Finding a TRT Physician

[BuzzardMarinePumper]

No hijacking as it all relates. Nelson's a friend and a good guy. You are on the right path as self-education is key. I'll throw a wrench at you, look into Aveed injections for TRT. It's testosterone undecanoate which has a very long lasting ester. Meaning you'd take a large initial injection, a booster about six weeks later then I believe it's one shot every 10 weeks after that. It has about a 90 day half-life.

It's been used for years overseas ( trade name Nebido) with much success and several guys here are on it and love it. Our FDA is always a bit slow and just approved it earlier this month. Do some research on it and talk to your doc about it. May be an option for you. Odds are your doc is not aware of it just yet.

Kel what is BW follow up after this injection as in how soon and as this injection relates to E-2

[kelkel]

Not sure when the follow up would be. That will be up to the attending physician and insurance protocols developed for this particular product. One thing I did learn is that the U.S. (FDA) downsized the dose by 1/4 as compared to across the pond. That said, I think there will be a ton of unhappy users of this product as they may not attain a level that they want / need, imho. But that remains to be seen.

[Ryanmcd]

Not sure when the follow up would be. That will be up to the attending physician and insurance protocols developed for this particular product. One thing I did learn is that the U.S. (FDA) downsized the dose by 1/4 as compared to across the pond. That said, I think there will be a ton of unhappy users of this product as they may not attain a level that they want / need, imho. But that remains to be seen.

Looking over all the people that took the trial most got around 5-600 test levels, that's not bad to be honest if you are at 200. Most here want 800+ I guess it all comes down to risk and how good your doc is, at 5-600 you have less E2 / side issues as well so I can see why they are happy at that level, I feel good at that level but great at 7-800

[kelkel]

And that's the thing. We all will not feel good at the same number and I don't know what type latitude they will have to make adjustments. But remember, the insurance industry pretty much controls this. And remember, TT is irrelevant and should not be the criteria. Too many factors influence TT.

[strive2thriveWBAM]

Kelkel, I have tried to read the majority of this thread, as well as the LOW T thread with the system admin. I decided to ask you as you as you are very thorough in your responses. I am only 20, almost 21. I have been researching low t, as I have had issues since puberty, but thought it would change between then and now. It has only gotton worse. Could it be genetic? My father had the same issues since he was 16.. Anyways, I have gotton my recent bloodwork last week, and my total testosterone is at 243. To reiterate, I am 20 years old. I feel down and have basically struggled to get through a day for the last 3 or so years. Also, since Highschool during wrestling season I weighed 180, lean. Sr Year I continued to slowly lose weight( I'm 5"11) I graduated and continued working out and eating right, (went to school for exercise science, and study bodybuilding ed). At 18, I was slowly losing weight and I felt like an old man... I did research and I used low dose testosterone alone (350cyp week). I weighed 205 after a couple months. I felt great for the first time in a very long time. I could actually get an erection and keep it, I didn't feel like I was wasting away, my depression disappeared, I slept amazing, and I enjoyed working out and didn't have to force myself to. I actually looked forward to it. I also didn't need 3 naps in a day to make it through! EVERYTHING CHANGED for the better it seemed. After 16 weeks I had to come off. I did PCT correctly and had no side effects. After about 3 weeks, I was back to ground zero, except weight, (which has slowly declined back to 185..) For the last two years, I have fought an uphill battle to gain weight.. Forcing myself to eat, forcing myself to work out, FORCING MYSELF TO ENJOY LIFE. I hate it. So I finally saw a doctor. He saw my T level and said its in the normal range... WTF. 243 is not normal for a 20 year old. I live in TX, near dallas and am very tempted to go see you guys. Would I be cared for despite my age? I also have my recent bloodwork on hand. My cholesterol is also high and my cardiologist says TRT would benefit me greatly, in more ways than just my vitality. She is actually the one who said I need to find a doctor who will prescribe it and watch my levels.. Most people cant believe I have low t looking at me, because I look to be in good health. But they don't see my sex life, my depression, or the way I have to force myself to take on the day, eating, and lifting...

My question is basically this.. Can I take my recent bloodwork to your dallas location, be honest with the doctor, and expect help? I also want to hear your opinion on my situation.. my family is normally taller than me, and had an average weight of 220 at my age. All very fit and athletic.. I am not sure if low t is the culprit for all of my issues, but I just look back at how I felt while ON and it was night and day difference in it all....

Thanks for your time, It is much appreciated...

[kelkel]

Very sorry to hear of your situation. If you have BW can you list what you have here with ranges please? Need to see LH, FSH, Total and Free T, prolactin, cortisol and everything thyroid. Now, if you do not have these then you need more BW. Most docs, cardiologist's or not, do not really know hormones unless they take an interest in it. Use the BW list at the top of this thread. Many things cause low T and good BW can clue us in with where to look.

At your age you need to find the cause, not band aid it with TRT. I know you don't want to hear that or to wait but life is long and it's important. Seeing your BW can guide us as to whether the issue is pituitary related (secondary hypogonadal) where an MRI will help, or testical related (primary hypo) where an Ultrasound may help determine if there's a varicocele or something impeding testosterone production.

Thyroid is important as being hypothyroid will cause hypogonadism. Too many doc's use TSH alone as their indicator on BW and by itself it's a weak indicator of thyroid health.

When it comes to LowT.com I'm sure they'd need a medical opinion as to why T is low for them to treat someone at such a young age. You can imagine the reasons why. Don't know where you're from but it would be worth the trip to one of the top doc's in the country such as Crisler, etc.

Glad you came here. Post up what you have please (important ones.)

Kel

[strive2thriveWBAM]

Need to see LH, FSH, Total and Free T, prolactin, cortisol and everything thyroid. Now, if you do not have these then you need more BW.



Glad you came here. Post up what you have please (important ones.)

Kel[/QUOTE]

Thanks for the quick response. I have
Free test 7.21
SHBG=11

That's all Ive got...... I guess I need more bw done. This was just basic, and more specific to a cardiologist. It is very apparent, from what you said, that I (and my doctor) will need a more comprehensive bw panel to find an underlying issue, if there is one.

[kelkel]

No good without ranges as labs are different.
But shbg is low.

Use the list at the top of this sticky, making sure you get an all inclusive thyroid panel.

[noteven]

I want to wallpaper my room with that picture, LOL! Talking about the cute butts in sico's avatar.

[MK1]

Just got off the phone with my PCP's assistant. I ha left a message about wanting to order labs and was specific about what I wanted. I used the follow up lab work at the beginning of this thread. She was confused as to what I was ordering. Hopefully all will work out. I'm about 8 weeks in and I feel really good as far as energy level but haven't lost any belly fat not really noticeable in the gym either.

[kelkel]

Just be patient and give it a bit more time. You didn't put the belly fat on overnight and it won't come off overnight! But you will love the effects of a properly dialed in protocol. It will do amazing things for you in conjunction with proper nutrition and training.

[MK1]

Thanks Kel
You are really positive! I'll clean up my nutrition and hit the gym harder and cut out some beers in the next few weeks also. Thanks

[Cam2012]

great info

[MBOS]

BW list is awesome kelkel, will use from this point on.
Regards,

[kewe]

Besides the above - is there a guide on what questions that I should ask? I have an appt on Monday

[kelkel]

Your main concern should be a proper diagnosis. Meaning do you really need TRT or is there a causative factor that is reversible that would help to restore normal function. Many things can cause low T including Hypothryoidism, pathologies, trauma, cortisol or prolactin issues. To many doctors simply look at T levels alone to determine if therapy is needed. That said, thorough blood work is step one. There's also a simple "Adam" questionnaire you can find on line which is a guide as to whether TRT may be needed or not.

To me, if it's determined via BW, how you feel, and consultation with your doctor that you do need TRT then one of the most important questions is will your doctor treat you by how you feel, not by numbers on a chart. Also will they treat with testosterone (whatever form,) HCG and an AI if needed. If they say they won't issue HCG / AI's it's time to find a more knowledgeable doctor. It's why we recommend calling and asking one of the nurses / staff that simple question. Why waste your time with an appointment if it's ultimately useless.

Take some time and read the sticky threads at the top of this forum. Write down questions that you have so you don't forget. This is a serious, life changing endeavor and not to be taken lightly so do your homework. Nothing worse than leaving a doc appt and realizing you forgot to ask an important question! I'd also recommend picking up Nelson Vergel's book "Testosterone A Man's Life" and reading between now and Monday. That or Abraham Morgantalers "Testosterone For Life." Easy reads that will greatly help you.

[MBOS]

Kewe, almost feel silly jumping in as I've not been around here near as long as these guys and don't pretend to have near the knowledge. I offer insight as a newer member, at 54 years old. If I could start this Dr issue back at the beginning, the moment I was diagnosed I would have contacted the LOWT Dr's listed on this site. It is very difficult to find ONE Dr who will handle T, HCG and Anastrozole. I'm running into the exact roadblocks all these very knowledgeable guys talk about as far as ignorance in treating the whole problem.
My GP issues T, I go to a Nurse Practioner for HCG, Urologist is sending me to my 2nd Endo (fired my first one) to explore and treat any Estrogen related issues, DAMN!! If this Endo doesn't work out I can assure you, I will find a way to afford the $199 per month and make the 2 1/2 hour drive to my closest clinic in Nashville. If it weren't for the fact that my insurance pays all but $10.00 of my T script now I'd already be on my way.
If you choose to try and find a one stop shop rather than these clinics, get your track shoes on and good luck sir.
Regards,

[kelkel]

Kewe, almost feel silly jumping in as I've not been around here near as long as these guys and don't pretend to have near the knowledge. I offer insight as a newer member, at 54 years old. If I could start this Dr issue back at the beginning, the moment I was diagnosed I would have contacted the LOWT Dr's listed on this site. It is very difficult to find ONE Dr who will handle T, HCG and Anastrozole. I'm running into the exact roadblocks all these very knowledgeable guys talk about as far as ignorance in treating the whole problem.
My GP issues T, I go to a Nurse Practioner for HCG, Urologist is sending me to my 2nd Endo (fired my first one) to explore and treat any Estrogen related issues, DAMN!! If this Endo doesn't work out I can assure you, I will find a way to afford the $199 per month and make the 2 1/2 hour drive to my closest clinic in Nashville. If it weren't for the fact that my insurance pays all but $10.00 of my T script now I'd already be on my way.
If you choose to try and find a one stop shop rather than these clinics, get your track shoes on and good luck sir.
Regards,

Very sad that so many physicians are behind the times with proper treatment protocols. Remember, most doc's only receive a handful of hours of training in hormones so it's up to them to further their knowledge, and so many simply don't and rely on old school dogma that's been debunked by modern medical science. That said, insurance covering things is always the way to go but if that doesn't work LowTestosterone.com is definitely the go to site.

[Annie Var]

My test was 1 .2 above the legal limit to subscribe test too. that's still extremely low. trying to find a DR in Australia the police capital of the world is almost impossible they all to scared to subscribe HRT unless your on ur death bed. I found a clinic thank god that cost a fortune but it turned my life around. Low test in a male, id rather be dead then go back to that life and they wonder why the black markets flourish for some of us its just quality of life.

[kelkel]

Way to much emphasis is put on numbers on a scale and should be on how you feel. Welcome to the forum Annie Var...

[NACH3]

Does this clinic provide HGH Therapy?... I pretty sure it was mentioned by KelKel said up top but brief... Thank you for your feedback!

[JennyHaskins]

This is a good idea.

[melendfi]

j2048b, thank you so much for the tip!! I just found a few of these around me in west central New Jersey.

[blanten]

Kelkel,
I have tried to read the majority of this thread, as well as the LOW T thread. I decided to ask you as you as you are very thorough in your responses. I just turned 28 im 6ft 1 215 lbs. I have been researching low t recently, as I have most of symptoms. Low libido, decreased energy and fatigue, irritability. What has been affecting me most is insomnia, depression, lack of motivation, focusing and concentrating. Plus ive put on 30 lbs in the last year, mostly belly fat. Ive recently have had to take a break from college because of these symptoms. Anyways, I received BW earlier this morning….

TOTAL TESTOSTERONE 188.
tsh 2.02
THYROID PANEL
T3 UPTAKE 35
T4 4.8
FREE T4 INDEX 1.7

I had more BW for follow up before I left my PCP today and will get the results Friday morning. What info should I be expecting to receive? What other info do I need to post from my initial BW I received this morning?

Thanks

blanten

[thebark]

Well I just called the 2 "Low T" clinics here in Columbus, Ohio. All they check is your T score and PSA. Thats IT.....seems even the Dr`s specializing in this treatment won`t do a full panel.

[kelkel]

Go to LowTestosterone.com - $199 All-Included Testosterone Treatment. You'll be treated properly.

[GetUpandLift]

Hi, I've been to my local doc and an endo and I am not seeing these different values "LH, FSH, and everything thyroid" on my Labcorp blood tests.

These are the different panels my docs ran on me for the low testosterone thing:

NMR LipoProfile (LDL, HDL)
CBC with Differential/Platelet (has 23 different words with values)
Basic Metabolic Panel (11 different things)
Hepatic Function Panel (7 different things)
Testosterone Free and Total
Hemoglobin A1c
Thyroxine (T4) Free, Direct, S
Cortisol
TSH
Vitamin B12
Prolactin

Do I need to do all of the testing you mentioned still? I just turned 27 and I was told by the endo that at 304 Total Testosterone on a 345-1197 scale, that I am "normal." I made another appointment with my family doctor, but I am scared that none of these doctors know what they are talking about. My family doctor was talking about getting a testicle ultrasound as well, but ended up just referring me to the endo that couldn't help me...

Would I be able to go to my family doc and ask for all of these other tests to be ran? My test was 204 the first time I went in when I wasn't fasted, but when I went back in and I fasted, it was 304. I'm not sure why that made a difference.

[kelkel]

Hi Getup!

The BW put together at the top of this thread is more comprehensive than what your doc pulled and geared to check the things that can impact a males testosterone levels . Hypothyroid, elevated cortisol or prolactin can all impact testosterone levels. I am glad he pulled an NMR Lipo Profile as it's a great way to know your LDL Particle size which is crucial in cholesterol.

At 27 years old your testosterone should be much higher. For your endo to tell you this is simply wrong in my opinion. Remember, most doc's just don't know hormones as they don't have training in them. The title "Endo" does not mean that they do know them. The reason LH & FSH are important is that they are indicators of pituitary function. This is where testosterone production begins basically. LH and FSH signal your testicals to produce testosterone and sperm, respectively. If these signals are weak you'll have low testosterone . This is why they are important to know.

If they're low then something is impacting them negatively and you then have to find out what. One indicator on your blood work could be TSH. If it's high then it's an indicator (albeit weak) of hypothryoidism which can cause hypogonadism. More thyroid panels should be pulled at this time. Elevated cortisol can suppress T levels as well as elevated prolactin. If prolactin is too high then an MRI should be performed for pituitary adenoma's, but lets not get ahead of ourselves here. Other things can cause low T as well, such as trauma, medications, varicoceles, etc.

So, if your LH is low your T will be low. If your LH comes back high and you have low T then the problem is testicular related and the ultrasound you mentioned should be performed.

What are the levels and ranges for:

TSH
Prolactin
Cortisol
T4 free

[GetUpandLift]

Hi Getup!

The BW put together at the top of this thread is more comprehensive than what your doc pulled and geared to check the things that can impact a males testosterone levels . Hypothyroid, elevated cortisol or prolactin can all impact testosterone levels. I am glad he pulled an NMR Lipo Profile as it's a great way to know your LDL Particle size which is crucial in cholesterol.

At 27 years old your testosterone should be much higher. For your endo to tell you this is simply wrong in my opinion. Remember, most doc's just don't know hormones as they don't have training in them. The title "Endo" does not mean that they do know them. The reason LH & FSH are important is that they are indicators of pituitary function. This is where testosterone production begins basically. LH and FSH signal your testicals to produce testosterone and sperm, respectively. If these signals are weak you'll have low testosterone . This is why they are important to know.

If they're low then something is impacting them negatively and you then have to find out what. One indicator on your blood work could be TSH. If it's high then it's an indicator (albeit weak) of hypothryoidism which can cause hypogonadism. More thyroid panels should be pulled at this time. Elevated cortisol can suppress T levels as well as elevated prolactin. If prolactin is too high then an MRI should be performed for pituitary adenoma's, but lets not get ahead of ourselves here. Other things can cause low T as well, such as trauma, medications, varicoceles, etc.

So, if your LH is low your T will be low. If your LH comes back high and you have low T then the problem is testicular related and the ultrasound you mentioned should be performed.

What are the levels and ranges for:

TSH
Prolactin
Cortisol
T4 free

Hi again,

Thank you for all of the information. I am going back to my regular doctor tomorrow.

He did mention my Cortisol level was a bit high, but he also mentioned this was most likely due to the fact that I had the flu with bronchitis when I first got the blood test. I tested again a month later and the cortisol level went way down, but is still considered a bit high. I have a high stress/anxiety level but I'm not sure if that has something to do with that as well.

I just got some blood tests back from last month and noticed FSH was tested on this test, but it doesn't say a range that it is supposed to be in. Here are my results:

FSH- 1.6 (Unknown)
Prolactin - 11.0 (3.5-19.4 scale)
Cortisol - 26.9 (2.3-19.4)
Free Test - 55.4 (35-155.0)
Total Test- 245 (250-1100)
LH- 1.5 (Unknown)
TSH- 3.42 (.35-4.94)
T4 Free- .9 (.7-1.5)

Some other notes:

Basic Metabolic Panel all numbers normal
Hepatic Function Panel all normal
CBC all normal
Lipid Panel - ldl-P a bit high (1754 on a <1000 scale), small ldl-P high 1590 on a <527 scale)





Hopefully this helps? Please advise. Thank you

[GetUpandLift]

Kelkel, are you still there? I posted my bloodwork above.

Also to update, I visited my family doctor again yesterday and he is very pissed off at what the endo said. He said that he is going to give him a call and see what the actual notes of my appointment with the endo says and then get back to me. He thinks the next step is going to be a cat scan of the pituitary gland or putting me on some testosterone gel.

From all of the reading on that testosterone gel, I don't really like the thought of it, but I think that's all this doctor prescribes. Would it be okay to do the gel? What about doing testosterone in general based off of my bloodwork above?

I played a lot of sports growing up (football, basketball, baseball) so who knows maybe my testicles are messed up. If they are, are they easily fixed or do you just have to go on testerostone?

The doctor said he wants to put me on the gel to see if making my levels go up, makes me feel a lot better. I currently like to sleep most of the day on my off days from work, feel depressed, have anxiety, no sex drive, hard to keep erections, etc etc. It is not a fun way to live life so I really hope I get this figured out. He said that he could always take me off of the testosterone if it doesn't work so that's why he is thinking about trying it, depending on what the endo says.

Please help. Thanks

[NotNATTY]

cool

[VegasTrader]

I'm new to this forum and need to get some help in finding a decent doc or clinic in Vegas where I can get test and hgh treatment combined.
I went to a couple clinics and when I don't sign up for the $1500 quarterly program doc or tech or whoever is in the room with me...gets all pissed off
there has to be a better clinic here in Vegas

[mussina123]

noticing you post a lot of awesome info man, i'll be reading up, thanks for the good information!

[kelkel]

I'm new to this forum and need to get some help in finding a decent doc or clinic in Vegas where I can get test and hgh treatment combined.
I went to a couple clinics and when I don't sign up for the $1500 quarterly program doc or tech or whoever is in the room with me...gets all pissed off
there has to be a better clinic here in Vegas

Check out LowTestosterone.com - $199 All-Included Testosterone Treatment as even if not in you're immediate area they'll fly you in for free.

[Chauffeur]

I just now realized that the list of recommended labs includes IGF-1 and IGFBP-3. Any insight as to why Dr. Crissler suggests ordering those labs?

I did some Googling and it looks like growth hormone deficiencies are extremely rare (one site mentioned 1 in 10,000 affected).

Is there some other significance to ordering those labs other than establishing a baseline value?

Dr. Crissler also says that IGF-1 will rise with TRT. Is that something that I should be concerned about?

[kelkel]

My thought would be as it relates to metabolic syndrome. Yes, they are rare and to find out actual GH levels you'd need an arginine stimulation test.
Rising IGF-1 is nothing to worry about. Be happy. It's why guys run GH.

[Chauffeur]

My thought would be as it relates to metabolic syndrome. Yes, they are rare and to find out actual GH levels you'd need an arginine stimulation test.
Rising IGF-1 is nothing to worry about. Be happy. It's why guys run GH.

Got it, thanks man!

[Xphanial]

Hi Guys,
whats your advice on finding a good doctor in Australia Victoria?
I've had 3 blood tests, all well below average (175) and the endo just brushed it aside.
Any help will be very appreciated.

[Simon1972]

Hi Guys,
whats your advice on finding a good doctor in Australia Victoria?
I've had 3 blood tests, all well below average (175) and the endo just brushed it aside.
Any help will be very appreciated.

start a new thread and post up your bloodwork.

[Chauffeur]

My thought would be as it relates to metabolic syndrome. Yes, they are rare and to find out actual GH levels you'd need an arginine stimulation test.
Rising IGF-1 is nothing to worry about. Be happy. It's why guys run GH.

Kelkel, just wanted to update you since I've received my lab work, and have a couple of questions that I'm hoping you can help me answer.

My IGF-1 looks great at 228 (88-246 ng/ml). I'm very pleased with that number. Although I have no baseline to compare these results to, I believe that I can thank my TRT protocol for allowing me to achieve such a healthy level.

Would there be any benefit (or detriment) to peptide use (GHRP, Ipam, Sermorelin, etc.) for somebody with a healthy IGF value?

I really have no interest in the potential gym benefits of peptide use, but am more interested in the potential for improved sleep and connective tissue strength.

I've had a nasty sleep disorder for the last decade or so and to be honest, it's reached critical mass. The only treatment that has been remotely successful for me has been prescription sleep aids, but I realize that this is not a sustainable way to deal with my sleep disorder.

I also had a pretty substantial shoulder repair a couple of years ago, and my level of recovery is not what I had hoped it would be. I've been rehabbing it endlessly, but it still limits me quite a bit.

I'm kinda grasping at straws at this point, looking for any possible way to help regain normal function.

In your opinion, are peptides a viable option for somebody like me? It's tough for me to separate the facts from the bro science when researching them.