Self treatment leading up to Endo Appt on 3-24???

[Enfuego129]

For those of you that have read my other posts I know they can be lengthy. If you got to know me nothing I do is hasty or without research. The devil is in the details, so here we go....

I have my first Endo appt on 3/24 and have a question about what I should do leading up to that date.

As some of you know I have been on TRT for about a month and a half and have a Dr that seems only open to using ONLY Testosterone to treat my low T diagnosis. During that time I started on 5 grams of Androgel for three weeks and am now using 10 grams with no significant change in TRT symptoms. I feel the same as I did on 5 grams with slight improvement in mood and energy. My research here suggests that most of you supplement with other things for sides and synergistic effect. I should mention that since going on the 10 gram dose I have developed sensitive nipples and am developing some acne. Regarding the Gyno I bet I have had that for years, maybe since puberty and didn't know it. I have had a disc shaped lump behind each nipple for as long as I can remember. I believe I am also carrying extra fat on my chest and hips, compared to the rest of my body, which would indicate extra Estrogen right??? FYI my GP wont treat or test for estrogen so I have to go on how my body feels and looks. Why wont some doctors test for Estrogen?

Anyway, should I look into supplementing to self treat for Estrogen and DHT or wait. Below are some of the safer drugs and supplements I have read others take here.

1. An AI such as 6-OXO or LiquiDex to increase my low T which is at 255, I have also read that it will help control fat gain, control bloating, sensitive nipples/gyno
2. Finasteride to again increase available T and for possible hair loss

My question is if I start treating some of my sides with the AI and/or use Finisteride for DHT will this goof up bloodwork in two weeks and again at the end of March when I meet the Endo for the first time. I want the Doctors to have an accurate picture of all my hormones so they might treat me with prescriptions instead of my buying through this site or supplement companies (6-OXO). I think my doctor is in over his head and wants the Endo to get me straightened out but March 23 is a long way off.

[flatscat]

yes it will "goof up" your bloodwork

[Enfuego129]

yes it will "goof up" your bloodwork

Flat, how messed up do you think a person can get in the meantime? What might I expect next if these sides go untreated? What else might happen?

Two months of feeding into the Testosterone converting to Estrogen circle, causing Gyno and acne seems like a lifetime. FYI, I plan on letting my GP know about my new side effects when I go in for a refill on my script.

[flatscat]

Idk - sounds like you think you have had gyno for many years - if that is true, another month and a half isn't that long. Sensitive nipples do not mean you have gyno though. I think most of us get those at some point or another. I had them when I first started, and yes my E2 was at the high end - but I did not have or get gyno. Can't advise on the acne - never had it. I choose to stay away from Finasteride and just deal the the hair loss.

I think the areas you carry extra fat are not an indication of excessive E. I think it is however one of the main reasons for conversion of T to E2. Everyone is predisposed to carry fat in different areas.

Did you explain the sides and the concerns you are having to the Endo's office when making your appointment? Why not leave a message for the doctor to call you if not? Maybe you can have them order a complete panel BEFORE your appointment so you won't have to wait a week for the results and then another 3 weeks to see him again.

Don't be suprised if the Endo wants you to come off of everything for a month or so and retest your levels.

I know you are not wanting to hear this - but I am trying to shoot straight with you.

And I still advise not to take anything else until your visit with the Endo.

Good luck,

Flats

[tboney]

Get on the injectable version. Tell your doc about your nipples sensitivity and if he wont give you an AI or atleast test for estrogen levels then fire him and get a new doc.

[Enfuego129]

Thanks flat, I only want straight advise from those who offer it. Since I am new to TRT I have read and searched numerous topics here to educate myself. In the process I may have confused myself on things. I have an appt tonight with my GP about the new sides and to get a refill on my Androgel . I am almost out due to him doubling my dose without writing a new script.

[Vettester]

Enfuego, sorry to hear about the sensitive nipples stuff. I know we've had several discussions on this board, so you kind of know where I stand on this already.

I'll shoot it straight with you just the same ... Look at HRT as an investment and go visit a HRT Clinic that will also shoot straight with you. The only ones not shooting straight with you are your doctors!!!! Think about it ... When you joined here, you had concern after concern about AndroGel . You were told 50 ways and sideways here about how this should be treated. Your concerns were legit! However, your Dr. Clooney addressed your concerns by doubling up the dose! They want you to wait until March? Maybe there's an ace card hidden here, Enfuego, but chances are that this medical group you are dealing with isn't going to get any better. You're from Chicago, right? Would you go to Pizza Hut to get real Chicago style pizza? You're getting your HRT from Pizza Hut just the same, and hoping that at some point they'll start making it just the way you like it. Sorry, but that program usually doesn't change, and at some point you usually need to pick it up and go to the places that really know how to make it right.

The problem with this analogy is that isn't about substandard pizza, it's about a person's health and well being.

[Enfuego129]

Well said Vette

I just returned from Clooneys office and flat out asked him what were his goals in treating me? Without using the words said that his goal is to treat my symptoms within his understanding of the condition and that the Endo will complement that.

Regarding the Androgel, we discussed this and he said his office doesn't offer injectibles and that I will have to work with the Endo on that. So at least I know he is not against it. I can live with that answer until the Endo says no.

Regarding the sensitive nipples he didn't offer to treat them with an AI. So regarding that I am stuck with two options

1) hope it doesn't turn into ful blown Gyno in the next two months and then talk to the Endo about treating it then.
2) Start treating myself with 6-OXO or one of the AI meds offered on this site. If I do this I the advise I got here is that I will screw up my Endo bloodwork and I will look balanced in regards to E2. As long as it isn't going to be permanent I will wait again with the hope that the endo is good and will balance me out.


Regarding the Pizza analogy, I could again wait it out and continue with the Androgel with my current office and Endo referral. If the Endo isnt worth his salt, I can then pay out of pocket for Dr Crissler out of Lansing Michigan. I hear he is an authority on TRT in my area and possibly the US. What I learned about Dr Crisslers office is that he doesn't accept insurance. His first appointment costs $495 and then each office or virtural visit thereafter costs $60. Until you are dialed in hormonally you can expect to see him every 6-8 weeks and then eventually quarterly to see if you are still dialed in and then every 6 months. The goal is every 6 months to maintain. I have also learned.

[Enfuego129]

Ok, here is my game plan;

1. I am going to be patient with my current treatment schedule and continue the 10 grams of Androgel
2. Contact Dr Clooney if any side effects appear or current ones get worse
3. Request bloodwork in three weeks to see where I am at with the 10 grams of Androgel
4. Keep my Endo appt scheduled for March 24th and hope he is worth his salt and can properly treat my condition
5. If then I am not satisfied witth the above I will then contact Dr Crisslers office for a full workup and pay out of pocket or use my insurance Flex Plan for treatment.
6. Other???

I am going to try to be patient for now.

[Enfuego129]

Hello Dave!

This is our standard new patient letter. It will answer many of your questions; however, you are always welcome to contact us by email or phone with questions not covered, or to schedule an appointment. We hope to see you soon!

In order for Dr. Crisler to dispense medical advice or treatment you must be a part of our practice. There are three ways to become a patient:
1. If you are local you may simply schedule an appointment.
We are located at 919 Chester Road in Lansing, Michigan 48912.
2. If you are out of state, you may schedule a day trip.
3. If you don't want to make the trip, you may have your primary care provider consult with Dr. Crisler. Additional information below.

If you choose to schedule a day trip, we recommend that you fly into Lansing's Capital City Airport (LAN), www.FlyLansing.com, which is only 15 minutes from our office. Our recommended cab company is Flyer Choice, www.flyerchoice.com , extending special rates for our guys, and their number is (517)367-7222. We've attached a list of recommended places to stay and things to do if you will be staying overnight. A great source for current events, including where to dine, can be found at [email protected]. Alternative airports are: Grand Rapids - Gerald R. Ford airport, www.grr.org, Flint - Bishop International airport, www.bishopairport.org, Detroit - Metro airport, www.MetroAirport.com, and are approximately 1 - 2 hours in distance depending on traffic and construction.

To begin your file, visit our website at www.AllThingsMale.com and go to Online Forms. Print and fill out the Medical History and the Consent/Authorization to Treat forms and forward them to us via fax or mail prior to your Initial Consultation. The Consultation takes between 1 and 1 1/2 hours, and the cost is $495.

Payment for Consultations is made in advance, before the appointment time is scheduled, and may be completed using our standard order form available on our website. We will also accept payment by phone when you call to arrange your appointment. After submitting your paperwork, please contact the office to schedule a time for your visit. Our office phone is (517) 485-4424.

Although we like to be as flexible as possible, we must require at least 24 hours notice if you need to cancel or change your appointment. Emergencies are handled on a case by case basis.

Preliminary lab-work need not be done. Dr. Crisler will create his own set of labs tailored to your specific needs. However, any records that you feel are pertinent to your current health may be brought with you. Please do not send this information prior to your visit. In order for Dr. Crisler to get a proper view of what is happening with your health, it is very important that you do not alter or change your medication or supplementation regimen prior to your visit.

A lab-work requisition form will be sent home with you after your visit, and the tests ordered may be performed at your lab of choice. Any prescription(s) may be filled at the pharmacies that we use or may also be sent with you to be filled at your pharmacy of choice.

Follow up care will be scheduled accordingly, the cost of a follow-up visit is $60 (in person or virtual). Follow up care may be face-to-face for local patients, or virtual (via telephone) for those of who are out of state. Please note that Virtual Office Visits (VOV’s) are available only after an initial face-to-face Consultation in our office. Office visits allow Dr. Crisler and you to discuss your lab results, and treatment regimen. VOV’s may be paid via our standard order form (found on the website under online forms) or telephone. We accept Master Card, Visa, or a check if you prefer.

In order to treat you virtually without an in house initial consultation, Dr. Crisler will need to work through your primary care physician. This can be done by having your doctor’s office call and schedule a time for your primary to confer with Dr. Crisler about your situation. If he/she is willing, you may be able to sit in on this conference. Dr. Crisler has a publication entitled “ TRT: A Recipe for Success” available on the website. This may be helpful information for you to take to your doctor when making this decision. All protocols, labs, medications etc. will be processed via your primary care physician per Dr. Crisler’s recommendations.

Once your doctor has consented to work with Dr. Crisler, you may go ahead and fill out the Medical History form and the Consent to Treat form and forward these two forms so that we may start a file for you here. You will also need to fill out and forward an order form for the $495 Consultation fee. Follow up care from Dr. Crisler will be charged as an office visit at the cost of $60 per consult.

As far as insurance coverage goes, we do not accept insurance here in the office for Dr. Crisler’s services. We do provide you with a coded, itemized receipt that you may submit to your insurance company. Most of our patients report that their labwork and prescriptions are covered, depending on their individual coverage and provider.

[subnet]

wishing you all the best Enfuego... one thing about Dr. Crisler, is that he prefers the gel - not saying that he's against injectibles, but wanted to let you know after reading about him and his treatment methods.

Now as to your endo visit - yes you'll screw around with your levels if you self-medicate before then. As flatscat said, I also wouldn't be surprised if he wanted you to come off to re-test your levels. I know you're feeling crappy and want/need it to change soon, I was the same way, but soon you'll get some good answers, be it with your endo or Dr. Crisler and you'll be on the way to feeling better...

My endo visits were useless - went to see her, she wanted a re-test of total T and free T which my GP didn't do. That came back high (the free test result) and she wanted to do another follow-up because of the free test. Had to wait a month to see if my free T levels dropped, tested low again on T and high on free T, and she prescribed gel. Of course my insurance required pre-authorization and that took 3 weeks to get them to fill out the damn form correctly The last test I asked her if she was going to test Estradiol after reading about it here and other places, and she said 'no', it wasn't important. I stressed that I wanted it done anyways and she conceded but she really didn't care.

Immediately found a different Dr. - not covered by my health plan but he knows his stuff with TRT. I hope you have better luck than me with the endo visit, but at least you have Dr. Crisler as plan 'C'! Yes, be patient - it's tough but you don't want to screw around with your health.