| Problem | Solution and Comments |
| Acne/oily skin Caused by Dihydrotestosterone (DHT) effect on increased oil production | · Accutane – a powerful prescription item - 40 mg/day for one week sometimes stops acne if started at the first sign or as directed by your doctor. Accutane is potentially highly liver toxic. · Sporanox – Effective for some acne-like eruptions that are caused by fungi. Some doctors also prescribe antibiotics, like tetracycline, for acne with good results. · Anti-bacterial soaps - Use a scrubbing brush and wash twice a day, especially after sweating during a workout. · UV light or sunlight with moderation. |
| Hair loss Caused by DHT effect on hair follicles | · Nizoral shampoo– Available by prescription and over-the counter as a lower dose product. · Rogaine – Available by prescription. · Propecia (finesteride) - Available by prescription. A few males experience decreased erections with finesteride |
| Increased sex drive | · A problem? Sex drive is part of quality-of-life. This is not necessarily a bad side effect. Enjoy it. |
| Unresolved erectile function | · Viagra, Cialis, Levitra – Available by prescription; enables robust erections. Take an allergy medication and ibuoprofen with it to minimize sinus congestion and headaches. · Yohimbine (Yocon) - Available by prescription; increases sex organ sensitivity. Can increase heart rate and blood pressure · Muse - Available by prescription; pellet inserted into the urethra to produce erection. · Trimix – Available by prescription. The best and cheapest formula for injection into the penis for lasting erections. Visitwww.apsmeds.com · Caverject - Available by prescription. An injection into the penis that produces an erection that can last 1 to 2 hours. Be careful with injecting too much since it can produce dangerously ling erections that need to be treated in emergency rooms! Follow instructions from your urologist. · Papaverine – An older injectable medication, less expensive than Caverject. · Wellbutrin – Prescription at 300 to 450 mg/day; increases dopamine. · Human chorionic gonadatropin (HCG) – First dose is 5,000 IU, then 250-500 IU a week. No protocol has been proven in controlled studies yet. Note: If impotence happens while on testosterone, try varying the doses of testosterone. E.g. higher and lower. |
| Insomnia Usually this is caused by dosages that are too high. Find the least amount that gives you a good result. | · Sleeping medications – e.g. Ambien, Sonata, Restoril · Melatonin - 1 to 3 mg before bedtime. · Avoid working out too close to bedtime. · Limit caffeine, especially after 3 pm. · Visit houstonbuyersclub.com for a comprehensive sleep formula with tryptophan, melatonin and inositol. Nutrients do not work as well as drugs, but they can help some people. |
| Sleep Apnea | · Have a sleep specialist prescribe a sleep study. Some people may have to wear a C-PAP machine to breathe at night. Visit http://www.sleepapnea.org/ for more information |
| Testicular atrophy | · Human Chorionic Gonadotropin (hCG)– One 5,000 unit injection per week for 2 weeks, followed by maintenance of 250 IU twice a week. Decrease testosterone dosage accordingly after starting hCG |
| Enhanced assertiveness | · Count until 10 and be aware of your interaction with others. · Decrease caffeine. · Meditation, yoga, breathe from your belly for a few minutes when over reacting. · The testosterone dosage may be too high. · Make sure your estradiol level is not much over 25 pg/dl |
| High blood pressure/water retention | · Blood pressure medications - Elevated blood pressure is usually transient and stops within a few weeks of the end of a steroid cycle. However, ongoing or chronic steroid use is associated with high blood pressure. Try ACE or ACE II inhibitors since they seem to have fewer sexual dysfunction related effects · Supplements – Magnesium (600 mg/day); vitamin B6 (100 to 200 mg/day); may help reduce water retention. · Water - Drink extra water every day to help flush the kidneys. |
| Gynecomastia (male breast development) Caused by overproduction of estrogen, which can happen when is there is too much testosterone. (Testosterone converts into estrogen.) | · Arimidex - Inhibits estrogen production. Available by prescription. 1 mg/day until sensitivity stops, then ½ mg per day. Some people take .5 mg three times a week for maintenance. Ensure that your estradiol is under 20 pg/dl but do not go too low since it is needed for bon, skin and hair health. Some people get it online if doctor does not prescribe. · Nolvadex – Competes with estrogen for receptors. Available by prescription, 10 to 20 mg/day. Not as effective as Arimidex. Use of Nolvadex during a steroid cycle may reduce the net anabolic effect, as it decreases the production of GH[i] and IGF-1. Severe cases may require removal of the breast tissue by surgery. · DHT cream- Some people have obtained great results by robbing a 10% DHT cream on their nipples. Ask your compounding pharmacy. By prescription only. · Some cases require surgery if not treated early |
| Virilization (body hair growth, deepened voice, clitoral growth in women) | · Women with this problem should ensure that they are using the lowest possible dosage · Testosterone replacement in men seems to exacerbate body hair growth in males. · Proscar – Available by prescription at 1 to 5 mg/day, for men. |
| Benign Prostate enlargement | · Proscar - Available by prescription. For men, 1 to 5 mg/day. (Note: Can cause decreased sex drive and erections in some men.) · Hytrin, Flomax - Available by prescription. · Saw palmetto extract – Very effective for reducing prostate problems, but one study suggests that this herb may reduce the effects of testosterone, too.[ii] · Estrogen inhibitors like Arimidex. Estrogen dominance appears to increase prostate growth.[iii] [iv] · Check your prostate specific antigen and have a digital rectal exam before starting any steroid program, to detect potential for prostate cancer, especially if you are over 35 or have a family history of prostate problems, and have it checked on a regular basis. |
| Polycythemia (Elevated hematocrit, which means there are too many red blood cells that can increase blood viscosity and cardiovascular risks) | · Therapeutic phlebotomy means to have a pint or more of blood removed, usually 1 pint per week over several weeks. (1 pint usually will lower hematocrit by about 3 points.) Polycythemia is a compelling reason to avoid using higher steroid doses than are necessary. Taking the lowest effective dose reduces the risk of over-production of hemoglobin (red blood cells). |
[i] Metzger, DL, et al. Estrogen receptor blockade with tamoxifen diminishes growth hormone secretion in boys: evidence for a stimulatory role of endogenous estrogens during male adolescence. J Clin Endocrinol Metab (1994) 79(2):513-518.
[ii] el-Sheikh, MM, et al. The effect of Permixon (saw palmetto) on androgen receptors. J Acta Obstet Gynecol Scand (1988) 67(5):397-399.
[iii] Suzuki, K, et al. Endocrine environment of benign prostatic hyperplasia: prostate size and volume are correlated with serum estrogen concentration. Scand J Urol Nephrol (1995) 29:65-68.
[iv] Gann, PH, et al. A prospective study of plasma hormone levels, nonhormonal factors, and development of benign prostatic hyperplasia. The Prostate (1995) 26:40-49.
