When you began HRT Did you Get it Right the First Time?

[junk2222yard]

This thread is for the people that have been on HRT for some time (say a few months or longer) to comment on their own experience with HRT, and if things went as smoothly as could be expected, or if they made mis-steps and would do it differently if they could go back in time?

I thought I would start it because one of the vets here mentioned they were themselves at a crossroads and wondered if they were really better off with HRT or not, long after beginning. If a respected vet is wondering this, I am sure many of us amateurs are wondering it, too.

In my own case, I am in month 7, and as time goes on -- and I learn more and more and uncover other underlying issues -- I wish I could go back in time and do it again. In my own case, I am sure I have an underlying Thyroid condition (which my doc has come around too as well), and wish my doctor knew more about that, and was less eager to just put me on Test right off the bat. As most know, hypothyroidism can cause hypogonadism, and I fear that is the case with me. Yet I was on Test before even having my LH and FSH tested, nevermind a whole whack of other stuff. Because I did feel better with the Test (stronger in gym, better erections, etc.) it was hard to not feel like things were coming together, but now -- 7 months into it -- I have discovered I have low ferritin (which I thought was tested in the beginning like it should have been, but I now know was not!) and it underscores how not enough investigation was done prior to treating the low T. I frequent thyroid boards now, and realize there are a whole host of things that need to be ruled out, that would help me fix my thyroid, which *possibly* could mean it cascades to fixing my low T, which *possibly* could mean being on one or even no drugs in the future, instead of the myriad that I am working with trying to "fix things underfoot".

What about your own experience? What would you do differently? And do you ever think about stopping HRT completely, and trying a different course of action?

[kelkel]

Not much I could do different as I've no choice when it comes to TRT as mines tumor related. But, it would have been nice to find a more knowledgeable doctor quicker. I went through my GP who soon couldn't handle my questions (self-education works) and was sent to and endo. I quickly realized he may have actually been less educated than my GP. So, fired him face to face and told him to stick to diabetes and metabolic diseases. He called later that night to try and get me back and do more of what I asked but it was too late in my mind.

I ended up with a Euro who pretty much lets me run my own protocol and will do what I ask as long as it's legitimate. We email frequently and he's even begun asking me for help for some of his patients who've abused AAS. They're just not taught this in med school...

[lovbyts]

Ive been on since 2008 and im still working on getting it right

[sirupate]

TRT is journey for about everyone. I was referred to an endo once my GP figured out there might be a problem. Endo put me on gel and I felt better almost immediately...like 20 years younger better. With time (and this Board), I came to realize that my endo didn't know all that much about TRT and I switched to a urologist for treatment. Better, but even that is still a journey, as we may be switching between the pellets and the gel or injections this Spring.

The only thing I'd do over again is get diagnosed earlier. I sort of "wasted" some of my better years having hypogonadism, but not knowing I have it.

[bullshark99]

Aggred, 2.5 yrs and still do not have the E2 dialed in??

[2Sox]

I agree. I should have begun sooner also but this was very much my fault because I didn't educate myself sufficiently. First urologist I went to discouraged TRT. That was twelve years ago. Second doctor I went to about three years ago said I was in the "normal" range and also subtley discouraged it. Finally last July I saw a young urologist who treats many patients with hypogonadism and I began my TRT journey. As I see it now, I probably wasted fifteen years being less than what I could have been. I've had a very good life, but it could have been even better.

Another BIG mistake was that I trusted doctors too much. No more. They have egos just like we do, and find it difficult to change their ways and look at new things, just like we do. Many are unforgivably ignorant about TRT and many others stick to outdated and ineffective - even harmful - protocols. They make mistakes and we suffer from them.

I was still pathetically uninformed and undereducated on the entire subject even when I first embarked. I didn't even know enough to ask the urologist if he tested for primary or secondary hypogonadism - which he didn't! And to insist on being tested! I didn't know enough to ask for certain blood tests. Most importantly, I didn't know that TRT was for life. This forum has helped me more than I can say. I know so much more now and I'm learning more everyday. And it has me feel I'm not alone and that I'm related to others.

To answer another of your questions: The question of stopping TRT flashed through my mind once. That was it. I NEVER want to go back to the way I was feeling and develop related health issues down the line. And if you are hypogonadal - with an endocrine disorder - why would you even want to consider it? Would a person with thyroid disorder consider stopping medication? Would a person with diabetes stop insulin ?

[fit2bOld]

My original GP told me to drink vitamin water. All my blood work was fine. But never did a hormone panel. Was up one night and saw a low T commercial. Took a online Q&A and that said I should consider seeing an Endo. After many calls trying to find a competent one I ended up at clinic. They got it right almost immediately. I now have new GP who is young and smart who manages my TRT.

[junk2222yard]

To answer another of your questions: The question of stopping TRT flashed through my mind once. That was it. I NEVER want to go back to the way I was feeling and develop related health issues down the line. And if you are hypogonadal - with an endocrine disorder - why would you even want to consider it? Would a person with thyroid disorder consider stopping medication? Would a person with diabetes stop insulin?

Well that is te crux of what I am getting at: many of us are being treated for low T without ever having established *why* it is low. Addressing a symptom downstream (low T) instead of the true cause, upstream.

In my own case, I have a thyroid disorder which should have been figured out before jumping into Testosterone , which if corrected could fix my low testosterone issue. But I didn't know enough about it back then, and (I have gathered) neither did my doctor.

I think many people are in a similar boat. Not just regarding having a thyroid disorder, but regarding "beginning testosterone before an underlying cause is figured out," whether it is thyroid, an injury, or a million other possibilities.

[HRTstudent]

Short answer... not even close...

[2Sox]

Short answer... not even close...

Not sure what you mean. Could you explain?

[2Sox]

Well that is te crux of what I am getting at: many of us are being treated for low T without ever having established *why* it is low. Addressing a symptom downstream (low T) instead of the true cause, upstream.

In my own case, I have a thyroid disorder which should have been figured out before jumping into Testosterone , which if corrected could fix my low testosterone issue. But I didn't know enough about it back then, and (I have gathered) neither did my doctor.

I think many people are in a similar boat. Not just regarding having a thyroid disorder, but regarding "beginning testosterone before an underlying cause is figured out," whether it is thyroid, an injury, or a million other possibilities.

You make a very good point. Too many haven't found the true cause of their condition. I could only imagine what stopping HR and going back to baseline would be like in order to do the tests that should have been done in the firs place. I guess in a sense I'm fortunate because my hypogonadism is due to age and it would be a waste of time for me to go back in time and take FSH and LH bloodwork. Very unlikely to get my HPTA going full tilt at this point - so TRT was the way to go.

[jasondd1]

Well that is te crux of what I am getting at: many of us are being treated for low T without ever having established *why* it is low. Addressing a symptom downstream (low T) instead of the true cause, upstream.

In my own case, I have a thyroid disorder which should have been figured out before jumping into Testosterone , which if corrected could fix my low testosterone issue. But I didn't know enough about it back then, and (I have gathered) neither did my doctor.

I think many people are in a similar boat. Not just regarding having a thyroid disorder, but regarding "beginning testosterone before an underlying cause is figured out," whether it is thyroid, an injury, or a million other possibilities.

I too fear I started too soon and should of ruled out thyroid. My next bloodwork in 2 weeks will include all the thyroid tests, not just the basics. i have thinning outer eyebrows and really want to know more about the thyroid then the basic tests.

i was thinking about adding this test
http://www.privatemdlabs.com/lab_tes...search=t4#2144
to this
http://www.privatemdlabs.com/lab_tes...search=t4#2158
or this
http://www.privatemdlabs.com/lab_tes...search=t4#2111

But i was unsure if needed all of that or if one of the testosterone tests were better than the other.

[HRTstudent]

Not sure what you mean. Could you explain?

I did the typical route... went to a primary (wasnt seeking any particular treatment) and had a total T drawn, result was very low. Symptoms matched up perfectly fine with what could have been low T.

Didn't get other things tested, didn't try to tune up thyroid first (my TSH was very good so that couldn't be it, right ), didn't try a clomid stimulation test, etc etc etc. Then I was on too low a dose for too long.... then I had E2 creeping up... got gyno... went to an endo (he knew nothing and wanted to wean me off of TRT over ONE YEAR)... finally found a decent doc and basically started over.

And that's just part of the reason I stress the importance of finding a GOOD doctor in male HRT BEFORE you start HRT.

[Trific]

If at all possible, I'd look for a doc that is on HRT/TRT themselves, then they are more likely to be interested enough in it to learn all they can about it.

[Trific]

Short answer... not even close...

Maybe you should be on HCG and in the near future attempt a restart?

[HRTstudent]

Maybe you should be on HCG and in the near future attempt a restart?

I might change things up when I try to improve fertility, which would hopefully be in the near future.

For right now, it just seems best to stick with TRT and address other areas.

[Times Roman]

getting it right the first time is like trying to hit a bullseye with your eyes closed. You have no idea what dose you need, plus you have no idea at what dose your RBC count begins to climb. it's a balancing act through trial and error.

[junk2222yard]

getting it right the first time is like trying to hit a bullseye with your eyes closed. You have no idea what dose you need, plus you have no idea at what dose your RBC count begins to climb. it's a balancing act through trial and error.

Hey TR, did you read my post or just the title?

I don't mean did you get everything perfect with your dosing. I mean, did you get it right regarding the whole process? Are there labs you wish you had done, and low T causes you wish you had investigated, before jumping in?

The people that went to a good doctor, that knows way more than they do even after reading forums like this for months, those guys probably got it right. But the majority of us, who didn't luck out or start with an expensive anti-aging doc, well for us we probably wish we could have a "re-do" on some or even many things.