4 days in

[cornfedboy2000]

I'm slowly starting to grasp some of the info in here regarding TRT, which is good. If you're just tuning in, I've been prescribed Androgel 1.62 at 2 pumps. Obviously it's very early on, so I'm not expecting miracles, but one thing that I've notice in the last 2 days is difficulty urinating... this might not seem like a big deal, but I have never ever had an issue with this and now I do. Any chance this could be correlated with the TRT, and if so, should I be worried at this point? I'm really trying to learn as much about this as possible, and also trying to make sure I optimize the whole process... any advice would be great.

[steroid.com 1]

Did you get a PSA and digital prostate examination before you started your Protocol?

Testosterone when first administered can increase PSA serum levels a small amount as well.

It's important to understand that Prostate cancers are for the most part androgen dependent and why it's critical to have a thorough Prostate examination before starting any TRT treatment protocol.

[cornfedboy2000]

no I did not... First off I don't know what PSA is, and no I didn't have a prostate exam. To be honest, my doc said take it, I listened and started using the androgel , and THEN I came and started to educate myself... I know it's pretty stupid on my part, but that's why I'm here now trying to gain knowledge to make this thing work. I hope I'm not too late. I was already told I'm too late to get another more thorough blood panel, and to just wait 4 weeks or so and then get it. I'm quickly backpedaling here, and trying to optimize everything. Still trying to figure out if I should add hCG to my protocol, because so far it sounds like I should... but don't know if I should wait for the 4 weeks stated before and then order a full blood workup and see where all my levels are at.

[cornfedboy2000]

ok... let me ask a quetion... so far from my reading on here, would it be beneficial to add 50mg of micronized DHEA and pregnenolone administered at 25mg twice daily, once in the morning and once in the evening? Still trying to piece this thing together but I think I'm getting there.

[steroid.com 1]

ok... let me ask a quetion... so far from my reading on here, would it be beneficial to add 50mg of micronized DHEA and pregnenolone administered at 25mg twice daily, once in the morning and once in the evening? Still trying to piece this thing together but I think I'm getting there.

I don't think you should be doing anything until you get the right medical care and diagnosis.

You can't screw around with your Prostate and especially any serious BPH or Cancer for that matter.

You Doctor doesn't know what he's doing and he not managing you correctly.

[cornfedboy2000]

so then what do I do... stop the TRT and go back to my doctor and say... what? I'm not trying to seem rude here, I'm just trying to get a handle on what the hell is going on with me. I've been literally broken for close to 8 months, and on top of that my T levels obviously have been in decline for a while, I don't just want to get back to a healthier me, I NEED to. I've been told because I've already started TRT that it's too late for BW to check anything, so do I stop then check on stuff after a while, or stay on it and check on stuff after a while. I know you guys aren't doctors, but you're obviously very well versed in these matters.

[Rusty11]

No. It's not too late to request psa bw. Nor is it too late for a digital(finger) rectal exam. You need to talk to doc soon about your urinary issues. Call him and tell him what's going on. He will check you out or refer you to a urologist. But, do it Monday. Don't try supplimenting with anything. You need to be checked out. Good luck.

Edit: I'm really shocked that your Dr. didn't even do minimal bw before prescribing testosterone . Odd!

[cornfedboy2000]

should be easy as my urologist is the guy who ordered the initial BW (which just told me my T was at 163), and then prescribed the Androgel . I'll get on him tomorrow. I'm going to go look up these BW articles, but if anyone wants to chime in with what I should request as far as BW is concerned I'd certainly appreciate it. Thanks guys.

[Rusty11]

I'm on my phone, so I can't link to it, but there is a sticky entitled, " Finding a trt physician" on the main page. It's got everything listed.

[2Sox]

A short FYI: As others have said you can still get blood work - and you don't have to wait very long. Androgel is out of your system in a day or two so if you stop application and wait a week or so, I'm guessing your numbers would likely be at baseline. Then you could have you blood drawn.

[cornfedboy2000]

So if I were to order the following blood work (copied from the sticky) at this point should I get off the gel first? I'll call him tomorrow and at the least request the full results of the previously ordered BW... who knows, maybe he did take a full panel, but judging from the info on this forum I assume he didn't based on the fact he didn't order any other tests prior to prescribing the gel. Or should I stay on the gel and take this info to him... he did seem to be realistic when I was talking to him prior. Again, thanks guys, I appreciate the guidance... I'm hoping I can get this stuff under control and stream line it... god knows I need it.


• Total Testosterone
• Bioavailable testosterone (aka Free and Loosely Bound)
• Free Testosterone
• SHBG
• DHT (gel users especially pay attention to this)
• Estradiol (specify “sensitive” assay for males)
• LH
• FSH
• Prolactin
• Cortisol
• Thyroid Panel (complete)
• CBC
• Comprehensive Metabolic Panel
• Lipid Panel
• PSA (age dependent)
• IGF-1, IGFBP-3 (if HGH therapy is being considered)
• Vitamin D


FOLLOW-UP LABS:

• Total Testosterone
• Bioavailable Testosterone
• Free Testosterone
• Estradiol (specify “sensitive” assay for males)
• LH
• FSH
• CBC
• Comprehensive Metabolic Panel
• Lipid Profile
• PSA (for those over 40 with family history of prostate CA. >45 all others)
• IGF-1, IGFBP-3 (if GH therapy has been initiated already)

[steroid.com 1]

After being on this board for as long as I have it comes to no shock to me whatsoever that the OP's Doc just threw Testosterone at him without evaluating all other clinical diagnosis for the cause before just thinking it's age related androgen deficiency...criminal in my opinion and violates his first medical oath of not doing harm...he is!!!

If I had a dollar for each time I saw this scenario here I wouldn't have to pay a bar tab for the next 12 months.

From Dr. Crisler re PSA lab and note the bold:

For all patients over 45, and over 40 if Family History of prostate cancer. Even though prostate CA is rare in men under the age of fifty, we don’t want it happening on our watch. At this time, accelerations in PSA above 0.75 are a contraindication to TRT (until follow-up by an Urologist). You may find, at the initiation of TRT in older men, when serum androgen levels are rapidly rising, PSA may, too. This is especially true when transdermal delivery systems are employed, because they more elevate DHT. Once T levels have stabilized PSA drops back down to roughly baseline. New TRT patients need to be cautioned, and reminded, to abstain from sexual relations prior to the draw, as they may now be enjoying greatly elevated amounts of same.

I get a PSA up front on my over 40 patients, at the one month follow-up in my more senior patients, and every six months after that. DRE (Digital Rectal Exam) is recommended twice per year as well, although the American Academy of Clinical Endocrinologists backs “every six to twelve months” in their 2002 Guidelines for treating hypogonadotrophic patients with TRT.

[cornfedboy2000]

thanks for the info, i'm gonna rattle the doctors cage tomorrow and see what I can shake out.