Had my first talk w Dr @ TRT

[Indiana J]

Went to my gp Monday to talk about TRT. At 38 I told him I should have more of a libido, more energy and more staying power. He agrees to do a blood test. Calls back yesterday and says my total test is 370 and he only does replacement under 300. But will give me Viagra samples. After researching on here I left a message asking what my other numbers were, sill waiting for the call back. I am thinking I should talk to him and say I would rather stay with you since you have been seeing me since I was a kid. But if not would you refer me to a urologist. Good plan?

[jtuner77]

Wouldn't you want to see a Endo?

[Indiana J]

From the research it seems that urologist are more concerned with your sexual functioning. Is that correct? Either one would be fine.

[steroid.com 1]

370 is not clinically low but it is low normal and if you are exhibiting symptoms you will want to see other panels like %Free, Bio Available, Albumin, SHBG, E2...

This is a way more complex diagnosis then just looking at total T levels.

Also, did he do a Thyroid assay? There are Anti Aging clinics that would treat this level.

[zaggahamma]

agree with gdevine and about which specialist..and endo should be better for you but its the one that will treat you like a patient with symptoms and not a number or numbers...some have better luck at urologists..

i like the way your being respectful to your long time doctor and he should in turn return the same respect..

and then like gdevine said....you could cut some red tape out and find an anti aging clinic...

..if it were me, i definitely would be wanting to see my other numbers and would think that 370 as a total T number wasnt optimal...plus you have the symptoms to go along

best of luck ...keep us posted

[JohnnyVegas]

All good advice above. In addition, I find it amusing that doctors are resistant to TRT, but give out boner pills and anti-depressants like candy. I am not saying that Test is not to be take lightly, I am saying that highly commercialized drugs should be taken just as seriously. Maybe it would be easier to get Test if the manufacturers gave as much money to doctors to prescribe their products as Pfizer does.

[kelkel]

Talk to your doc, see an endo. Also start getting all copies of your bloodwork mailed or faxed to you from this point forward. You will need them. Just fill out the Hipa release nexttime at lab and your good to go. Just remind
them every time.

[Indiana J]

370 is not clinically low but it is low normal and if you are exhibiting symptoms you will want to see other panels like %Free, Bio Available, Albumin, SHBG, E2...

This is a way more complex diagnosis then just looking at total T levels.

Also, did he do a Thyroid assay? There are Anti Aging clinics that would treat this level.

Doc called during lunch meeting, figures. I'll ask and see if he ran those levels too. If not I'll ask for additional tests.

[Indiana J]

I'm in upstate SC, the only clinics I've found are bio-identical. My insurance will cover if from a Dr tho so that's a positive.

[Indiana J]

Talk to your doc, see an endo. Also start getting all copies of your bloodwork mailed or faxed to you from this point forward. You will need them. Just fill out the Hipa release nexttime at lab and your good to go. Just remind
them every time.

Thanks for the advice.

[Indiana J]

All good advice above. In addition, I find it amusing that doctors are resistant to TRT, but give out boner pills and anti-depressants like candy. I am not saying that Test is not to be take lightly, I am saying that highly commercialized drugs should be taken just as seriously. Maybe it would be easier to get Test if the manufacturers gave as much money to doctors to prescribe their products as Pfizer does.

Me too. I saw him last year around this same time and he loaded me up on viagra samples. At least this time he did some blood work.

[bass]

All good advice above. In addition, I find it amusing that doctors are resistant to TRT, but give out boner pills and anti-depressants like candy. I am not saying that Test is not to be take lightly, I am saying that highly commercialized drugs should be taken just as seriously. Maybe it would be easier to get Test if the manufacturers gave as much money to doctors to prescribe their products as Pfizer does.

thats because TRT will prevent you from using the highly commercialized drugs like viagra, AD, pain killers, and so on!

[Tbound]

How does TRT prevent you from using pain meds?.....I listed all of the meds I take(which included Lortab) and they didn't even bat an eye during my intial visit and have me on board with TRT.

thats because TRT will prevent you from using the highly commercialized drugs like viagra, AD, pain killers, and so on!

[zaggahamma]

How does TRT prevent you from using pain meds?.....I listed all of the meds I take(which included Lortab) and they didn't even bat an eye during my intial visit and have me on board with TRT.

he means...if you feel better cuz your hormones are tight a lot of those meds arent needed

[Indiana J]

Doc called back @ 6pm, thought that was good. He said they only ran total t. He doesn't think my # (370) warrants more now. He wants to wait 2 weeks and try again. He said if they are still low "we will go from there."

[Indiana J]

On a side note, anyone ever have an aa clinic covered w insurance? I have bcbs.

[Tbound]

Thats what I was hoping you'd say......wanting to get off of all this stuff I'm on.

he means...if you feel better cuz your hormones are tight a lot of those meds arent needed

[JohnnyVegas]

Thats what I was hoping you'd say......wanting to get off of all this stuff I'm on.

When I went to the doc I was having the usual libido and tiredness issues, but I was also having constant pain, burning and cramps in my upper back and neck muscles. My wife would need to lean into me on her elbow (she is only 100 pounds) to release the knots, and I would ask her almost every night. This went on for more than a year. Four or five weeks after starting TRT those problems were gone. That is the one thing that kept me from thinking my good feelings were placebo effect. People don't realize how great it is to be able to get off the couch without pain or making old man noises until they can't do it for a while.

[GotNoBlueMilk]

On a side note, anyone ever have an aa clinic covered w insurance? I have bcbs.

I have BCBS. The clinic is out of network, and BCBS only covers it after I exceed my deductible. Since I never go to a doc for anything besides TRT, that deductible thing isn't going to happen.

[Indiana J]

I have BCBS. The clinic is out of network, and BCBS only covers it after I exceed my deductible. Since I never go to a doc for anything besides TRT, that deductible thing isn't going to happen.

Thanks I will check and see if there are any in network on my policy.

[JD250]

When I went to the doc I was having the usual libido and tiredness issues, but I was also having constant pain, burning and cramps in my upper back and neck muscles. My wife would need to lean into me on her elbow (she is only 100 pounds) to release the knots, and I would ask her almost every night. This went on for more than a year. Four or five weeks after starting TRT those problems were gone. That is the one thing that kept me from thinking my good feelings were placebo effect. People don't realize how great it is to be able to get off the couch without pain or making old man noises until they can't do it for a while.

Right on bro!! I will attest to what I call "astounding improvements" in my physical well being, I was talking about TRT with my trainer the other day and as it turns out he knows his shit about this stuff and in the course of our conversation we talked about the physical ailments that just seem to "magically" disappear when you get your HRT dialed in correctly. Low T will kill you! ever so slowly but it will kill you!

[steroid.com 1]

Doc called back @ 6pm, thought that was good. He said they only ran total t. He doesn't think my # (370) warrants more now. He wants to wait 2 weeks and try again. He said if they are still low "we will go from there."

Your Doc needs to test more then just total T.

You are low normal and total T won't tell the whole story.

Look at:

Bio Available
% Free

These two are way more telling of your current state considering you are presenting symptoms.

Also, need to look at SHGB and Albumin at a minimum.

These will tell you where you are at. Low normal with symptoms is a problem and you should be treated in my opinion if you want to feel good and prevent all the things low T can cause.

[pittbulldad]

I would suggest that you have estroen or estrodial levels checked also..

[sirupate]

The PDE5 inhibitors like Viagra do not work well, or even at all, if your free testosterone is low. If you get that addressed, things will be better. Probably much better. Which doctor specialist type is a toss-up. You just need to find someone knowledgable about TRT and who is willing to treat your symptoms. Sometimes that will be an endo and other times a urologist, or anti-aging specialist. Some primary care docs may take a special interest in TRT, but it won't be many of them.

[zaggahamma]

The PDE5 inhibitors like Viagra do not work well, or even at all, if your free testosterone is low. If you get that addressed, things will be better. Probably much better. Which doctor specialist type is a toss-up. You just need to find someone knowledgable about TRT and who is willing to treat your symptoms. Sometimes that will be an endo and other times a urologist, or anti-aging specialist. Some primary care docs may take a special interest in TRT, but it won't be many of them.

j

wut do u recommend to free up T....theres a new thread where a guy's total T is fine but free is way low.....

[sirupate]

j

wut do u recommend to free up T....theres a new thread where a guy's total T is fine but free is way low.....

Heck if I know. The e2 inhibitors if e2 is high...but we don't know that in this case. I suppose SBGH is a possibility (my doctors preferred lab doesn't even have that on their list of tests...). Then there is the whole liver function thing...liver must function normally to rid your body of excess estrogen. But I did stay at a Holiday Inn Express last night!

[zaggahamma]

Heck if I know. The e2 inhibitors if e2 is high...but we don't know that in this case. I suppose SBGH is a possibility (my doctors preferred lab doesn't even have that on their list of tests...). Then there is the whole liver function thing...liver must function normally to rid your body of excess estrogen. But I did stay at a Holiday Inn Express last night!

good stuff i know right

[Indiana J]

I have my follow up w my GP Monday am. I have contacted a few clinics and the consensus is for the following blood work:

- CBC with/ Diff
- PSA
- DHEA Sulfate
- T3 UPTAKE
- ESTRADIOL
- T4 FREE
- FSH
- TSH
- IGF-1
- TESTOSTERONE FREE / TOTAL
- LH
- HEPATIC PANEL
- LIPIDS
- CORTISOL

Look about right?
I also had a question about one of the FL clinics, anyone with experience?

[Indiana J]

OK, back from round 2 with my GP. I started out telling him of all the research I've been doing. How at 38 I shouldn't have the symptoms and problems that I have, libido, lack of energy..... I showed him some info and the health and blood work background from a clinic in Fl. I explained that since I have been seeing him for 30 years, I would prefer to be treated locally. But with my symptoms and total T numbers I was willing to pay out of pocket to a clinic. He starts to order the above tests and stops. Saying he has to "code" them so insurance will cover. After a few minutes, he says " I am going to order the T total and free, plus the TSH. If we are going to do this I am sending you to a urologists!" I will find out the numbers Wed and be referred then. I am chalking this up as a minor victory on my way.

[steroid.com 1]

I'd chalk it up to big victory! Good for you man, you educated yourself, armed yourself with research, provided professional courtesy to your Doc and are managing [your] health care. Do the same eval on the Urologist as well...many of them are not educated to TRT as well.

Good stuff I!

[JD250]

^^X2 We need to save this thread as an example to new folks who don't know how to manage their own health or even know that it's possible to take charge. Good job!!

[Indiana J]

OK so now I am totally confused!!!! Doc call me around lunch again. Says my totals are:
Total T= 573 (249-836)
Free T = 16.45 (5-21)
% free = 2.87 (1.5-4.2)
TSH = .56 (.35-5.5)

Wow, I am floored!! My initial total last Mon was 370. He has no reason for the big change. I thought he was just trying to fudge the numbers so I went by and got a copy of my lab results, and they were right. How could there be that big of a jump?

[Indiana J]

So now he's sending me to a sleep doc to check for sleep apnea. Energy and libido are still in the tank.

[zaggahamma]

OK so now I am totally confused!!!! Doc call me around lunch again. Says my totals are:
Total T= 573 (249-836)
Free T = 16.45 (5-21)
% free = 2.87 (1.5-4.2)
TSH = .56 (.35-5.5)

Wow, I am floored!! My initial total last Mon was 370. He has no reason for the big change. I thought he was just trying to fudge the numbers so I went by and got a copy of my lab results, and they were right. How could there be that big of a jump?

test levels fluctuate..

did you take both blood tests upon an hour of awakening or close to?

[Indiana J]

Both were taken about an hour and half after waking. I understand they fluctuate but that seems excessive. Now he wants to wait 4 weeks to test again.

[bass]

yea allot of things effect levels, like stress not sleeping enough, desk job, not enough sex! however that is a big jump!

[steroid.com 1]

OK so now I am totally confused!!!! Doc call me around lunch again. Says my totals are:
Total T= 573 (249-836)
Free T = 16.45 (5-21)
% free = 2.87 (1.5-4.2)
TSH = .56 (.35-5.5)

Wow, I am floored!! My initial total last Mon was 370. He has no reason for the big change. I thought he was just trying to fudge the numbers so I went by and got a copy of my lab results, and they were right. How could there be that big of a jump?

These are healthy numbers...but as mentioned by other who know; then can fluxuate.

What were your cortisol levels?

My guess is that life events are hurting you. STRESS (which has been my best friend my entire 50 years on this planet) can be a really bad thing and exhibit all the symptoms of low T and hypothyroidism.

[lifter65]

youve gotta get your : bio t, reverse t3, prolactin, and estradiol

[zaggahamma]

So now he's sending me to a sleep doc to check for sleep apnea. Energy and libido are still in the tank.

did u give him any indication of sleep issues

[steroid.com 1]

youve gotta get your : bio t, reverse t3, prolactin, and estradiol

Yes!!!