TRT has become cost prohibitive, please advise

**nwjt** · 01-13-2016, 09:02 PM

Ive been on TRT for 5 years.
200 mg of cyp per week
The AI is off and on.
My reb blood count runs high so I donate blood.

Part 1:

My insurance usually covers 100% of the cost and my self injections are $25 per vile. because of this, I think this provider was racking in the $$
I recently switched jobs and a new insurance company. They denied the claim.

I now owe over $800 for one visit.

Is this what it cost you guys? This provider likes to see me 4 times a year. I *may* be able to get it down to 2 times a year. However its still cost prohibitive. They run all kinds of test on me, a dozen at least in each visit. Is this normal?

Interesting the same insurance company covers the test, though its $60 a vile now.

Please advise as to the costs, NO PMs with offers plz. I want to know if I go to a normal doctor if it will be cheaper, and I have one that will take me on. There are several trt clinics in my area so I could call around.

If that is the cost so be it.

Part 2:
I've been taking 200 mg per month for a couple months now. Its been 5 weeks since my last injection, is the TRT out of my system now?
Ive used HCG some but its been a couple years.
My testicles seem to be getting bigger, and my strength is down but still way higher than before TRT. I feel like crap BUT Ive been sick with 3 things in a row, lots going around here so I cant tell.

Sex drive is low but I can still go with proper motivation.

SHould I start some PCT? I could probably get a doc to help me with that.

BTW my original test score was 294. I am not sure I should have been on trt, I was 32 when I started. I just didnt know better

My original test:

Total: 294 (range 285-950)
Free: 68 (range 50-247)
% Free: 2.3
Sex binding globulin: 21 (10-24)

Thyroid:
Free T4: .9 (.6-1.5)
Free T3: 2.9 (2.5-3.9)
TSH: 2.51 (.5-5)

Estradiol TMS: 3.4 (range is 10-42)

**kelkel** · 01-13-2016, 09:25 PM

That's a whole lot to respond to! I'll be brief.

200 mgs per week is high end TRT. Where were your levels on this? Particularly free T?
Lowering your dose would assist with your RBC's.
Why an AI "off and on."

What do you mean, "self injections are $25 per vial?"
What was done in one visit to cost you $800?
Four times per year is ridiculous unless there's an underlying problem. Twice is pretty much normal.
$60 per vial is not horrible. Costco I believe is around $40.

Call your insurance and see exactly what they will cover move forward with that in mind. I would almost always prefer a normal doctor who can take care of all of your needs, including TRT. If that's not possible then a reputable clinic. And they are out there.

When it comes to taking 200 per month and nothing for the past 5 weeks. See the chart below:

HCG should be used consistently for best results and be a part of a healthy TRT protocol if at all possible.
You feel like crap due to having low T.
Sex drive is more than just testosterone , but eventually such a low T level will catch up to you.

After being on TRT for 5 years I strongly doubt a restart is possible.
Way too many people are put on TRT unnecessarily.

**nwjt** · 01-13-2016, 09:38 PM

Ill have to check old records on the 200 mg per week. I know I was in the 700s usually, somtimes my E2 woudl go higher as my body fat increased.
Self injections: $25 per vile which is the standard 10ml bottle, now its $60

Honestly, my usage has been very spurratic, not uncommon for me to go 3 weeks without a shot.
I am sitting on 16 viles now due to stocking it up when not using my recommended dose because I know its high.
If I took 100 mg per week, I have enough for 3 more years. But I will end up in the same boat after 3 years.

$800, man they ran so many tests on me, I'd take an hour to type them out.

So what you are saying with that chart is the test cyp. is out of my system in 10 days? Wierd it takes 3 weeks for me to start losing the affects.

I would say on average I have been taking 200 mg every 2-3 weeks. My prescription is 200 mg per week, I didnt make that clear. sorry.

My RBC runs high also due to my sleep apnea, which was caused by my trt.

Unfortunately at 38, I am in the middle of life with 3 kids and while fitness and diet are important, they get out of whack. This is why my BF % fluctuates which then affects my E2.

I agree, I am thinking though if I can be back to my 294 test level I can live with that.

Just to be clear, after 5 weeks, I should have 0 test in me? Or is my body still making some because I still get a morning erection.

So 2 times a year, and what is the cost I should be looking for for the BW itself?

My PCP will be taking it over but I may have her try me on some PCT, Clomid?

**kelkel** · 01-13-2016, 09:56 PM

Originally Posted by nwjt

Ill have to check old records on the 200 mg per week. I know I was in the 700s usually, somtimes my E2 woudl go higher as my body fat increased.
Self injections: $25 per vile which is the standard 10ml bottle, now its $60

Honestly, my usage has been very spurratic, not uncommon for me to go 3 weeks without a shot. Why?
I am sitting on 16 viles now due to stocking it up when not using my recommended dose because I know its high. Yes. Very few need that much.
If I took 100 mg per week, I have enough for 3 more years. But I will end up in the same boat True. A good doc's care is always best. But if that's not an option there are private labs for BW that are very cheap compared to how you were treated.

$800, man the ran so many tests on me, I'd take an hour to type them out. That's what I figured

So what you are saying with that chat is the test cyp. is out of my system in 10 days? Wierd it takes 3 weeks for me to start losing the affect. That graph is based on a 200 mg shot. So basically yes. Test has about a 5-7 day half life, metabolism dependent. Caveat is people metabolize differently and levels can build up similar to guys who cycle.

I would say on average I have been taking 200 mg every 2-3 weeks. My prescription is 200 mg per week, I didnt make that clear. sorry.

My RBC runs high also due to my sleep apnea, which was caused by my trt. Also due to your dose.

Unfortunately at 38, I am in the middle of life with 3 kids and while fitness and diet are important, they get out of whack. This is why my BF % fluctuates which then affects my E2. That's understandable. Find a way to be consistent as your health is important not just to you but to your family as well. E2 fluctuations are normal.

I agree, I am thinking though if I can be back to my 294 test level I can live with that I would say it's a road to unhappiness

Just to be clear, after 5 weeks, I should have 0 test in me? Or is my body still making some because I still get a morning erection Pretty close, yes. Erections are not based solely on testosterone.

So 2 times a year, and what is the cost I should be looking for for the BW itself? a Take a look at Private md labs and also Discounted labs to get an idea.

My PCP will be taking it over but I may have her try me on some PCT, Clomid? Clomid is a viable form of TRT assuming your pituitary responds to it. I'd be curious to hear how you make out.

Bold above.

**nwjt** · 01-13-2016, 10:11 PM

The reason for spurratic usage is due to life events, sometimes 2 weeks go by and I realize I forgot to inject. Also I do not like injecting and sometimes would procrastinate.
I would like to think my dose caused sleep apnea but should it not go away after I am off TRT? I would think after 5 weeks it would go away but I am ignorant on that.

Let me put it this way, if $200 per month is out of my range, am I screwed?

**kelkel** · 01-14-2016, 08:52 AM

Not screwed. Go to a local doctor for care. Even if you buy the test yourself at Costco for say, $40 per bottle. Inject 100 mgs per week and it will last 20 weeks.

**nwjt** · 01-14-2016, 10:51 PM

I went ahead and injected 100 mg today, the symptoms were horrible. My knees kept giving out and I was dizzy, had a headache, nasua and leg cramps.
I feel like I am going through withdrawal. No sex drive at all, constantly thirsty. Thought I had a blood sugar issue but it checked out fine (I am not diabetic though it runs in my family).

I will go to a real doc and get some clomid or order it from ***. Cold turkey wont cut it.

I did call my insurance company today, they are still reviewing the claim so it could turn out ok. But I expect the bill to be over $500, the office visit alone was $200!

Thanks for all the advice.

**Simon1972** · 01-15-2016, 02:31 AM

Where are you injecting, that would cause you so much anxiety?
If your not already doing so, consider subcutaneous or test creams.

**PersuAsian** · 01-15-2016, 10:27 AM

I would go to a regular doctor. I found mine by calling a compounding pharmacy and asking for doctors that prescribed testosterone and hcg as I wanted that in my protocol when I finally made the switch to TRT. They gave me a list. I googled all of them and read reviews. Made an appointment and it has been great ever since. $20 copay every three months for a visit. My insurance hasn't approved my T prescription yet, but I bought my first two months of Test Cyp at CVS for $50. It should have been less with my GoodRx coupon, but the lady that checked me out said I couldn't use it. I called another CVS and they said it was fine so next month if my insurance still hasn't approved I will go there and pay $28 for the same two month supply. You can get HCG cheap online. I pay less than $20 for a 10 week supply. Even if my insurance never covers this I'll be fine.

One thing that I would say is that you need to commit to the protocol if you are going to do it. No skipping shots. Your body chemistry has to be all over the place with the inconsistency of the dosing. I pin every 3.5 days SQ with a 27 gauge .5" needle. It tickles that's about it. Totally painless. Good luck mang.

**2Sox** · 01-15-2016, 10:48 AM

^^^I agree with Simon. It's an alternative you may want to consider. And Kel's advice in post number 4 is golden. Take it seriously.

Also, It seems to me from what you write that you lack a certain seriousness about your own health. If you were serious, you wouldn't miss you doses of T. You're being irresponsible with your own health and you only hurt yourself by doing this. Without consistency of treatment, it's impossible to come to any scientific conclusions about how you are feeling and how to make a treatment plan. It's just hit and miss.

Regarding the reaction you had to your 100mg shot of T. First are you absolutely sure you measured your dose correctly? These types of reactions usually only occurs when people are given megadoses of T - which has not been unheard of on this forum. It happened to me before I learned better. Otherwise, I'd say this may have other causes. Think about what else you were putting into your body at this time. And by the way, testosterone doesn't cause sleep apnea. Otherwise, every man in the world would be sleep deprived.

I'd suggest you start thinking of testosterone as a natural substance your body produces and for some reason you now have to help your body by supplying it yourself through outside means. If you feel like shit, it's because you don't have enough of it freely circulating in your body. And to "live with it" at a level of 294, as Kel said above, "It's a road to unhappiness". It's a choice between "living" or "thriving". You make the choice. I pretty sure I know what any other sensible person would choose.

My advice is consistent with Kel's. Get a regular urologist; repeat - a urologist who does TRT. Bring your past blood work. Pay your co-pays and have none of this bullshit of $800 a visit at a "Park Avenue' practitioner. Get a script for T cyp. Go to Goodrx.com and get a coupon (You can get an app on your smartphone and just show the phone to the pharmacist). Bring it to Walgreens, CVS, Rite Aid etc and pay for it in cash. NOT through your insurance company. At Walgreens a vial costs about $43.

Don't make things complex and overthink. It's as easy as you want to make it.

**nwjt** · 01-15-2016, 04:16 PM

Everything you say here is good, except sleep apnea. It is a well noted side effect due to the swelling of tissues due to water uptake in the tissues. It happens at higher doses but can also happen on low doses.
Not every man is going to have all of the side effects. I dont get gyno or puffy nipples, I used to get acne but that stopped.

Also, I use .5CC which is 100 mg. I do feel better but not 100% by far, I may of exaggerated my recovery. I feel better but certainly not going to be going to the gym tonight. I woke up this AM with some energy instead of getting out of bed and nearly having my legs collapse on me.

Im also going to check out the cost, are you saying you get the test for $50 without insurance??

I used to use walgreens but they acted like I was using steroids and what I was being prescribed was somehow illegal. They also never had it in stock. I will try CVS.

Originally Posted by 2Sox

^^^I agree with Simon. It's an alternative you may want to consider. And Kel's advice in post number 4 is golden. Take it seriously.

Also, It seems to me from what you write that you lack a certain seriousness about your own health. If you were serious, you wouldn't miss you doses of T. You're being irresponsible with your own health and you only hurt yourself by doing this. Without consistency of treatment, it's impossible to come to any scientific conclusions about how you are feeling and how to make a treatment plan. It's just hit and miss.

Regarding the reaction you had to your 100mg shot of T. First are you absolutely sure you measured your dose correctly? These types of reactions usually only occurs when people are given megadoses of T - which has not been unheard of on this forum. It happened to me before I learned better. Otherwise, I'd say this may have other causes. Think about what else you were putting into your body at this time. And by the way, testosterone doesn't cause sleep apnea. Otherwise, every man in the world would be sleep deprived.

I'd suggest you start thinking of testosterone as a natural substance your body produces and for some reason you now have to help your body by supplying it yourself through outside means. If you feel like shit, it's because you don't have enough of it freely circulating in your body. And to "live with it" at a level of 294, as Kel said above, "It's a road to unhappiness". It's a choice between "living" or "thriving". You make the choice. I pretty sure I know what any other sensible person would choose.

My advice is consistent with Kel's. Get a regular urologist; repeat - a urologist who does TRT. Bring your past blood work. Pay your co-pays and have none of this bullshit of $800 a visit at a "Park Avenue' practitioner. Get a script for T cyp. Go to Goodrx.com and get a coupon (You can get an app on your smartphone and just show the phone to the pharmacist). Bring it to Walgreens, CVS, Rite Aid etc and pay for it in cash. NOT through your insurance company. At Walgreens a vial costs about $43.

Don't make things complex and overthink. It's as easy as you want to make it.

**2Sox** · 01-15-2016, 04:37 PM

^^^^As I said, if testosterone caused sleep apnea, every man in the world would be sleep deprived.
If you have data to prove otherwise, please present it here for consideration.

The relationship between sleep disorders and testosterone in men. - PubMed - NCBI

And yes, I am saying exactly this. Take that coupon which you can print or bring in on your smartphone, hand the script to the Walgreens pharmacist, and get your 10mL vial for about $43 - without insurance. Don't make a very simple thing complex.

**Chauffeur** · 01-15-2016, 05:23 PM

Originally Posted by 2Sox

^^^^As I said, if testosterone caused sleep apnea, every man in the world would be sleep deprived.
If you have data to prove otherwise, please present it here for consideration.

The relationship between sleep disorders and testosterone in men. - PubMed - NCBI

And yes, I am saying exactly this. Take that coupon which you can print or bring in on your smartphone, hand the script to the Walgreens pharmacist, and get your 10mL vial for about $43 - without insurance. Don't make a very simple thing complex.

Just adding my anecdotal two cents...

I had 2 sleep studies done prior to TRT, both of which concluded that I did not have sleep apnea.

After ~16 weeks on TRT (and a whole lot of sleepless nights for my wife due to my newfound snoring) a third sleep study showed that I had developed moderate sleep apnea.

**bullshark99** · 01-15-2016, 05:23 PM

GoodRx I have been using this cupon for the last 6 months, 44 dollars 10ml 200mg Cyp at Walgreens, no insurance pay out of pocket!

**2Sox** · 01-15-2016, 09:18 PM

Originally Posted by Chauffeur

Just adding my anecdotal two cents...

I had 2 sleep studies done prior to TRT, both of which concluded that I did not have sleep apnea.

After ~16 weeks on TRT (and a whole lot of sleepless nights for my wife due to my newfound snoring) a third sleep study showed that I had developed moderate sleep apnea.

I certainly hope you've taken care of it. Interesting story I have no doubt is true - although lacking in scientific evidence to prove the connection between the two. Kind of like the guy who lost all that weight by just eating Subway sandwiches. True he lost the weight, but what other factors were involved. Or was it really his exclusive diet of Subway sandwiches that caused it and nothing else?

**Simon1972** · 01-15-2016, 09:48 PM

i think you have alot more to worry about by not having your hormones sorted out over sleep apnea. If you want both sorted, do what i did and get UPPP surgery. Google it.

takes 1.5 weeks to recover.

**Jbolt62** · 01-15-2016, 10:57 PM

I had bad sleep apnea before I started TRT, it's gotten much better since I started.
I still sleep with a bipap machine, but have been able to lower the pressure a lot .

**Chauffeur** · 01-16-2016, 03:00 AM

Originally Posted by 2Sox

I certainly hope you've taken care of it. Interesting story I have no doubt is true - although lacking in scientific evidence to prove the connection between the two. Kind of like the guy who lost all that weight by just eating Subway sandwiches. True he lost the weight, but what other factors were involved. Or was it really his exclusive diet of Subway sandwiches that caused it and nothing else?

Absolutely. A CPAP machine fixed my apnea without issue. I sleep much better now...and so does my wife. In my case, I'm not aware of any other factors that could have contributed to it. I've always been a lean/slim guy who eats well, stays active, etc. None of that changed around the time of my diagnosis.

My sleep schedule on the other hand, has been a train wreck for many years due to my occupation. But the first 2 sleep studies still concluded that all was well.

I agree with you that the research based link between TRT and OSA is pretty weak at this point. However, I've seen quite a few anecdotal reports from TRT patients (and those cycling testosterone ) across the internet who claim to have developed sleep apnea shortly after their treatment began. Enough for me to at least entertain the notion that it may be a risk/side effect on exogenous testosterone administration in some men.

**JimR** · 01-16-2016, 08:31 AM

Florida must be different because I have not found 10ml vials anywhere for less than $100 and I've been doing this for over 5 years. Only place I haven't checked is Costco but Walgreens and CVS are both over $100

**2Sox** · 01-16-2016, 08:51 AM

Originally Posted by JimR

Florida must be different because I have not found 10ml vials anywhere for less than $100 and I've been doing this for over 5 years. Only place I haven't checked is Costco but Walgreens and CVS are both over $100

From my knowledge all Walgreens are the same, sharing the same electronic record system. The same applies to any national drug chain. The coupon should work in any one of them.

**Beethoven** · 01-18-2016, 04:13 PM

Originally Posted by 2Sox

From my knowledge all Walgreens are the same, sharing the same electronic record system. The same applies to any national drug chain. The coupon should work in any one of them.

Just got my bottle of test at Walgreens. Have always used goodrx coupon, then got the app on my phone. This last time it was automatic on their part. They had the updated price and didn't require me to flash the coupon. This is here in Florida.

**CobraMustangSVT** · 01-19-2016, 06:45 PM

Originally Posted by Chauffeur

Just adding my anecdotal two cents...

I had 2 sleep studies done prior to TRT, both of which concluded that I did not have sleep apnea.

After ~16 weeks on TRT (and a whole lot of sleepless nights for my wife due to my newfound snoring) a third sleep study showed that I had developed moderate sleep apnea.

Same thing happened to me. After a few months, I had to get on a CPAP

**nwjt** · 01-19-2016, 11:26 PM

After some research, I realized since I am veteran with a 10% service related disability I can get free health care through the VA. I did some googling and the VA does hand out TRT.
Wile the cost of the drug is cheap, its them damn blood tests.

My current provider (who screwed me) offered me a cash price of $535 per visit, 3 times a year. Hmm.

I get prescribed a $7 bottle of thryoid pills too, and he wants to run a bunch of test for it, obviously a rip off.

I'll up date here what I find out with the VA. Looks like they give 200 mg twice a month but more if you complain later. Ill take it.

I will also see what they can do about my sleep apnea.

Wish me luck!

Either way a new provider may just fix it all up anyways, and it wont be a big deal.