would you trust your doctor ?

[bolic]

would you trust your general doctor if your life depends upon his/her recommendations ?

correct me if i'm wrong guys but i think lots of doctors are clueless when it comes
to hrt and its positive effects. I think most of them are better informed on the
negative side effects of steroid use whether this knowledge has come from the media fanfare that causes it or the unfinished study or ignorance on the subject.

I have read posts with similar and close enough resemblances to my own personal journey searching for this doctor that would put an end to my unwellness feeling and miserable existence where words to describe the reasons why an appointment was made are indeed unnecessary.

No matter how you say it, how good you prepare the notes the night before to recite them later on or how many days ahead you plan your 5 minute discussion about your own health and wellbeing, doctors seem stupid knucleheads or sometimes smart enough to make you take a countless number of ridiculous tests so they can put in their pockets the keys to a new dodge viper or the
down payment for a new condo in the bahamas.

It does not matter, right ? as long as the health problems get corrected, but no, you end up with more problems. Thats why when someone starts going to the doctor they find themselves in deeper sh t than ever before.

so i wonder, what the fvkc is it anyways ? is it true in order for someone to get at least sound advice from a doctor, money and medical practice should not be mixed together ? ( lets forget this last sentence because its not how this country works )

its sad when you think about it but how many of us have gone through this ?

[bluethunder]

For the most part that is true. Best is to find a anti-anging specialist or HRT specialist endo specialist as the ordinary family doc is going to prescibe andro gel or cream and not inform you of estrogen ratio's and/or pct therapy.

[darmadoc]

Well, I am sure with that attitude most doctors would be exstatic to work with you. If they are all so stupid, get a textbook and diagnose yourself! I am sorry to seem so harsh, but your generalization of all doctors as stupid, money grubbing, idiots bothers me some.

P.S. I don't have a Viper.

[bluethunder]

Well, I am sure with that attitude most doctors would be exstatic to work with you. If they are all so stupid, get a textbook and diagnose yourself! I am sorry to seem so harsh, but your generalization of all doctors as stupid, money grubbing, idiots bothers me some.

P.S. I don't have a Viper.

You are very right darmadoc...

[bolic]

Well, I am sure with that attitude most doctors would be exstatic to work with you. If they are all so stupid, get a textbook and diagnose yourself! I am sorry to seem so harsh, but your generalization of all doctors as stupid, money grubbing, idiots bothers me some.

P.S. I don't have a Viper.

Well, I am sure with that attitude most doctors would be exstatic to work with you.

What attitude would be suitable or more appropiate doctor ? agreeing to everything this doctor has to say even if he is dead wrong while at the same time generalizes about the symptoms or possible consequences but not being able to properly diagnose, treat or cure the problems ?

If they are all so stupid, get a textbook and diagnose yourself!

i think you misinterpreted what I said to begin with, I was putting an emphasis on general practice doctors.....and yes I have been treating myself!

I am sorry to seem so harsh, but your generalization of all doctors as stupid, money grubbing, idiots bothers me some.

Harsh ? no, not at all, it just seems to me that my overview of "yes money grubbing doctors" has hurt your feelings, if you felt this was indirectly thrown at you then you have some issues to work with.

And about the money issue do not dare to talk about it.

There are countless numbers of doctors committing fraud every single day and getting away with it.
Yes there are honest doctors but most likely the majority in the United States and other parts of the world have or would be involved one way or another on some kind of fraud.

You might not like a Viper but who knows, if you are more conservative the new Bentleys are worth to test drive. What do you think doctor ?

[darmadoc]

I would dispute your contention that the majority of doctors in the world are committing fraud. Please show me some statistics that would back that up, unless this is based on your personal experiences, which I daresay do not involve a large enough sample to make that conclusion.

I am curious, what occupation are you involved in? Are all its members paragons of virtue?

I am always concerned when someone has a problem that no doctor seems to be able to diagnose. I become even more concerned when the patient states that the reason they can't be diagnosed is because all doctors are stupid and corrupt. It makes me wonder-are all the doctors the problem, or is it the patient?

[bolic]

Please show me some statistics that would back that up

That is the problem, you start relying on statistics and depending on the literature you bump into you get the wrong idea. If you are indeed a doctor you should know better not to trust every piece of misinformation you read as it might lead you to believe that everything is running perfect.

I was going to use special syntaxes to pull a list long enough, not from a regular text-search engine as your limited visual capacity has handled in the past but with enough reasons to agree with me or at least to properly interpret what I am trying to say since it seems you are the type of person that goes by the book and that too, is one of your problems. Not long ago doctors used to diagnose anything by just looking at the eyes of a person, the patient did not have to say a single word. If you are a doctor or a wannabe you perfectly know it is the truth, unless you want me to pull names of doctors since you are one of those 'show me the paper' kind of persona.
That I won't do.

Secondly, depending on the environment an individual is interacting, the harder it is to make that person understand there is always another side of the story. That it seems to be another problem you are facing, hope you improve.
My profession does not allow me to reach conclusions on anything but simply to analize the facts and have the courage to separate them.

The root of the problem lies on the fact around the monetary mechanism all the parties ( doctors, insurance co., pharmacies, even patients, etc. ) are involved. As we read threads on this forum do you have any idea how many illegal transactions are taking place on small and large scale medical businesses ?
To fix this you need to change the whole system beginning with the government itself.

That won't happen so we need to suck it up.

Take care darmadoc nice talking to you.

[The Baron]

Endocrinology is a specialty. Can't expect a GP to be expert in every facet of every specialty, IMHO. Sometimes you have to do your own research and even suggest things to your doc. You are paying him for his experience and GENERAL medical knowledge, which takes years to acquire. OTOH, you can learn a LOT about just hrt in only a few months of diligent research and your knowledge in this one small area would dwarf that of a typical GP. That's just the way it is. Can't hold it against your GP that he isn't expert in hrt, and you should be surprised if he IS. An endocrinologist, that's a diferent animal. Your average endo will have a reasonable knowledge of hrt, though your own dedicated research would still probably outshine his in that department.

[darmadoc]

So if the statistics don't back up your ideas, discount the statistics?

Medicine has evolved into a much more science based profression. Technology, laboratory science, pharmacology all have combined to enable doctors to do much more to help their patients than ever before. We develop new diagnostics and therapeutics almost daily. Some of these are great advances, some are useless or downright dangerous. In order to be sure we help our patients and don't harm them, we rely on studies and statistical analysis to interpret the data. The days of diagnosing a patient by looking at his eyes are over and I, for one, don't miss them.

[bolic]

Endocrinology is a specialty. Can't expect a GP to be expert in every facet of every specialty, IMHO. Sometimes you have to do your own research and even suggest things to your doc. You are paying him for his experience and GENERAL medical knowledge, which takes years to acquire. OTOH, you can learn a LOT about just hrt in only a few months of diligent research and your knowledge in this one small area would dwarf that of a typical GP. That's just the way it is. Can't hold it against your GP that he isn't expert in hrt, and you should be surprised if he IS.

Totally agree with you.

An endocrinologist, that's a diferent animal. Your average endo will have a reasonable knowledge of hrt, though your own dedicated research would still probably outshine his in that department.

Yes, indeed, I would not underestimate any endocrinologist.
They all have a profound and vast knowledge on the endocrine system.
I am far away from their level of expertise and experience.

However, it is ridiculous the existent gap between their knowledge on the field and the appropiate application to hormone replacement therapies.

This is an excerpt from a letter an endocrinologist send to his patient. ( I am omitting the facility to protect the patient information, but I am sure he would not mind to post it ):

It was a pleasure to meet you recently in the Endocrinology Clinic. As we discussed that day, it is likely that your hypogonadal or low testosterone state was due to your previous anabolic steroid use. With regards to the information you sent to me via Dr. Crisler. ( omitted ) Dr. Crisler’s work is no where in the medical literature that I can find. In addition, the proposed procedures don’t make intuitive physiologic sense to me.

This was from an endocrinologist, what the hekcc is he talking about ?

This endocrinologist is supposed, or at least to be aware of names like Crisler or Shippen on the field.

'..nowhere medical literature that I can find' lol, did he try to look for a book by, for instance, Dr Crisler on amazon ? lol

this is an endocrinologist that should know better, has he lived in a cave for the last 5 years ?

Generally speaking, I think we are years away from educating the public on hrt.

[PrimoPup]

When it comes to steroids i would think that you would need a young Dr and who is hip and what is going on, not just an old fart who read 1 article, JMO.

[Stat1951]

Unfortunately - as I have found out so completely - the endocrinology field has become specialized also. The biggest area of speciality is probably diabetes, with thyroid problems second. And unfortunately very few endocrinologists actually "specialize" in TRT... and a number of those who suppsedly do aren't really anywhere near being updated with their recommendations. Not to pick on anyone in particular, but here's just one example from a Cleveland Clinic source (and the Cleveland Clinic is considered annually to be one of the top 4 or 5 hospitals in the US):

http://www.clevelandclinicmeded.com/...pogonadism.htm

QUOTE: Although the usually quoted range for young adult males is 300 to 1,000 ng/dL, the lower limit reported for The Cleveland Clinic is 220 ng/dL. In general, values below 220 to 250 ng/dL are clearly low in most laboratories; values between 250 and 350 ng/dL should be considered borderline low... Androgen replacement therapy is relatively straightforward... Typically, the depot esters are administered by the deep intramuscular route once every 2 weeks at a dose in adults of 200 mg... Doses may be adjusted by aiming for midnormal (400-600 ng/dL) testosterone values after 1 week or at the low end (250-350 ng/dL) just before the next due injection at 2 weeks... again, a value in the midnormal range (400-600 ng/dL) is the goal... END QUOTE

When I was first diagnosed as hypogonadal, it was done by a GP who only ran (as extra tests from my normal blood work) Total T, PSA and Hematocrit. Since the Total T was 180 and my PSA was 0.3 and Hematocrit was 44, he put me on 5 grams of AndroGel.

The first Endo that I saw was (as I discovered later) a diabetes specialist. He had me stop my AndroGel for a couple weeks and then ran tests again. But did include not only Total T, but also Free T, FSH, LH, TSH, Prolactin and Hematocrit. He then simply bumped me up to 7.5 grams AndroGel.

My second endocrinologisty was a Pituitary/Adrenal Gland Specialist (as I found out later). I had been sent to him due to aproblem with highly elevated cortisol levels (which may have most likely actually caused the hypogonadis). This endocrinologist's contribution was to test for Total T, Free T, E2, and PSA. My Total T was only 358 and the Free T was 113. Wehn I commented about the Total T being barely in the "low normal range" and that I'd like to get it into more optimal ranges, his reply was that my testosterone levels were probably higher than his!!!

I had already switched to a new GP and the second mentioned Endo has given indications that he's not real excited about proceeding through with continuing administering the TRT follow-ups, so I'm currently working on getting my new GP to work with Dr. Crisler on getting a legitimate TRT program going.

But that's the type of problem I think. Too much specialization in some cases... and too generalized knowledge while not being up-to-date in specialized subjects in other cases (like is the case with most GPs). And unfortunately the field of TRT is simply not an area of specialization regarded in demand in medical field... yet. Some studies have shown that only about 5% of hypogonadal males currently seek treatment. At some point, the medical field and the pharmaceutical fields are going to realize what a major market is actually out there.

Until then..... "we" have to band together, speak out, seek out new research going on and pass it around, advise each other of successes and failures, hype the really good and knowledgeable doctors who ARE out there, advise "newbies" with good, legitimate advice (and all, newbies or otherwise, should not just accept whatever at face value, but do some research on it), etc., etc.

I know I very definitely consider myself a "newbie"... and probably always will because I believe that no program or system or regimen or process is "THE Last Word". At one point the "cutting edge" of TRT was oral tablets (with all their liver problems) and then it was IM shots but taken once a month or every 3 weeks... and now there's new processes in research and trials that are clearly going into the "next generation"...

See:
http://pharmalicensing.com/company/d..._404257aae8f87
http://pharmalicensing.com/company/d..._3f8abbb584d45
http://www.transdermaltechnologies.c...placement.html
http://www.transdermaltechnologies.c...hancement.html

Now only if the medical field would keep up with not only those advances but the proper use of those advances (for example with the TransDermal TDS product above I see problems of low potency in the sample charts indicated and that it would need to be dosed 3 or maybe even 4 times daily... but the new process itself is the most intersting element).

Larry