Hi guys need some help / guidance in East Tennessee

[RSwannabe]

Thanks for looking in here and providing any help you can. I am sorry to not have all my numbers, but I needed to at least start some conversation for my own sanity and guidance. I am reading and learning daily.

I am 35 years old and began TRT about 6 months ago, I'm 6'1 and weighed 225lbs when I started. Things have been hit or miss and I am really contemplating looking for a new Dr.
After going talking with my doctor at an annual physical I mentioned that I was out of ambition to do anything, feel weaker and easily tire, brain fog and focus were gone, and I seemed to be getting flabby around the chest and midsection. He did what I thought was a good blood work up and the only thing that came back off was my Testosterone level, and it was around 260. So my complaints and his thinking line up with the T number being off. SO he prescribed me Fortesta 4 pumps a day (40mg) to start and see where it goes from there.

I was starting to feel some improvements a couple weeks out. But as the weeks passed I was really feeling a difference but it was in the opposite direction. I felt off and asked him to see if my levels were still good. This next check showed levels around 1500 and so he reduced my dosage to 3 pumps daily. This carried on for about 2 months and I went back to him for a face to face follow up. I explained I can see myself getting flabbier and and my mood was diminishing, and I was losing ambition again as well as losing sex drive, morning woods general arousal and erection quality. He tested my T levels again and this time checked the prolactin level. Well prolactin cam back good but my T levels were waaay down at 300.

I've started to watch my calorie intake and quality of calories (1600 / day) and trying to drop some of this fat / flab and have started doing 3 days of Maximum interval training. I was really out of shape physically compared to my younger days. But with this activity level and calorie restriction I am still having a hard time shedding weight. I only lose like a pound a week. I would think I should be losing a little better than that. Now I am at 212lbs

So now back to 4 pumps daily of Fortesta, and waiting to get tested again. It has been 4 weeks since we upped my dosage again, I feel better mentally, but nothing has improved sexually, still no libido, erection quality is poor, general arousal or morning wood is non existent. Since I started this 4 pump dose again I have been on here reading and trying to learn, because I thought I need to help this guy figure out what is wrong with me. I have realized that this is pretty common outcomes for people trying to deal with this through their doctor. I really think he is interested in helping me, but just doesn't know all the right stuff.

I plan on taking the outline of blood work listed on one of the stickies and telling him to run everything listed, and then reporting it back here. And also getting all my previous results to share for some understanding of where I started. I wish I would have researched more before starting, but I didn't know this stuff was so complex and mysterious for doctors to understand.

Please advise me on how to go about handling this next visit with my doctor. Or provide me with your thoughts so I can research them and be better prepared. I also wouldn't mind if any of you had a great doctor in east Tennessee and shared who it is. I'd consider a clinic if my insurance paid for it so this is something I can check into.

Thanks in advance

[lovbyts]

What is your doctors specialty? GP, Endo or ?
Your best bet would be go here. They have one in Nashville.

LowTestosterone.com - Our Clinic Locations

[Rrexy]

First off, I agree with above ^^.
Your best bet would be to get with a Dr. That has more knowledge on the subject. LowTestosterone.com is a great place to look in to.
Second, has your doc been checking your Estrogen levels?
Most of the symptoms you are describing would indicate your E levels could be way out of line..........
More thorough blood work numbers are crucial for getting things figured out.

Best of luck getting "tuned in".

[2Sox]

Prexy has a good point. For some reason transdermal T seems to aromatize very readily. When I was on Androgel , I needed to take an aromatase inhibitor to keep my estrogen under control.

Get your blood work done and talk to your doctor about E2 control. Here's a good primer:

Estrogen, Prolactin, Progesterone Management + Gynecomastia Prevention & Reversal

[Low Testosterone]

We have a physician in Nashville if you're interested. You'd only have to go face-to-face once per year. All blood work could be done locally at LabCorp. I also know of a couple physicians in Knoxville that are pretty good, you didn't mention which part of East TN but I'm guessing Knox or Tri-Cities. Anyway, they're decent, good guys but a little pricy.

[physicslifter]

LT, could you pm me with the name of the guys in Knoxville? I'm trying to find someone here in Knoxville that has a clue about proper TRT who are in my provider network for my insurance...

[RSwannabe]

Thanks for the responses everybody I really appreciate them.

To answer some of the questions raised.

My doctor is a general practice Dr.
Thanks for the link to the clinic in Nashville. I read the material, and I really am interested in them. My only caveat is that I pay an extreme amount out of pocket for my health insurance, which is really pretty good and I would like to use it if at all possible. I think their monthly rate for supervision / scripts and everything they offer is a great value. But to spend $200 out of pocket more a month on top of my $500 I pay for health insurance is a little steep. It may be the route I go since feeling great and performing well is priceless I would at least like to give it a shot through my insurance.

I was reading and my thoughts were estrogen related , but I didn't want to say it without seeing what you guys thought about my situation.

2Sox: Thanks for the link I'll be reading and writing, since I am getting ready for blood work and review in the next week with my Dr.

Low Testosterone : I am just North of Knoxville. The physicians that you know over in my area, do you know if they will do it through insurance? Or are they a stand alone clinic as you are. I am surely not against using you all, but like I said I pay so much for insurance I at least think they should pay to make me well.

[Low Testosterone]

Dr. Andrew Sugantharaj, Knoxville TN. Very easy to talk to, very nice guy. He just became interested in TRT a few years ago and at that point he was a little green IMO but very open minded and eager.

Dr. Tom Rogers, Knoxville TN. Also has clinics in Kingsport and Johnson City. Been doing TRT for several years, nice guy. Probably not as open minded as Dr. S but still a better doctor than what you'll normally find.

[physicslifter]

Dr. Andrew Sugantharaj, Knoxville TN. Very easy to talk to, very nice guy. He just became interested in TRT a few years ago and at that point he was a little green IMO but very open minded and eager.

Dr. Tom Rogers, Knoxville TN. Also has clinics in Kingsport and Johnson City. Been doing TRT for several years, nice guy. Probably not as open minded as Dr. S but still a better doctor than what you'll normally find.

Awesome, Andrew Sugantharaj is in my provider network. Thanks you very much LT, I appreciate the info!

[Viper1111]

Sorry to revive an old post, but I'm wondering if you ever got in touch with Dr. Sugantharaj. I'm looking for a new doctor.

Any feedback you can provide?