Have an appointment with endo. Need advice.

[Ace111]

Hi everyone

Here's my original thread I started a year ago with blood work posted throughout the thread in case someone asks for my history -
http://forums.steroid.com/showthread...=#.URjM9_KfnFx

Short version of post - how do I convince the endo to look into my symptoms and hopefully offer treatment? Scientific research? Play on his empathy? Get angry and cuss at him? (semi srs)


I've got an appointment with an endo in a weeks time and I'm just looking for advice on the best way to get this guy on my side and convince him into looking at what's causing my low testosterone. I say 'convince' because all my blood tests so far have either been low normal or 'just' below range which was good enough for a previous endo and a couple of GP's to not offer any help and suggest other treatment instead ie. anti depressants, therapy.

The last guy got irritated when I showed him some paperwork regarding testosterone levels and where they should be at my age (26) so I'm hesitant to do the same in case I piss this guy off and get refused treatment. Another reason is this guy is covered by Medicare (universal healthcare) so I don't pay anything which is rare here in Australia when it comes to specialists. Otherwise I'm probably looking at spending a lot of money which would be difficult at the moment.

My plan is to first see where this guy stands in regards to HRT, the testosterone reference range and if he offers treatment for low normal levels. If I get the hint that he follows the reference range to the letter I plan on crashing my test levels before any bloodwork he orders becauseif I'm in range or slightly below, treatment won't be an option. My only concern with doing this is that it will skew any other blood tests he orders and I won't be any closer to finding the cause.

I don't know if I should tell him I lift weights at all because he might think I'm just looking for free steroids but one of my symptoms is I lose strength fast and only pretty much put on fat during a bulk. So I don't know how to go about mentioning that without him becoming suspicious. I'll definitely play up my other symptoms which affect my life and that non lifting people can relate to - fatigue, depression, mood swings, no libido, no motivation, etc.

Also I want to ask about other standalone treatments instead of TRT such as Clomid therapy or HCG (if possible) but I'm not sure where docs stand in regards to those alternative treatments here in Aus. Would it be a good idea to print off studies to show him that these can be an alternative to TRT. If anyone has any links on hand can you please post them.

Sorry it's a bit long winded but any ideas and advice on how to approach this to have the best shot at getting treatment would be appreciated.

Thanks

[Ace111]

Had the appointment today. It doesn't seem like I'll be getting any treatment from this guy. He's ordered blood tests but he doesn't believe my testosterone is low (9.5 nmol/L) because my free test is apparently high according to this. It's at 81.

What do I do? Crash my testosterone before I go in for the blood draw? Tell him I have another doctor that will treat me if he won't or tell him I'll self medicate?

[Ace111]

Testosterone - 8.5 (8.3-29)
Free Testosterone - 29.1 (25-120)
FSH - 2 (<7)
LH - 1.6 (<7)
OEST2 - 71 (<150)

TSH - 5.5 (0.5-4.5)
FT4 - 16 (10-20)
FT3 - 4.4 (3.5-6)

Prolactin - 214 (40-450)
Serum CRP - <4 (<6)

Sodium - 137 (135-145)
Potassium - 4.2 (3.6-5.4)
Chloride - 99 (97-110)
Bicarbonate - 24 (21-30)
Anion Gap - 18 (10-20)
Urea - 10.9 (2.5-7.5)
Creatinine - 100 (40-120)
eGFR - >90
Bilirubin - 28 (<20)
AST - 32 (<35)
ALT - 38 (<40)
GGT - 12 (<40)
Alkaline Phosphatase - 69 (35-110)
Protein - 76 (65-85)
Albumin - 51 (35-49)
Globulin - 25 (22-38)


HB - 151 (130-180)
RCC - 5.1 (4.5-6.5)
HCT - 0.45 (0.4-0.54)
MCV - 87 (79.99)
MCH - 29 (27-34)
MCHC - 337 (320-360)
RDW - 13.8 (10-17)
PLAT - 200 (150-400)
WBC - 6.8 (4-11)
NEUT - 3.7 (2-7.5)
LYMP - 2.3 (1-4)
MONO - 0.6 (0.2-1)
EOS - 0.1 (<0.7)
BASO - 0.0 (<0.2)

He said my testosterone is fine. He offered thyroxine for my thyroid but retracted the offer a few minutes later. He said keep an eye on it and get it retested in 3 months. Told me to stop doing intermittent fasting and low carb/paleo. Thinks I'm obsessed with wanting to gain muscle even though that's a secondary concern. Back to square one but this time I'm going to the right doctor.

[Vettester]

Wow, what an ignorant fvck of a doctor that is!!

Note to anyone else out there reading this, you CAN'T teach these sorry types of docs to become the great HRT physician you expect. There are good doctors, who will partner with a patient, and work to be better ... Then there are doctors who sucked the day they got out of medical school, they suck now, and 99% of them will suck their whole careers!

OP, only if you were in the US, we could point you in a variety of directions. I have no clue where you go from here in Australia. Just be proactive and keep trying. BTW, your test is 245ng/dl, and your LH/FSH clearly indicate secondary issues. Not to mention that the huge concern for hypothyroidism, or possible pathologies related thereof. Would he prefer that you be obsessed with gaining fat instead?? Sorry to hear you are still dealing with this crap 1 year later!

[Trific]

Wow, what an ignorant fvck of a doctor that is!!

Hah...thanks for the laugh!

Ace, got any blackmarket test available is Assieland?


Good Luck with the new doc!

[austinite]

Agree with Vette. Really it's trial and error with docs. I dropped the 1st 2 I dealt with very quickly (both wanted to put me on anti-depressants) , and now I'm happier than ever with my current one. Time to seek another doc.

[Ace111]

Wow, what an ignorant fvck of a doctor that is!!

Note to anyone else out there reading this, you CAN'T teach these sorry types of docs to become the great HRT physician you expect. There are good doctors, who will partner with a patient, and work to be better ... Then there are doctors who sucked the day they got out of medical school, they suck now, and 99% of them will suck their whole careers!

OP, only if you were in the US, we could point you in a variety of directions. I have no clue where you go from here in Australia. Just be proactive and keep trying. BTW, your test is 245ng/dl, and your LH/FSH clearly indicate secondary issues. Not to mention that the huge concern for hypothyroidism, or possible pathologies related thereof. Would he prefer that you be obsessed with gaining fat instead?? Sorry to hear you are still dealing with this crap 1 year later!

Thanks for the support Vett.I know where to go from here thanks to some members of this board referring me to a doc who apparently knows his stuff so I'm hoping it works out. I'll post updates when it happens, in the meantime I'll keep lurking here and trying to learn more from yourself and the other knowledgeable guys on this board.

Hah...thanks for the laugh!

Ace, got any blackmarket test available is Assieland?


Good Luck with the new doc!

I'm sure I could get some if I tried but don't want to self medicate just yet. Maybe clomid would be a safer option to trial/start off with and easier to get.

And thanks.

[Ace111]

Agree with Vette. Really it's trial and error with docs. I dropped the 1st 2 I dealt with very quickly (both wanted to put me on anti-depressants) , and now I'm happier than ever with my current one. Time to seek another doc.

Yep I've gotten the "you're suffering from depression, take some pills and see a psychologist" talk from about 4 docs combined now. 5th time lucky hopefully.