TRT Advice??

[EBuck]

Let me say thanks to whoever put this forum up. And to those of you who have 'been there, done that'.

First off, I am 41 and 5'10" @260lbs. So I know I am overweight. I wasn't always like this, but as time has gone by I have gotten worse.

A year ago I maxxed out at 310lbs and decided that something had to change. At any rate I have been working at dropping the weight, but it is a slow go. It seems that no matter what I do in the gym I can't make any progress.

For the past few years I have been low energy, loss of focus, low libido, and crying at the drop off a hat.

I finally decided to go to the doctor about it and she immediately put me on antidepressants. I think that may have helped hide the facts, but ultimately I just couldn't function and started researching my symptoms myself. When I happened to find an article on hypogonadism and I had a lot of the symptoms, I asked her to do a TEST screen. Initially she didn't think that was my problem. And I just said, hey its a blood test and I'm paying for it, so let's do it to rule it out.

When my results came back she said I had 'somewhat' low TEST numbers, and that we could consider doing some TRT. So she started me on TESTIM. That has been a week ago tomorrow. I decided to drop by the Dr. office yesterday to get my blood test info and that is when I discovered that she didn't do a 'full' work up like you guys are saying.

Pretty much she did a Testosterone , Serum and a PSA screen.

My Number on that are:
Test Serum: 227 range: 241 - 827
PSA 0.8 range: 0.0 - 4.0

Now I know this isn't the whole picture, but I would think that 227 is below the 'normal' range. To me that doesn't signify 'somewhat' low. Also I see no tests on E2 or Free Test, etc.

She did do the Cholesterol and I am low on good, high on bad, high on ratio.

Ultimately I want 2 things out of this. #1 and most important, I want my sex drive back. And #2 and really close to #1, I want this crying shit to stop.

So I have been thinking of going to an endo and just getting her out of the loop. My question is, do you guys think I should do that or continue to try and work w/ my regular doc?

She has been pretty good up till now, but I really don't have the time or effort to educate myself and then educate her. I was hoping that I could 'shop around' for a doc that deals with this on a more regular basis. Unfortunately I don't know any good docs in the Tennessee area. I know I saw a link on some thread that had a list of doctors by state, but I can't find that now. And if any one is in Middle TN and know of someone that is knowledgeable, please help a brother out.

Thanks!

[THORSZ]

I would say you qualify for treatment. You are not even in the range. I am only 2 months ahead of you, but I will tell you treatment improves your mood and sex life. I would call some of the doctors in your area and ask the nurse if the doctor treats TRT and what they use before booking an appointment. Most of the guys here like injections more than gel for many reasons. You might ask if they do injections too just incase you go down that road. I would get a full blood work done and an exam too just to rule anything else out. Hang in there man, you will feel better.

[natureboy]

I would ask the Dr for a refferal to an Endo. She won't be out of the loop, you need someone who deals with this on aregular basis. Who knows about everything to check before putting you on trt. Like other hormones and pitutitary checks. These are things an Endo will look at before puting you on, but that's the way it should be. Good luck.

[EBuck]

Yeah the TESTIM is a gel and I already hate it.

It seems to liquify somewhat when it hits my hand. And then to make matters worse, I don't think I have enough surface area on my body to spread it all...... That stuff just keeps on spreading the more you rub it.

Then there is the 'drying' time before you can finish getting dressed, etc. All in all, I'm not happy with it.

She recommended the patch, but I have allergic reactions to quite a few adhesives. Even bandaids cause my skin to blister if they are left on for more than a few hours.

When looking for a new doctor, should I be specifically looking for an endocrinologist, or would an internal medicine doc work just as well?

I did find the link on the lef.org site for doctors in my area. Unfortunately for me 1 of them I recognized as no longer in business for medicare fraud. It was a big stink around here at the time.

Are there any other links to anti-aging clinics by state? I plan on going thru all of the ones on lef.org, but if there is any other sites out there I could look at it would be helpful.

Thanks again!

[Pac Man]

I hear ya buddy, I stopped taking all anti D's.
I haven't mentioned this yet but I was so depressed that I attempt suicide by taking my entire month and a half prescription anti d's at once. I sent the kids to their friends house, locked the doors, took all the phones apart and cuffed myself to a chair and just waited it out. My wife knew something was wrong, guess intuitively. She came home from work 5 hours early, all I remember is cops busting into the room and being taking out on a gurney. Surprisingly I survived, docs were amazed. Said that since I don't drink, eat healthy and exercise that my liver was able to work in overtime, they were worried about me going into liver failure but everything worked out ok.
The Anti Depressants might help a bit but you can't treat a symptom and hope to solve a problem, sadly allot of Dr's don't see it that way.
I know now that what I did was definitely not the best idea but I wasn't thinking properly. If you ever get to that point just take my word for it, there is hope and things can get better.
Go to an Endo, interview them first and ask if they know about TRT, you don't want a run around for them to tell you you're fine when you know that's not the case. I've only been on TRT a week now and already I feel a little better, not on top of the world yet but there's definitely something going on. I woke up with morning wood yesterday and today.
If she checked your PSA she might be planning on starting you since that needs to be checked prior to starting TRT.
If your insurance is good talk to a life extension doc, they're the best with this stuff.
Good luck


http://www.lef.org/doctors/directoryofdoctors01.htm

--edit--
Missed the testim part, you're already on the right track. Ask to switch if you hate the gel, it's your body you should be able to choose the delivery.

[natureboy]

Yeah I missed the testim part as well. You just need to get your Dr or an Endo that will give you the doseage you need to start to feel normal, again.

[zaggahamma]

welcome
you came to a great place to learn about TRT...you will learn a lot just by reading old posts and you can type in some questions into the search box and find them more directly....
congrats on your weight loss thus far and without any help
yes, she did miss a few tests but at least she didnt try to hide her mistake when she said she doesnt think its the problem...i see your point where you dont want to have to educate her but maybe she is in the minority and will learn from you and give you what you want....i would share your thoughts with her after reading and learning here for a bit and see if she's on board then....dont burn your bridges
so how much testim are you on, 5mg? Have you felt any differnce in the one week?
i feel ya on the cryin.....dude? j/k
best of luck bro

[testy1975]

totally agree with nature boy. go see endo. family prac put me on test with out even figuring out what was wrong. now endo wants me to go of test for 8 weeks. this sucks very tired no gym. to figur out whats causing my low test.

[Mikata]

I agree with jpkman, I did the samething with my doctor. Started out with androgel which didn't do a thing for me. Talked to my doctor about what I had read and learned here (dosage, frequency etc....) and ended up doing injections and adjusting it to a dosage that has really helped to eliminate the symptoms that made me go to the doctors in the first place.

[EBuck]

.i would share your thoughts with her after reading and learning here for a bit and see if she's on board then....dont burn your bridges
so how much testim are you on, 5mg? Have you felt any differnce in the one week?
i feel ya on the cryin.....dude? j/k
best of luck bro

Yeah she is a friend of my wife, won't burn the bridge.

The TESTIM is a sample pack that she gave me. It says 50mg testosterone per 5g tube.

I think there has been something maybe, my sex drive is still dead, but I noticed the other day that my muscles just felt tight. That is not a usual feeling for me.

[FullMoonHowlingWolf]

IMO an endo would probably be the best choice, but you don't want to burn any bridges with your current doc like jpkman mentioned. If you can work with your current doc that's great, but a doc that deals with these types of issues all the time will better serve you in the long run. You just need to find the right doc. Shop around, you are the customer and it's your body. I hope you feel better soon. Think positive b/c the mind is very powerful!

[EBuck]

I called one of the LEF 'recommended' facilities today.

I know they aren't recommended per se, but you know what I mean.

They said they are doing HRT/TRT using bio-identical hormone pellets. That was new and not something I had heard about.

Apparently they start you off w/ anywhere from 6-12 pellets placed under the skin. They are time release and since they are bio-identical it gets metabolized by the body like normal TEST. Also since they are time release you can go 4-6 months per treatment.

That sounds almost to good to be true, and I'm a bit leary of it because of it. I have seen a few sites out there that talk about how good it is for women, do any of you guys have any experience with the pellets?

[zaggahamma]

heard of em but like the good ole fahioned syringe

[FullMoonHowlingWolf]

heard of em but like the good ole fahioned syringe

Ditto that!

[THORSZ]

Hey buddy,

If you want off the gel come in with a good reason. I blamed it all on the wife and kids. It did make my wife a little nervous after reading the package insert about skin contact and all, but i really played it up. Some of these docs are really against injections because of the whole steriod thing. Good luck!

[FullMoonHowlingWolf]

Thorsz is correct; my doc wanted me to do gel or a patch. I simply told her I would like injections. Your epidermis is your first line of defense and the needle bypasses that and goes straight to the muscle. Sometimes old fashion is best. Anyway you can exaggerate things or just tell your doc straight up, depends on your relationship, but always remember the doc works for you. Too many people just go with whatever a doc says and what's interesting is so many docs have different opinions on the same thing; it kind of makes you wonder.

[Ntpadude]

I would say you qualify for treatment. You are not even in the range. I am only 2 months ahead of you, but I will tell you treatment improves your mood and sex life. I would call some of the doctors in your area and ask the nurse if the doctor treats TRT and what they use before booking an appointment. Most of the guys here like injections more than gel for many reasons. You might ask if they do injections too just incase you go down that road. I would get a full blood work done and an exam too just to rule anything else out. Hang in there man, you will feel better.

The AndroGel isnt exactly ineffective. I had cholesterol level of 230, triglicerides of 360 (off the charts high), 25% body fat.. and low testosterone in the neighborhood of 225 back in March...

I just got a blood test checking up the progress of Androgel. Well it was one of the best blood tests I ever had. Cholesterol now is waaay down to like 169, triglicerides waaay down to 120, HDL of excellent 49, and blood testosterone was 930 with 199 FREE testosterone. Doctor said my cholesterol and triglicerides levels was the biggest 4 month turn around she had ever seen in her professional career, but they also put me on synthroid as well so testosterone and synthroid probably worked together to bring the numbers down. Also I lost fat weight BIG and at around 9% body fat, even abs showing up and all this with absolutely no change in diet, exercise about the same as it ever was... in fact probably a little less exercise because knee bursitus keeping me off my feet.

[zaggahamma]

The AndroGel isnt exactly ineffective. I had cholesterol level of 230, triglicerides of 360 (off the charts high), 25% body fat.. and low testosterone in the neighborhood of 225 back in March...

I just got a blood test checking up the progress of Androgel. Well it was one of the best blood tests I ever had. Cholesterol now is waaay down to like 169, triglicerides waaay down to 120, HDL of excellent 49, and blood testosterone was 930 with 199 FREE testosterone. Doctor said my cholesterol and triglicerides levels was the biggest 4 month turn around she had ever seen in her professional career, but they also put me on synthroid as well so testosterone and synthroid probably worked together to bring the numbers down. Also I lost fat weight BIG and at around 9% body fat, even abs showing up and all this with absolutely no change in diet, exercise about the same as it ever was... in fact probably a little less exercise because knee bursitus keeping me off my feet.

yes...we usually dont rule out androgel/testim...it just becomes a hassle and its easier for injectioins and you could have gotten the same results with the injections as the gel, no?
the synthroid addition is very interesting and those are REMARKABLE changes...how many mg ED of gel is this based on?

[EBuck]

So I spoke w/ the doc again yesterday evening. My doc's office has 3 docs in it, so I ended up speaking w/ a male this time.

He switched me to androgel .....

He said I needed to get a B12 shot. It was low so I'm not entirely against that.

And said if the androgel is not working that we could switch to injections every 3wks..... When I told him about the crashes that everyone seems to experience on injections that far apart, he said he had never heard of that. And that he had several people on it.

When I asked for a reference to a good endo, he beat around the bush and said the endo would cost me a lot more money. But with the rate I'm going there, I'm not so sure..... The female doc is on vacation .

So at this point, I am just going start looking for a doctor that seems to have a clue at least.

[zaggahamma]

So I spoke w/ the doc again yesterday evening. My doc's office has 3 docs in it, so I ended up speaking w/ a male this time.

He switched me to androgel .....

He said I needed to get a B12 shot. It was low so I'm not entirely against that.

And said if the androgel is not working that we could switch to injections every 3wks..... When I told him about the crashes that everyone seems to experience on injections that far apart, he said he had never heard of that. And that he had several people on it.

When I asked for a reference to a good endo, he beat around the bush and said the endo would cost me a lot more money. But with the rate I'm going there, I'm not so sure..... The female doc is on vacation .

So at this point, I am just going start looking for a doctor that seems to have a clue at least.

well maybe he wants your business...tell him to put up or shut up....not up to him if you go to an endo....do you need a reference under your insurance to go to a specialist? i wouldnt think he could deny you on greed alone...it's like a political/medical ethical situation but maybe he can be persuaded to give you an appropriate dose....unfortunate that the one that should be the educator needs a push but so be it...play him first ...show him some facts...the proof is in the freakin inserts of the medicine

[FullMoonHowlingWolf]

well maybe he wants your business...tell him to put up or shut up....not up to him if you go to an endo....do you need a reference under your insurance to go to a specialist? i wouldnt think he could deny you on greed alone...it's like a political/medical ethical situation but maybe he can be persuaded to give you an appropriate dose....unfortunate that the one that should be the educator needs a push but so be it...play him first ...show him some facts...the proof is in the freakin inserts of the medicine

Well said jpkman! People need to keep in mind that they are the paying customer and docs are a dime a dozen, with so many different opinions. Without the white coat he's just another man or woman.

[Ntpadude]

yes...we usually dont rule out androgel /testim...it just becomes a hassle and its easier for injectioins and you could have gotten the same results with the injections as the gel, no?
the synthroid addition is very interesting and those are REMARKABLE changes...how many mg ED of gel is this based on?

Well I had been on the injections for 6 years and took about 4 months off (without talking to doctor about it first). The scar tissue built up over time and made injecting difficult. I had my period a few years ago of supplementing my TRT with underground test and deca , etc... got big but during the 4 months off everything... IN addition to difficulty poking either glutes or quads anymore, I started getting to where if I pinched my nipples, they'd leak fluid. It took most of that 4 months OFF and being on nolva most of the time to get the nipples to stop lactating.

Finally went back to doctor and requalified for TRT and wanted to try the Androgel for a change. It seemed to work much better for me because it got the testosterone back to where I could at least have sex again 2 or 3 times a week (hey at 43 yrs thats pretty good in a 10 yr relationship). BTW, I also apply rubbing alcohol to the androgel "white crust" and this is supposed to increase absorption. I apply mind to my abs and since I work at home it seems just fine, I can hang around a couple hours shirtless around the house and computer work. So far 5 months on Androgel and no more lactating nipples so that seems better right there.

As for the change in lipids. I think the synthroid helped. I had been over 200 in my cholsterol for a most of the last 6 yeras on the shots. I am almost amazed at the turn around in lipids. Here is the catch. I said there was no change in my diet, but I forgot one thing. Well I am kind of no longer cheating with TRT and taking more testosterone then I need, but weird when I took 4 months off of the shots to get nips down, my cholesterol climbed even higher. Well anyways, since going on androgel I have laid off the everyday or several times a day protein shakes. Now I only take a protein shake after my 2 times a week workout, this is reduced because I cant work out legs with the knee bursitus. I think laying off the protein shakes had a lot to do with dropping the cholesterol.

I also had liver emzymes thru the roof after those 4 months on Nolva... I dont drink alcohol and never had liver emzymes before but since being on the androgel the emzymes are all back to normal now. I suspect some of my past underground test had some methyl-something in it and I didnt know it. How do the underground steroid guys know what they think is testosterone Enanthate isnt really dianabol enanthate or something like that which can zap the liver some?

[EBuck]

Just thought I would give an update.

I decided to give the pellets a try. I went last Friday for my blood workup and will be going Friday for the consultation/implantation with the doctor.

I spoke with this doctor about the pellets already and apparently they have been around since the 40s but had fallen out of style in favor of the injections.

This doctor did say they were planning on getting me up to the 800 area on the scale. Considering the scale tops out at 827, I'm thinking that might be a good thing. (I realize this is probably an age bracket).

I did contact another doctor that also does this and he uses injections. I figure I will give the pellets a run and see how they work. If they aren't working to my satisfaction, I will ask this doctor about trying injections and if the doc refuses, I will just switch doctors.

Ultimately I want something w/o the hassle. The pellets are slow release and are only added every 4-6 months. I like that better than giving myself a shot once a week.

If anyone is interested, I will be back here next week with an update on how the pellets are going.

[THORSZ]

E-Buck,

Please do give an update. I don't know anyone on the pellets and I am curious. Good luck!

[zaggahamma]

yes...good luck and keep us posted...i saw a few posts about pellets and i believe they worked....definately keep the post going...we're subscribed so hear from you in a week

[EBuck]

Well I have the pellets in.

They numb the area they put them in, so it really wasn't a big deal. I had a bruise about the size of my hand on my hip/quad area. But that was gone this morning.

The pellets are 200mg each and I had 10 implanted. The doctor said that her test levels were usually higher than mine. She was originally going to add 11 but decided to play it cautiously.

I will say it is more sore today, and you aren't allowed to lift anything above 50lbs for the week after. For some that will be a big deal, but considering it is is every 4-6 months for an implant, it could be scheduled when you were taking a week off for recovery.

The pellets are $50 each and the implant fee was $200, and of course the doctor's consultation fee. So $900 for this visit. But she said if she had to add more she wouldn't charge me the implant fee again. Just the cost of the pellets.

The doc said I would be 'peaking' about 5-6 weeks and should remain at that level for the duration, and start coming down in about 5.5 months. She said I would know when it was time to come back. Oh and she said that she wants my levels to be between 1000-1500.

Anyway next week I am going to join a real gym. Screw this trying to work out at work's gym.

Are there any recommended workouts for old farts that anyone can point me to?

[THORSZ]

Good for you. I hope you start feeling good soon. Curious how they do the implant. Is it just injected in or over the muscle or do they make an incision?
As far as working out for old guys. You are my age and that isn't old. One thing I will say is that test makes it much more interesting. Keep the update coming.

[EBuck]

They make an incision and use a trocar to implant them below the skin in the fat.

They try not to get it in the muscle.

Still a little sore this evening. I am hoping that tomorrow will be better.

[EBuck]

Well it's been a week.

So far I am starting to notice a difference in my focus. I don't think I am where I want to be, but my doctor did say it would be up to 5-6 weeks before I got that youthful feeling back.

I found a local gym that is $15/month. Not a bad price and they are open 24hrs.

They have a couple of PTs that can get me set up on a workout program. I just to figure out when is the best time for me to get in there. I am thinking early in the morning because I just really don't have time otherwise.

[THORSZ]

Good for you. That is a great price for a gym too. When does your doc want you to test your levels again?

[EBuck]

She said 5-6 weeks to do a follow up blood test.

Focus seems to be getting better every day. And I noticed that I had joint pain in my left shoulder that is all but gone now.

The wife is starting to like it as well.

She is afraid that my son and I are going to be butting heads soon. She said she doesn't want the rage back that I had when I was younger. I tried to explain that I am a lot more mature now, so while I may get angry, I am pretty sure I can control it.

[THORSZ]

That is good. I have lost some nagging aches too. How are the workouts going? I wouldn't worry so much about rage. I think it is more a myth than anything and HRT is no where near what guys do on a cycle. If anything, I actually feel more at ease.

[FullMoonHowlingWolf]

She said 5-6 weeks to do a follow up blood test.

Focus seems to be getting better every day. And I noticed that I had joint pain in my left shoulder that is all but gone now.

The wife is starting to like it as well.

She is afraid that my son and I are going to be butting heads soon. She said she doesn't want the rage back that I had when I was younger. I tried to explain that I am a lot more mature now, so while I may get angry, I am pretty sure I can control it.

You can reassure your wife because a lot of anger issues are due to immaturity and as you get older you learn to control your temper.

[FullMoonHowlingWolf]

That is good. I have lost some nagging aches too. How are the workouts going? I wouldn't worry so much about rage. I think it is more a myth than anything and HRT is no where near what guys do on a cycle. If anything, I actually feel more at ease.

Also, as Thorsz states you are doing hormone replacement dosages, which should normalize your mood. Even at cycle dosages, which can cause one to be moody, losing your temper is still a choice. One that's not worth making b/c no one wins when this occurs!

[zaggahamma]

i hate the term roid rage

[FallenWyvern]

TRT leveled my mood swings and I am much calmer now. I don't even know if roid rage is real. Women take birth control pills all the time, they are powerful hormones that can mess with a woman's moods worse than TRT. Go figure.

The pellets sound expensive and hassle.

Why not just inject "bio-identical" testosterone cypionate once a week? Less invasive and cheaper.

[zaggahamma]

TRT leveled my mood swings and I am much calmer now. I don't even know if roid rage is real. Women take birth control pills all the time, they are powerful hormones that can mess with a woman's moods worse than TRT. Go figure.

The pellets sound expensive and hassle.

Why not just inject "bio-identical" testosterone cypionate once a week? Less invasive and cheaper.

is this the "bio-identical" test thread? LOL

fallen, did you think of an avy 4 me yet? u want a shot of my bi or a girl with heaving breast?

[THORSZ]

is this the "bio-identical" test thread? LOL

fallen, did you think of an avy 4 me yet? u want a shot of my bi or a girl with heaving breast?

I vote for heaving breast, altough Fallen's avy distracts me...

[FallenWyvern]

is this the "bio-identical" test thread? LOL

fallen, did you think of an avy 4 me yet? u want a shot of my bi or a girl with heaving breast?

Duh, breast...

[zaggahamma]

she just left....so heaving breast will have to wait