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September 19, 2020

Getting (Testosterone) Under Your Skin: Is Subcutaneous Hormone Therapy Right For You?

Speaker 1: 

Welcome back to the Armour men’s health hour with dr. Mystery and Donna Lee .

Speaker 2: 

Hello and welcome to the Armour men’s health hour. I’m dr. Mystery , your host here with my cohost Donnelley ,

Speaker 3: 

Everybody I’m just reeling on what you said before we came on air

Speaker 2: 

The Donna Lee , the seventh funniest mom .

Speaker 3: 

That’s right per Nick at night. So I got street cred.

Speaker 2: 

Is it wrong of me to have one , to see the episode where you cried off the stage?

Speaker 3: 

No, I have the episode in a CD at home or DVD CD. I cannot watch it again or watch it a couple of times in my life. My goodness. I won’t even let my husband or children watch it.

Speaker 2: 

A little bit of disappointment in life. Really built in such a wonderful career on the radio. Thank you guys so much for joining us. Uh , I’m a board certified urologist. My name really is dr . Mystery, Cindy mystery. I go by Sunday ,

Speaker 3: 

M I S T R Y. When you’re Google

Speaker 2: 

That’s right. My 11 year old went to junior high, big shout out to coach Hodges at style’s middle school. He , uh, was , uh , uh, I guess they were, you know, reading off their locker numbers or something like that. Uh , he looked at it and goes, it looks at his fellow coach and goes, it looks like we’ve got another mystery on our hands.

Speaker 3: 

I hope that was a good thing.

Speaker 2: 

Two older siblings looks like we got another mystery on her

Speaker 3: 

That could have gone either way. He could have said it looks like we’ve got another mystery.

Speaker 2: 

I’m pretty sure there’s a little bit of that. My children are wonderful. We’ve been in practice since 2007. Our practice called NAU urology specialists . We are open for business. We are ready, willing, and clean to see you. We’d like to think that we were clean all the time, but we’re really worried . Even Gleaner. Now we are seeing patients of all types, both from telemedicine , um, as well as , uh , in-person , uh, we are still doing routine surgeries in the operating room. All the operating rooms are open. Everything is open, ready to go. So if you are, if you have a problem, whether it be a need for a vasectomy, a surgical issue that wants to be that needs to be addressed or any other neurologic concern, we would encourage you to come in. Especially since now, you know , getting towards the end of the year and people had their deductibles paid off and we understand there’s lots of confusion about work and whether you can take time off or do things, I completely understand all, all those concerns, but when it comes to your health, there’s no value in putting it off. These problems just get bigger and worse and harder to treat later. So we would encourage you to , to come in right away for us to help treat you in a safe manner.

Speaker 3: 

Right. And it amazes me. How many of us ectomies we do every week? It’s like, there’s, there’s a never ending line of disectomy . Why can’t believe we don’t do more. Really? Yes , we do something

Speaker 2: 

Mid October . It’s going to be national. Have a sector day . Really ? No, I’m sorry. International.

Speaker 3: 

Oh, wow. That’s bigger. I know you are mr. Worldwide. So that fits in right there with your model, the vasectomy, Ethan

Speaker 2: 

Farthest anybody’s ever flown to get a secretary from me is from Saudi Arabia. Somebody came from Saudi Arabia because we did my dissertation. He was not, he was not a chic . No, but he, you know, was very nice and

Speaker 3: 

Was super rich. Did he fly on his private plane?

Speaker 2: 

No. He like has one of these things where he works for those oil companies and they like trap . They fly them out once a month, anywhere he wants to go. And he’s like, you know what? I’m going to Austin.

Speaker 3: 

You guys little snips it ,

Speaker 2: 

Your questions and your, and your presence in our office as a patient is what keeps us moving both really in terms of having a practice to open them , but also spiritually in terms of giving us the , um , excitement to do this show. We love when you give us feedback as a listener, especially when you come to see us as a patient, but even just to give us feedback on what information we may have provided, that was a value to you. It helps us understand how to put shows together in the future.

Speaker 3: 

That’s right. I had a patient, I talked to the other day and she said, you sound just like you do on the radio. And I was like, well, I hope so. I don’t know . I don’t know. I don’t have another voice, but thank you. Yeah , they were very kindness .

Speaker 2: 

Why don’t you tell them about where our offices are and then let’s go. Yeah .

Speaker 3: 

All right . You can call us during the week at (512) 238-0762. You can Google us. It’s armor men’s health.com. Send your questions to Armour men’s health@gmail.com. And we will get these questions answered right away. Uh , this one that I want to apologize. He sent this question in twice, but we got a little busy last weekend with the show. So this is for you, dr . Minister . He was listening to the Sunday program cause you know, we’re on set Saturday and Sunday. That’s right. Thank you, Kelly. About the topic of subcutaneous testosterone placed underneath the skin, which is a discussion that we had. I imagine it means pellets. We’ll talk about it. I have heard of this method of testosterone delivery before I would like to know more. I’m currently prescribed to apply six pumps per day of generic for Testa that’s right . To help maintain a testosterone level above 300, which is the low end of the range between 308 90 listed on my bloodwork listing. When I get a physical can, the subcutaneous technique dispense an equivalent level of testosterone as the six pumps on a daily basis and still last a few months under the skin.

Speaker 2: 

What a great question. And so what we’re really talking about, our methods of testosterone delivery, what’s best for you. What’s the most convenient for you? And there’s a lot of things that go into consideration before I go too far and do it stop using six pumps. That is way too much cream. There is no way. I mean, in order for it to work, it has to be spread out over a surface area wide enough. So that it’s thin enough to absorb into the skin. You’re going to be putting that all down your thighs all the way down to your calves. I mean six bumps, a lot of bumps. Number one is I certainly think finding a cleaner, more efficient way of doing the testosterone is probably in your best interest , right ? To that end. If we use that as the standard you listener are currently doing six pumps and are achieving a level that’s at the very low end, you’re doing all that work to barely even get into the normal range. What’s the right number for you. I don’t know if you’re performing wonderfully at three Oh eight of a testosterone. You getting good erections, good libido workouts are great. Sleeping, wonderfully cognitively doing well. Then that’s maybe where you’re supposed to be. And then finding the easiest way to get to that level would be your goal. If you’re suboptimally performing at three Oh eight, then more and more creams not going to do it. You know? So we need to find a better way. Now . Now why don’t creams work? Why do some people get away with two pumps, water, some people need six pumps. I’ve had people on one pump get up to 1200 testosterone. Some people are just what we call hyper absorbers. Their skin is just particularly well suited to absorb the testosterone nature made all sorts of people. So some of us are great absorbers. Some of us aren’t thick skin, thin skin. A lot of things can be broken around our office. In any case, if you have the, if you have the cream and you’re not absorbing it, then coming to a different option for treatment is something to consider. So I’m going to talk about two of the ways that we’ve discussed dispensing testosterone that could be listed as subcutaneous. Okay. Which means under the skin. One of the ways that we do it is the bio T pellet. Now the bio T is just the name of the company that makes the pellet. Uh , we use that company because they make millions of very high quality pellets. They never get delivered to us broken. They are very high quality with good , um , reliable dosage, something that I can’t say that we used to get from smaller compounding companies. And so being able to offer that kind of a treatment has allowed us to provide six months of treatment in one small little procedure here in the office, we charge about six fifties or tens . Turns out to be about a hundred dollars a month to give you a level that we routinely get to for your size and extra exercise level of about eight to 900. And that’s kind of what we’re looking for. And that’s kind of the , the , the, the, the right kind of patient. If you’re happy at a 300, we have easier ways to get you to 300. But if you’re a patient , uh , you know, if you’re a firefighter police officer or somebody who is exercising quite a bit and go through a lot of testosterone in your body, as well as that’s given to you, then getting that higher level through a bowtie pellet can be a wonderful way of achieving that goal. The other way that we’ve described administering testosterone on the show has been subcutaneous injections. So traditionally what we do is we have you inject into the muscle and we have you, if you do, self-injection self-injection to the leg, if somebody is injecting for you, they do it into the gluteus or the buttocks a once a week is our standard regimen for intra muscular injections. But some people don’t like using the bigger needle, they , they find it hard to inject the volume of testosterone, which is like an oily substance into the muscle as they want to find an easier way. And so what we also offer is sub and that’s a very small needle, a much smaller volume, and it goes right under the skin. We do it twice a week, or we prescribe it twice a week, but some of our patients, they like to do even less every day, really . And so , um, whatever works for you, and we can certainly achieve that level of 300 , uh, with sub either of those options,

Speaker 3: 

Is that a psychological thing to do it every day? Are you really getting a little boost there ?

Speaker 2: 

You might be an , and , and it’s a routine, like if you told me that I had to do something twice a week, I’d probably forget it, like at least once a month . Right . And you would , you’d be inconsistent. You just , it’s just a very different experience when you’re doing something, every part of your routine, right ? Get up, brush your teeth, little sub Q injection testosterone, move on your day, right? And the needle is tiny, tiny, it’s super tiny. It doesn’t hurt. And it’s just much more acceptable option for some patients. The monitoring is the same. We would just do a routine blood monitoring if testosterone, estrogen, and blood count levels on some interval that incidents of conversion to estrogen is a little less with sub Q injections. And I think the incidents of Polycythaemia or excessive blood counts is also much lower , uh, with sub Q injection. So there’s , there’s some benefits the cost to you. Um, you know, if you get , uh , the testosterone , um, uh, from one of our preferred compounding pharmacies run something like 25 or 30 bucks a month, it’s really inexpensive that comes with the needles and everything else. So , um, it’s, it’s inexpensive. It can be a very high value and something that’s .

Speaker 3: 

Wow. That’s really inexpensive. Yeah. Well, that’s a great question. People ask more, you can send your questions to Armour men’s health@gmail.com and call us during the week (512) 238-0762. Thank you so much. Dr. Mystery wants to hear from you email questions to Armour men’s health@gmail.com. We’ll be right back with the armor . Men’s help hour .

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