To Clinic or not to Clinic

[black6]

Hi all,

First of all Thank to everyone that post on the forums here. The information here has been very helpful. The reason I join was over the past 1-2 years just havent been feeling right. Seen the Low-T ad and it seemed like it was a fit.

Went to my GP doctor and had a BP done since I have never been sick hardly in the last 10 years, thought I would kill two birds at once. Check normal stuff and T levels.

Results came back and everything was normal, T count was 311. Still within the normal range I was told by my Doctor for a 40 yr. old. Been reading on the forum the reluctance of GP's to really do anything if within the "normal" range.

Plan "B" was to check with an Urologist and see what he had to say. Just got the BP back and it was 420 T, LH was 5.9. I asked about free/bound T and he didnt check it or E2 levels. So everything seemed fine with him and was good to go.

The question here I guess is, (and dont take this the wrong way) if i want to explore TRT should I run with information I have and use a clinic or buy something on my own? The concern I have with the clinic ideal is that they seem like a "candy store" type of establishment.

I have looked into many of them, and read many threads on this board. The fact of being legal is the really only underlining strength. The common results seem to be an overload of meds to make money.

I have not nailed down the cycle I would want to use but, 100mg/wk cyp. and a HCG booster would be the right starting area.

Just a tad more background on me.

age 40
BF% 16.5%
Weight 155
Height 5' 10.5"
Not a big gym person,but do go 2-3 times a week. Mostly strength training.
Diet is normal, not great/not bad.

Goal of this whole process would to get my libido back and feel normal again. Gains in the gym would be a bonus but nothing more.

Thanks in advance with any insight you have as I try to do the right thing for my well-being.

[JohnnyVegas]

I would stick with a local doctor if you can find a good one. I don't think most clinics care one bit about your health. As soon as I get the impression that a "clinic" has me dealing with a salesman I realize their goals are not in line with mine. I have a local doctor that has me on 200mg/week of Test Cyp and HCG . I talked to a clinic because I was hoping to get HCG cheaper. It was like talking to a car salesman. He did everything short of saying "what do I have to do to get you into some steroids today?". He called me back a few times to pester me, and then bugged me for a while for supplements, B-12 shots, etc. That isn't medicine, and it freaked me out.

[black6]

My thoughts exactly. However finding a local doctor with me in a range of 311-420 T, (didnt know there was that much swing in it) I doubt i will find much help. The ideal of dropping 1k and then not trusting them seems pointless. As far as BW goes, seems I could get more target info then the doctors did on me.

I believe I will continue to do more research and go from there.

[zaggahamma]

if it were me with your levels i would work with a clinic if i could...i would want them bumped up toward the upper quadrant

just my .02

[JohnnyVegas]

if it were me with your levels i would work with a clinic if i could...i would want them bumped up toward the upper quadrant

just my .02

Yeah, it might be hard to get help with your levels. Doing your research should make dealing with a clinic less frustrating...or maybe it is awesome to have access to everything. I guess I shouldn't knock it until I have tried it.

[mperk]

Oh yeah been down that path with several docs. They were totally ignorant about trt and knew nothing about test or other drugs. And you level like mine is "low normal" so they won't prescribe anything that isn't sanctioned by the insurance companies. One doc suggested 50 mg once a month as a booster- that would be just enuf to shut me down and go to lower levels! I say go for the clinic or self prescribe. Advantage of the clinic is that you get a script so it's good shit.

[bigbossofdariver]

Oh yeah been down that path with several docs. They were totally ignorant about trt and knew nothing about test or other drugs. And you level like mine is "low normal" so they won't prescribe anything that isn't sanctioned by the insurance companies. One doc suggested 50 mg once a month as a booster- that would be just enuf to shut me down and go to lower levels! I say go for the clinic or self prescribe. Advantage of the clinic is that you get a script so it's good shit.

just i dont even, im speachless. 50mg a month you would have the test levels of a 13 yr old girl.

[APIs]

if it were me with your levels i would work with a clinic if i could...i would want them bumped up toward the upper quadrant

just my .02

x 2. If you go with a clinic at least you'll be under the supervision of a Doctor which is needed IMO, even if it's via telephone. Just be firm with them, as someone in yr situation will likely only need 100 to 150 mgs of Test Cyp/week, HCG , AI (if warranted) & monitoring. IMO, you'd be insane to play Doctor with TRT yourself as it's a life-long commitment. First try & find a local Dr. that is qualified of course. Good luck...

[GotNoBlueMilk]

Just another two cents: With values in "range" it will be hard to find a Doc that will prescribe. Total T of 410 is definately in range. A clinic is going to push to get your numbers in the upper quadrant, so they will give you a script. To avoid legal issues, they will be more willing to let you call the shots, too. If you want HCG wiht your test they will accomodate. If you want only test they will accomodate. The clinic will make recommendations, but they leave the final decision to you. Many doctors will dictate treatement, and you get that or nothing.

Insurance probably won't pay for a clinic, or will consider it 'out-of-network' at best.

[zaggahamma]

Just another two cents: With values in "range" it will be hard to find a Doc that will prescribe. Total T of 410 is definately in range. A clinic is going to push to get your numbers in the upper quadrant, so they will give you a script. To avoid legal issues, they will be more willing to let you call the shots, too. If you want HCG wiht your test they will accomodate. If you want only test they will accomodate. The clinic will make recommendations, but they leave the final decision to you. Many doctors will dictate treatement, and you get that or nothing.

Insurance probably won't pay for a clinic, or will consider it 'out-of-network' at best.

thats the part i just dont understand....what loophole are they taking to be able to prescribe different forms and doses of roids"...

[GotNoBlueMilk]

thats the part i just dont understand....what loophole are they taking to be able to prescribe different forms and doses of roids"...

The legal issues are not legal issues from AMA/FDA. It's legal issues from the patient. If the clinic pushes steroids to patients who have numbers within acceptable ranges, then they need to avoid having the patient turn around and sue the clinic, if something goes bad, based on the claim that the clinic is nothing but a steroid shop. If the patient "chooses" the option and was informed of benefits and risks in advance, the lawyers and insurance companies are happy.

[zaggahamma]

The legal issues are not legal issues from AMA/FDA. It's legal issues from the patient. If the clinic pushes steroids to patients who have numbers within acceptable ranges, then they need to avoid having the patient turn around and sue the clinic, if something goes bad, based on the claim that the clinic is nothing but a steroid shop. If the patient "chooses" the option and was informed of benefits and risks in advance, the lawyers and insurance companies are happy.

i see

[black6]

Well I thought I would post here for some feed back rather then a new thread and see what the thoughts were. I told him i didnt want a candy store laundry list of meds and this is what he sent as a "normal" therapy would include. Noted that its baseline and may change after the BW and meeting with the Dr.

12 weeks of Testosterone Cypionate 210 mg/mL at 1.5 mL per week.

24 Anastrozol 1 mg tablets taken twice per week.

12 Tamoxifen 20 mg tablets 1/2 taken twice per week.

20 Days of HCG 1000 units per day

20 Days of clomiphene 51 mg capsule taken every other day

This is fresh off my desk so I havent researched any of them yet. Maybe I can get some insight from you guys and cross that with the research I do and can come back with more informed question to add to the conversation.

Thanks in advance.

[GotNoBlueMilk]

Well I thought I would post here for some feed back rather then a new thread and see what the thoughts were. I told him i didnt want a candy store laundry list of meds and this is what he sent as a "normal" therapy would include. Noted that its baseline and may change after the BW and meeting with the Dr.

12 weeks of Testosterone Cypionate 210 mg/mL at 1.5 mL per week.

24 Anastrozol 1 mg tablets taken twice per week.

12 Tamoxifen 20 mg tablets 1/2 taken twice per week.

20 Days of HCG 1000 units per day

20 Days of clomiphene 51 mg capsule taken every other day

This is fresh off my desk so I havent researched any of them yet. Maybe I can get some insight from you guys and cross that with the research I do and can come back with more informed question to add to the conversation.

Thanks in advance.

Wow, hope you lift weights, work out, and have a horny sex partner. That is on the upper end of the range for starting out on. But you definately won't waste weeks starting with a low dose an building up. The Anastrozol may be a bit high, so if you get sore joints it could be your E2 is too low. On the other hand, the E2 bounce will be avoided.

[black6]

Wow, hope you lift weights, work out, and have a horny sex partner. That is on the upper end of the range for starting out on. But you definately won't waste weeks starting with a low dose an building up. The Anastrozol may be a bit high, so if you get sore joints it could be your E2 is too low. On the other hand, the E2 bounce will be avoided.

Yeah, after some lite research it seems like 2 of the meds are trying to control E2 levels. Now maybe they have the background to know that it will be an issue. IDK but if the body uses the extra T that is in the body from being somewhat on the low end as a starting point. Also from what I have read that you drop levels of T from constant strength training type of workouts. I will assume that the first run will be kinda of a blanket type of formula, and follow-up meds will be more pin pointed.

As far as the "horny wife", I do. She has dropped extra weight and is all over me. I turned her down acouple weeks ago and thought she was going to have a heart attack. Hence my research and looking into this all together. Moods, size and strength is one thing. It starts screwing up my sex life at 40 and something has to get fixed.

On a side note: looks the the meds will be covered on my insurance. Im just worried about the amounts being too high for a long term type of treatment and looking into long term side effects.

Of the people that have done HRT does this look like that type of treatment or a body building type?

As always Thank You for your knowledgeable feed back and insight

[zaggahamma]

NEVER in my 5 years have i heard of such a protocol for hrt anastrozole, tamox, and clomid....

and agree with the milkster...lots of anastrazole especially before blood work and yes thats a high starting dose for test...

TOO MANY compounds to start with...you wont know what is causing ANY SIDE EFFECTS if they happen to show up

[MJRuff01]

Well I thought I would post here for some feed back rather then a new thread and see what the thoughts were. I told him i didnt want a candy store laundry list of meds and this is what he sent as a "normal" therapy would include. Noted that its baseline and may change after the BW and meeting with the Dr.

12 weeks of Testosterone Cypionate 210 mg/mL at 1.5 mL per week.

24 Anastrozol 1 mg tablets taken twice per week.

12 Tamoxifen 20 mg tablets 1/2 taken twice per week.

20 Days of HCG 1000 units per day

20 Days of clomiphene 51 mg capsule taken every other day

This is fresh off my desk so I havent researched any of them yet. Maybe I can get some insight from you guys and cross that with the research I do and can come back with more informed question to add to the conversation.

Thanks in advance.

That's pretty nuts. Too much anastrozole, no need for the tamoxifen or clomiphene, and too much hcg. 1000 IU's a day?

[black6]

TOO MANY compounds to start with...you wont know what is causing ANY SIDE EFFECTS if they happen to show up

I agree, thanks for the input

[flatscat]

The legal issues are not legal issues from AMA/FDA. It's legal issues from the patient. If the clinic pushes steroids to patients who have numbers within acceptable ranges, then they need to avoid having the patient turn around and sue the clinic, if something goes bad, based on the claim that the clinic is nothing but a steroid shop. If the patient "chooses" the option and was informed of benefits and risks in advance, the lawyers and insurance companies are happy.

My take on this is a little different. While I would say your statement is correct, I believe it has to do with two other things. First, there is a moral question (that is preventing these Family, Uro's and Endo's from doing the right thing) based off of public perception and common ignorances in play. Second, employers and insurance companies do not want to open the flood gates on this treatment (it would cost them billions) - even though the positive health benefits far out way the negatives. When you pay cash to a physician/clinic, these ignorances are wash away with that same green.

Flats

[GotNoBlueMilk]

My take on this is a little different. While I would say your statement is correct, I believe it has to do with two other things. First, there is a moral question (that is preventing these Family, Uro's and Endo's from doing the right thing) based off of public perception and common ignorances in play. Second, employers and insurance companies do not want to open the flood gates on this treatment (it would cost them billions) - even though the positive health benefits far out way the negatives. When you pay cash to a physician/clinic, these ignorances are wash away with that same green.

Flats

Definately another valid issue. Money and stupidity . . . the two biggest obsticles to overcome in moving any society to a better place.

[Karo]

that's not trt, it's a cycle. Big difference. They probably want you on Test for 12 weeks along with the anastrozole for any estrogen issues (which you might not need at all). The hcg , Clomid and Tamoxifen are for your pct which is the period immediatly following the end of your 12-week test cycle.
The problem is if you have low test levels now they will most likely go back to being low once this cycle is over. You'll feel great when you're on the test and you'll feel like shit 6 weeks after you stop.
If you really want to get on a trt program you should see a different clinic. Most start patients out at 100-200mgs of test per week. Once you find your sweet spot you stay there.....forever. You do not come off. You may need a little bit of anastrozole if you start getting estrogen-related side-effects from the test (which is rare at 200mgs/week and less). The need for hcg is arguable. I have lots of it and never use it. You don't need the clomid and tamoxifen for anything. Keep in mind this is all IF you're going to get on trt and stay on it. You have to weigh the risk vs benefit and make an informed decision.
My test levels were a bit lower than yours. I have been on for a while now and cannot envision myself ever getting off of it. If you train, have a good diet and lead a healthy lifestyle the benefits can be substantial and life-changing.
My opinion (if you want it) is that you should scrap this clinic and start with a new one. Feel free to PM me if you want the name of the place I use.

[black6]

that's not trt, it's a cycle. Big difference. They probably want you on Test for 12 weeks along with the anastrozole for any estrogen issues (which you might not need at all). The hcg , Clomid and Tamoxifen are for your pct which is the period immediatly following the end of your 12-week test cycle.
The problem is if you have low test levels now they will most likely go back to being low once this cycle is over. You'll feel great when you're on the test and you'll feel like shit 6 weeks after you stop.
If you really want to get on a trt program you should see a different clinic. Most start patients out at 100-200mgs of test per week. Once you find your sweet spot you stay there.....forever. You do not come off. You may need a little bit of anastrozole if you start getting estrogen-related side-effects from the test (which is rare at 200mgs/week and less). The need for hcg is arguable. I have lots of it and never use it. You don't need the clomid and tamoxifen for anything. Keep in mind this is all IF you're going to get on trt and stay on it. You have to weigh the risk vs benefit and make an informed decision.
My test levels were a bit lower than yours. I have been on for a while now and cannot envision myself ever getting off of it. If you train, have a good diet and lead a healthy lifestyle the benefits can be substantial and life-changing.
My opinion (if you want it) is that you should scrap this clinic and start with a new one. Feel free to PM me if you want the name of the place I use.

Thanks for the info and insight. I do agree that it is too much and anyside effects that are really an issue will be hard to pin down.

One question I have for the community here that is on HRT, is the 100-200mgs of test that your on is that 52 weeks a year? If that is the case do you have any problems with testicular atrophy? Or E2 levels getting out of control? Thats the part im confused on. E2 will only go up if the body can not use the amount of free test that is in the body?

...ok maybe more then one question there,lol

Thanks

...I read alot of info about how these meds interact but there is so much info out there it is taking me longer then i thought to soak it in. So if you have the time to dumb stuff down for it would be great. I feel like Im building a filling case on this stuff when I wish I could just TRUST the doctors for clear and untainted info not being based on the Almighty Dollar. Again TY for all your guys help and and repeated info you have given me.

[JohnnyVegas]

I take 200mg/week every week. I assume forever. After a couple of weeks, my doc put me on HCG for testicular atrophy. I assume he did it in stages just to see how I react to things. That is all I take. He once mentioned he would consider an AI if I had any problems, but he didn't expect them at my dose.

I agree with many above...keep it simple.

[GotNoBlueMilk]

Thanks for the info and insight. I do agree that it is too much and anyside effects that are really an issue will be hard to pin down.

One question I have for the community here that is on HRT, is the 100-200mgs of test that your on is that 52 weeks a year? If that is the case do you have any problems with testicular atrophy? Or E2 levels getting out of control? Thats the part im confused on. E2 will only go up if the body can not use the amount of free test that is in the body?

...ok maybe more then one question there,lol

Thanks

...I read alot of info about how these meds interact but there is so much info out there it is taking me longer then i thought to soak it in. So if you have the time to dumb stuff down for it would be great. I feel like Im building a filling case on this stuff when I wish I could just TRUST the doctors for clear and untainted info not being based on the Almighty Dollar. Again TY for all your guys help and and repeated info you have given me.

Yes, yes and yes.

Most people start somewhere between 100-200 mg Test a week. It is for life unless you decide to try and get off. It is NOT a cycle. Some people have E2 issues and they either drop the amount of Test they take or go on an AI. Nuts will shrink. HCG can prevent this. Usually done 2 times a week, 250 IU each shot. Some people may do 500 IU each shot.

[Karo]

I don't run into any estrogen issues until I go above 300mgs/week. At 200 or less than 200 I never have any. The only thing I ever get is a little bit of pain behind my left nipple. When I get this I take .5mgs of arimidex and then another .5mgs two days later and it disappears after taking just 1mg of arimidex (substitute for anostrozole). It's always good to have anti-estrogen meds on hand in case this situation arises but I can't under why doctors/clinics recommend that patients take it right from the start and throughout their trt program. It just doesn't make any sense.
As for nuts shrinking, yup that definitely happens. It doesn't bother me a whole lot to be honest. I know I can take a few shots of hcg to get them back up normal size. I guess it doesn't bother me enough to take hcg every week to combat it. Beware if you're taking large doses (1000 of above) of hcg also. This can trigger estrogen issues itself.