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• Evaluate formulation-specific adverse effects at each visit:
- Intramuscular injections of testosterone enanthate and cypionate: Ask about fluctuations in mood or libido.
- Testosterone patches: Look for skin reaction at the application site.
- Testosterone gels: Advise patients to cover the application sites with a shirt and to wash the skin with soap and water before having skin-to-skin contact because testosterone gel leaves a residue on the skin that can be transferred to a woman or child who comes in close contact. Serum testosterone levels are maintained when the site is washed 6 hours after applying the gel.
Our recommendations always include Hi Lo Strength Training which was developed in part in the early 1980's by Ken Hutchins, the founder of SuperSlow Strength Training. He was working with Nautilus at the time and Nautilus was given the "Nautilus Osteoporosis Project" and asked to design a strength training program for frail ladies with osteoporosis. The Original Nautilus Protocol was a 2 second Positive, 4 second Negative repetition. The ladies were hurting themselves moving the weights this fast, so Ken slowed it down to 10 seconds up and 10 seconds down. The ladies could do this, they got a lot stronger and bone density improved, however little data was forthcoming due the the crude measurements of bone density at that time. To Quote Ken Hutchins " And if we can assume the body to be logical then bone strengthening should result from muscular strengthening" It would make no evolutionary sense to allow the muscle to get stronger and not allow the tendon and bone attached to the tendon to get stronger at the same time. Since aerobics does not build strength, it is a poor choice to build bone density.