WEBVTT 00:00:08.970 --> 00:00:11.130 A lot of women have this horrible misconception 00:00:11.130 --> 00:00:13.750 that testosterone is just for guys. It's like 00:00:13.750 --> 00:00:16.969 a boys only club and they shouldn't have it at 00:00:16.969 --> 00:00:19.870 all. And some practitioners will even preach 00:00:19.870 --> 00:00:23.309 that. But the reality is testosterone is just 00:00:23.309 --> 00:00:25.969 as beneficial for a female as it is for a male. 00:00:48.750 --> 00:00:51.490 What's up, guys? Welcome to Hormones Happen. 00:00:51.490 --> 00:00:54.210 I'm your neighborhood NP, Jeremiah, and I'll 00:00:54.210 --> 00:00:58.390 tell you what. We've been lied to, tricked, and 00:00:58.390 --> 00:01:01.350 brainwashed to be reactive with our health instead 00:01:01.350 --> 00:01:04.370 of proactive. There's no such thing as normal, 00:01:04.469 --> 00:01:07.969 and no one knows you better than, well, you. 00:01:08.530 --> 00:01:11.209 Stick around, and we'll talk about hormones, 00:01:11.549 --> 00:01:15.629 peptides, and other amazing advancements in proactive 00:01:15.629 --> 00:01:18.719 medicine. I won't sit here and say I know everything, 00:01:18.879 --> 00:01:22.840 but like they say, knowledge is power, and I'm 00:01:22.840 --> 00:01:26.040 trying to become more powerful every day, just 00:01:26.040 --> 00:01:29.859 like you. Let's get optimized together and become 00:01:29.859 --> 00:01:43.079 the heroes of our own stories. Welcome back, 00:01:43.120 --> 00:01:45.079 guys, to another episode of Hormones Happen. 00:01:45.400 --> 00:01:47.280 Today, I'm going to talk to you about the differences 00:01:47.280 --> 00:01:50.739 between injectable testosterone and transdermal 00:01:50.739 --> 00:01:53.579 creams, okay? And I get asked all the time, like, 00:01:53.659 --> 00:01:56.560 what's better? What's better? And the reality 00:01:56.560 --> 00:01:59.620 is, they both have their pros and cons. Now, 00:01:59.659 --> 00:02:02.519 when we talk about replacing testosterone, there 00:02:02.519 --> 00:02:06.180 are so many ways to do it. We have oral, we have 00:02:06.180 --> 00:02:10.099 pellets, we have sublingual trochies, you know, 00:02:10.099 --> 00:02:12.639 not just creams and not just injections, nasal 00:02:12.639 --> 00:02:15.460 sprays, believe it or not. And today we're just 00:02:15.460 --> 00:02:17.520 going to focus on the injections and creams because 00:02:17.520 --> 00:02:20.759 those are the two most commonly used forms of 00:02:20.759 --> 00:02:23.360 therapy, plus the ones that I'm most versed in 00:02:23.360 --> 00:02:26.719 because I use these all the time. So before we 00:02:26.719 --> 00:02:29.099 talk about the different forms, the first question 00:02:29.099 --> 00:02:32.400 is, well, Jeremiah, what's the benefit? Why would 00:02:32.400 --> 00:02:36.039 I even get on it? Because what can I expect to 00:02:36.039 --> 00:02:38.699 have? What can I expect to feel on the testosterone? 00:02:39.020 --> 00:02:41.300 Doesn't matter how I get it, but why would I 00:02:41.300 --> 00:02:43.219 want it? What symptoms are we talking about? 00:02:43.360 --> 00:02:45.120 Because we always say, if you have symptoms, 00:02:45.400 --> 00:02:48.479 if you have symptoms, and the reality is the 00:02:48.479 --> 00:02:52.020 symptoms vary. But if you're saying, hey, sleep 00:02:52.020 --> 00:02:54.620 is crap. I have horrible energy during the day. 00:02:54.680 --> 00:02:58.520 I have brain fog, anxiety, depression. My gym 00:02:58.520 --> 00:03:01.699 workouts suck. My lumbito is horrible. Well, 00:03:01.819 --> 00:03:04.319 it could be a testosterone problem. Maybe not, 00:03:04.439 --> 00:03:07.560 but it could be. Those are all symptoms of low 00:03:07.560 --> 00:03:10.460 testosterone. And so once we've identified, hey, 00:03:10.909 --> 00:03:13.250 Those are your pain points. Those are your issues. 00:03:13.310 --> 00:03:16.530 I think that based off of those symptoms and 00:03:16.530 --> 00:03:18.650 your blood work, I think you would benefit from 00:03:18.650 --> 00:03:20.830 treatment. We've already established that. Now 00:03:20.830 --> 00:03:23.849 we say, well, how should we treat this? What's 00:03:23.849 --> 00:03:27.229 the best way to implement that? And like I said 00:03:27.229 --> 00:03:29.270 before, there are a lot of different ways. There 00:03:29.270 --> 00:03:31.729 are a lot of different forms and which form you 00:03:31.729 --> 00:03:35.490 select really is based off your lifestyle and 00:03:35.490 --> 00:03:39.849 your ability to adhere to it. When we talk replacement, 00:03:39.909 --> 00:03:42.169 when I talk replacement for both men and women, 00:03:42.289 --> 00:03:44.990 it's important to first understand testosterone 00:03:44.990 --> 00:03:47.810 as a whole. Testosterone does a lot of things. 00:03:47.990 --> 00:03:50.650 And the first thing we think of is it gets you 00:03:50.650 --> 00:03:54.090 big and gets you jacked, right? So yes, it preserves 00:03:54.090 --> 00:03:57.870 and helps to build muscle mass. It helps to metabolize 00:03:57.870 --> 00:04:00.569 fat. It also helps to protect your bones. But 00:04:00.569 --> 00:04:04.430 let's not sleep on the fact that limbido skyrockets 00:04:04.430 --> 00:04:08.800 on testosterone. And the mental effects. Testosterone 00:04:08.800 --> 00:04:12.960 increases serotonin reuptake transporters, okay? 00:04:13.080 --> 00:04:15.120 These are neurotransmitters in the brain that 00:04:15.120 --> 00:04:17.360 help regulate our serotonin. And believe it or 00:04:17.360 --> 00:04:21.300 not, it's the same mechanism of action as a Prozac, 00:04:21.540 --> 00:04:24.759 okay? Natural antidepressant. But if you go a 00:04:24.759 --> 00:04:26.279 little bit further, you just peel back a little 00:04:26.279 --> 00:04:29.060 bit more, the aromatization of testosterone to 00:04:29.060 --> 00:04:31.819 estradiol now helps to regulate serotonin and 00:04:31.819 --> 00:04:34.620 dopamine in the brain, right? Estradiol is a 00:04:34.620 --> 00:04:38.360 huge component. to the mental benefits of testosterone. 00:04:38.759 --> 00:04:42.420 Okay. Now, you know, depending on how much benefit 00:04:42.420 --> 00:04:45.040 you would get would depend on your symptomology. 00:04:45.139 --> 00:04:46.720 Once again, I hate to keep going back to that, 00:04:46.800 --> 00:04:48.860 but it doesn't matter what your number is. If 00:04:48.860 --> 00:04:51.899 your number's clinically low, but you feel fine, 00:04:52.100 --> 00:04:53.720 I'm not going to sit here and say that you would 00:04:53.720 --> 00:04:57.279 benefit significantly. But if your number is 00:04:57.279 --> 00:05:00.899 normal and you feel like absolute crap, all those 00:05:00.899 --> 00:05:02.920 symptoms we talked about, that's going to be 00:05:02.920 --> 00:05:05.569 the guy that's going to say, oh my God. this 00:05:05.569 --> 00:05:07.629 was life -changing and i see it all the time 00:05:07.629 --> 00:05:10.350 guys are like i don't really i don't i don't 00:05:10.350 --> 00:05:11.769 know if it's going to help me i don't know if 00:05:11.769 --> 00:05:14.310 it's going to benefit kind of a toss -up sometimes 00:05:14.310 --> 00:05:17.069 it is life -changing and sometimes it's like 00:05:17.069 --> 00:05:20.449 i do feel better but i can't say that it's life 00:05:20.449 --> 00:05:22.970 -altering right so it's kind of you kind of get 00:05:22.970 --> 00:05:25.430 a gauge of who's going to benefit the most and 00:05:25.430 --> 00:05:29.009 what i will tell you is women need testosterone 00:05:29.009 --> 00:05:32.810 huge misconception a lot of women have this horrible 00:05:32.810 --> 00:05:35.050 misconception that testosterone is just for guys. 00:05:35.250 --> 00:05:38.670 It's like a boys only club and they shouldn't 00:05:38.670 --> 00:05:41.290 have it at all. And some practitioners will even 00:05:41.290 --> 00:05:44.230 preach that. But the reality is testosterone 00:05:44.230 --> 00:05:47.730 is just as beneficial for a female as it is for 00:05:47.730 --> 00:05:51.329 a male. Now, us guys give us testosterone. We're 00:05:51.329 --> 00:05:54.009 so happy. That's really all we need. It's rare 00:05:54.009 --> 00:05:55.829 that you have to replace other hormones for a 00:05:55.829 --> 00:05:58.670 guy. But for women, I would say the most beneficial 00:05:58.670 --> 00:06:00.889 hormone for replacement is actually going to 00:06:00.889 --> 00:06:03.589 be estradiol. right then you're on estradiol 00:06:03.589 --> 00:06:06.269 if you have a uterus you need progesterone also 00:06:06.269 --> 00:06:08.529 both of those hormones are amazing but let's 00:06:08.529 --> 00:06:10.730 not sleep on testosterone because i have some 00:06:10.730 --> 00:06:13.910 women on just testosterone and it's life -changing 00:06:13.910 --> 00:06:17.569 because it's correcting those symptoms typically 00:06:17.569 --> 00:06:20.509 if you're still perimenopausal and you're making 00:06:20.509 --> 00:06:23.250 enough estradiol and you're not needing the support 00:06:23.250 --> 00:06:26.029 for the bones the heart and the brain but we've 00:06:26.029 --> 00:06:28.930 already established you feel like we got a lot 00:06:28.930 --> 00:06:31.220 of problems a lot of things to fix We've already 00:06:31.220 --> 00:06:33.079 talked about the importance of testosterone. 00:06:33.439 --> 00:06:36.740 Now, the most important part, how do we fix this? 00:06:36.800 --> 00:06:39.019 How do we replace this? Well, my recommendations 00:06:39.019 --> 00:06:47.660 would be either injections or creams. There's 00:06:47.660 --> 00:06:50.220 plenty more where that came from. Head over to 00:06:50.220 --> 00:06:54.379 stillcity -trt .com for expert insights, tips, 00:06:54.540 --> 00:06:57.139 and everything you need to know about HRT and 00:06:57.139 --> 00:07:04.759 TRT. Now let's dive back in. This is what a testosterone 00:07:04.759 --> 00:07:07.379 cream looks like. And so it comes in different 00:07:07.379 --> 00:07:10.160 colors. This one's blue for testosterone. Haha, 00:07:10.180 --> 00:07:12.300 cool, huh? And with this, this is cool. This 00:07:12.300 --> 00:07:16.360 is a actual, a self applicator. So when you pop 00:07:16.360 --> 00:07:18.939 the top off, Cream comes out of the top and you 00:07:18.939 --> 00:07:20.579 can actually apply it with this. You don't have 00:07:20.579 --> 00:07:23.100 to, for women, you don't have to use your fingers 00:07:23.100 --> 00:07:25.120 and apply it. You can just go ahead and apply 00:07:25.120 --> 00:07:27.639 it with the cream itself. And on the back is 00:07:27.639 --> 00:07:30.360 a dial, which is how we adjust our dosage. When 00:07:30.360 --> 00:07:33.019 you turn that dial, you hear a click. That click 00:07:33.019 --> 00:07:35.920 correlates with your dosage. Now, you don't have 00:07:35.920 --> 00:07:38.060 to get caught in the minutia of the percentages, 00:07:38.220 --> 00:07:40.800 the milligrams. You know, as a patient, you should 00:07:40.800 --> 00:07:43.319 just be saying, what are my clicks? Because the 00:07:43.319 --> 00:07:45.040 reality is, is you can compound those creams 00:07:45.040 --> 00:07:48.670 to the sky, right? Like for instance, let's say 00:07:48.670 --> 00:07:50.430 I had a guy come in. He wants to get on testosterone 00:07:50.430 --> 00:07:53.449 cream. He's going to be at 20 % concentration. 00:07:53.750 --> 00:07:57.050 Okay. That's equivalent to 200 milligrams per 00:07:57.050 --> 00:08:01.069 gram. For a female, we're starting at 1%, 10 00:08:01.069 --> 00:08:04.209 milligrams per gram. So you have to kind of individualize 00:08:04.209 --> 00:08:07.110 it. And the reason is the needs, the testosterone 00:08:07.110 --> 00:08:11.230 needs for a female when emphasizing the feminizing 00:08:11.230 --> 00:08:14.889 effects, lumbido, energy, preservation of mass, 00:08:15.149 --> 00:08:18.199 muscle mass, that is. bone density is not going 00:08:18.199 --> 00:08:20.439 to be the same as a guy, right? We're avoiding 00:08:20.439 --> 00:08:24.459 virulizing effects, which are facial hair, deep 00:08:24.459 --> 00:08:26.959 voice, those characteristics that make a man 00:08:26.959 --> 00:08:29.439 a man. And we don't want that. I haven't had 00:08:29.439 --> 00:08:32.440 a female come to me yet asking for a mustache 00:08:32.440 --> 00:08:35.340 and a deep voice. Hasn't happened yet. I'm never 00:08:35.340 --> 00:08:37.899 going to say never, but it hasn't happened. So 00:08:37.899 --> 00:08:39.779 we really need to take that into account. So 00:08:39.779 --> 00:08:43.000 dosing is all different. That's one of the beauties 00:08:43.000 --> 00:08:45.340 of the cream because we have two different forms 00:08:45.340 --> 00:08:48.639 of dosage we can adjust the clicks which is your 00:08:48.639 --> 00:08:51.759 dose we can also adjust the concentration of 00:08:51.759 --> 00:08:55.080 the creams now as far as application of them 00:08:55.080 --> 00:08:58.019 where do you put these so for women i recommend 00:08:58.019 --> 00:09:00.320 we apply the cream either to the back of the 00:09:00.320 --> 00:09:03.740 knees or the inner thighs because we've done 00:09:03.740 --> 00:09:06.779 two things we've already limited transference 00:09:06.779 --> 00:09:10.429 and those are great areas for absorption Not 00:09:10.429 --> 00:09:12.230 a lot of hair follicles, which is important to 00:09:12.230 --> 00:09:14.590 know because when you use the cream, which is 00:09:14.590 --> 00:09:18.330 testosterone in general, it breaks down to dihydrotestosterone, 00:09:18.389 --> 00:09:21.690 DHT, which can stimulate hair follicles to get 00:09:21.690 --> 00:09:25.009 darker, more hair growth. So you put this on 00:09:25.009 --> 00:09:27.909 an area prone to hair, right? Forms folders back. 00:09:28.230 --> 00:09:30.570 I've seen this stuff. It can cause the hair to 00:09:30.570 --> 00:09:32.330 get a little darker. And this is not something 00:09:32.330 --> 00:09:34.129 where you'd want to put it on your head and help 00:09:34.129 --> 00:09:35.549 that you're going to get some hair growth, okay? 00:09:35.870 --> 00:09:38.769 So back of the knees, inner thighs, perfect for 00:09:38.769 --> 00:09:41.679 women. a little more complicated. We're going 00:09:41.679 --> 00:09:43.440 to want to apply this to the scrotum. And I've 00:09:43.440 --> 00:09:45.860 talked about this before, the scrotum. And that's 00:09:45.860 --> 00:09:48.860 because the scrotum is a very thin vascular membrane. 00:09:49.379 --> 00:09:52.159 And it's going to absorb like a dream. Now, not 00:09:52.159 --> 00:09:54.659 only do we apply it to the scrotum, shaven. I 00:09:54.659 --> 00:09:57.039 know that's huge because that hair will cause 00:09:57.039 --> 00:09:58.860 interference. It's going to cause problems. And 00:09:58.860 --> 00:10:02.580 I've seen levels, you know, vary by up to 700 00:10:02.580 --> 00:10:05.159 points, whether or not that scrotum is shaven 00:10:05.159 --> 00:10:08.809 or not. So that is important. these are both 00:10:08.809 --> 00:10:10.970 twice a day applications for both men and women 00:10:10.970 --> 00:10:14.230 not a hard and fast rule but the main benefit 00:10:14.230 --> 00:10:17.529 to creams is how steady those levels are you're 00:10:17.529 --> 00:10:19.830 not going to get steadier levels than with creams 00:10:19.830 --> 00:10:23.269 maybe arguably if you inject it every day but 00:10:23.269 --> 00:10:26.210 creams are the hallmark of steady levels and 00:10:26.210 --> 00:10:29.049 in order to do that twice a day application okay 00:10:29.049 --> 00:10:31.909 now what are some caveats to the creams well 00:10:31.909 --> 00:10:34.629 skin quality that's huge right let's say you've 00:10:34.629 --> 00:10:36.990 got some scarring some poor absorption areas 00:10:37.500 --> 00:10:39.679 It's going to vary on how much you absorb through 00:10:39.679 --> 00:10:42.279 the skin. Whether or not you sweat a lot, sweating 00:10:42.279 --> 00:10:44.580 can play a role too. And then of course, moisture, 00:10:44.700 --> 00:10:47.539 right? I recommend that when you put the creams 00:10:47.539 --> 00:10:50.700 on, that you give it at least six hours of contact, 00:10:50.960 --> 00:10:53.779 cream to skin contact. Granted, the cream should 00:10:53.779 --> 00:10:57.480 be dry in about 10 to 15 minutes, six hours to 00:10:57.480 --> 00:10:59.460 really know you got your full dose. So that could 00:10:59.460 --> 00:11:01.279 be a little problematic if you put your cream 00:11:01.279 --> 00:11:03.320 on and then you want to go do something that 00:11:03.320 --> 00:11:06.299 requires a shower afterwards. yard work, gym, 00:11:06.519 --> 00:11:08.779 whatever. So you do have to kind of plan these 00:11:08.779 --> 00:11:11.960 things out. Now with the injections, this is 00:11:11.960 --> 00:11:14.179 what a vial of testosterone looks like. We can 00:11:14.179 --> 00:11:16.480 also customize it for men and women. For men, 00:11:16.580 --> 00:11:19.120 typically it's 200 milligrams per milliliter. 00:11:19.179 --> 00:11:22.279 That's the concentration. For women, it can vary 00:11:22.279 --> 00:11:26.179 anywhere from 25, 100 milligrams per milliliter. 00:11:26.259 --> 00:11:29.559 It depends on the dosing, how much volume they 00:11:29.559 --> 00:11:31.679 want to use, how long you're going to use it. 00:11:32.000 --> 00:11:34.279 There's a lot of variables, but you can individualize 00:11:34.279 --> 00:11:36.720 injections too. So it's not like just creams 00:11:36.720 --> 00:11:39.320 can be tailored for women. I have plenty of women 00:11:39.320 --> 00:11:42.100 who are on testosterone injections and they're 00:11:42.100 --> 00:11:45.159 doing fantastic. No, no virulizing effects, right? 00:11:45.279 --> 00:11:47.379 The things we have to consider with the injections 00:11:47.379 --> 00:11:50.159 is that there's a couple of variables in the 00:11:50.159 --> 00:11:52.500 actual vial, right? We have the testosterone, 00:11:52.740 --> 00:11:55.389 which is the medication. Then we have an ester, 00:11:55.389 --> 00:11:57.590 which gives us our time release properties. And 00:11:57.590 --> 00:12:00.110 then we have a carrier oil because testosterone 00:12:00.110 --> 00:12:02.789 is what we call hydrophobic. It can't move through 00:12:02.789 --> 00:12:04.769 the body on its own. It has to be mixed with 00:12:04.769 --> 00:12:07.090 an oil. So the testosterone, we already talked 00:12:07.090 --> 00:12:09.450 about the benefits of testosterone. We know what 00:12:09.450 --> 00:12:11.330 it's going to do. Help with sleep, help with 00:12:11.330 --> 00:12:13.470 energy, help with lumbido, help with sports, 00:12:13.610 --> 00:12:16.309 you know, performance in the gym. Fantastic. 00:12:16.789 --> 00:12:18.990 Now the ester, the ester is the time release 00:12:18.990 --> 00:12:21.759 property, and there's a lot of them. propionate, 00:12:21.759 --> 00:12:24.659 enanthate, cypionate, and decanoate. There are 00:12:24.659 --> 00:12:27.620 more even. And so we typically use cypionate. 00:12:27.720 --> 00:12:30.820 This is probably the most commonly used. It's 00:12:30.820 --> 00:12:32.860 the most well studied. And we use it because 00:12:32.860 --> 00:12:35.600 we know that in three to four days, you're at 00:12:35.600 --> 00:12:38.720 your peak effect. And we know at seven days, 00:12:38.759 --> 00:12:40.860 half the medication's out of your system. So 00:12:40.860 --> 00:12:42.879 one thing that I'll see often that is a huge 00:12:42.879 --> 00:12:46.000 mistake is people will dose this once a week. 00:12:46.440 --> 00:12:49.059 And what happens is you'll hit this peak at three 00:12:49.059 --> 00:12:50.899 to four days. Then right before your next injection, 00:12:51.120 --> 00:12:53.320 you hit the half -life. So half the medication's 00:12:53.320 --> 00:12:55.399 out of your system. And you just do this little 00:12:55.399 --> 00:12:58.460 roller coaster. And you feel like crap. You feel 00:12:58.460 --> 00:13:01.220 like crap. And your levels are on a roller coaster. 00:13:01.440 --> 00:13:04.340 Your mind's on a roller coaster. By having the 00:13:04.340 --> 00:13:06.980 rapid fluctuations, you're more likely to develop 00:13:06.980 --> 00:13:14.080 things like erythrocytosis, which is... Guys. 00:13:14.840 --> 00:13:18.639 If you like content like this, please like, follow, 00:13:18.740 --> 00:13:21.299 and share the Still City HRT and Weight Loss 00:13:21.299 --> 00:13:23.940 Facebook and Instagram page. Now back to the 00:13:23.940 --> 00:13:29.379 podcast. Elevation of red blood cells, acne, 00:13:29.580 --> 00:13:32.500 it's not good. We want hormones to be steady. 00:13:32.700 --> 00:13:34.460 So with that being said, what do we do? Well, 00:13:34.519 --> 00:13:37.159 I recommend at a minimum, twice a week injections. 00:13:37.480 --> 00:13:39.919 And by doing twice a week injections, we're right 00:13:39.919 --> 00:13:41.740 up here at this peak, and we're just kind of 00:13:41.740 --> 00:13:44.529 doing this. We're never falling down here. We're 00:13:44.529 --> 00:13:47.389 just right up here. So we can maintain nice, 00:13:47.529 --> 00:13:50.529 steady levels. Now, twice a week, once again, 00:13:50.629 --> 00:13:53.350 isn't isn't the most steady. I'd say every day. 00:13:53.690 --> 00:13:56.549 But poking yourself every day is a bitch. OK, 00:13:56.649 --> 00:13:58.990 so the next thing is the oil, right? The oil 00:13:58.990 --> 00:14:02.970 is huge because the oil quality can really make 00:14:02.970 --> 00:14:05.450 or break your injection experience. There are 00:14:05.450 --> 00:14:07.629 some shitty oils out there like cotton seeds, 00:14:07.710 --> 00:14:10.610 sesame seed. These are standard. They're cheap. 00:14:10.809 --> 00:14:13.370 They're inflammatory. There are good quality 00:14:13.370 --> 00:14:17.529 oils. like grapeseed oil, MCT oil. There's even 00:14:17.529 --> 00:14:20.289 other ones. And so these oils are thinner and 00:14:20.289 --> 00:14:22.529 not nearly as inflammatory. And because of that, 00:14:22.629 --> 00:14:26.629 it gives us, excuse me, it gives us more ability 00:14:26.629 --> 00:14:30.129 to customize how we inject. For instance, we 00:14:30.129 --> 00:14:34.070 use insulin syringes. Look at that. That's a 00:14:34.070 --> 00:14:37.509 27 gauge, half inch needle. Okay. This is the 00:14:37.509 --> 00:14:41.889 same size syringe you would use for peptides. 00:14:42.360 --> 00:14:46.139 growth hormone, insulin. It's tiny. It's a small 00:14:46.139 --> 00:14:49.139 guy. And because of that, we can actually inject 00:14:49.139 --> 00:14:52.240 this subcutaneously. We don't have to inject 00:14:52.240 --> 00:14:54.460 it into the muscle. We can pinch up a little 00:14:54.460 --> 00:14:57.220 belly fat, poke it in, just like some glutide, 00:14:57.220 --> 00:14:59.700 trisepatide, or you could do muscle. I personally 00:14:59.700 --> 00:15:02.139 prefer muscle. I'm going to put this cap back 00:15:02.139 --> 00:15:04.919 on and show you. I still prefer muscle for a 00:15:04.919 --> 00:15:07.059 couple reasons. Muscle would be something as 00:15:07.059 --> 00:15:08.779 simple as this. Run to that meaty part of your 00:15:08.779 --> 00:15:10.860 shoulder. Or you could do your thigh. You don't 00:15:10.860 --> 00:15:13.330 have to do your butt. butt's really thick, chances 00:15:13.330 --> 00:15:15.750 are you're going to hit fat tissue anyway, not 00:15:15.750 --> 00:15:19.669 muscle. The reason I like muscle is because it 00:15:19.669 --> 00:15:21.769 absorbs quicker. And this could just be psychological. 00:15:22.169 --> 00:15:24.929 I feel better. I do. I just feel better when 00:15:24.929 --> 00:15:28.049 I do muscle. Subcutaneous, you get the same levels. 00:15:28.350 --> 00:15:31.629 Half of my patients do just subcutaneous and 00:15:31.629 --> 00:15:33.450 they love it. They'll never go to anything else. 00:15:33.610 --> 00:15:36.429 The other caveat is some people are more sensitive 00:15:36.429 --> 00:15:39.389 to the subcutaneous tissue. So you could inject 00:15:39.389 --> 00:15:41.789 it. For instance, this happened to me. inject 00:15:41.789 --> 00:15:43.690 in the back of the arm pinch up some fat inject 00:15:43.690 --> 00:15:46.470 and you might get a little bit of local site 00:15:46.470 --> 00:15:50.169 irritation redness swelling heat warmth right 00:15:50.169 --> 00:15:52.409 feels like an infection but once again if you're 00:15:52.409 --> 00:15:54.610 using good injection technique using alcohol 00:15:54.610 --> 00:15:57.570 swabs you're cleaning the skin using these tiny 00:15:57.570 --> 00:15:59.990 needles chances are it's not infection it's just 00:15:59.990 --> 00:16:03.549 a localized irritation it's inflammatory response 00:16:03.549 --> 00:16:05.870 and it hurts like hell okay it'll happen right 00:16:05.870 --> 00:16:07.590 it'll happen right away and i'll stay that way 00:16:07.590 --> 00:16:10.649 for a couple days typically just inject somewhere 00:16:10.649 --> 00:16:12.570 else next time. Don't inject in the same spot. 00:16:12.629 --> 00:16:15.429 Let it go down. But some guys are just more sensitive 00:16:15.429 --> 00:16:17.129 to it. Could be some of the preservatives in 00:16:17.129 --> 00:16:19.389 there. Could be the oil. Hard to say. It's happened 00:16:19.389 --> 00:16:21.549 to me just a handful of times. But the bigger 00:16:21.549 --> 00:16:24.730 issue is because of all that inflammation, there 00:16:24.730 --> 00:16:27.269 is a chance that all those inflammatory mediators 00:16:27.269 --> 00:16:31.049 are breaking down the metabolism of that testosterone. 00:16:31.289 --> 00:16:33.909 So you may not be getting your full dose when 00:16:33.909 --> 00:16:36.769 that happens. And I felt that way when that would 00:16:36.769 --> 00:16:39.039 happen to me. I didn't feel as good. I didn't 00:16:39.039 --> 00:16:40.840 feel like I was getting my dose. As crazy as 00:16:40.840 --> 00:16:42.700 that sounds, I just didn't feel as good. Since 00:16:42.700 --> 00:16:45.600 then, all muscle. And I've had not a single problem. 00:16:45.759 --> 00:16:47.419 So that's going to be something that you have 00:16:47.419 --> 00:16:50.399 to make the determination of. But you have options, 00:16:50.659 --> 00:16:54.500 right? And so what's better? Creams or injections? 00:16:54.899 --> 00:16:56.720 It doesn't matter. One's not better than the 00:16:56.720 --> 00:16:59.460 other. Some people will say, I want to start 00:16:59.460 --> 00:17:01.899 with creams because I'm afraid of needles. We 00:17:01.899 --> 00:17:05.319 start with creams. They say, my lifestyle doesn't 00:17:05.319 --> 00:17:07.799 allow for this twice a day application. Nonsense. 00:17:08.380 --> 00:17:11.279 i can't do it i want to go injections and plus 00:17:11.279 --> 00:17:13.539 i'm not as afraid of needles as i thought boom 00:17:13.539 --> 00:17:16.059 the other case would be someone's on injections 00:17:16.059 --> 00:17:19.779 and maybe they feel uncomfortable injecting for 00:17:19.779 --> 00:17:22.599 whatever reason around friends family so they 00:17:22.599 --> 00:17:24.660 go ahead and they do creams they feel safer more 00:17:24.660 --> 00:17:27.240 comfortable with the creams doesn't matter you 00:17:27.240 --> 00:17:30.279 get good results with both now i'll be honest 00:17:30.279 --> 00:17:32.640 and transparent that we have a better ability 00:17:32.640 --> 00:17:35.759 to increase the dosage and get your levels higher 00:17:36.279 --> 00:17:38.200 with injections because really honestly, the 00:17:38.200 --> 00:17:40.000 sky's the limit. One limitation to the creams 00:17:40.000 --> 00:17:42.920 is the strength, the concentration. Because when 00:17:42.920 --> 00:17:46.079 we have a cream, we're mixing a liquid into a 00:17:46.079 --> 00:17:48.799 solid and then we get the cream. And you can 00:17:48.799 --> 00:17:51.799 only mix so much solid into a liquid and keep 00:17:51.799 --> 00:17:56.160 it stable. So for instance, 20 % is a standard 00:17:56.160 --> 00:17:58.680 concentration for a cream for males. They are 00:17:58.680 --> 00:18:03.460 available in like 25%. I think I've seen 33%. 00:18:03.460 --> 00:18:06.660 But I think it's garbage. I think that's garbage 00:18:06.660 --> 00:18:09.700 because it just precipitates out. It's not stable. 00:18:09.940 --> 00:18:13.779 20 % is stable. Anything above that, you're probably 00:18:13.779 --> 00:18:17.420 not getting any more benefit. So there is a limitation 00:18:17.420 --> 00:18:26.759 to the concentration and the strength. Let's 00:18:26.759 --> 00:18:30.200 get real for a second. Yeah, aging happens. But 00:18:30.200 --> 00:18:33.529 feeling exhausted? Struggling with sleep? Losing 00:18:33.529 --> 00:18:35.529 your edge in the bedroom and watching your confidence 00:18:35.529 --> 00:18:38.670 tank? That's not just getting older. That's a 00:18:38.670 --> 00:18:40.970 hormonal imbalance, and you don't have to live 00:18:40.970 --> 00:18:43.309 with it. They'll tell you hormones are dangerous, 00:18:43.529 --> 00:18:46.150 but hand you a prescription with a mile -long 00:18:46.150 --> 00:18:49.769 list of effects. Enough is enough, guys. At Still 00:18:49.769 --> 00:18:52.190 City HRT and Weight Loss, we cut through the 00:18:52.190 --> 00:18:55.730 noise. We offer safe, bioidentical hormone therapy 00:18:55.730 --> 00:18:59.029 customized to you and backed by real lab monitoring 00:18:59.029 --> 00:19:01.940 and personalized care. Because your health isn't 00:19:01.940 --> 00:19:04.599 one size fits all. If you're done with the BS 00:19:04.599 --> 00:19:07.359 and ready to feel like yourself again, strong, 00:19:07.359 --> 00:19:10.859 focused, and confident, call or text us at 719 00:19:10.859 --> 00:19:15.359 -669 -4223. Let's build a plan that actually 00:19:15.359 --> 00:19:18.660 works for you. Steel City HRT and Weight Loss. 00:19:18.940 --> 00:19:31.220 Be the hero of your own story. on their total 00:19:31.220 --> 00:19:33.980 testosterone with creams i've seen it time and 00:19:33.980 --> 00:19:36.240 time again it piqued my curiosity enough for 00:19:36.240 --> 00:19:39.279 me to stop injections and do the creams for a 00:19:39.279 --> 00:19:42.380 full month now i'm talking meticulous every other 00:19:42.380 --> 00:19:44.839 day i'm shaving the scrotum razor shaving that's 00:19:44.839 --> 00:19:47.880 important first time you do it it is instant 00:19:47.880 --> 00:19:50.519 trauma you're one nick away from a life -altering 00:19:50.519 --> 00:19:53.420 event but after that it's actually super simple 00:19:53.420 --> 00:19:56.259 i still do it to this day i know that's tmi but 00:19:56.259 --> 00:19:58.339 every other day i was shaving i was applying 00:19:58.339 --> 00:20:01.450 it twice a day routine I got my levels I was 00:20:01.450 --> 00:20:04.170 just north of a thousand which is not bad right 00:20:04.170 --> 00:20:06.450 that's still fine typically with my injections 00:20:06.450 --> 00:20:10.670 I'm around 15 but to be honest I on it felt pretty 00:20:10.670 --> 00:20:13.750 similar I would not say that I felt worse and 00:20:13.750 --> 00:20:15.750 I think that's because the levels were so steady 00:20:15.750 --> 00:20:18.809 that I kind of just had this constant yeah I 00:20:18.809 --> 00:20:20.789 feel good I think you're able to get away with 00:20:20.789 --> 00:20:23.329 maybe lower levels because it's just constant 00:20:23.710 --> 00:20:25.829 and even at twice a week you're still having 00:20:25.829 --> 00:20:28.569 some little fluctuation hell even three times 00:20:28.569 --> 00:20:31.789 a week which is in my opinion even better than 00:20:31.789 --> 00:20:35.089 twice a week you have fluctuations okay it just 00:20:35.089 --> 00:20:36.930 depends on how many times you want to poke yourself 00:20:36.930 --> 00:20:40.829 per week how you know how routine are you to 00:20:40.829 --> 00:20:43.410 put on the creams begin to a good routine it's 00:20:43.410 --> 00:20:45.789 a piece of cake so it just depends on the individual 00:20:45.789 --> 00:20:49.809 one use case i will talk about is erythrocytosis 00:20:49.809 --> 00:20:52.900 in the creams so i've had this happen I had a 00:20:52.900 --> 00:20:55.900 patient, maybe mid -50s, and we were on the injections 00:20:55.900 --> 00:20:58.420 and he was having a lot of erythrocytosis, which 00:20:58.420 --> 00:21:00.519 is the increase in the red blood cells. If you 00:21:00.519 --> 00:21:02.420 guys have listened to me before on this, you 00:21:02.420 --> 00:21:04.779 know, you don't have to freak out, stop testosterone, 00:21:05.359 --> 00:21:07.740 jack up the dose, nothing like that. But it was, 00:21:07.759 --> 00:21:10.619 you know, it was staying elevated above, you 00:21:10.619 --> 00:21:13.660 know, I'd say 58 or so. And we had focused on 00:21:13.660 --> 00:21:15.980 hydration. We had increased injection frequency. 00:21:16.200 --> 00:21:18.480 We had implemented grapefruit, which if you've 00:21:18.480 --> 00:21:21.079 heard me talk before. actually has a very positive 00:21:21.079 --> 00:21:23.440 effect on bringing down hematocrit levels and 00:21:23.440 --> 00:21:25.660 we even adjusted the ester so we even had him 00:21:25.660 --> 00:21:28.619 on a shorter ester to see if that would help 00:21:28.619 --> 00:21:31.740 keep steadier levels well unfortunately we still 00:21:31.740 --> 00:21:34.039 weren't able to obtain this and the other thing 00:21:34.039 --> 00:21:36.599 too is he was having some symptoms he would get 00:21:36.599 --> 00:21:39.119 headaches and then after a therapeutic phlebotomy 00:21:39.119 --> 00:21:41.680 he would feel better but routinely doing these 00:21:41.680 --> 00:21:44.720 therapeutic phlebotomies is just not a good long 00:21:44.720 --> 00:21:47.599 -term strategy so we switched to creams guess 00:21:47.599 --> 00:21:51.000 what erythrocytosis gone you know because the 00:21:51.000 --> 00:21:53.180 creams are so steady and this is my thought process 00:21:53.180 --> 00:21:55.799 the creams are so steady that we're not having 00:21:55.799 --> 00:21:58.799 those peaks and troughs which are driving the 00:21:58.799 --> 00:22:01.839 erythrocytosis and it could also be potentially 00:22:01.839 --> 00:22:03.440 a preservative or something in the injection 00:22:03.440 --> 00:22:07.059 too but creams do not have the same degree of 00:22:07.059 --> 00:22:09.980 erythrocytosis so that is one indication that 00:22:09.980 --> 00:22:12.700 i would say a cream is going to beat out injections 00:22:12.700 --> 00:22:15.640 every time someone who has persistent erythrocytosis 00:22:15.640 --> 00:22:19.390 symptomatic requiring frequent therapeutic phlebotomies, 00:22:19.470 --> 00:22:22.230 which is not good, I think creams would be great. 00:22:22.349 --> 00:22:24.250 Because you can still be on hormone replacement 00:22:24.250 --> 00:22:27.470 therapy, testosterone, without having those fluctuations. 00:22:27.950 --> 00:22:30.329 But once again, at the end of the day, it comes 00:22:30.329 --> 00:22:33.009 down to you, personalized discussion with your 00:22:33.009 --> 00:22:35.430 provider, whether that's me, whether that's anyone 00:22:35.430 --> 00:22:37.569 else, and what do you feel comfortable with? 00:22:37.650 --> 00:22:40.329 Because when we're talking about adjusting your 00:22:40.329 --> 00:22:42.490 hormones, optimizing your hormones, you should 00:22:42.490 --> 00:22:44.829 be in the driver's seat. Your provider is in 00:22:44.829 --> 00:22:47.329 the passenger seat. We're giving guidance. But 00:22:47.329 --> 00:22:49.170 at the end of the day, it's your choice. And 00:22:49.170 --> 00:22:51.130 I think it's always a good idea to educate yourself 00:22:51.130 --> 00:22:53.289 with information like this, with going online, 00:22:53.589 --> 00:22:55.670 looking up what are some of the pros and cons 00:22:55.670 --> 00:22:57.609 of each. And then when you come to a consult 00:22:57.609 --> 00:23:00.230 with someone like me, that brings a lot of information 00:23:00.230 --> 00:23:03.650 because then we can go deeper into what is going 00:23:03.650 --> 00:23:12.470 to work for you specifically. That's a wrap on 00:23:12.470 --> 00:23:15.339 today's episode of Hormones Happen. I hope you're 00:23:15.339 --> 00:23:17.180 walking away with some clarity and confidence. 00:23:17.700 --> 00:23:20.779 If this resonated with you, let's keep the conversation 00:23:20.779 --> 00:23:24.039 going. Connect with us on Facebook, Instagram 00:23:24.039 --> 00:23:27.059 or over on the blog. And if you haven't yet subscribed 00:23:27.059 --> 00:23:30.500 yet, go ahead. It's the easiest way to keep growing 00:23:30.500 --> 00:23:33.579 and learning. As always, we believe in your power 00:23:33.579 --> 00:23:37.000 to heal, thrive and lead. Be the hero of your 00:23:37.000 --> 00:23:37.539 own story.