LOW T Tribulations.

[ktmsmith]

I decided to start a new thread about my TRT experience as the original one is getting a little long in story line and my TRT process is starting to feel more like a tribulation than a triumph. I have reached the unfortunate conclusion that I am working with the wrong Dr. for this therapy. I wish I had discovered this forum before beginning treatment as I now realize that the original blood work ordered by the Dr. was insufficient in scope and has left a number of potential pathways of explanation as to why my T levels were low unexplored ie. am I primary or secondary, baseline LH, FSH,SHBG, ALBUMIN, PSA, DHT, etc. etc. The table below shows the extent of blood test run by my Dr. to date.



Date:................................. 12-2-11............. Date: 3-6-12

PSA ...................................None........... .........1.6..... ........Range: 0.00 to 4.00 ng/ml

Free T3 ................................2.7 .....................3.1.............Range: 2.5 to 3.9 ng/

DHEA-S................................144.............. .....297.1...Range: 44.30 to 331.00 ug/dl

Total Test ............................188................... ...610............ Range: 348 to 1197 ng/dl

Free Test .............................6.80................. ..12.70......... Range: 6.80 to 21.50 pg/ml
.
Estradiol...............................18.70..... ...........69.1 0.........Range: 7.60 to 42.60 pg/ml

TSH.....................................1.97...... .............1.28...........Range:0.34 to5.60uIU/ml

It has become painfully clear to me that he is not up to speed with the latest protocols for male TRT therapy. As some may recall my wife and I are seeing the same Dr. for TRT and the Dr. is even more behind the times with her therapy. Needless to say we are bummed as we are both 3 months into this without satisfactory progress and have as many or more questions than when we started. Here is the most recent post I made in my original thread highlighting my Dr. visit yesterday.


"Well the Dr. visit today was interesting. Doc resisted my request to try AI and rather pushed for Resveratrol 200mg/day. He claims this will suppress T conversion to E naturally and may eliminate the need to go on an AI. I argued that I wanted AI and we agreed to compromise with me trying the Resveratrol until next visit...which I plan to schedule 30 days from now. Basically I figure I can give a go and see where I am at and if necessary go to an AI if it doesn’t work. His suggestion for Resveratrol was a complete unknown to me."


What I didn’t mention in that tread was how the debate went. I knew my E was elevated and needed to come down in part because of all the good help on this site. I also have had developed a new issue never experienced before; serious erection issues. I expected an AI therapy from the Dr. but he started down a path of diet and lifestyle changes to reduce E. I explained that this was not the source of the E issue as evidenced by my original E levels before treatment and that I had to be converting T to E. I explained my erection issues telling him I couldn’t keep it up for more than 5 minutes. His response: “some guys would be happy with that.” I assured him I was not. He then suggested lowering the T prescript to control E. WTF!!...that’s the whole reason I am here in the first place….to get my T levels to a level of a 20 to 29 age male. He thought my Free T of 12.70 was fine as it was right in the middle of the 40 to 49 age group. I assured him it was not. He resisted AI therapy and pushed for a natural process through Resveratrol, something I was not familiar with so I acquiesced, agreeing to give it a shot. Incidentally, when ordering my blood work for the next visit I pushed for some new tests not previously done. I could tell a couple of them through him for a loop as I had to spell out the Albumin test.

At this point I think I am throwing in the towel. He did maintain my original T prescript but I think I have to find a new Dr. which is going to be painful. What makes this a difficult decision for me is this Dr. seems willing on some levels to work with me as he took the Dr. Crissler protocol program I printed out for him and said he would read it. He says he is open to AI but wants to try the Resveratrol therapy first, which I am ok with if its not a waste of time. But I am not interested in trying to get this guy up to speed with current TRT for men. The more I read about it I see things in my future like possible IM delivery and HCG therapy etc. which I don’t think this guy knows or cares to know anything about. Also I am especially pissed off about his failure to order the correct panels in the first place as any credible Dr. is going to have try to interpret his incomplete job and now having been on therapy for 3 months I have no baseline to work with which leads me to my final question.

Would it make sense to jump off therapy and let my body return to it pre T therapy levels and then start this process all over again with the right Dr.? Can this even be done? How long would it take? Is it a big deal not knowing if I am primary or secondary? As an alternative I have considered getting some AI on my own to lower the E until I can get to the right Dr. That way I don't have to sacrafice the T progress I have made. I am thinking this Resveratrol is going to be a waste of time for significant E suppression although it does look like a highly benificial supplement for other reasons.

As always guys and gals…thanks for all the help and suggestions.


PS. Anybody got a good TRT Dr. to recommend in the NE Ohio area for either my wife or I or both?

[bass]

well obviously you understand how TRT works and what needs to be done. at this point yes you can try PCT (go to the PCT section to get better help) to get you back to your natural levels. you're not far from Dr. Crisler, it might be worth a drive there, you will be taken care of correctly.

[steroid.com 1]

Your E2 is high and Resveratrol IS NOT going to control that; you need an AI protocol.

Don't stop your therapy; you are in HPTA shutdown and you will crash and things will get a lot worse...so stay the course.

Find a new Doctor who understands TRT protocols for men right away...make it an urgent priority.

If you're close to Crisler that would be ideal. If not, there is a link in one of the threads here from www.leg.org where you can find an Anti Aging Doctor near your home.

You need the right care and the cause of you ED is your high E2 levels and that won't change till you get that under control.

[HRTstudent]

Your story sounds the exact same as mine if you simply change the blood work numbers.

My experience is.... get a good doctor that knows about male hormones ASAP. Do not waste your time, and do not bother to "educate" your doctor. It's foolish to think we can give doctors a printout of Dr Crisler and now they are capable of overseeing our hormonal health. At best, we can get them to control high estradiol until we find a good doctor.

It might be hard to find a good doctor, but it's a long term choice. The right one I believe.

I probably wouldn't go off cold-turkey. My doctor recommended that and I dropped my dose to the bare minimum. It was bad.

For you, I would say deal with the erection issues. It should resolve itself once you get good care, but in the short term just let your lady know your doctor was foolish and prescribed drugs he didn't know enough about. And now you are paying the price.

Finally, the resveratrol might help to lower your estrogen. It's not typically done (I believe) because there is not enough research on it compared to things like anastrozole which have been around and heavily studied for years and years. Also, I am unsure how dramatic the results can be... I mean... you tripled your levels and who knows how long a mild "natural" treatment might take to fix that?

[sirupate]

Sorry about your situation...but, I've had worse doctors for TRT. It is unusual to find a doctor that will treat you to optimum health with regard to TRT. That doctor will usually be an anti-aging specialist. Insurance won't usually cover treatment and this will end up being expensive. Most of us muddle along in between somewhere, trying new doctors and self-treating to some extent.

The high estradiol level on your last bloodwork probably has something to do with the ED issues. You can source anastrazole if you are interested and can't get a scrip....but it would be good to stay on top of your levels once you begin self-treating with something like anastrazole. Too low is just as bad as too high.

You are probably 6 hours from Dr. Crisler...each way. May be well worth your frustration to make the drive. Maybe spend a night in East Lansing with your spouse and have dinner somewhere nice.

[kelkel]

Absolutely concur with everyone above. Pull the trigger and you guys go see Crisler ASAP!

[ktmsmith]

Well I am not screwing around anymore. Just got my appointment confirmed with Dr. Crisler for March 26th. Extremely pleased I was able to get in so quickly. He is about 4.5 hours from me so it will shoot up a day but based on what everybody has been saying.....its gonna be worth it. Now all I have to do is get the right doc for the wife.

[vinceproduction]

Best decision you can make! After five minutes of talking with him you will know you are in the right place. I made the decision in feb and while we are just starting the journey I know I'm already on the right track. He will run the right labs, probably do the 24hr Rhein lab urine test that checks like 22 hormones related! He is very thorough and his goal is to get you to a happy healthy life. Best decision I ever made concerning my health.