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Thread: Pre-Appointment Advice Needed!

  1. #1
    BBrock293 is offline New Member
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    Pre-Appointment Advice Needed!

    I have an appointment with my primary Dr. on Wednesday. We are following up on my TRT program and doing blood. Long story short, he has me on 2ML/200MG every other week. After two injections, I felt terrible the 1st week, very up and down, sad, bloated, etc. After some reading, I switched myself to 1/2 that dose but every Sunday (Weekly). I feel better, but I know I am not dialed in. I am not sure I want to tell him I switched the schedule because it discredits what I tell him so here are my questions:

    1. Should I tell him my injection was the prior week on Sunday so I would get more accurate results considering the real injection was 3 days prior to the appointment? (Hope that makes sense)

    2. Libido is still up and down randomly and the ED problem persists. Should I ask about more T, along with Cialis or something to that effect? I have high BP, so I figure Cialis might be the best of both worlds!

    3. If I mention that my balls are the size of marbles, what are the chances he goes with HCG or something similar?

    I have a back-up plan with another Dr. but I am close with this one, so I don't want to make him think I am not trustworthy. Looking for any tips and advice and I apologize for the giant rant. Thanks guys.
    Last edited by BBrock293; 01-17-2014 at 08:09 PM.

  2. #2
    FRDave's Avatar
    FRDave is offline Senior Member
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    I would be honest and tell him how you were feeling with the up and downs and after reading the pamphlet with your bottle of test, you adjusted to once a week based on the 7 day half life. Tell him you feel better but would like his opinion on injecting every 3.5 days to keep a stable serum level.

    As for cialis, most dr's are open and will write a script since it's good for libidio, blood pressure, prostate, etc. The issue is the price to purchase that script. Ridiculous.

    And yes, print the sticky on HCG and see if he is willing to write a script. Tell him your testes ache and are creating insecurities due to size. Or if you plan to have kids in the future...

    Good luck.
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    Brett N is offline Senior Member
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    I have to agree 100% with Dave. Just talk to him, tell him you want to be actively involved in improving your quality of life. Who wouldn't? Tell him you have been reading some studies and gotten some other information on it as well? I would play up to his ego a little, maybe tell him you know that there is a lot more behind TRT than what you can read on the internet and you trust his treatment but... insert objection here.

    There is absolutely nothing wrong with being cautious about your treatment. Especially with a GP, they do not do TRT for a living. I am sure he is learning as much as you are as your treatment progresses.

    Don't forget that blood work is a crucial part of TRT. Knowing your estrogen levels are just as important if not more so than your test levels. Your test can be through the roof and if your estrogen is on the high or low side you will feel like total shit. Blood work at 5-7 weeks in of treatment.
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  4. #4
    BBrock293 is offline New Member
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    So I should let him know that I switched the dosing frequency on my own? I am not sure I have the pamphlet that came with it. Does it mention the 1/2 life in there? That would be a good basis for my decision in his eyes. Thanks guys.

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    Brett N is offline Senior Member
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    It is here at the bottom - would be something to print out. Testosterone Esters

  6. #6
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    kelkel is offline HRT Specialist ~ AR-Platinum Elite-Hall of Famer ~ No Source Checks
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    Really good advice above guys.

    Make your doc your partner in this. If not comfortable with something he advises, tell him so and discuss it.
    Have your questions prepared before you go. Know the answers as well and if he answers differently, politely question him.
    Make him aware that smaller, more frequent dosing causes less estrogen spikes.
    HCG is necessary. If he says it's not a proper use for it just show him a print out from Pregnyl, etc., where it says for the treatment of Hypogonadic Hypogonadism. If his nuts were shrinking he'd be on it in a heart beat.

    Let us know how you make out please.
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    BBrock293 is offline New Member
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    Quote Originally Posted by kelkel View Post
    Really good advice above guys.

    Make your doc your partner in this. If not comfortable with something he advises, tell him so and discuss it.
    Have your questions prepared before you go. Know the answers as well and if he answers differently, politely question him.
    Make him aware that smaller, more frequent dosing causes less estrogen spikes.
    HCG is necessary. If he says it's not a proper use for it just show him a print out from Pregnyl, etc., where it says for the treatment of Hypogonadic Hypogonadism. If his nuts were shrinking he'd be on it in a heart beat.

    Let us know how you make out please.
    He agreed to keep the same dose of 2ML but change to a 1ML on a weekly basis now. Took some bloodwork and he is going to call me tomorrow morning to discuss. We went over the ball shrinkage. What worries me, is he said he doesn't want to halt my production of exengenous (sp) T with too high of a dosage. He said he doesn't want my T level to exceed 500! I totally don't understand this at all. I started at 302 and he doesn't want me to exceed 500? He also said if we get too high, then I would have to be on for life. Aren't we going to anyway?!

    Is there any harm in my level being higher than my bodies' "normal"? I can't see how there would be. I feel like if my balls shrunk, then my production has already halted and brought me down even lower. He did ask if I had planned on trying for kids anytime soon, I told him anytime if I can fix the ED! Help!
    Last edited by BBrock293; 01-22-2014 at 06:51 PM.

  8. #8
    kelkel's Avatar
    kelkel is offline HRT Specialist ~ AR-Platinum Elite-Hall of Famer ~ No Source Checks
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    Progress at least. Halt production? You're already shut down. Make sure he tests your LH & FSH and this alone will show him that your are totally out of production. Jeez. He should not be focusing on Total T anyway, focus on Free T as that's what works for you. 500 is an arbitrary number and really means nothing. Look at free T. On for life, well that depends on what put you on TRT initially.

    No, there no harm in your level being higher than what it normally would be. Why go on TRT if not to have the levels of a younger man. Hell, I'm going to keep mine like a twenty something until the day I die. Testosterone is not what's bad for you, it's ignorance, incompetence and estrogen, dammit! Your doc should join here.

    Is he going to write you for HCG ?
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    BBrock293 is offline New Member
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    Quote Originally Posted by kelkel View Post
    Progress at least. Halt production? You're already shut down. Make sure he tests your LH & FSH and this alone will show him that your are totally out of production. Jeez. He should not be focusing on Total T anyway, focus on Free T as that's what works for you. 500 is an arbitrary number and really means nothing. Look at free T. On for life, well that depends on what put you on TRT initially.

    No, there no harm in your level being higher than what it normally would be. Why go on TRT if not to have the levels of a younger man. Hell, I'm going to keep mine like a twenty something until the day I die. Testosterone is not what's bad for you, it's ignorance, incompetence and estrogen, dammit! Your doc should join here.

    Is he going to write you for HCG?
    I asked him what to do to address the shrinkage and he said he wants to wait for the bloodwork to come back. He also mentioned an endo since we are trying for kids soon, so not really sure what his intentions are. Not sure why I am in TRT, I just went to him after feeling terrible and my level was 302.

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    Quote Originally Posted by BBrock293 View Post
    I asked him what to do to address the shrinkage and he said he wants to wait for the bloodwork to come back. He also mentioned an endo since we are trying for kids soon, so not really sure what his intentions are. Not sure why I am in TRT, I just went to him after feeling terrible and my level was 302.
    I cannot stand when a doctor puts guys on TRT without finding the causative factor.
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    BBrock293 is offline New Member
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    Quote Originally Posted by kelkel View Post
    I cannot stand when a doctor puts guys on TRT without finding the causative factor.
    I should clarify, he did tell me that sometimes low T just happens. We couldn't really find a cause. I was losing muscle, gaining fat, libidio problems, and was moody and lethargic. The symptoms fit, so we tested T.

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    BBrock293 is offline New Member
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    Quote Originally Posted by kelkel View Post
    I cannot stand when a doctor puts guys on TRT without finding the causative factor.
    I should clarify, he did tell me that sometimes low T just happens. We couldn't really find a cause. I was losing muscle, gaining fat, libidio problems, and was moody and lethargic. The symptoms fit, so we tested T.

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    Quote Originally Posted by BBrock293 View Post
    He agreed to keep the same dose of 2ML but change to a 1ML on a weekly basis now. Took some bloodwork and he is going to call me tomorrow morning to discuss. We went over the ball shrinkage. What worries me, is he said he doesn't want to halt my production of exengenous (sp) T with too high of a dosage. He said he doesn't want my T level to exceed 500! I totally don't understand this at all. I started at 302 and he doesn't want me to exceed 500? He also said if we get too high, then I would have to be on for life. Aren't we going to anyway?!

    Is there any harm in my level being higher than my bodies' "normal"? I can't see how there would be. I feel like if my balls shrunk, then my production has already halted and brought me down even lower. He did ask if I had planned on trying for kids anytime soon, I told him anytime if I can fix the ED! Help!
    This is a great discussion. Kel, Dave, and Brock said it all very clearly. I'll state the obvious: Based on what you doctor said to you above in the bolded section, it's clear that he doesn't understand TRT. This should give you an indication of what you might choose to do next - look for someone who does.

    I'll just ad that my strategy for speaking with doctors is to simply say that "I'd feel more comfortable doing ______" OR "I don't feel comfortable doing ________" I don't know why but it always seems to make them stop and really listen to my concerns.

    Also, I'd advise you get on hCG right away. If your physician won't write for it or you insurance won't cover it, or it's too expensive by script, you can get it very cheaply overseas. That's where I get mine. About $23 for a 5000iu vial. Lasts for months. Both my doctors are mules about writing for it and I got tired of arguing with them. (Here my strategy didn't work.) PM me if you'd like to know where I get it.

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    BBrock293 is offline New Member
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    Just got a voicemail from my Dr. He said that my level was 1063, up from 458. He said that we are over supplementing and wants me to back down the dose to 1ML every other week. I am wondering why I haven't felt much of a change at all going from 302 to 1063. Anyone have any feedback on this? I am also wondering what questions I need to ask him when I go back in this week. He wants to address the mood swings this week, which I am thinking he is looking at trying Zoloft or something like that, which I want to avoid if I can. I want to be prepared for our next visit. Do I ask about free test or estrogen or anything like that? Thanks!
    Last edited by BBrock293; 01-25-2014 at 01:05 PM.

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    BBrock293 is offline New Member
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    Anyone have any other feedback on the above? Thanks!

  16. #16
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    Drop down to the 1ml (200mg), but dose 50mg every 3.5 days (100mg weekly ). This should give you a nice stable serum level without the ups and downs.

    The reason you don't feel a difference or any better is because you are not dialed in and the ups and downs over the weeks is making it worse.

  17. #17
    BBrock293 is offline New Member
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    Well, looks like I need to find a new Dr. He told me today that my level at 1063 was the same level that someone on anabolic steroids would be at and I was getting way too much T. Dropped me down to 1/2 ML weekly, didn't want to do 1/4 ML twice a week. He doesn't want me to shutdown so he is wanting to air on the side of caution. Frustrating because I was starting to feel much better and lose weight for once.

    He also gave me a copy of my labs, where he was only testing the total T, nothing else!

  18. #18
    Brett N is offline Senior Member
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    That's uneducated to say the least that he would say that. Normal range from Labcorps is Test, serum 348-1197. A blast about me at around 2300 @ 500mg a week. I agree, time to find a new doc.

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