Moving to Testosterone Pellets

I am anticipating change. Today is the day that I receive 2400 mg of timed release bio-identical Testosterone pellets with Anastrozole (an estrogen inhibitor).  I’m hoping for observable changes for my depression,  weight gain, lethargy, and nonexistent libido.

img_20161019_083910

The topical gels that I have been using over the past year have been ineffective.  I was originally prescribed Androgel pump, then Testim gel; and in both cases I haven’t seen any effect of using these.  In September 2015 (before starting the gel) I tested at 154 ng/dL, and in September 2016 was tested at 91 ng/dL.  My body clearly isn’t absorbing the gel.

Based on my low T numbers, I’m receiving 2400 mg of Testosterone pellets with a goal of raising my numbers between 900-1200 ng/dL.  Blood tests will be performed in approximately 6 weeks to determine actual levels for Testosterone and Estradiol so that any adjustments can be planned.  Every four months I’ll be going back in for more pellets.

The Procedure
Lidocaine is used as a local numbing agent prior to insertion of the pellets (plan to wait for 10-15 minutes while the numbing takes effect). A small incision is made, and a pellet trocar (essentially a tube with a push rod) is inserted into the fatty tissue above the hip, and the pellets are fed through the tube into the fatty tissues (testosterone absorption is aided by fat). The tube is removed and steri-strips skin closures are applied.  Those are covered with gauze and tape to complete the procedure. The whole procedure takes less than 30 minutes.

A video of the procedure (not me) can be seen on YouTube.

Following the procedure, some blood/drainage is expected.  Bandages typically stay on for 4-5 days. There will be bruising and tenderness for up to 10 days while it heals.

The following supplements are suggested:

  • Vitamin D3 gel caps (2000 iu) – take 4 daily for one month, then 3 daily. Vitamin D deficiencies are correlated to men with Testosterone deficiency.
    img_20161019_155318
  • Iodine capsules (12.5 mg) – take one daily for one month, then 3 times weekly.  Iodine helps increase testosterone levels.
  • Myomin (500mg) – a natural estrogen blocker that may be used if estrogen numbers are higher than anticipated

It’s also important to note that anti-inflammatories (Aleve, Motrin and Ibuprofen) should be avoided because they block the effectiveness of the Testosterone.  Alternative pain medications that can be taken include Aspirin, Tylenol and Excedrin.


Why am I doing this?

Last year I finally broke down and decided to seek medical help. After a few years of steady weight gain I was depressed, lethargic and uninterested in anything.  My energy was gone, I had lost inspiration, and constantly felt depressed.  I knew I needed to change the direction but could not be motivated.  It was this apathy, and a long conversation with my wife, life partner and co-conspirator Angela that made me place a call.

Admittedly, I hadn’t seen a doctor in years.  I no longer had a primary care physician, but started by scheduling an appointment with an endocrinologist to request a consultation.  It was from that appointment that I learned I was diabetic, and had low testosterone.  These two issues relate to each other because low T can lower metabolism and increase weight gain, which triggers diabetes.

I was placed on Metformin for the diabetes, and Androgel pump to improve T levels.  There was a noticeable affect taking the Metformin (I was no longer exhausted at mid-day, I slept better, and my blood sugars were lower).  I started the Androgel  two weeks later, and didn’t experience any significant change (as in there was no change). After my health insurance plan changed their tier pricing for Androgel, I was essentially pushed to the Testim product as a replacement.  Neither gel had a noticeable effect; apparently some men experience low absorption of gels, and this seemed to be my issue.

 

 

Reality Sets In

After 1 year I don’t have a routine down for my Type 2 Diabetes and Low Testosterone diagnosis.  I don’t sleep well. I’m constantly tired. I’m depressed. I think my doctor’s suck because with them it’s all about tests and prescribing medicine. There’s no discussion about lifestyle, and as much as I’d personally like to think it’s just eat less and run more to fix everything, it’s not.

Ultimately the best chance I have is to lose weight because it can reverse the diabetes and possibly remedy the other issue of low testosterone (which can be caused by type 2 diabetes).

So, the recipe seems to be take my medicine, eat right and exercise more. Only it’s not that simple.  This is about pushing past the depression and lethargy, and making a habit out of a lifestyle change.  It’s about a schedule that overrides other schedules, and in fact cutting things out in order to make room for the things that are becoming a priority.  It’s about finding motivation when there isn’t any.  It’s about learning new ways of doing things that I’ve done my entire life, and yes – I know it’s going to suck for a while.

It’s all about the plan, isn’t it?

When I checked my blood glucose this morning it was 191.  I hadn’t been testing recently and decided to do so.  It was a stark reminder to get my shit together.

 


Targets

Normal Blood Glucose
Fasting
Normal for person without diabetes: 70–99 mg/dl (3.9–5.5 mmol/L)
Official ADA recommendation for someone with diabetes: 80–130 mg/dl (4.5–7.2 mmol/L)

2 Hours after Meals
Normal for person without diabetes: Less than 140 mg/dl (7.8 mmol/L)
Official ADA recommendation for someone with diabetes: Less than 180 mg/dl (10.0 mmol/L)

HbA1c
Normal for person without diabetes: Less than 5.7%
Official ADA recommendation for someone with diabetes: 7.0% or less

Blood Pressure
120/70 blood pressure goal


Medications

  • Metformin 500mg (Rx) – 2 pills twice daily to improve blood sugar control
  • Loperamide Hydrochloride 2mg (OTC) – 2 pills twice daily as an Anti-Diarrheal because hey, Metformin
  • Victoza 1.2mg (Rx) – inject once daily to stimulate insulin production
  • Lisinopril 5mg (Rx) – 1 pill daily for blood pressure
  • Testosterone 50mg/5g gel – 1 tube topically once daily for depression (which I have) and libido (which I have none)
  • B12 Natures Bounty 2500mcg (OTC) – 1 pill daily
  • Taurine Solgar 500mg (OTC) – 1 pill daily for stress, blood pressure
  • Rhodiola Solaray 500mg (OTC) – 1 pill daily for stress

Equipment

  • OneTouch Verio Blood Glucose Meter
  • OneTouch Verio Test Strips
  • Unistik Travel Lancets AT1048/Comfort, or OneTouch Delica Lancets
  • NovoFine Plus 32G Disposable Needle 32Gx4mm (1/6″)

 

MIRL

Meal Prepping: A Prescription for the Kitchen

It’s true that half the battle takes place in the kitchen.  One of my favorite local running stores offers a simple weight loss plan written on a board in the back of the store: “eat less and run more“.  If the weight isn’t coming off, then eat less and run more.  It may be overly simplistic, but the basic tenant is true: manage your caloric intake and get regular exercise commensurate with your health and you will see results.

I’ve mentioned before that I’m a reddit fan, and I recently came across a post in the r/MealPrepSunday sub reddit that linked to a blog hosted by a medical student’s foray into meal prepping.  It has some really practical advice on setting up your kitchen, and includes some great, simple recipes that you can use to plan and create your own breakfast, lunch and dinner meals.

Remember that this is part of becoming a better version of you.  It’s time to start improving your health, your body, and your mind.

rollins-lifetime-quote

Check it Out: Prescription for the Kitchen: The Adventures of a Medical Student Taking a Bit of Her Own Medicine: Replacing Fast Food with Home Cooking

#WorldHealthDay 2016 – Focus on Diabetes

April 7 is World Health Day, and the World Health Organization’s focus in 2016 is on curbing the rising trend of Diabetes‬. In the US the Center for Disease Control estimates that almost 22 million adults in America were diagnosed with Diabetes in 2014. In 2015 I joined those ranks. Although my diagnosis was a wake up call, it explained symptoms I had struggled with, and it also gave me a path to recovery.

For anyone diagnosed with Type 2 Diabetes medication is critical, but it’s important to know that lifestyle changes including weight loss and exercise can often help control the disease. Two of the best things you can do are to learn more about what you eat, and to engage (now, not down the road) in a more active lifestyle. One of the most important steps you can make is to spend more time taking care of yourself by planning meals and dedicating time to an active program.

  • Step outside for 30 minutes during your day.
  • Find something you can be passionate about, then find out a way to be active in it.
  • Spend an hour each week to learn how to cook again.
  • Plan your meals, and your trip to the grocery.

But back to me again: It was on a particularly hot day last summer that I walked out of my local grocery store with a Bai5 Tanzania Lemonade Tea. From a dietary standpoint one of the biggest challenges has been to restructure how I eat. I look more closely at nutrition labels. I’m looking for more natural foods with fewer ingredients. I’m looking for new foods and healthy alternatives that replace things I enjoy, but which I know aren’t healthy. I’m a huge Arnold Palmer fan, but I had just found its 5 calorie doppleganger.

I’m trying to learn how to stop making myself “responsible” for things that are outside my direct control, and focus more on living a life that is worth living. Bai is my new trick to help me maintain my blood-sugar levels while still enjoying a great tasting variety of flavors.

Walk 1 Mile for Someone; for Something Bigger Than Yourself

I’m challenging you to #walk1mile; run, walk or roll your mile and tell me why you did it – it can be a walk for the homeless, for military service, for better health or to fight depression.  It can be a walk for those who can’t. Whatever your cause, by participating you can help to raise awareness and grow empathy for something that’s bigger than you or I.  Share pictures and stories in social media with the hashtag #walk1mile and I’ll add your pictures to the site

I’m setting up this site to inspire you to do something. I’m working on a unique incentive to recognize your contribution to our program – stay tuned and expect something from me soon!

Will you join me?

“You never really understand a person until you consider things from his point of view – until you climb in to his skin and walk around in it.” – Atticus, To Kill a Mockingbird

Walk 1 Mile 75px