Blood work and finding a new doctor in KY

[luciuswillson]

Ok. I am a 36 yo male that has been on testosterone cypionate 1.5 biweekly for the past year. I had been on androgel prior but it had been about a year in between because of insurance issues. My first run about 4 years ago with the gel I got my numbers up to a high 800 range but they keep falling every year. Last year when I got new insurance that covered TRT I got tested again and I was about 150 when I started the cypionate and started with 1ml. After a month I had just got my number ups to a low 300 and my Doc increased me to a 1.5. I got tested last week and my numbers he said were the best they were going to get at around 400. I feel like he is missing something. I have asked him about estrogen and GH and he said that I should not worry about those. I still feel like shit. I have been doing a IF diet the last 3-4 months have lost about 20 lbs. Currently I am 6'0 269 around 19%BF according to skin fold.

My question is I would like to find a doctor who specializes in male hormones and is in a reasonable driving distance for me (2-3 hours max) and wold take my insurance. I have looked at the low testosterone page but the closest doctor is about 6 hours away. Does anyone know of a good hormone doctor in the Lexington KY area? I live in south east KY on the TN/VA Border and Lexington and Knoxville TN are about 2 hours away.

I just got a copy of my Blood work from the doctor and he didn't test anything but the T levels so I am not happy with that but here they are:

Testosterone Serum 588 (348-1197)
Testosterone, % Free + weakly bound 42.6 (9.0-46.0)
Testosterone, F+W Bound: 250.5 (40.0-250.0)

Any help you can give me would be awesome.

Thanks

[kelkel]

Hi Lucius and welcome to the forum!

First, for clarity purposes edit your post and add ranges to what you listed.
So you're currently on 300mg per week of test? Wow.
Were you ever given a reason why your T was low? Causative factor?
The higher BF% the more T will turn to E which is more than likely part of your issue here. At 6', 269 I'm guessing your BF is actually higher. Vicious cycle with T & E and BF. Simply getting your E2 in the proper range can dramatically raise your T level.
GET a sensitive estrogen assay asap.
As you know, your doc is not on top of things here and you need to find another.
You need complete BW. In the "Finding a Doc" Sticky at the top of the forum are examples for you.

When it comes to lowtestosterone.com they will fly you in for free if need be. Call and talk to them please. You can also obtain BW on your own in most states with services such as private md labs.com

Keep us in the loop on this thread please.

[luciuswillson]

When I had by blood work done again a year ago levels T was around 150 (expected 348-1197). The only thing I was told could be the problem is the abdomen fat and the possibility that the ando (pinnacle poppers) I took for about six months in 2000 had some affect.

I have been testing my BF in the last few months using the jacksonPollock 3 caliper method and tracking my circumference measurements. According to the skin calipers two weeks ago my BF was 19.5. I do plan on going to a clinic in the next month to do a Bodpod measurement to get a more accurate measurement. After I completed the original post I called a compounding pharm and got a reference to a local provider and got the earliest appointment I could but that is not until Jan 13. I am thinking about calling my primary right now and seeing if instead of taking the 1.5 biweekly I can split them up and do a once per week, do you think that is better than biweekly?

[kelkel]

Wow. Just saw that you did say bi-weekly. Yes, that's a horrible protocol. He obviously does not understand the half life of testosterone . If you inject at home consider switching to a twice weekly (every 3.5 days) protocol. Logic is simply this: Less injected = less spike in E2 = less need for ancillary drugs. It will also maintain even serum levels that your current protocol doesn't come close to doing. That simple switch will more than likely lower your E and raise your T.

[luciuswillson]

Just to clarify my injections are still at 1.5 biweekly. I started at 1.0 biweekly and after a month my testosterone level was around 300 and my Doc bumped me up to the 1.5 biweekly where I have been at for the last 10 months and my levels are not at 588. Sorry for the confusion.

[kelkel]

Well, when is your BW being pulled relative to your injection? How long after?

[luciuswillson]

This BW was pulled a week after my last injection.

[kelkel]

Ok, if not at 588 then where are they. Pulling bw a week after is fine as it gets you at trough level.

[luciuswillson]

The BW was at 588 one week post injection of 1.5. I am not sure what it would have been at 2 weeks. When I go to my new doc in january is the BW you recommend
• 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

Also should I ask about doing a 1per week injection?

[kelkel]

So you were probably double that level earlier in the week.
Eliminate LH & FSH. You don't need them now.
Refer to my post (#4) about injection protocols. Best way to go.

Now to back-track a minute. How long after prohormones did you get BW finding your low T? Know that prohormones are suppressive of your natural test production and if you tested when suppressed you very well may be on TRT absolutely unnecessarily and a restart may be prudent.

[luciuswillson]

I took the pro hormones (andro for about 6-8 months in 2000. I also did some type (can't remember) of an andro patch in 2002 for about 6 months. I was fine for a long time but didn't workout much at all. I get really stressed in 2008 put about 50lbs on and almost got a divorce. I went from 245 to about 290 in about 6 months. I went and got my blood work tested as I was felling like a complete bag of crap. T numbers came back at around 200 and my Doc put me on androgel . I did this for about 6 months and got rechecked. Upon rechecking my BW I was up to 900 so he kept me at that level. I switched insurances and lost my ability to pay for the androgel so I couldn't get anything. I started running real hard last year and lifting again in the summer of 2012 because I was just tired and got a new insurance carrier that would pay for tx. I got my BW redone and my T was at 150. Over the past year I have lost about 50lbs. I would like to keep going but still feel completely drained especially after working out. My goal is to get to 8-11%BF.

[kelkel]

Wow. Well, lifestyle means a lot here and I'm glad to hear you're getting that in order. You need to enlighten your doc to better protocols or simply find another one that is knowledgeable. It all starts with proper BW and a good protocol. Consider Sub-Q shots as well if you go twice per week. It may be easier for you.