How to get Gp to change my doses from 1 a month to 1 a week?

[SD3000]

I am lucky to have found a doctor period who does TRT in my rural Texas area. Almost every doctor here is afraid of anything new and or different. I like my Doc but he has me on 1 a month and everything I read says I should be doing 1 shot a week (and maybe even 2), so how do I get my point across. I know he treats many patients for TRT and this is how he does all of them. What can I bring with me to show to him I know what I'm talking about?

[Vettester]

Hmmm ... I know what you're saying about feeling good that you have a doctor who will treat you with TRT, but I don't know just how lucky I'd feel with 1x per month. The hormonal fluctuation would make any man miserable, not to mention the impact it will have with your E2 when it spikes.

For starters, what dosage is your doctor giving you? Does he require you to make an office visit for treatments, or can you take it home?

To answer you, I would just point blank tell the man that you have done some research and you have some concerns. Let him know that the half-life of cyp/eth is at/around 7 to 8 days, and that the medication actually peaks with 2 to 3 days. Depending on your dosage amount, you could literally be >1,500 on your serum level at 3 days after injecting, and back to baseline by day 21 (+/- a few days), which could be in the 100's or lower. All the doctor would have to do is run a serum lab after the 3rd week and the facts would speak for themselves. Take a professional, articulated approach, and see if that might just make it an easy transition to go at least 1x week.

Since you're having this conversation with him, you should also discuss the E2 subject, since surely the man is aware that testosterone converts directly downstream to estrogen (and DHT), and also the subject of HCG to offset the testicular atrophy subject associated with TRT.

It's either 1 of 2 ways ... The man will be receptive to a patient who presents 'factual' information that he can utilize to HELP HIM be a better practitioner, or he will be ego stricken that anyone with less medical education than him dares to make any suggestions on his diagnosis, prognosis, or treatment ability. Sadly, your odds will be the later, or some variation thereof, which will just put you back to square one.

If indeed you have no success, you can always explore other options with clinics that will treat you in other cities, or out of state. In fact, you can probably expect to see a new clinic in Houston, TX in the not so far distant future, which will be affiliated with the ownership of this board.

I haven't viewed your profile, but would enjoy knowing more about yourself (age, stats, etc.), and a little bit about your journey with getting to TRT.

[steroid.com 1]

Search on Dr. John Crisler's website All Things Male and look for his paper on his forum titled: TRT: A recipe for success.

Print it out and have your Doctor read it.

Or simple do a Google search on Testosterone Half Life.

Here's the section of his paper that you want to highlight:

"In most cases, I start my guys out on either testosterone cream/gel 5mgs QD or testosterone cypionate 100mg per week. The IM test cyp must be administered in weekly injections, as opposed to taking twice the dosage every other week. Some physicians even dose every third or fourth week, producing wide swings in serum androgen levels. Where else in medicine do physicians dose medications completely void of consideration for the pharmacokinetics of same? This puts the patient on an emotional roller coaster, increases the risk of developing polycythemia, greatly accentuates aromatase activity (and therefore unnecessarily elevated E production requiring expensive aromatase inhibition), and actually leaves them lower than they were when they started for the last half of the injection “cycle”.

[SD3000]

Thank you for the response. I am taking 1ML (I think 100mg) a month. Your answers are just what I was looking for, some hard facts to take to him. My doctor has always been open-minded in the past. And about me, I'm 31 and have tested 180 T in my most recent blood test. I am broke as a joke and am 5 hours from Houston, so I don't see that working for me.

[SD3000]

And I am giving the shots myself too btw

[steroid.com 1]

Let me say this to you; for an otherwise healthy male 31 yo with serum levels at 180 needs to be diagnosed for pathology.

There are some very serious diseases and conditions that can cause you to be so low.

If your serum levels are this low and baring any past aas abuse or other type of condition like head injury or medication you need to know what's wrong with you as soon as possible.

Just throwing Testosterone at you like this is malpractice in my opinion.

Please take my words of advise seriously; you need to rule out all serious pathologies first before starting on Testosterone...and find a Doc who knows how to manage your health correctly as this one doesn't.

[Vettester]

OP, in most cases, 1ML will = 200mg. Regardless, 100mg or 200mg, it's not a good protocol at all. 50mg/wk might be on the low end, but I'd take it any day over a 1x per month protocol. Even at 50mg/wk, if you could get some HCG, you could potentially have a semi-decent program. All that would be dependent on your diagnosis (primary or secondary), and how receptive your testicles would be to the LH analog (HCG).

When you were diagnosed, did he determine if it was primary or secondary hypogonadism. Any other labs taken that might be beneficial (Thyroid panels, DHEA, SHBG, Free/Bio, LH/FSH, etc.)? Just curious to what caused you to have low T at a pretty young age?

[SD3000]

OP, in most cases, 1ML will = 200mg. Regardless, 100mg or 200mg, it's not a good protocol at all. 50mg/wk might be on the low end, but I'd take it any day over a 1x per month protocol. Even at 50mg/wk, if you could get some HCG, you could potentially have a semi-decent program. All that would be dependent on your diagnosis (primary or secondary), and how receptive your testicles would be to the LH analog (HCG).

When you were diagnosed, did he determine if it was primary or secondary hypogonadism. Any other labs taken that might be beneficial (Thyroid panels, DHEA, SHBG, Free/Bio, LH/FSH, etc.)? Just curious to what caused you to have low T at a pretty young age?

Vet I don't know if I am primary or secondary. I don't even know what that means yet!? I'm still very new to this. Just felt sluggish went to the doctor said I wanted my Test levels taken, he told me "no way you are low on test I can tell from looking at you" then I came back with a 180 and he was shocked and he set me up on one shot a month and is retesting me at 6 wks and we will go from there.

I just want to have all the info I can for when I go back so I'm prepared to ask for the proper treatment. He has made no mentions of HCGs, Ai's or anything like that. When I mentioned treating the extra Estrogen he just laughed it off saying I didn't need it.

[SD3000]

He also never made mention of looking for an underlying condition or finding whatever is causing this which seems to be an issue. I never though of it, just thought it was natural for some people to be low =/

No steroid use in past at all by the way.

[steroid.com 1]

It's not natural and you have a "Physician" who doesn't know what he's doing.

I had this exact conversation with my TRT Doc today and he agrees it happens all the time and in fact against the Docs oath not to do harm...he's harming you.

You need to have a heart to heart with your Doctor and rule out any disease or pathology...these things can range from tumors, Cancer, Testicular conditions, Hypothyroidism to diabetes and more...