jpkman and others please weigh in, AMMO needed for next Endo appt

[Enfuego129]

Fellas, some of you may remember me. About 8 months ago I was diagnosed with Low T after requesting some additional blood work at my annual wellness physical. In short the bloodwork came back just above the bottom of the reference range for testosterone. Because of this my GP agreed to start me on Androgel and things were going along pretty good but in my opinion could have been better. By my GP’s admittance he doesn’t treat many men for low T and agreed to send me to an Endo for better treatment. Unfortunately, my GP didn’t do the recommended blood work I read about here and just did free and total Testosterone. Because of this the Endo he referred me to took me off of everything so he could see what my baseline values were (results attached 5-1-2010). At the time he took me off of the 10 grams of Androgel my total Testosterone was around 268 after being on it for about five months. Attached you will find the results from two sets of blood work I had done on 4/5/2010 and again on 5/1/2010. Today I received the results from last weeks blood work, which was for total Testosterone at 222 and % free was 2.37 (range1.5 to 2.2). I have another blood draw scheduled for tomorrow morning and will have two more after that before I see the endo again with the hope he will start me on HRT again. Unfortunately, this endo is conservative and will not recomend HRT if my values fall within normal range. Fortunately they have fallen below normal after a brief rise to 319 after my testicles started producing again. Since then my total dropped to 222.

Please give me your opinions on all my blood work and explain why my total Testosterone is now below the normal range at 222 and my % free is above the normal range at 2.37. Is this Estridiol binding up my testosterone? Everything else seems to fall within normal range otherwise.By the way I feel worse than I ever did and am concerned that I found the worlds most conservative Endo. FYI, I am unable to switch doctors for another six months due to open enrollment in my HMO.

[zaggahamma]

hey enfuego,

my best advice first before i comment on what i do know about your bloodwork is head your own advice "worlds most conservative endo" this cannot/will not be who you want...

you shouldnt need ammo for your doctor...for one...no estrogen check? all total test scores low with some even below range? but this guy WONT treat you if he sees the 300 score?

you said you've been reading here...did you ask him to check for estro? if you did and HE DIDNT order it...the only ammo i could recommend is "YOURE FIRED"

If it were me..I prolly would have never went off the gel...I actually went a similar route as you but just went from endo to endo til i found one with the right penstroke?

wish i could help you more than that but thats where it lies...if you can afford a clinic you can cut out all the red tape and white coats

let me know how else i can help...

[tubs]

hey enfuego,

my best advice first before i comment on what i do know about your bloodwork is head your own advice "worlds most conservative endo" this cannot/will not be who you want...

you shouldnt need ammo for your doctor...for one...no estrogen check? all total test scores low with some even below range? but this guy WONT treat you if he sees the 300 score?

you said you've been reading here...did you ask him to check for estro? if you did and HE DIDNT order it...the only ammo i could recommend is "YOURE FIRED"

If it were me..I prolly would have never went off the gel...I actually went a similar route as you but just went from endo to endo til i found one with the right penstroke?

wish i could help you more than that but thats where it lies...if you can afford a clinic you can cut out all the red tape and white coats

let me know how else i can help...

^^^THIS^^^
way to much blood work and not enough help - find a new doc. - go to the a4a web site and search for a doctor in your area (may be a good lead)

[Epic Ed]

Ask your endo if he believes reference ranges are an absolute measurements of well being for all patients regardless of individual differences and circumstances. If he says "no" then you have some room to work with to persuade him to treat you, the patient, and not just your numbers.

If he says "yes" tell him he's a fecking idiot and walk out of the office.

[Enfuego129]

hey enfuego,

my best advice first before i comment on what i do know about your bloodwork is head your own advice "worlds most conservative endo" this cannot/will not be who you want...

you shouldnt need ammo for your doctor...for one...no estrogen check? all total test scores low with some even below range? but this guy WONT treat you if he sees the 300 score?

you said you've been reading here...did you ask him to check for estro? if you did and HE DIDNT order it...the only ammo i could recommend is "YOURE FIRED"

If it were me..I prolly would have never went off the gel...I actually went a similar route as you but just went from endo to endo til i found one with the right penstroke?

wish i could help you more than that but thats where it lies...if you can afford a clinic you can cut out all the red tape and white coats

let me know how else i can help...

jpkman and others, you guys are lucky in that you have found a doctor capable of treating your condition and have had the results you were looking for. In my case it is complicated, I have good insurance, but because of it being a HMO I have to endure enrollment periods to switch doctors or plans (HMO vs PPO) if I switch doctors then so does my wife. She is sympathetic to my condition and supports me in what is going on. But we have to wait until the next open enrollment period for this to occur.
Regarding my treatment plan right now, I am frustrated and will not stop until I get proper comprehensive treatment but until then justify this by knowing that I probably have had this condition for many years without HRT and will have to go a little longer to start treatment again. If my doctor or endo refuses to give me HRT I will move on to another doctor when I can. Until then I have two choices, be paitient with what is going on or spend a lot of money out of pocket. This economy has hurt all of us and money is tight.

[Enfuego129]

^^^THIS^^^
way to much blood work and not enough help - find a new doc. - go to the a4a web site and search for a doctor in your area (may be a good lead)

All that bloodwork should have been done by my GP before beginning treatment. I now know this but the fact of the matter is it wasn't done. Because it wasn't done by my GP, the endo wants to and probably needs to restart from scratch fro proper treatment. Regarding this I am glad he is being thourough and it appears the bloodwork is necessary from proper treatment.

As I posted earlier I cannot switch doctors or plans until next open enrollment period.

What is a a4a?

[Enfuego129]

Ask your endo if he believes reference ranges are an absolute measurements of well being for all patients regardless of individual differences and circumstances. If he says "no" then you have some room to work with to persuade him to treat you, the patient, and not just your numbers.

If he says "yes" tell him he's a fecking idiot and walk out of the office.

Ed, I had just that conversation with the endo after the bloodwork came in about reference ranges and general wellness. He stated that in my case it would be a balance between the two. He further stated, he cannot justify Testosterone treatment unless it is out of its reference range. I agree this isn't the right Endo for me because of his conservative approach but for now he is the only one in my insurance plan.

[Enfuego129]

Fellas, let me clarify something. I requested the extra bloodwork when after I was shut down by the endo and rebounded to 333 he said all my bloodwork is within its respective ranges and couldn't recommend TRT. It was then that I suggested this 333 was a rebound number and that that draw was the highest my T was tested at. He agreed to do four more draws for free and total T to find an average.

Regarding the OP, I asked for an opinion on the bloodwork in general and specifically my most recent draw, where my total T was 222 and my % free was 2.37 (1.5 to 2.2). Why is the % free above the reference range? Is this the T to E relationship altering my numbers what could cause this? This was the reason for the OP the rest of the info was just background on how I got here. I cant change the past but want to control my future.

[tubs]

All that bloodwork should have been done by my GP before beginning treatment. I now know this but the fact of the matter is it wasn't done. Because it wasn't done by my GP, the endo wants to and probably needs to restart from scratch fro proper treatment. Regarding this I am glad he is being thourough and it appears the bloodwork is necessary from proper treatment.

As I posted earlier I cannot switch doctors or plans until next open enrollment period.

What is a a4a?

sorry a4m and they won't help as it would be out of pocket
http://www.worldhealth.net/pages/directory/

you should only need 2 blood tests before you would start trt - but i see your issue



I think the free goes higher when you are using test so i am wondering if it was still in your system somehow (seems unlikely) 333 is to low to feel good imo


when my test came back at 1080 my doc asked how i feel becuse we can go higher if we need to - i was shocked - and I know what you are thinking, he was making $0 on the test at that time

hate to say it but it doesn't sound like this guy is going to take care of you

good luck but with out a new doctor i don't think you will get the service you deserve