Finding a TRT Physician

[Vettester]

I wonder why all Eurologists dont have all this knowledge about TRT , isnt part of their specialty?
While ago I was trying to get info from this doctor at Kaiser and he had no clue..

Kaiser isn't up to speed at this point, but my GP has actually got a little better, and has had willingness to learn a few things from my protocol, which I go to a clinic outside of Kaiser. Avoid their Endo in Fontana at all costs!

[tdh96]

THANKS FOR THE INFO. YOU'VE BEEN A REALLY BIG HELP. JUST WANTED TO LET YOU KNOW I'M FOLLOWING YOUR ADVICE AND STILL READING/LEARNING. I'VE POSTED A FEW INFORMATIONAL ITEMS FOR THE FEW DIABETIC trt FRIENDS HERE. IT TOOK ME AWHILE TO FIND THIS BUT NOW I WILL HOPEFULLY HAVE A BETTER B/PANEL DONE AND WILL BE TALKING TO YOU AGAIN, BROTHER!

[bratski2]

I currently am getting injections of HRT. My urologist first had me on injections but i had to travel to his city which was 45 minute drive twice a month. Beside the fuel costs and co-pay this started adding up. I also wasn't feeling much better, I had read a online chart and for the amount of test I had in me was equal to a 101 year old man and after injections i was equivalent to a 80 year old man. my level should be 636 for my age weight and height and the best they did is 299.
So i said buggar with this I will get my doctor to do this for me, I fought with him for three weeks telling him my hormones were too low. His idea of injections is 1/2 of what my urologist gave me and the nurses are bloody idiots that enjoy giving painful shots.
Obtaining a different doctor I then got him to prescribe me the same amount as my urologist. I asked around if there is a naturalist or a real MD plus a homeopathic doctor near by only to find one back in the city of my urologist.
Besides HR injections he gives me steroids or something not sure what. Within 30 days my strength has come back, wake up in the morning with rock hard erections, i look at women like i did when i was young and can get an immediate erection and losing a nut is strong and feels great. I am losing weight, my fatigue is gone so much better concentration. My medical pays for the injections and i have to pay out of pocket for the pills. Yeah fuel costs and more money out of pocket BUT I FEEL HUMAN AGAIN and to me it is work that.
Doc said to me one of the problems doctors don't want to get involved with giving higher doses of HRT is the fact of federal rules with steroids. They are highly monitored by the government each time they prescribe it. Since steroids were so widely abused and got a bad name for themselves it places professional doctors to think twice. I honestly think the real reason is that they don't offer correct doses is the fact they don't take it themselves and really have no clue.

[pharmacuticali]

sorry to get in on this thread. i havent had a physical in a long time and i was curious about asking my primary care physician, which i have not seen yet, hes new. but how would i go about asking him to test me for everything?

[kelkel]

Explain to him how you feel. He's your doc, he should listen. If he's indifferent to it then it's time to find another one. Hence this thread! The above initial list is a good start and gives you baselines that you need if you end up in the TRT world. Most people here wish they had good initial BW to reference later on. It really does help. Print it out, take it with you. Also do your best to educate yourself on your issues prior to seeing him. The more you know the better you will be treated and your opinions won't be dismissed quite as easily. Your doc will also put more effort into preparing for your visit when he knows your not a lemming.

Good luck pharma and welcome to the forum. Post your results in the TRT forum after your visit. We are very good at interpreting BW here and can basically make sure your doc is treating you responsibly.

[Stevens03]

I found this doctor and he doesn't live too far. They want to set up a consultation, physical, and blood work for $880. This is a little steep but if it's what I need, I'll pay whatever.

I was wondering if someone could take a look at the doctors website and give me their opinion. I would have to PM you the link to the site because I cannot post a URL yet.

Thank You!

[pharmacuticali]

so i went in yesterday, for an irrelevant reason, stupid fungal infection. prescribed me some 3 stupid little pills i need to take once a week. anyway, i went and told them to do a comprehensive blood test. so how do i go about asking for the results?

[kelkel]

Stevens: Just put spaces in the link that we can close. Ex: spot injections .com

Pharma: The results are yours. When you go for your BW at the lab fill out the HIPAA form and they will either mail it, fax it or depending on the lab, you can pull it off line. Always best to have results in hand before your doc appt so you can research and not go in blind.

[Stevens03]

Good call, Kel. wernermd .com/index.php

[kelkel]

Doesn't look bad. He mentions DHT and E2 which is a good thing. I would still call and ask his staff if he basically treats people along Crislers protocols, which is what you are looking for. Then check with your insurance about reimbursement, etc. Also, does this doc write you the scripts to get filled elsewhere or is it one of the offices that also require you to purchase from them?

[Stevens03]

Where exactly is Dr.Crislers protocols on his site? Thanks for look at the site Kel!

[kelkel]

There is no real list. I refer to his methodology of treatment. As in treating the person, not just their bloodwork results. Also the ability to use T, HCG and an AI if needed. Many doc's will dole out T but refuse an AI or HCG as it's "not needed." If they are knowledgeable in TRT then they know who Crisler is.

[MRNJ1992]

Good info-going to get all the bloodwork listed. My levels of T are so whacked out Im just tired of being tired. Thanks

[BigBadBob]

Awesome thread! I'm 48 now. Did a few cycles in my twenty's and thought i knew a little something. Now I realize how uninformed i was and am amazed at the knowledge of you guys'. Thanks for taking time to help so many people. about five years or so ago I was in pain management for an auto accident. My doc sent me for blood work and said I was a little low. Gave me gel for a while which seemed like it helped a little. Then he says my levels were ok and stopped perscribing. Don't have any insr. now so have been performing some experiments of my own. Can't thank you guys enough and I mean everyone who ever puts up a post!

[kelkel]

Glad it helped Bob! Stick around and keep learning, you're not alone. Be care with the "experiments" and remember there are private labs you can use for bloodwork such as privatemedlabs.com. Discount coupons are also available if you search.

Kel

[NE333]

I was told that TRT Physicians are not likely to take on patients under the age of 35 etc. Is that true in all cases?

[kelkel]

Not true at all thankfully. People can develop pituitary tumors (I did) or have testicular trauma or other pathologies that can both land you in the TRT world. If someone is under 35 with low T then the cause needs to be discovered first and foremost.

[ROIDS47]

awesome thread. Thanks

[idshadow]

I'm not on TRT or anything but do have an interest in my health and feel like blood work is a good indicator of things.

I recently got insurance again after years of not having any while doing my Bachelor's.

Anyway, I went to a GP/PCP doctor and had the list of blood work I wanted to do and he kinda shrugged off half the list saying those tests are only done for old people and women (ie. the LH, SHBG, FSH, estradiol, prolactin, cortisol). He was willing to do the rest but I'm kinda miffed that he just shrugged off the rest.

Any idea on what kind of doctor I can go to that would be more open to doing the missing blood work? I have CIGNA co-insurance that doesn't require referrals (in-network they pay more after hitting my deductible though).

Should I try an endocrinologist (would this type of specialist be more open to doing a full battery of hormone tests just to form a baseline or would I have to have some sort of existing condition already)?

Or would an LEF.org doctor be more willing to do that and do they take CIGNA? I'm gonna check myself but it'd be nice if someone more knowledgeable could point me in the right direction. Would suck to have to go to lots of different doctors and pay for appointments only to be turned away and refused to be given the blood work tests I'm seeking.

[kelkel]

Hey idshadow. Sorry for the late response. I don't know how I missed this. An A4M doc would be your best bet if you can find one in your immediate area. Titles, other than A4M really mean very little. Most docs just don't know hormones and if you find one that does, stick with him or her. I started with a GP, then was referred to an endo who was horrible and I fired him. I then found a Euro who's knowledgeable and if just fantastic to work with. I don't understand docs who won't do the BW that a patient requests, unless of course it's absurd. If it's reasonable then it should be done as you are paying for it, not the doc. He is there to help you.

The goal here is to enhance your knowledge to the point that your doctor is there to assist you in your treatment. Not to be a "lemming" and led by the hand by a doc who is dismissive or who doesn't really know TRT. So, like the sticky said. Don't just go to different docs office and waste everyones time. Call first and ask specific questions on how the doc will treat you. Will he use injectable test and allow you to self inject. Prescribe HCG and an Aromatase Inhibitor if needed, etc. Most docs if knowledgeable in the TRT field will know who Dr. Crisler is. Ask if they will treat you along his protocols!

Again, I apologize for missing this thread. Welcome to the forum and please stick around. Let me know how your progress is going please.

kel

[SD421]

So much info in this thread, a must read for anyone that comes to the site.

[kelkel]

Thanks SD and welcome to the forum!

[Darth Orgoglius]

I might have missed this in your article, KelKel, so if this is a redundant question, I apologize. So...let's say the doc diagnoses you with low T. In your experience, do you have to go in to the Dr.'s office on a weekly basis, or does the doc simply write you a prescription and send you to the pharmacy to pick up your vial of testosterone ? Just curious...

[kelkel]

Well, your doc should be your partner here and you should discuss the treatment methodology and come to a decision based on what is best for you. Be it gels or injections. You should not have to go to your doc's office for injections once you are properly instructed how to do so. Injections should be once a week at a minimum and more advanced/effective protocols are twice per week (every 3.5 days.) Advantages of twice per week (weekly dose split in half) are more stable serum levels and less spike in E levels requiring hopefully less to zero aromatase inhibitor usage. Less is more here.

Keep in mind there are many docs who are not up to speed on hormones. Hopefully yours is. Any doc that is modern and aware of hormone therapy will not have you come to their office weekly. Unless, of course, he wants that office visit fee!

Visit this site to help you learn about injections: spotinjections.com

Proper methods and choice of syringes make a world of difference. Both IM and SubQ can be done.

Welcome to our forum Darth. Read the sticky threads at the top as there is a wealth of knowledge for you there. Begin to follow and participate in various threads. Self education is key here!

Kel

[600@50]

Welcome Darth. And to piggyback on Kel's post.....your doctor works for you. If he or she doesn't want to listen, you will need to find one that will. Your health and well being are at stake.

There is a wealth of information in this forum. Read and learn so you can partner with a doctor to get your hormones at optimum levels.

[Bushyhead]

Nice post. The physician searchs I found through your post want to perform implant surgery. I hope I can find a better doctor. I will keep searching.

[Bushyhead]

Most of the Doctors I am finding want to perform recurring surgery. I would rather give myself an injection for the rest of my life than have surgery every 4-6 months.

[kelkel]

Personally I agree with you. The protocol should be of your choosing, not the doctors. Pro's and cons should be discussed and all things considered.

kel

[junk2222yard]

Another thing would be good to include in Kel's original post is the recommend hormone test panels... this question is always asked and we always have to list them again and again!

That is a good idea and I see it was added... thing is, I thnk it should be in its own sticky. I only realized recently that these recommended panels were buried in a thread titled "Finding a TRT Physician". Since I already had my doc, there was no reason to look here.

[rd27]

Another site I found helpful was healthgrades (http://www.healthgrades.com/). It lets you do a search for docs in an geographical area, on your insurance, that have done Hormone Replacement Therapy, and that have a certain speciality (e.g. Endo vs Ob). I then used that to do google searches on those doctors and testosterone .

d

[kelkel]

Thanks rd27!

[Rusty11]

Very informative info in this thread. Thanks for creating it. Fortunately, at this point, everything is going ok for me. I'm just taking a gel and only pay 25/month. I really don't like the care I'm getting. No offense to Drs who spend years in schooling, but mine gives me the gel, but doesn't give me the time of day regarding estrogen levels. He really makes me feel foolish for even bringing it up, so I don't anymore. I've spent hours looking online, but there just 'ain't no one in Central Cal. I guess, at some point, I'll need to travel to northern or southern cal. But, how do you know if a particular doc is going to respond to your needs? Some have websites that sound great. I've read where guys have called the office of a doctor and asked specific questions. Are most doctors offices really open to answer your specific questions? It's one thing to travel a few miles, only to be disappointed, but to travel hundreds of miles (and pay a large consultation fee) and not feel satisfied would really suck!

[kelkel]

Definitely worth your time to make some calls and attempt to ascertain the docs methodology. It's exactly what I did as my first two were failures. With my current euro I interviewed his nurse, gave her the readers digest (mine is tumor related) and she responded that she's very familiar with proper protocols (Crisler like) and her husbands low T it almost ended her marriage. She made me an appt in about 3 weeks. She called back later that day and she said the doc ordered her to get me in right away. So, it worked for me.

[rd27]

How did you get connected to the nurse? Did you just call and ask to talk to her or go by ask to see her?

[fireeater49]

Hey guys newbie here. Looking forward for all the info I can get my hands on. My DO has put me on 200ml test cyp two to three times a month with no PCT program. He says I do not need it. Lab work start up 233 total test with free being 8 nh (5-21) and free % 2.79 (1.5-2.79) cholesterol 230 with HDL 56 LDL 158 TRIG 90. Other labs look in range prostate. Hemoglobin good T3 good.

48 yo, 11% bodyfat, freaking tired and joints hurt, workout 5x5 method twice week,

crossfit three times week 25-30 min at a time.

Question., I have gut feeling DO is over his head. Any reasons or suggestions fellas?

[kelkel]

Welcome fireeater. Well, if he's putting you on a TRT program then you don't need a pct as you don't normally come off of TRT. But your injection protocol should be weekly at a minimum and 200 is pretty much the top end of a protocol. You'll need to get some BW done in about 6 weeks and check levels and adjust from there. BW examples are at the top of this thread. Many docs are not really up to speed on TRT and you end up either educating them yourself or moving on. You will probably also need HCG and maybe an AI in the future, depending on BW.

Do us a favor and paste your message into a new thread in the actual TRT Forum. That way you'll get responses from the entire body of members here as well. Also, post up your entire BW with ranges for review in that thread. We have members here that are very adept at analyzing it and can help to steer you in the right direction.

Again, welcome!

kel

[fireeater49]

Thanks will do

[rd27]

@kelkel, Could you maybe add something to start of the original post in this sticky to tell folks to post their geo/health specific questions in the main forum (maybe point at the right sticky)? I can understand how some new folks might assume this thread is the place to ask how to find their doc, rather than the place to learn how to search for docs in general.

PS, I am still wondering how you suggest approaching the nurse/doctor to ask the questions. Do you just drop in, call and ask for the nurse, call and schedule a time to meet with the nurse?

Thanks,
dave

[kelkel]

Been planning that addition as well as a specific and more detailed blood work sticky. It's in the works just will take me some time. Life is busy! Really appreciate the input and links and they will be added when I do. That's what this place is about. Learning and helping each other out! Questions here are fine, just you'll get more responses from the body of members if a new thread is started.

I just called and asked the receptionist if I could speak to a nurse about the doctors TRT protocols. The receptionist can't answer it and are quick to hook you up and get off the phone in most cases. Then just keep the questions short and to the point regarding methodology emphasizing not wanting to waste the docs valuable time or yours. They should appreciate it. Above all, be exceptionally nice and use your best interpersonal skills. It's exactly how I found my doc.

kel

[flozoya]

Good Info, New bie here. I have been reading my A$$ off and its been paying off. You guys & ladys have been very supportive.
I have set up my appointemt for my blood work and now i know what to ask and look for, some what anyway... more so now then back then.
I will post results and once again thanks...
P.S I also spoke to my doctor about this to some degree, he seem like he was will to run with me but will know more when i see him.
I hope it goes.