Insight on why Doctors refuse to treat?

[CraigWatts]

Hello all.

I am a 38 year old male with testosterone levels that hover between 390 and 400. (The range according to Labcorp is 350 - 1200). While i realize 390 isn't devastatingly low, when its viewed on a range of 350 to 1200 it looks pretty damn low.

I have "tolerated" this lackluster lifestyle and Testosterone level since I was 30.

My Estradiol levels are "6" on a scale of 0 - 80, which is below the proper level for men of a minimum of "10".

I have recently been made aware of the health risks of not just low Testosterone , but also extremely low Estrogen in males. Most notably the risk of osteoporosis and bone weakness over time.

The bottom line is that I would like to get myself into "normal" ranges and I can't figure out why endocrinologists know as much as they do, but they don't think 400 for a 38 year old male is a problem.

I know a lot of folks on here will state that I should be at around 700 for vitality and (more importantly) optimal long term health. But why is it that doctors don't agree, when they are trained in this? I understand that embarking on the increase in testosterone is a big step to take, and should be done with caution as it has to be managed, and will become a life long process.

Is this why they will let guys get so unbelievably low before they'll take any steps?

There seems to be a contradiction here. If a guy goes into their office with levels around 250, they will put them on Testosterone and get them to the 600-800 range (i assume). Yet a guy walks in with 400 and they tell him to go home. Why?

I suppose this is the age-old question, and there is no clear cut, fool-proof answer. But I have used androgel in the past when everything was unbearably sluggish (at 380), and I felt like a million dollars just by getting myself up to 700. It was a whole new universe compared to how I was normally feeling. So I can't help but believe my health and body processes are suffering on some level.

Is it really a pandora's box you open when you begin embarking on TRT ? A monster you may not want to awaken?

Thanks.

[Torqued]

Don't have an answer, but am interested in others' opinions on this.

I even ran into issues with my doctors and my T was half (195) of your unbearably sluggish level.

[CraigWatts]

At 195 its a no brainer. If you were being refused then the doctors were just idiots. What I am wondering is why guys who 100-150 below optimal minimum get refused. At age 30 I was at like 375. So i've been at this lackluster level for 8 years. I got myself up to 740 with Androgel alone. Self prescribed. My entire universe felt better. Although I was more aggressive and easily angered.

[HRTstudent]

First of all, you need to understand that most doctors know almsot nothing about testosterone replacement . In medical school they are taught the entire subject in probably a month or less and it is focused on a few genetic diseases. They are not trained to treat for optimal health or well being, they are taught how to treat DISEASE.

If you are suffering from low testosterone and don't have any clear disease or physical trauma then it was probably a culmination of poor nutrition, lifestyle, stress, endocrine disruptors, and time. It all took its course and now you're left in a sub-par situation. Without the disease, however, most docs wouldn't want to nor even know how to treat it.

Medicine today is very defensive. It's been that way for some time, and it's very important to remember that testosterone has gotten a really bad reputation from the media in general. I'm sure many endocrinologists think someone taking 150mg of testosterone per week are simply trying to become bodybuilders... what a joke!

If you want to achieve optimal health and quality of life, you need to find doctors who also want to reach those goals. Not all docs are created equal.

[CraigWatts]

I realize I am not low, low, low. But I just found a test result from 2002 (when I was 28) and my testosterone was 435. So I've basically been in this range since I was 28. And my sex life reflects it. Believe me. I would like to just kick myself up to 500 or a maximum of 600. I dont want much. I'm all about conservative and intelligent steps. Is this a feasible idea for me? Or am I opening a can of worms I shouldn't mess wth unless I really need it?

[Back In Black]

Ignore!

[Times Roman]

Doctors are people just like you or I. There is the possibility of increased liability when they become involved and their actions fail.

[steroid.com 1]

I personally think you are low for your age and I know for sure my TRT Doc would probably put you on an HCG mono-therapy or low dose Testosterone injections to get you closer to 800 or so.

Find the right Doc, they are out there, but you need to search of travel to see the good ones if they are not near you.

[kelkel]

Would love to see recent, complete BW so we could analyze it and see if the doc's are missing anything. Remember other variables can effect your T levels like HRT mentioned. One thing you can immediately do is begin supplementing with D3. It will increase your free T level.

Many people here have been in your shoes and like GD mentioned, bite the bullet and drove/flew to highly recommended docs. After the initial meeting the rest are normally done remotely. Stop suffering. Get proper help.

[elde_01]

I'm in the same situation, my range was in the lowest possible "acceptable" range. And I'm 20!!

Granted my doc knows something about testosterone he suggested going back, getting a full blood test done on just my testosterone and doing it earlier in the day (8am not 10am)

And he said if its low again he will put me on some stuff to raise it. But still he seems apprehensive to help right now, and wouldn't give me my blood test there and then so ill be going to the blood bank and seeing if I can get my results.and going to a diff doctor.

[CraigWatts]

1) Regarding bloodwork - I have recently developed a pretty severe condition that is playing out like Fibromyalgia after some toxic medications I took back in February, so I have had honestly 20 or 30 blood tests run, and everything from top to bottom is within normal range. I've literally been tested for everything in the book. The only slightly abnormal items have been elevated ACE levels, my testosterone at 400, my estradiol at 6, my cholesterol at a shockingly low 110 .... and my IGF-1 was elevated. Aside from those things, everything is perfect. No diabetes, no cancer, MRI is clean, EMG is clean, nerve conduction clean, all bloodwork good.

2) Regarding Vitamin D3 - coincidentally I have been supplementing D3 for the last 3 months at about 4000 IU per day. My Vitamin D levels are at 48 right now after all of that. So any hormonal benefit Vitamin D would have given me has already been realized.

3) Here are my complete numbers:

Testosterone Serum 400 (range 348-1197)
Testosterone Free 10.13 (range 5-21)
% Free Testosterone 2.49 (range 1.50-4.20)
PSA: 0.3 (range 0.0-4.0)
Estradiol: 6 (range 3-70)
IGF-1: 242 (range 69-226)

Total Cholesterol: 110
Triglycerides: 59
HDL: 47
LDL: 56
VLDL: 12

TSH: 1.690 (range 0.450-4.500)
Thyroxine T4: 10.0 (range 4.5-12.0)
T3 Uptake: 32% (range 24-39)
Free Thyroxine Index: 3.2 (range 1.2-4.9)

AST: 28 (range 0-40)
ALT: 24 (range 0-55)

So you guys dont think I am opening a can of worms by starting something that will kick me from 400 up to 600-700 ? Do I really want to begin a life of juggling hormone balances?

[Juced_porkchop]

Find a new DOC...

[CraigWatts]

Im still interested in the veterans take on this:

If someone is at 400 (versus 150) and they would like to get to 600 (just a short jump) ... is it worth it / necessary / important to open that can of worms and embark on a lifetime of artificial hormone supplementation?

I realize after more reading that this is why doctors don't just prescribe Testosterone . There's a risk involved (apparently?). So they wait until you are so low... that the benefits will *Outweigh* that risk.

Would that be the case for someone at 400 who just wants to jump to "optimal" ? Or are we looking at a low benefit / high risk situation with that?

Thanks.

[kelkel]

Well, if your levels can't be raised by natural means, e.g. diet, exercise, and abnormalities are ruled out then I sure would not sit at 400. Double that at least.

Op did I miss your LH/FSH level anywhere? Like HRT said, not many docs fully understand hormones and those that don't tend to be dismissive in nature. As long as your on the chart your good which we all know is crap.

[CraigWatts]

Those two weren't checked I think. I ordered my own stuff. I'll order another full workup. Gotta love that you can order your own bloodwork online. Does anyone know a cheaper option than PrivateMDLabs? They are getting more and more expensive.

So what should I order, total?

LH
FSH
Total T
Free T
Estradiol

Anything else? DHT ?

did you see my PSA? Im a prostate rock star! LOL .... what the heck. Why is it so low?

I was on Finasteride for 4 years ... im pretty sure all of this is a result of that.

[kelkel]

Those panels are fine. LH & FSH are important and can give us a clue if your primary or secondary or a combination of both. Make sure it is a sensitive estrogen assay. Always good to know your DHT level. Look for coupons for private med labs as well.

PSA rock star. Funny!

[HRTstudent]

Im still interested in the veterans take on this:

If someone is at 400 (versus 150) and they would like to get to 600 (just a short jump) ... is it worth it / necessary / important to open that can of worms and embark on a lifetime of artificial hormone supplementation?

I realize after more reading that this is why doctors don't just prescribe Testosterone . There's a risk involved (apparently?). So they wait until you are so low... that the benefits will *Outweigh* that risk.

Would that be the case for someone at 400 who just wants to jump to "optimal" ? Or are we looking at a low benefit / high risk situation with that?

Thanks.

Its far more important than numbers. The symptoms and life are more important than numbers!

[sparverius]

T
did you see my PSA? Im a prostate rock star! LOL .... what the heck. Why is it so low?

I was on Finasteride for 4 years ... im pretty sure all of this is a result of that.

That's why your PSA is so low. Finasteride lowers DHT. DHT is what the prostate responds to. Saw Palmetto, a common prostate supplement, also lowers DHT.

I felt reasonably normal on 400-450 total T (from gel, not injections). If I could be there naturally I'd prefer that over taking meds. By a lot.

[CraigWatts]

But I've been off Finasteride for 8 years now. I just have a feeling it made some long term changes.

I agree with you that 450 feels normal. Nothing spectacular. Nothing horrible. 400 I felt slightly less than normal. Nothing horrible. But its a sensation of riding the fence ... For example, on days that I dont "release" with my girlfriend or alone, my T level creeps up. Maybe I hit 410 ... then another day maybe I hit 415 .... and ... oh look ... im feeling microscopically horny. Go a third day and im feeling a little bit fiesty ... im sure I've hit 420 maybe ..... So exciting ...!!! (eyeroll) .... then I will "Release" and its a sensation of dropping right down to 390. I will go 2-3 days with zero sex drive. I dont feel like im dying, but there's nothing happening. Its just nothingness. Flat-line. That's me at 390-400. And I have to wait a few days for my body to creep back up to a whopping 410 .... I dont sleep well. I never feel rested. Feeling "envigorated" hasnt happened in years. Literally. Gym workouts are lackluster. And health problems don't recover. Vitality is ...... blah.

So you're right. Its not a nightmare at 400. 450 would be a fun day for me though. 500 would be better. When I hit 750 on androgel alone, i was a rock star again. Could take on the world.

That's basically my situation.

[CraigWatts]

UPDATE:

Okay I got all my stuff run. Here are the numbers. Regarding free testosterone - I "relieved myself" about 3 times in the day prior to the test. I did this on purpose. I wanted to simulate my lifestyle before I lost all my interest in sex.

Total Testosterone: 366 (range 250 - 1100)
Free Testosterone: 68.4 (range 35 - 155)
LH: 3.1 (range 1.5 - 9.3)
FSH: 3.3 (range 1.6 - 8.0)
TSH: 1.3 (range 0.4 - 4.5)
Prolactin: 6.5 (range 2 - 18)

T4 Free: 1.1 (range 0.8 - 1.8)
T3 Free: 3.5 (range 2.3 - 4.2)
T3 Total: 101 (range 76 - 181)

Thoughts?

[sparverius]

If you can wank three times in a day your libido is doing pretty well.

If your regular dr won't prescribe, you can surely find one who can. It may be at a clinic and may cost more. You have to decide if a lifetime of hassling with hormone levels is what you want. It's not like you get a script and it's all birds singing and happy fornicating for the rest of your life. The replacement hormones aren't the same as what you produce naturally. If you land one of the few really good doctors, the least you'll be doing will be a lot of tests. You'll feel off at times because your meds aren't working right. If your doctor is not so good you will have to figure it out on your own. That's time that you could be using for something else like filing your taxes or fornicating.

[steroid.com 1]

UPDATE:

Okay I got all my stuff run. Here are the numbers. Regarding free testosterone - I "relieved myself" about 3 times in the day prior to the test. I did this on purpose. I wanted to simulate my lifestyle before I lost all my interest in sex.

Total Testosterone: 366 (range 250 - 1100)
Free Testosterone: 68.4 (range 35 - 155)
LH: 3.1 (range 1.5 - 9.3)
FSH: 3.3 (range 1.6 - 8.0)
TSH: 1.3 (range 0.4 - 4.5)
Prolactin: 6.5 (range 2 - 18)

T4 Free: 1.1 (range 0.8 - 1.8)
T3 Free: 3.5 (range 2.3 - 4.2)
T3 Total: 101 (range 76 - 181)

Thoughts?

Finasteride is an evil drug that could possibly be playing into your current state.

I can tell you this, based on these panels most well trained TRT Physician's would put you on a TRT protocol right away.

Your thyroid looks fine BTW.

What did your E2 panel say?

[BallSak]

UPDATE:

Okay I got all my stuff run. Here are the numbers. Regarding free testosterone - I "relieved myself" about 3 times in the day prior to the test. I did this on purpose. I wanted to simulate my lifestyle before I lost all my interest in sex.

Total Testosterone: 366 (range 250 - 1100)
Free Testosterone: 68.4 (range 35 - 155)
LH: 3.1 (range 1.5 - 9.3)
FSH: 3.3 (range 1.6 - 8.0)
TSH: 1.3 (range 0.4 - 4.5)
Prolactin: 6.5 (range 2 - 18)

T4 Free: 1.1 (range 0.8 - 1.8)
T3 Free: 3.5 (range 2.3 - 4.2)
T3 Total: 101 (range 76 - 181)

Thoughts?

My labs are pretty close to yours. I'm 30 yrs old with TT of 375 (348-1197) and free T of 7.5 (5-21) and i feel absolutely terrible. My body has turned to mush and mentally and psychologically I'm a mess. Interesting how similar levels result in such radically different symptoms for two different guys. Perhaps a good testament of symptoms being more important than numbers.

[Vettester]

Agree with GD ... You should have no trouble getting a physician/clinic on board with a treatment program for you. Your LH/FSH is mildly suppressed, which is reflecting on the lower end test serum results. This is what we commonly refer to as secondary hypogonadism. Find a physician who will also prescribe HCG , and you will be more than just a prostate rock star!

If your 'new' physician says that you need to retake labs again in six (6) weeks after starting your protocol, then you know you're off to a good start. Make sure this is part of the package. If you're inclined, you might check into the new clinic mentioned at the top of the forum, which will be opening soon.

Lastly, you should also see some increase in your E2 once your test level gets higher and starts converting more downstream. Your free test is fine at the 2.5% range, so just optimizing upwards of 750-800ng/dl will do wonders

[BallSak]

CraigWatts, please keep us updated on your progress finding a good doc. Just out of curiosity, are you experiencing joint pain?

[CraigWatts]

"If you're able to wank 3 times"

Believe me - its not that I wanted to. I just did it to do it. Im able to get a 70% erection which is FINE for jerking off, but those of you here - you know what im talking about - 70% doesn't cut it for sex. ESPECIALLY if you wear a condom. So im able to jerk the dying salami and make it "finish" but its not like i was walking around raging and "In need of 3 wanks today". I could have gone a week or more without 1 if I based it on my actual libido.

"What was your E2"

He didnt run it this time. Dammit. But ill get it run.

"Do you have joint pain?"

I have a major physical problem going on right now that spans my entire body which may or may not be related to my hormone levels. And yes joint pain is included. I took some very toxic medications in February that destroyed my mitochondria and caused pretty bad myopathy. I've had every symptom in the book and am almost being diagnosed with Fibromyalgia at this point or Chronic Fatigue Syndrome. I was fine before those medications in February - just low T and ... yes sometimes joint pain. But now joint pain is the norm. Bottom line - I want to get all my levels - hormone and otherwise - in range so my body can heal. Thats the goal anyways with HRT right?

I keep hearing about HCG but i know nothing about it. I need to do some reading.

"The clinic at the top of the page opening soon"

Hope i can figure out what you mean ..... is it in Miami where I am?

[CraigWatts]

By the way guys i am *really* worried that I will kickstart hair loss again. That might be a deal killer for me on this. I know Finasteride is what knocked me down hormone-wise. I know for a fact it basically castrated me on some level. Which has been great for my hair. I was losing tons and here I am at age 38 with a thick full head of hair and almost no interest in sex. I have used Androgel and within a week my hair starts looking horrible. Flat and starts thinning out. I dont want to take finasteride to offset the androgel ... bad idea..... so I am not sure. This is why I started doing androgel just for a few weeks, then stopping. Waiting a month or three, then doing androgel again for a few weeks. I know that isnt the norm, but it allowed me to enjoy normal function for a period of time without any long term damage to my hair, and I got periodic reprieves from the aggression which I did not enjoy either.

[spywizard]

so??? you mentioned health and quality of life.. but now you are worried more about your hair??

if you had cancer would you forgo chemo so you don't lose your hair??

good luck with all that, sorry if i couldn't share the magic pill with you..

[makingwaves]

Craigwatts
You said at xyz level "I'm a rockstar". Go be a rockstar.

[Vettester]

"

I keep hearing about HCG but i know nothing about it. I need to do some reading Bingo!!

"The clinic at the top of the page opening soon"

Hope i can figure out what you mean ..... is it in Miami where I am? What I said was the clinic at top of the "forum". On the front page, at the top of the stickies, you will find the thread. It might be a great option for you there in Florida!

In bold.

[steroid.com 1]

This is your problem----> "I know Finasteride is what knocked me down hormone-wise."

You need to get re-started, if you can, right quick.

Post Finasteride Syndrome is real and I hate to tell you but some men can't get corrected.

You need to do some research on this...Google is your friend.

[CraigWatts]

Craigwatts You said at xyz level "I'm a rockstar". Go be a rockstar.

I said my PSA level made me a prostate rock star. Major difference than what you're implying. Go back to reading comprehension class.

so??? you mentioned health and quality of life.. but now you are worried more about your hair?? if you had cancer would you forgo chemo so you don't lose your hair?? good luck with that.

This was a completely retarded comment. You're going to compare low Testosterone levels to Cancer? Good luck with that. Its called weighing the benefits to the side effects. People do it every day. Do i want a raging hard dick and be unable to attact women because im balding? I think thats a valid concern. Sorry you don't get it.

Post Finasteride Syndrome is real and I hate to tell you but some men can't get corrected. You need to do some research on this...Google is your friend.

Youre right. I know about Finasteride. You may be suprised who I am ... I have to keep my identity low key, but lets just say I am heavily involved in the hair loss world .... and you probably know about one of the web sites I run ... some of my users are the guys who started the other sites on Finasteride side effects. Its only a minimal number of guys who have the problems, but they're a vocal bunch and i respect what they're dealing with. But I will say its not an option for me to start balding again. Im going to have to weigh the benefits.

[kelkel]

Update us on the path you choose please!

[CraigWatts]

What I said was the clinic at top of the "forum". On the front page, at the top of the stickies, you will find the thread. It might be a great option for you there in Florida!

Unfortunately I am in Miami, and Orlando/Tampa are a bit far for me.

I have decided to use up the Androgel I still have while I look for an HRT place and set up an appointment. I respond very strongly to everything, so I am literally able to use a dime sized bit of androgel on my hand - smear it on my chest and shoulders, and that gives me a tiny kick. I know most of you guys will scoff at that, but its true. I have tested my T levels after half packet daily and I got myself to 700 with that alone. Using a little less, I am assuming will get me up to 500 or 600. Which is where I am comfortable being. Im glad I am just in need of a little adjustment. Also taking 25mg of zinc.