) just isnt possible unless you are a true genetic freak.

I am no genetic freak, which means floating around in the normal Testosterone range, Im not ever going to have a great body.

I know this because in the years prior, my diet and training had always been on point. I was taking the right supplements to close any possible deficiencies. Sleep was good.

Yet, still, I wasnt able to put on any muscle or make progress in terms of lifting heavier weights in the gym. Any weight gain (however slow it was) would go directly to my belly area.

The only thing for me to change and expect drastic changes from that was left was my hormones: Testosterone.

The tiredness I was experiencing was gone right away.

I wasnt tired anymore. I could get work done, go to the gym and wouldnt even need coffee or music to motivate me. This was really profound.

During the day when walking around I didnt yawn (as Id usually do), or feel really exhausted mentally. I felt good, steady energy.

I would also say that I was more emotionally resilient. In the sense that I wouldnt overthink, ruminate too much or be emotional about petty things, such as feeling like I am missing out on something, wondering if others are having more fun/a better time

In the last few years, I literally couldnt get myself to go to the gym or work out more than a few minutes without consuming a large amount of coffee first.

These were the first profound changes Ive noticed right away. And these were things that clearly werent subjective.

The things that were subjective: very little rumination or negative thoughts. Feeling more positive.

Before the first injection, the clinic I went to did another blood test to get my baseline. Turns out my Testosterone was actually 580 (just a few days after a blood test that showed 328).

I was confused as to how this could possibly be?Are the Testosterone tests inaccurate?

The doctor explained that I also have high prolactin. Ideal is 10-12; mine was at 25. Prolactin is a barometer of stability of the system. High prolactin, as the doctor said basically means one day I am feeling good, the next day not so much.

Testosterone can be 580 one day, then 328 the next day. Massive ups and downs. Still, even if it were steadily at 580, that wouldnt be good enough for me and what I expect from myself.

To get my prolactin down, I had to take Cabergoline.

By the way, high prolactin also means you have a longer refractory period after sex.

Anyway, this was my first week on Testosterone Replacement Therapy.

On the last day of the first week, I noticed that some of the symptoms I was complaining about had come back.

Definitely not at full force but I noticed a slight increase in rumination and generally not feeling as positive as during the 6 days prior to that.

It couldve been random.

Perhaps sleep was off?Perhaps the intense leg workout the day before?

However, if it really were related to sleep or external circumstances, it would be a bit odd for the reason that I didnt sleep much the first week and generally felt great nonetheless.

Anyway, I will continue to keep track of changes.

At the beginning of week 2, I came across the topic of NoFap and semen retention and did further research.

The following comment sparked my curiosity:

Whats interesting about this comment is that it was posted by a guy who had done steroids in the past and knows what supernatural Testosterone levels feel like.

In other words, this isnt coming from some scientist doing a study; this is based on first-hand experience.

Notice the super boost your Testosterone levels?

Ive tested this and found that on day 3, the sexual arousal (horniness) became so unbearable that I had to ejaculate.

The normal NoFap protocol would be to simply refrain from masturbation/ejaculation.

The super-boosting-Testosterone protocol (mentioned in the comment above) says you should masturbate or have sex but refrain from ejaculation.

Thats precisely what I did.

Heres the good and the bad:

Given enough practice, I guess the increased sex drive can be channeled as to not be a distraction.

Of course, there is a connection between sex drive and testosterone but its not as simple as saying high testosterone equals high sex drive or vice versa.

You see this a lot inNoFap communities.

Guy doesnt masturbate for a few days, feels higher sex drive and attributes it to heightened testosterone.

If you research masturbation testosterone, you find studies stating that masturbation does not affect testosterone levels.

Other studies claim that abstinence can increase testosterone, but that T levels go back to their baseline after day 7.

Noticing higher than usual sex drive, but that could just be a normal fluctuation.

Ive noticed that sex drive is higher on an empty stomach not sure, it might just be that digestion requires a lot of energy/blood flow and sex drive is automatically put on the back-burner.

Right before I received the first Testosterone shot of week #3, a blood test was done.

Total testosterone turned out to be at 1251 ng/dL (which is just outside the normal range).

Estradiol (E2) is also optimal at 26.9 pg/mL

Estradiol should be kept in the 20-25 pg/mL range, otherwise you might experience some nasty side effects such as acne outbreaks, mood swings or weight gain.

High Estradiol (E2) can causegynecomastia, but the same can be said about high prolactin. My doctor has said that by keeping Estradiol in check, you also automatically control your prolactin.

That might be the case with most men, but didnt apply in my situation. My Estradiol was already in the normal range, yet prolactin was out of range.

I used to think that gynocomastia can happen so quickly that you can wake up the morning and realize its already too late.

I can only talk about my experience, but thats totally not the case at all. First, you notice increased nipple sensitivity; at worst a minor burning sensation.

At that point, you can still take action and no damage is done (yet). Lower Estradiol and itll all be good.

Anyway, back to the Testosterone test results I mentioned

The fact that my Testosterone levels were measured right before I got another shot of Testosterone Enanthate is reason to believe that my testosterone levels were much higher in the days prior.

When you inject Testosterone, plasma levels rise quickly only to drop steadily in the days after.

This drop is why another injection is required to keep plasma levels somewhat stable.

When it comes to injectable Testosterone, there are different esters you can choose from.

Testosterone is Testosterone, however, the ester dictates how quickly the Testosterone is being released to the body.

As is the case with many other drugs, there are versions of the exact same compound with quick or slow release.

The faster-acting the ester, the more frequent the injections should be.

I am using 125mg of Testosterone Enanthate per week injected twice per week (62.5mg each time).

My first month on TRT is $440.

That price includes everything from the injections, to ancillaries and blood tests. I expect the monthly costs to drop sharply in the months after.

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TRT (Testosterone Replacement Therapy) - My Journey 2019 ...

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Testosterone Replacement Therapy – Maui Athletics

Posted: March 5, 2020 at 1:44 pm

Testosterone Replacement TherapyMale Testosterone Replacement Therapy (TRT) is treated by many doctors as taboo. This is mainly due to under-education on the topic, stigma from the public, and fear of litigation in todays society. Due to liability issues, a large percentage of doctors are not willing to even educate themselves on the matter. In reality, TRT is a valuable treatment modality that can greatly increase quality of life for many men, with minimal risk in otherwise healthy individuals (as long as some precautions are followed). A competent doctor will focus on treating symptoms and root-cause, not numbers on a blood panel.

This compilation intends to provide the most up to date information on all things TRT. Bare in mind that this research does not look into supra-physiological use. It is also not intended to diagnose or treat any medical condition, please talk with your physician if you suspect you are a candidate for TRT.

Testosterone preparations come in various forms (injectable, cream, pellet, etc). My number one recommendation is always injectable as you can more safely and accurately tailor the dose to your own body. Testosterone is generally bound to an ester in injectable form. The type of ester yields vastly different speeds of absorption. Fast acting (short-acting) esters such as Propionate produce higher blood levels much quicker, but also come at the risk of more side-effects.

One such side is the aforementioned erythrocytosis. This is why longer esters such as Cypionate or Enanthate (or in the future Undecanoate) are typically used for TRT. Benefits of these long-acting esters include decreased side effects/risks as well as the requirement for less frequent injections. Another way to mitigate red blood cell production (and estrogen conversion) is to inject smaller doses more frequently to produce smaller blood level spikes of testosterone. Blood panels to monitor hematocrit are of paramount importance during TRT. Luckily, a therapeutic phlebotomy can take care of the issue of erythrocytosis should the need arise. The trick is regular monitoring to catch this before it becomes a significant problem. In many following a TRT dosing protocol, this is never an issue.

When monitoring estrogen, especially in men, I recommend an E sensitive test rather than the standard test. Standard estrogen tests can give false values as they can be altered by C-reactive protein. E sensitive tests take this into account and provide a more reliable reading.

All graphics credited to their respective authors.

https://www.ncbi.nlm.nih.gov/pubmed/18160461

https://www.ncbi.nlm.nih.gov/pubmed/28526632

https://www.ncbi.nlm.nih.gov/pubmed/29933385

https://www.mayoclinicproceedings.org/article/S0025-6196(17)30824-8/fulltext

http://www.societaitalianadiendocrinologia.it/public/pdf/bellastellanovembre2017.pdf

Testosterone Therapy Coronary Plaque and Calcium Score

https://www.ncbi.nlm.nih.gov/pubmed/29542875

https://www.ncbi.nlm.nih.gov/pubmed/29978359

https://www.ncbi.nlm.nih.gov/pubmed/29974886

https://www.ncbi.nlm.nih.gov/pubmed/28202344

https://www.nature.com/articles/ijo2016242

https://www.ncbi.nlm.nih.gov/pubmed/27488887

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913536/

http://dx.doi.org/10.1155/2015/970750

https://www.ncbi.nlm.nih.gov/pubmed/28241244

https://www.tandfonline.com/doi/abs/10.1080/14779072.2018.1510314

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299269/

https://www.physiology.org/doi/abs/10.1152/japplphysiol.00165.2018

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Testosterone Replacement Therapy - Maui Athletics

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Aromatase Inhibitors and Testosterone Replacement Therapy …

Posted: March 5, 2020 at 1:44 pm

A good balance of hormones helps to maintain a healthy body and mind. The sex hormones estrogen and testosterone are responsible for sexual reproductive and other functions in men and women. As men age, their body produces less and less of these hormones.

This often results in a severe hormonal imbalance which leads to various symptoms or health conditions including low testosterone or hypogonadism, andropause, excess weight gain or obesity, and gynecomastia.

Testosterone can deplete naturally or decline due to the bodys natural conversion of testosterone to estrogen. Estrogen is primarily a female hormone but is also needed for certain functions in men. In fact, it helps regulate sexual functions in men.

The three estrogens are estrone, estradiol, and estriol. Estradiol is the most potent of them all. The conversion of testosterone to estrogen is a common reason for a decline in testosterone. This happens when the body aromatize testosterone and androgens (another sex hormone) and convert them into estrogen. While testosterone decreases estrogen increases and may cause the following symptoms:

You may have low T if you experience one or more of the symptoms related to high estrogen or estradiol. However, low T can be accurately diagnosed by your doctor. Your doctor will assess your medical history and symptoms and will need to run blood tests to determine the level of the hormone in the body. If you receive a positive diagnosis, your doctor may recommend one or more treatments including testosterone replacement therapy by injections.

Testosterone replacement therapy is used to boost testosterone levels. It is best and most effectively administered by intramuscular injections. Depending on the patients individual needs, the treatment can be done with or without aromatase inhibitors.

Aromatase inhibitors (AIs), or estrogen blockers, are a class of drugs used to prevent the body from converting testosterone to estrogen, especially estradiol. These drugs, for example, anastrozole, letrozole, and exemestane are used off-label in men undergoing testosterone replacement therapy. By blocking estrogen, aromatase inhibitors help to boost testosterone levels.

It is not necessary for all men taking hormone replacement therapy to receive aromatase inhibitors. Your doctor will make this determination based on the baseline level of estradiol. For example, treating you with an AI when your estradiol is high will cause uncomfortable symptoms. Your doctor will also need to test your blood regularly to monitor hormone levels.

While testosterone replacement can be done through the use of skin patches, skin pellets, gels, or implants, hormone replacement by injections remain the most effective way of treatment. However, testosterone replacement therapy is not right for everyone due to potential health risks. For example, men planning to have children should avoid TRT since it can lead to a drop in sperm count or infertility.

You may need to take the treatment for a lifetime, otherwise, once you stop taking it your hormone levels will drop. Furthermore, persons with the following conditions should avoid this therapy:

The results of TRT vary from patient to patient. Some men with low T who undergo testosterone replacement reportedly see improvement in energy levels and sex drive as well as an increase in sexual functions and performance. Some men say they feel youthful and rejuvenated, experience hair regrowth, and see an increase in muscle mass.

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Aromatase Inhibitors and Testosterone Replacement Therapy ...

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Testosterone Replacement Therapy Market Insights with Latest Statistics and Growth Prediction to 2026 | AbbVie, Endo International, Eli lilly, Pfizer,…

Posted: March 4, 2020 at 10:45 am

The Testosterone Replacement Therapy Market report draws accurate insights by examining the latest and prospective industry trends, helping the readers recognize the products and services that are boosting revenue growth and profitability. The study performs a detailed analysis of all the significant factors impacting the market on a global and regional scale, including drivers, constraints, threats, challenges, prospects, and industry-specific trends. Additionally, the report cites worldwide certainties and endorsements, along with a downstream and upstream evaluation of leading participants.

To ask for a sample copy of the Testosterone Replacement Therapy Market Report, visit:https://www.reportsanddata.com/sample-enquiry-form/229

Scope of the Report:

The report focuses on the important geographies of sale of the Testosterone replacement therapy such as North America, Europe and Asia-Pacific, South America, Middle East and Africa. The entire testosterone replacement therapy market has been categorized into three segments in this report, namely- manufacturers, regions, type and application.

Reasons to Buy the Report:

For the purpose of this report, Reports and Data has segmented the Testosterone Replacement Therapy market on the basis of type, source, animal, application, and region:

In market segmentation by types of testosterone replacement therapies, the report covers

Get Discounts on the Testosterone Replacement Therapy Market Report at:https://www.reportsanddata.com/discount-enquiry-form/229

In market segmentation by applications of the testosterone replacement therapy, the report covers the following uses

Regional Outlook (Revenue in USD Million; 20162026)

Key highlights of the Testosterone Replacement Therapy market:

The report is distributed over 15 Chapters to display the analysis of the global Testosterone Replacement Therapy market.

Chapter 1 covers the Blow-Fill-Seal (BFS) technology product Introduction, product scope, market overview, market opportunities, market risk, market driving force;

Chapter 2 talks about the top manufacturers and analyses their sales, revenue and pricing decisions for the duration 2016 and 2017;

Chapter 3 displays the competitive nature of the market by discussing the competition among the top manufacturers. It dissects the market using sales, revenue and market share data for 2016 and 2017;

Chapter 4, shows the global market by regions and the proportionate size of each market region based on sales, revenue and market share of Blow-Fill-Seal (BS) technology product, for the period 2012- 2017;

Chapter 5, 6, 7, 8 and 9, are dedicated to the analysis of the key regions, with sales, revenue and market share by key countries in these regions;

Browse Table of Contents with Facts and Figures of Testosterone Replacement Therapy Market Report at: https://www.reportsanddata.com/report-detail/global-testosterone-replacement-therapy-market-by-manufacturers-countries-type-and-application-forecast-to-2022

We are grateful to you for reading our report. If you wish to find more details of the report or want a customization, contact us. You can get a detailed information of the entire research here. If you have any special requirements, please let us know and we will offer you the report as you want.

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Testosterone Replacement Therapy Market Insights with Latest Statistics and Growth Prediction to 2026 | AbbVie, Endo International, Eli lilly, Pfizer,...

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Key Emerging Trends in Testosterone Replacement Therapy Market 2020 | AbbVie, Endo International, Eli lilly, Pfizer, Others – Feed Road

Posted: March 4, 2020 at 10:45 am

The Testosterone Replacement Therapy Market report draws accurate insights by examining the latest and prospective industry trends, helping the readers recognize the products and services that are boosting revenue growth and profitability. The study performs a detailed analysis of all the significant factors impacting the market on a global and regional scale, including drivers, constraints, threats, challenges, prospects, and industry-specific trends. Additionally, the report cites worldwide certainties and endorsements, along with a downstream and upstream evaluation of leading participants.

To ask for a sample copy of the Testosterone Replacement Therapy Market Report, visit:https://www.reportsanddata.com/sample-enquiry-form/229

Breadth of the Report:

The report focuses on the important geographies of sale of the Testosterone replacement therapy such as North America, Europe and Asia-Pacific, South America, Middle East and Africa. The entire testosterone replacement therapy market has been categorized into three segments in this report, namely- manufacturers, regions, type and application.

Reasons to Buy the Report:

For the purpose of this report, Reports and Data has segmented the Testosterone Replacement Therapy market on the basis of type, source, animal, application, and region:

In market segmentation by types of testosterone replacement therapies, the report covers

Get Discounts on the Testosterone Replacement Therapy Market Report at:https://www.reportsanddata.com/discount-enquiry-form/229

In market segmentation by applications of the testosterone replacement therapy, the report covers the following uses

Regional Outlook (Revenue in USD Million; 20162026)

Key highlights of the Testosterone Replacement Therapy market:

The report is distributed over 15 Chapters to display the analysis of the global Testosterone Replacement Therapy market.

Chapter 1 covers the Blow-Fill-Seal (BFS) technology product Introduction, product scope, market overview, market opportunities, market risk, market driving force;

Chapter 2 talks about the top manufacturers and analyses their sales, revenue and pricing decisions for the duration 2016 and 2017;

Chapter 3 displays the competitive nature of the market by discussing the competition among the top manufacturers. It dissects the market using sales, revenue and market share data for 2016 and 2017;

Chapter 4, shows the global market by regions and the proportionate size of each market region based on sales, revenue and market share of Blow-Fill-Seal (BS) technology product, for the period 2012- 2017;

Chapter 5, 6, 7, 8 and 9, are dedicated to the analysis of the key regions, with sales, revenue and market share by key countries in these regions;

Browse Table of Contents with Facts and Figures of Testosterone Replacement Therapy Market Report at: https://www.reportsanddata.com/report-detail/global-testosterone-replacement-therapy-market-by-manufacturers-countries-type-and-application-forecast-to-2022

We are grateful to you for reading our report. If you wish to find more details of the report or want a customization, contact us. You can get a detailed information of the entire research here. If you have any special requirements, please let us know and we will offer you the report as you want.

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Key Emerging Trends in Testosterone Replacement Therapy Market 2020 | AbbVie, Endo International, Eli lilly, Pfizer, Others - Feed Road

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Massive Demand of Testosterone Replacement Therapy Market by 2020-2026 with Top Key Players like Endo International, AbbVie, Eli lilly, Pfizer,…

Posted: March 2, 2020 at 11:41 am

Testosterone Replacement Therapy Market research is an intelligence report with meticulous efforts undertaken to study the right and valuable information. The report encompasses the competition landscape entailing share analysis of the key players in the Testosterone Replacement Therapy market based on their revenues and other significant factors. Report analyzes changing trends and competitive analysis which becomes essential to monitor performance and make critical decisions for growth and development. It also provides market information in terms of development and its capacities.

Some of the Top companies operating in Global Testosterone Replacement Therapy Market are: Endo International, AbbVie, Eli lilly, Pfizer, Actavis (Allergan), Bayer, Novartis, Teva, Mylan, Upsher-Smith, Ferring Pharmaceuticals, Kyowa Kirin, Acerus Pharmaceuticals.

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This study provides an evaluation of aspects that are expected to impact growth of market in an undesired or constructive method. The Testosterone Replacement Therapy market has been consistently examined with respect to the corresponding market segments. Each year within the mentioned forecast period is concisely considered in terms of produce and worth in the regional as well as the global markets respectively. Technical expansions of the Testosterone Replacement Therapy market have been examined by focusing on different technical platforms, tools, and methodologies. The notable feature of this research report is, it incorporates clients demands as well as future progress of this market across the global regions.

The report is presented in a clear and concise manner so that readers can understand the market structure and dynamics effectively. Recent trends and developments in the global Testosterone Replacement Therapy market have been analyzed. Opportunities leading to the growth of the market have been analyzed and stated. The report focuses on the global market, and answers some of the most critical questions stakeholders are currently facing across the globe. Information about the size of the market (by the end of the forecast year), companies that are most likely to scale up their competitive abilities, leading segments, and challenges impeding the growth of the market are given.

Global Testosterone Replacement Therapy Market Segmentation:

Segmentation by Type:

GelsInjectionsPatchesOthers

Segmentation by Application:

HospitalsClinicsOthers

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Key Influence of the Testosterone Replacement Therapy Market report:

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Table of Contents

Global Testosterone Replacement Therapy Market Research Report 2020 2026

Chapter 1 Testosterone Replacement Therapy Market Overview

Chapter 2 Global Economic Impact on Industry

Chapter 3 Global Market Competition by Manufacturers

Chapter 4 Global Production, Revenue (Value) by Region

Chapter 5 Global Supply (Production), Consumption, Export, Import by Regions

Chapter 6 Global Production, Revenue (Value), Price Trend by Type

Chapter 7 Global Market Analysis by Application

Chapter 8 Manufacturing Cost Analysis

Chapter 9 Industrial Chain, Sourcing Strategy and Downstream Buyers

Chapter 10 Marketing Strategy Analysis, Distributors/Traders

Chapter 11 Market Effect Factors Analysis

Chapter 12 Global Testosterone Replacement Therapy Market Forecast

If you have any special requirements, please let us know and we will offer you the report as you want.

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Massive Demand of Testosterone Replacement Therapy Market by 2020-2026 with Top Key Players like Endo International, AbbVie, Eli lilly, Pfizer,...

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Indiana Regenerative Medicine Institute Offers Innovative Approaches in Regenerative Medicine, Hormone Replacement and Pain Management – Zionsville…

Posted: February 29, 2020 at 2:44 pm

February 2020

Are you looking for a health care provider who offers innovative alternatives and a customized approach to your health issues? Indiana Regenerative Medicine Institute (IRMI) believes in offering specialized alternatives to health care. Its medical team, headed by Doctor of Chiropractic Preston Peachee, utilizes the latest developments in regenerative medicine, hormone replacement and pain management.

Dr. Peachee is a native of Jasper, Indiana. He graduatedfrom Logan College of Chiropractic and has been in practice since 2003. Hisareas of specialty include patients with chronic and severe back, neck andjoint pain as well as other complex neurological conditions.

Dr. Peachee has earned a reputation as an innovative thinkeras well as a compassionate practitioner who brings his wide expertise andexperience to the Greater Indianapolis area. His ability to help those in needof regenerative medicine, neuropathy pain relief, low testosterone or otherphysical ailments, such as back pain or fibromyalgia, makes him not only uniquebut highly sought-after.

A key member of the IRMI team is Leann Emery, FNP. Emery isa family nurse practitioner with more than 20 years of experience in hormonereplacement and alternative pain management. Emery provides optimal patientcare through personal consultations and assessments to identify her patientsspecific health needs. She was rated in the top 10% of providers in the U.S.with patient satisfaction.

Regenerative medicine is making huge leaps in our understanding of the human body, and it is offering real, possible treatments that would have seemed like science fiction a few short years ago, according to IRMI. Most patients we see have tried other more traditional treatments and have either not gotten any better or have gotten even worse. Unfortunately, a lot of people we see depend on multiple medications per day to try and function but still are not happy with how they feel or how they live their lives. It is unfortunately the nature of deteriorating and degenerative joints, they will get worse with time, and generally the pain increases as well.

Depending on the injury, Dr. Peachee will often combinelaser therapy with the regenerative medicine protocols to improve the outcomesand try and speed the recovery process.

We offer mesenchymal stem cell therapy, Dr. Peachee said. With the combination of laser therapy, mesenchymal stem cell therapy is incredibly effective for rotator cuff problems and treating knee pain. Eighty percent of our stem patients are dealing with knee pain or Osteoarthritis. Osteoarthritis-or O.A. of the knee- is a huge problem for a lot of people, and we get great results from these therapies. Most people can even avoidknee surgery.

Dr. Peachee recently introduced hormone treatments for low testosterone. Family Nurse Practitioner Leann Emery has been doing [hormone] treatments for 20 years, and that area of medicine became a natural fit for IRMI.

I have several patients who were seeking this type ofcaremany who are police officers and firefighterswho couldnt find thetherapy and individualized care and attention that they needed.

Dr. Peachee explained that low T treatments help patients with unique and even complicated cases of Erectile Dysfunction (E.D.). Most people seek us out for treatment because they are tired, worn out, stressed out and just simply lack the energy they used to have.

We are able to fill a niche with patients who hadcomplicated cases that were not responding well with their primary careproviders or other places, Dr. Peachee shared. We have a patient who hasstruggled for a long time with fertility issues but has done very well [withtreatments], and we just got good news that he and his wife are expecting aftertrying for a really long time. So, he is really enthused about that.

The typical candidates for low T treatments, according toDr. Peachee, are men who feel worn out, are lethargic and have lost theirzest for life.

Our patients dont have the same pep that they had 10 or20 years ago, Dr. Peachee stated. They struggle getting up in the morning andmight be struggling in the afternoon after having six cups of coffee or threeRed Bulls just to get through the day. We have a lot of people that want to getback into the gym and get the maximum benefit of their workouts. We can helpthem improve their overall health and energy so that they can enjoyrecreational activities like working out or practice with the Little Leaguewith their kids. Many times we hear from spouses, friends and family how muchbetter they feel and that they seem happier and get more out of life again.

It goes without saying that proper hormonal balance canimprove a patients personal relationships as well and improve the overallmental health of a patient by reducing stress, anxiety and depression oftencaused by symptoms related to low testosterone levels.

We focus on injectable [low T] treatments because we canmodify the dosage and give more frequent doses to keep our patients at a levelthats going to give them the maximum benefit and improvement for theirconditions, Dr. Peachee explained.

With the modern changes in medicine over the last 20 and 50years, were helping people to live a lot longer and adding 20 to 30 years totheir lives, but we have not given them an improved quality of life as theyage. By working with their hormones and getting them in balance, their qualityof life becomes way better, and were seeing a positive improvement for manypeople with these treatments.

Patients suffering from severe disc injuries, such a bulgingor herniated disc or discs, or who suffer from degenerative disc disease mayhave undergone treatment from chiropractors or have seen physical therapistsbefore coming to Indiana Regenerative Medicine Institute.

Our typical patient who comes in for this type of treatmenthas seen other therapists or chiropractors but hasnt found lasting relief,Dr. Peachee said. Many of our patients want to get off the rollercoaster ofopioids and pain medications. They are looking for a solution without narcoticsand risk of addiction or other possible negative side effects of narcoticsand/or surgery. We are generally able to alleviate the pain in 90% of patientsand are able to keep them from having surgery or from taking addictivemedications.

Laser therapy allows Dr. Peachee to work on the damaged tissue so that it can heal, and the method reduces inflammation and swelling in a way that traditional treatments cannot.

Its an innovative new therapy within the last decade thatallows us to do some amazing things, Dr. Peachee stated. We perform ourprocedures in our office and have several different devices for the specificneeds and issues of our patients. For instance, we have a unique device forpeople with knee pain that can help the majority of our patients walk betterand live more pain-free. We get a phenomenal outcome with this procedure.

One of the other major differentiators that sets IndianaRegenerative Medicine Institute apart from other offices and clinics is thatthey are advocates for their patients, especially when it comes to dealing withtheir patients insurance providers.

A lot of our low T patients are able to get their insurancecarriers to cover the services so that it doesnt cost them as much out ofpocket for the care they seek, Dr. Peachee said. Weve partnered with abilling company that has helped us to be able to navigate the craziness of ourmodern insurance companies, and by doing so, were able to keep the cost downfor a lot of patients. Not every insurance plan will cover this type of care,but a lot of them will. When its possible and ethical, we do whatever we canto benefit our patients to help keep the cost low. I have spent a lot of freetime writing letters on behalf of our patients. We go above and beyond with ourservice and care of our patients.

The Indiana Regenerative Medicine Institute team will make housecalls or come to a patients place of work when the situation calls for thatlevel of care.

We will go and draw blood for blood work, bring medications and even do exams in some situations, Dr. Peachee said. As I mentioned before, we see a lot of police officers and firemen all over the statefrom Mishawaka to South Bend and all over Indiana. We go once a month to see these patients at their departments and stations so that we see them all in one day versus making 10 to 15 guys drive hours to come in to see us. Its a service we can offer because we are a small clinic and we are focused on that one-on-one patient attention and relationship building. We have great relationships with our patients, and thats something that we work very hard at.

Building trust and transparency is crucial to the success ofhis practice, Dr. Peachee emphasized. The trust that we build with ourpatients is crucial to not only the success of the practice but to thepatients outcomes. And not just with hormone therapy but also with ournonsurgical spinal decompression patients. These are patients with significant discinjuries, and we need them to tell us everything we need to know so we can givemore accurate and complete care for a better outcome.

I would say to anybody if you have any doubts or reservations to take some of the burden and some of the anxiety out of the equation and schedule an initial consultationabsolutely free of charge, Dr. Peachee encouraged.

Dont put off living your best life any longer. Visit Indiana Regenerative Medicine Institutes website at indianaregen.com or call (317) 653-4503 for more information about its services and specialized treatments and schedule your free consultationtoday!

Writer:

Janelle Morrison

Photography:

Laura Arick and submitted

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How high testosterone levels have different health outcomes for men and women – Health24

Posted: February 28, 2020 at 2:48 am

High levels of the sex hormone testosterone may trigger different health problems in men and women, a new study reveals.

In women, testosterone may increase the risk for type 2 diabetes, while in men it lowers that risk. But high levels of testosterone increase the risk for breast and endometrial cancer in women and prostate cancer in men, the researchers reported.

"Our findings provide unique insights into the disease impacts of testosterone. In particular, they emphasize the importance of considering men and women separately in studies, as we saw opposite effects for testosterone on diabetes," said lead researcher Katherine Ruth, of the University of Exeter in the United Kingdom.

"Caution is needed in using our results to justify use of testosterone supplements until we can do similar studies of testosterone with other diseases, especially cardiovascular disease," Ruth explained in a University of Cambridge news release.

Dr Joel Zonszein, an emeritus professor of medicine at Albert Einstein College of Medicine in New York City, said there is a "sweet spot" of normal values for men and women. "Too much is not good, and too little is also bad," he explained.

"Testosterone supplementation is widely used in both men and women with normal values with no good evidence of benefit. Testosterone replacement in truly deficient individuals is something else," said Zonszein, who had no role in the study.

For the study, British researchers collected genetic data on more than 425 000 men and women listed in the UK Biobank. The investigators found more than 2 500 genetic variations associated with levels of testosterone and the protein that binds it sex hormone-binding globulin.

The researchers checked their results with analyses of other relevant studies and used a randomisation method to see if associations between testosterone and disease are causal.

In women, a high level of testosterone was tied to a 37% increased risk for type 2 diabetes and a 51% increased risk for polycystic ovary syndrome.

In men, however, a high testosterone level was linked to a 14% lower risk of developing type 2 diabetes, the findings showed.

"The findings in men that higher testosterone has a protective effect and reduces the risk of type 2 diabetes is news to me," Zonszein said. "This needs to be shown by other studies and its mechanism needs to be elucidated."

Dr Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York City, said that testosterone may not be as protective in women because it converts to estradiol, which is related to the risk for breast cancer.

"High levels of testosterone in women have also been shown to increase visceral fat, which is linked to the components of metabolic syndrome," Sood said.

That men with high testosterone are at lower risk of developing type 2 diabetes is likely related to having more lean muscle mass, which improves insulin sensitivity and reduces the likelihood of type 2 diabetes, she said.

But Sood isn't a fan of men using testosterone supplements to ward off diabetes.

"Testosterone therapy comes with potential risks, including a high red blood cell count and higher rates of high-grade prostate cancer if a man is already predisposed to develop prostate cancer," she said.

Obese men or those with type 2 diabetes would benefit more from lifestyle changes to improve testosterone levels, namely, weight loss, healthy diet and exercise.

"This approach is preferred in that population over testosterone replacement whenever possible," Sood said.

The report was published in the journal Nature Medicine.

Image credit: iStock

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American College of Rheumatology Releases First Guideline to Address Reproductive Health for Patients with Rheumatic Diseases – Myers Messenger

Posted: February 27, 2020 at 5:46 am

ATLANTA, Feb. 24, 2020 (GLOBE NEWSWIRE) Today, the American College of Rheumatology (ACR) published the . This is the first, evidence-based, clinical practice guideline related to the management of reproductive health issues for all patients with rheumatic diseases. With 131 recommendations, the guideline offers general precepts that provide a foundation for its recommendations and good practice statements.

This guideline is paramount, because it is the first official guidance addressing the intersection of rheumatology and obstetrics and gynecology (OB-GYN), said Lisa Sammaritano, MD, lead author of the guideline. Rheumatic diseases affect many younger individuals; however, little education has been provided to rheumatology professionals on current OB-GYN practices. The guideline [and more detailed ] presents vital background knowledge and recommendations for addressing reproductive health issues in the full spectrum of rheumatology patients, with additional focus on specific diagnoses that require more detailed recommendations such as (SLE) and (APS).

The guideline provides 12 ungraded good practice statements and 131 graded recommendations that are intended to guide care for rheumatology patients except where indicated as being for patients with specific conditions or antibodies present. Good practice statements are those in which indirect evidence is compelling enough that a formal vote was considered unnecessary; these are ungraded and are presented as suggestions rather than formal recommendations. The recommendations were separated into six categories: contraception, assisted reproductive technology (fertility therapies), fertility preservation with gonadotoxic therapy, menopausal hormone replacement therapy, pregnancy assessment and management, and medication use.

While some of the recommendations are strong, many of the recommendations presented are conditional due to a lack of data. Pregnant women are not generally enrolled in clinical studies; and few maternal health studies focus on rheumatology patients. A few notable recommendations from each category include:

Contraception

Strong recommendation for women with rheumatic disease who do not have lupus or APS to use effective contraceptives with a conditional recommendation to preferentially use highly effective IUDs or a subdermal progestin implant.

Strong recommendation against using combined estrogen-progestin contraceptives in women who test positive for anti-phospholipid autoantibodies (aPL) or APS.

Assisted Reproductive Technology (Fertility Therapies)

Strong recommendation for fertility therapy in women with uncomplicated rheumatic disease who are receiving pregnancy-compatible medications, whose disease is stable, and who test negative for aPL. Specific recommendations also address patients testing positive for aPL and suggest an anti-blood clotting procedure.

Conditional recommendation against increasing prednisone dosage during fertility therapy procedures in lupus patients.

Fertility Preservation

Conditional recommendation against testosterone co-therapy in men with rheumatic disease receiving cyclophosphamide (CYC) and a good practice suggestion to cryopreserve sperm before CYC treatment in men who desire it.

Conditional recommendation for monthly gonadotropin-releasing hormone agonist co-therapy for premenopausal women with rheumatic disease who are receiving monthly CYC injections/infusions to prevent premature ovarian insufficiency.

Pregnancy Assessment and Management

Strong good practice suggestion to counsel women with rheumatic disease, who are considering pregnancy, on the improved maternal and fetal outcomes associated with entering pregnancy during low disease activity.

Conditional recommendation to treat lupus patients with low-dose aspirin daily (81 to 100 mg) starting in the first trimester. For women testing positive for aPL who do not meet the criteria for obstetric or thrombotic APS, it is conditionally recommended to preventatively treat with a daily aspirin (81 to 100 mg) starting early in pregnancy and continuing through delivery.

Menopause and Hormone Replacement Therapy

A good practice suggestion to use hormone replacement therapy in postmenopausal women with rheumatic disease who do not have lupus or have a positive aPL test; and who have severe vasomotor symptoms, have no contraindications, and desire treatment.

A conditional recommendation for hormone replacement therapy in women with lupus and without aPL.

Conditionally recommend against treating with hormone replacement therapy for women with asymptomatic aPL, and strongly recommend against hormone replacement therapy for women with any form of APS.

Medication Use (Paternal and Maternal)

Strongly recommend against use of CYC and thalidomide in men prior to attempting conception.

Strong recommendation against the use of NSAIDs in the third trimester.

Individuals involved in the development of the new guideline included rheumatologists, obstetrician/gynecologists, reproductive medicine specialists, epidemiologists, and patients with rheumatic diseases. ACR guidelines are currently developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, which creates rigorous standards for judging the quality of the literature available and assigns strengths to the recommendations that are largely based on the quality of the available evidence.

This guideline should open avenues of communication between the rheumatologist and the patient, as well as between the rheumatologist and the OB-GYN, said Dr. Sammaritano. A better understanding of the risks and benefits of reproductive health options will enhance patient care by providing safe and effective contraception, improving pregnancy outcomes by conceiving during inactive disease periods, and allowing for continued control of rheumatic diseases during and after pregnancy with the use of well-suited medications.

A draft of the guideline was presented during the 2018 ACR/ARP Annual Meeting in Chicago. Since that time, the guideline team has condensed the original three-part draft into a single, concise manuscript, with detailed background and discussion now available . The guideline development team also incorporated color-coded flow charts to highlight common decision-making points to make it user friendly.

The paper containing the full list of recommendations and supporting evidence is available at

###

About the American College of Rheumatology The American College of Rheumatology (ACR) is an international medical society representing over 8,500 rheumatologists and rheumatology health professionals with a mission to empower rheumatology professionals to excel in their specialty. In doing so, the ACR offers education, research, advocacy and practice management support to help its members continue their innovative work and provide quality patient care. Rheumatologists are experts in the diagnosis, management and treatment of more than 100 different types of arthritis and rheumatic diseases. For more information, visit .

Monica McDonald American College of Rheumatology ext. 332 mmcdonald.org

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Testosterone Replacement Therapy Market Size Current and Future Industry Trends – News by aeresearch

Posted: February 26, 2020 at 1:45 am

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