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    Abraham H. Kryger, MD

About Dr. Kryger
Dr. Kryger has been a physician for over 30 years. The cornerstone of his practice, and his published books, is the principle and medical  fact that one's health, longevity, and overall quality of life can be greatly improved through the proper monitoring and management of hormone levels. 

Dr. Kryger takes a mindful, 21st Century, holistic approach to caring for his patients. He believes that by taking time to listen to all the symptoms, concerns, and goals of his patients, he can properly diagnose  the problem.  Only then, is it possible to design an individualized treatment program.

In an effort to give his patients  an easier to use and more problem free testosterone replacement therapy than commonly prescribed gels or shots, Dr. Kryger developed Testocreme®.  This patented, high potency testosterone cream has been prescribed by physicians worldwide  to optimize men's testosterone levels to  healthy physiological levels.

Testocreme® is very easy and convenient to use. Once applied to an area the size one’s palm, it is rubbed on to smooth, thin skin over the patient’s ribs, biceps muscle or back.  Since there are testosterone receptors in the skin, and to avoid receptor fatigue, the patient must alternate the locations for application each week, while applying the full dose to  only one site. Testocreme can also be applied to the scrotum, which is considered to have a higher absorption rate than other skin areas.  

With scrotal application the  total amount of cream required is reduced significantly,  though clipping of scrotal hair is necessary when using Testocreme.  Because there is a high concentration of 5-AR enzyme in scrotal skin, DHT levels increase more after scrotal application  than after application to other  areas. As little as one fifth of an individual’s maximum dose can be used.For most men over 45, one half gram is sufficient.  Younger men may require scrotal application of up to one gram per day . After application, a shower can be taken within an hour to avoid any risk of transferring testosterone to one’s sexual partner.

Prior to testing patients should apply Testocreme each night for three to four consecutive nights before lab appointments Blood specimens  are sent to Esoterix.com for testing. Because Esoterix is a subsidiary of  Labcorp, any Labcorp station can perform the blood draw  and  forward the results to our office.  Our office manager will contact the lab of your choice, if you give us a fax number to order your follow up testing. [Does this last sentence mean the patient has the option of choosing a lab other than than Esoterix? –not clear.]

If  tests still show levels below the upper quartile, then the prescribed  dose can beincreased appropriately. Men with HIGH NORMAL testosterone outlive men with LOW NORMAL testosterone.

Monitoring :  You will need regular testing until your hormone levels have stabilized and every three to six months thereafter, depending on your hormone dose.  It will be helpful if you provide information as to the frequency of AM erections, frequency of ejaculations per week, and increase or decrease in sexual drive at the time of your visit.

Under the endocrine guidelines the following studies should be performed every six months at a minimum: Free and Total Testosterone, DHT, Sex Hormone Binding globulin (SHBG), CBC (complete blood count), PSA and Liver function studies. A digital rectal exam performed by the patient’s physician is necessary once a year.  

We make every effort to work with our patients who have insurance, and with those who do not, to make the testing financially feasible for you. Periodic testing must be done so that we can continue to provide a quality service for you.  Your progress notes can be added to your medical records by e-mail or phone consultation if you live outside California once you have been seen in the office in Monterey.

Each patient’s hormone levels and requirements are unique.  To assure optimal dosing, retesting is required every six months.  At baseline, we measured your blood for our male panel profile which included a PSA,  free T, DHT, E2, TT and SHBG , 12 hours after your last application. After a year we measure your FT, TT, SHBG and PSA at a cost of $500. Otherwise, if you have hypogonadism, most insurances will pay for your lab tests.
 
   
   
           
           
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