Finding a TRT Physician

**kelkel** · 07-21-2015, 08:18 PM

Chauffeur it sounds like you'd be a perfect candidate for TB-500. Have you read Bass' log on it?
Yes, that's a great IGF-1 level. I'd have to run 1 iu of GH to attain that myself. I'm jealous.
Have you looked into or tried Melatonin? Seems obvious but I wanted to throw it out there anyway.

Melatonin - Scientific Review on Usage, Dosage, Side Effects | Examine.com

**Chauffeur** · 07-23-2015, 12:42 AM

Originally Posted by kelkel

Chauffeur it sounds like you'd be a perfect candidate for TB-500. Have you read Bass' log on it?
Yes, that's a great IGF-1 level. I'd have to run 1 iu of GH to attain that myself. I'm jealous.
Have you looked into or tried Melatonin? Seems obvious but I wanted to throw it out there anyway.

Melatonin - Scientific Review on Usage, Dosage, Side Effects | Examine.com

TB-500 has definitely crossed my mind, but it doesn't look super cheap to use it for any length of time. I'm just a public servant, so my salary doesn't allow a ton of room for the finer things in life.

I recall reading somebody's TB-500 log awhile back, but I can't remember who's it was. If memory serves me, the poster didn't seem to think it was as helpful as it's made out to be.

Do you have a link to his thread?

I'm pretty excited about my IGF-1 value too! I was pleasantly shocked by it.

Yea man, I've tried melatonin many times to no avail. I still take it from time to time with the hopes that I'll start responding to it. No dice.

I've tried quite a few OTC sleep aids over the years and nothing has worked. I kinda gave up searching for a panacea that just may not exist for me. Being dependent on prescription sleep aids is starting to take its tole on me for sure. Something's got to change.

**kelkel** · 07-23-2015, 09:55 AM

Here's Bass' Log:

Bass's TB500 Log

Know that Melatonin can improve IGF-1 levels. Not that you need it!
Have you ever considered a sleep study?

**Chauffeur** · 07-24-2015, 01:48 PM

Originally Posted by kelkel

Here's Bass' Log:

Bass's TB500 Log

Know that Melatonin can improve IGF-1 levels. Not that you need it!
Have you ever considered a sleep study?

Thanks for the link, I'll check it out tonight when I've got some more free time.

I've had a few sleep studies. Two of them prior to TRT showed no abnormalities. I decided to have a third one ~5 months into TRT when I started showing signs of apnea, which was confirmed by the sleep study. I now use a CPAP machine and the apnea is very well controlled.

I still struggle to fall asleep, and to stay asleep though. I use the CPAP basically because I know it's good for me, but I don't feel any different/better most mornings.

**kelkel** · 07-24-2015, 05:34 PM

I can only assume you're doing everything else correct, right? Off caffeine in the evenings, electronic's, etc.?

**Chauffeur** · 07-25-2015, 10:56 AM

Originally Posted by kelkel

I can only assume you're doing everything else correct, right? Off caffeine in the evenings, electronic's, etc.?

Yup. I'm pretty good about that sort of stuff.

It doesn't help that my work schedule requires really odd hours and long stretches of minimal/no sleep, but I had these issues long before I got into the fire service.

My work schedule certainly isn't helping though.

I've always been kinda weary of peptides. Many of them seem to be surrounded by a fair amount of bro science. I also don't love the idea of injecting things that don't come from the pharmacy.

At this point, I'd be willing to give anything a chance to help my sleep issues though. Even if it was brewed in some dude's bathtub.

**Chauffeur** · 07-26-2015, 12:27 AM

Just read Bass' TB500 log. He says:

"sadly my conclusion TB didn't do shit for me!"

You trollin me Kel?!

Kidding. Looks like TB500 might not be the peptide for me though.

**kelkel** · 07-26-2015, 02:11 PM

Well damn, I did not know it ended that way for him! That just sucks then.

**RickyReed** · 07-30-2015, 06:32 AM

I had my test tested and was going to try and get my doctor to give me some test by prescription and she came back and said my test was way to high ,she said mine was1700 and for my age it should be 1500 and I am 47 so I really don't understand what the big deal is when she coud just give sript instead of me having to go tome where else where, you know I mean? Does antone have any ideas?

**kelkel** · 07-30-2015, 07:47 AM

Your numbers sound way off Ricky. Example, the normal range for testosterone via Labcorp is 348 - 1197. You're way above that. Are you running testosterone now? The big deal to your doctor is maintaining her license. They actually do occasionally investigate these things.

**Xphanial** · 08-04-2015, 07:35 PM

Hi guys,
From Australia and just need some advice with TrT.
Now in Aus the total testosterone range is 8.3-30.2 (thats 225-725 Free test)
I've had 3 tests now that have all indicated that I am at 7.4-7.6 (175-198 Free test). The first endo I saw Fobed it off as I am too young at 26 and I wouldn't be able to have kids if I was treated, nothing else was really said on the subject :/ at that point I had no idea what to do.
So after that I went to a sports medicine clinic and he was more than happy to help me but in stead of doing some sort of trt he put me on Sarms , cjc/ghrp6 and hcg ............. that didn't go down to well ether after 3 months and no change. so I've gone to another Endo (this time a woman from a great background in the field) long story short, tests show that everything is running as normal, all hormone lvls are where they should be but my total test is still at 7.4, she says it is most likely a gland issue and wants me to get an MRI to see if there any discrepancy's. The kicker is though, thanks to new laws passed the Level range for TrT has been lowerd from 8.0 to 6 and under. So If it isn't a gland issue I'm left with very little options

any advice on what I can do ?

**kelkel** · 08-04-2015, 08:36 PM

Hi Xphanial. Favor please. Copy and paste this over to a new thread in this forum. That way you'll get a much broader response from the members.

Thanks,

kel

**Xphanial** · 08-04-2015, 11:46 PM

Thanks Kel, Have done.

**RickyReed** · 08-20-2015, 02:22 PM

You should go to your primary care doctor and be tested and then they should give you the shots there at least that is what I had to do

**nomdeplume** · 11-30-2015, 03:06 PM

I want to have all the values you mentioned checked but I don't know where to get it done or how to ask for it. Is blood work à la carte in that I would pick and choose what I want tested or is there a proper "term" to use telling doctors what I would like tested. On a side note, I called the number at lowtestosterone.com to ask about their blood work and I was told that they are not currently accepting any new patients.

**kelkel** · 11-30-2015, 03:57 PM

You can print the list and request your doctor script them for you if you're having insurance cover it. If not, you can look at places like Discounted Labs .com or Private MD Labs . com. (have to type them that way or the filter blurs them out.) I'm trying to find out about LowT myself.

**nomdeplume** · 11-30-2015, 06:16 PM

Thank you for the site. I went to discounted labs and a chatted with a "live sales agent." I copied and pasted your list and the person suggested their pre TRT panel ($250) which I will paste at the end. The guy said to hold off on Prolactin and DHT for later. My question is: Is this list good enough or would I be missing some important tests?

- LH and FSH (Pituitary hormones that stimulate testicular cells that can help diagnose primary (testicular) or secondary hypogonadism)
- Total and free testosterone
- Prostatic specific antigen (PSA) (TRT is contraindicated for PSA equal or above 4.0)
- Estradiol (sensitive)
- Thyroid stimulating hormone (TSH)
- Comprehensive Metabolic Panel (CMP) (Glucose, electrolytes, liver/kidney functions)
- Comprehensive Blood Count (CBC) (Immune cells, hematocrit)

**kelkel** · 11-30-2015, 07:02 PM

It's a great start! Go with it and when received post it up in the forum and we'll evaluate it. There are many things than can suppress testosterone and LH / FSH will show pituitary function which is crucial. Thyroid issues can cause hypogonadism. TSH is a weak indicator but will help in determining to get further panels pulled. Let's see how they come back and then you can move forward with a few other tests if needed at that time.

**Macros** · 01-23-2016, 01:25 PM

I got two blood tests. My total test came in at 434 and 546 ng/dL. My free test came in at 6.2 and 13.7 pg/mL. My family doc said he would put me on TRT using gel and I said I didn't want the gel bc it was too expensive and I didn't want it to come in contact with my young daughter. He said he couldn't prescribe injections unless I went to an endocrinologist. I also asked my doc if he would prescribe any HCG or PCT if I did use the gel and he said no. He said if I experienced shrinkage that is my body's way of telling me I didn't need the extra test.

I just want to know if all doctors are this clueless and if there is anyway I could be prescribed an appropriate TRT regimen given my test numbers I listed above?

**kelkel** · 01-23-2016, 02:55 PM

Hi Macros,

What is the range on your Total T and Free T?
Are you in the states?
Any doc can prescribe injections. Yours is apparently uncomfortable with them.
Totally ridiculous theory regarding HCG and shrinkage.

Unfortunately many doc's don't know hormones. I can't really answer your last question until I see your ranges. That said, how old are you? Also, if possible, post up your BW as many things can suppress T levels that are fixable. Always best to rule out possible contributing factors before embarking on a TRT regimen.

**Macros** · 03-13-2016, 03:39 PM

Hi kelkel

I'm 30 yo 5'9" 170lbs. I've been training hard and consistently for 10 years. I have always eaten healthy but for the past 5-6 years I've been extremely disciplined and smart with my diet. My problem is I haven't gotten the results I would expect from all of my efforts and I was also having some symptoms that I thought could be linked to low testosterone after I did some research. I got 3 blood tests (which were not full panel and I realize now that I should have asked for a better tests) here are my test results:

Test 1(November): total - 582 ng/dL; free - 6.7 pg/mL
Test 2 (December): total - 601 ng/dL; free - 19.6 pg/mL
Test 3 (January): total - 539 ng/dL; free - 13.3 pg/mL

Ranges: total: 348-1197; free: 9.3-26.5

My doctor said these levels are not necessary "low" but he did say he would prescribe me gel. I know they might not be extremely low but they are low enough to have a noticeable effect on my body composition, mood, libido and energy level.

I have an appointment with another doc on Saturday. But I had a few questions before starting a TRT regimen if he decides to put me on one:

Would I ever be able to do a cycle like the suggested first cycle while on TRT?

If yes, would I need to take a break from the TRT and run pct before starting the suggested first cycle?

If I did the suggested first cycle would I need to run pct before starting TRT again?

Thank you very much

**kelkel** · 03-13-2016, 07:57 PM

Hi Macros,

Your serum T fluctuations are relatively normal. The jump from 6.7 in FT to almost 20 is odd.
Don't judge by serum T. Always judge by FT as that is what works for you.

You really need to get the following from this new doc is possible:

Full thyroid panel (not just TSH)
Prolactin
Cortisol
SHBG
LH & FSH

LH and FSH will show pituitary function and help you to assess things further. To be honest, your December numbers, particularly the FT is not bad at all. Whether there's something slightly suppressing your overall T can only be determined by the correct BW. Main thing is to not be treated like you're a number on a chart. Be treated based on how you feel and the symptoms you present. The BW is a guide, not the ultimate judge.

A cycle can be in your future but you need to figure this all out first. If you end up on TRT then you really need to give it time to work as the elevated levels can make a big difference in your progress. It also takes time to get dialed in which may require some frequent BW, and you don't want to screw things up with your doctor and lose trust. To your question, PCT is never needed on TRT.

Don't get ahead of yourself but in the AAS Q & A Forum is a "Successful First Cycle Sticky thread. Read it when you can. It's very well written and will answer many of your questions.

**Macros** · 03-14-2016, 10:20 AM

Kelkel you are awesome. I very much appreciate your answer, opinion, and advice. You and this forum have helped me tremendously as I am new to the AAS world and have been trying to do research and gain knowledge. Also I think I am a legitimate candidate for TRT even if I may not be a typical candidate. I have read the "successful first cycle" sticky and it's good to know I could potentially run something like this down the road if my doctor does put me on TRT - thank you for clearing that up. I will post my bw results from my upcoming visit.

Thank you again!

**kelkel** · 03-14-2016, 10:40 AM

Glad to help. Post them up in a separate thread so more members will chime in as well.
If possible, check your Vit D level as well. It's actually a hormone and can help suppress SHBG and thus result in better FT levels. Most are low in N. America so it's a good item to track.

**Macros** · 03-23-2016, 04:39 PM

Kelkel I hope you are well. I wanted to check in and let you know I had my doctors appointment last Saturday and I'm still waiting on the bloodwork. I scheduled a follow up appointment to go over the bw in 2 weeks. The good news is it's a full panel test so I'll have good results to post. The doctor spent some time talking me to and I really liked him. He is definitely progressive and he should be able to help. He works at a rejuvenation clinic and said he has worked with some bodybuilders such as Shawn Rhoden and Guy Cisternino. the doctor also said he is on TRT himself. I don't know if it seems like a shady establishment or if it's the perfect way to get what I need under doctor supervision. I asked him about HCG and that was the only downside of the visit. He said he does not use HCG while on exogenous test because he said it doesn't stimulate the testes. I told him all I knew about HCG and also mentioned the other benefits I knew about such as how it can combat fatigue and stress, betters your mood, has a role in energy, reduced cardiovascular risk, immune stimulation, and betters memory but he still disagreed. I guess my question is - if he puts me on test could I run my own HCG on the side?

I will post the bw after my follow up.

Thanks!

**kelkel** · 03-23-2016, 08:58 PM

Well, for as much as he knows he's misinformed when it comes to HCG . It's even on many HCG package inserts as a viable use for Hypogonadic Hypogonadism. Let me see your BW when you get it. I'll be off site most of next week so be patient please.

Here's a small quote from a study regarding fertility in the hypogonadal male that deals with the effectiveness of HCG from 2015:

A known critical element in the development of healthy spermatogenesis is high intratesticular testosterone.13 In men using exogenous testosterone, these levels can be greatly diminished. Intramuscular human chorionic gonadotropin (hCG) therapy is an option shown to protect against, or at least to diminish, the impact that exogenous testosterone has on intratesticular testosterone levels. In a randomized, controlled trial of 29 healthy men randomly assigned to four groups, testosterone enanthate was given 200 mg per week plus either intramuscular saline, 125, 250, or 500 IU hCG every other day. Sperm, intratesticular testosterone levels, and gonadotropins were measured at day 0 and day 21. Intratesticular testosterone levels were suppressed by 94% in the placebo group, 25% in the 125 IU hCG treatment group, and 7% in the 250 IU hCG treatment group, and they were increased 26% from baseline in the 500 IU hCG treatment group.13 Thus, even with supraphysiologic doses of testosterone replacement , healthy levels of intratesticular testosterone were maintained by low-dose hCG therapy.

**Macros** · 03-24-2016, 04:16 AM

Kelkel this is great! Thank you for proving sound scientific backup. I will bring this info with me when I meet the doc for my follow up. Also I will post bloodwork in a separate thread so more members can chime in. No worries about the delay, I won't be going back in until the first week of April. Enjoy the time away!

**bioshocked** · 03-24-2016, 08:56 PM

Read a lot of threads on this forum and others. I can't find a search function for this forum though. Since this is a sticky thread, I will start here. Never been on any hormones before. Short history is my T has been 450 or lower since I started checking it in my early 30's. I am now 39. Last year it was 390 and just a few weeks ago it was 429. I think my new bed helped as I am sleeping better with my new bed.

I asked my primary Dr and he is anti hormones. So I am looking for a different Dr. I checked out a local clinic, but the cost is insane. Given this is a long term process, I don't even want to get started with them.

One site said I should call compound pharmacies and ask for a TRT doctor. That has actually helped a lot, but I still haven't found that I think is the best option for me.

From what I have read in the rules and other people asking, I am trying to find a Dr in Phoenix that allows self injections at home and is ok with maintaining a T range in the 800-1200 range. One Dr I found says he only goes up to 700. I don't know what I need, but I don't want to be too limited right from the start.

Should I have my own thread for this question?

**kelkel** · 03-25-2016, 09:08 AM

Hello bios! Yes, start your own thread in the HRT Forum and maybe a member who lives in your general area can clue you in to a good one. Also, be sure you obtain full BW as listed at the top of this thread. This way you can see if there's anything else suppressing your T production that can be corrected. When it comes to "numbers," always go by your free T level. Total T really means nothing if all your FT is bound up.

Welcome to the forum!

**bioshocked** · 03-25-2016, 01:33 PM

Originally Posted by kelkel

Hello bios! Yes, start your own thread in the HRT Forum and maybe a member who lives in your general area can clue you in to a good one. Also, be sure you obtain full BW as listed at the top of this thread. This way you can see if there's anything else suppressing your T production that can be corrected. When it comes to "numbers," always go by your free T level. Total T really means nothing if all your FT is bound up.

Welcome to the forum!

Thanks. I have gone ahead and started my own thread below. Which is more of asking if I should even go down this road at all. Includes some lab numbers as well.

forums.ster*id.com/hormone-replacement-therapy-low-testosterone -treatment-anti-aging/579885-doesnt-seem-low-should-i-even-go-down-road.html

Being new it won't let me post a link to another thread on this same forum. lol. So you will need to correct the link to use it until I have enough posts.

**TexasManDan** · 04-09-2016, 10:33 AM

I must have had a heartless guy then. Bloods came in at 8.2 free direct and 312 total. He said they were "acceptable" levels. That was when I was 23.... -_-

**bioshocked** · 04-09-2016, 12:09 PM

Originally Posted by TexasManDan

I must have had a heartless guy then. Bloods came in at 8.2 free direct and 312 total. He said they were "acceptable" levels. That was when I was 23.... -_-

I agree, seems many doctors are this way. If you are within the lab range, many say you are fine. I believed that when I was younger and now I am going to see what it is like to have the high end of the range instead of the low end. I know there is more to it than just the numbers as it seems people utilize free and total T differently. So one level might keep one man fit and lean and yet be total garbage for someone else.

**kelkel** · 04-09-2016, 06:26 PM

Originally Posted by TexasManDan

I must have had a heartless guy then. Bloods came in at 8.2 free direct and 312 total. He said they were "acceptable" levels. That was when I was 23.... -_-

Originally Posted by bioshocked

I agree, seems many doctors are this way. If you are within the lab range, many say you are fine. I believed that when I was younger and now I am going to see what it is like to have the high end of the range instead of the low end. I know there is more to it than just the numbers as it seems people utilize free and total T differently. So one level might keep one man fit and lean and yet be total garbage for someone else.

Normal doctors are simply not trained in hormones. Some also live and die off of numbers on your blood work chart, which is absurd. When a doc see's numbers such as that and then doesn't look further he's not following his hypocratic oath, imho. To not look deeper for a causative factor is ridiculous.

**bioshocked** · 04-09-2016, 10:23 PM

Originally Posted by kelkel

Normal doctors are simply not trained in hormones. Some also live and die off of numbers on your blood work chart, which is absurd. When a doc see's numbers such as that and then doesn't look further he's not following his hypocratic oath, imho. To not look deeper for a causative factor is ridiculous.

In my particular case of 390, which isn't as low as 312. My doctor did keep looking based on my symptoms. EKG, sleep study, etc. Though my symptoms are not as wide spread as others with low T. Still, in the end when he tried everything else, when I brought up TRT; he made it clear that he doesn't "believe" in hormone therapy and would need to refer me to someone else. Whatever the reason, that seems to be pretty common. Though at the same time it is also evident that hormone therapy isn't the taboo it once was. With all the calling around that I have been doing, no one has made me feel uncomfortable or acted like it was out of the norm to ask.

Still, it is sad that it's 2016 and we still haven't completely escaped all the negative stigmas and laws that stand in our way of improving our lives when properly used. And seeking doctor's help shouldn't be so hard to get for this. I was actually surprised when my primary Dr said he wouldn't help at all with hormone therapy. I was at least expecting him to say that he simply didn't have experience but that he would be willing to proceed if I was comfortable with his lack of TRT monitoring experience. As least that would have put the choice in my hands.

**kelkel** · 04-10-2016, 09:22 AM

Sounds like he's just operating to his own knowledge level, which is limited in this area. To say he doesn't believe in hormone therapy would make me run from his office. What other medical therapies does he not believe in? What if the loss of hormones is tumor or trauma related? Would he agree to it then? I imagine if he developed a pituitary tumor that shut down his own T production he'd be on TRT in a heartbeat.

A doctor ignoring a simple bio-identical medicine is frightening. He needs to crack open a book and do some reading.

**bioshocked** · 04-10-2016, 06:11 PM

Originally Posted by kelkel

Sounds like he's just operating to his own knowledge level, which is limited in this area. To say he doesn't believe in hormone therapy would make me run from his office. What other medical therapies does he not believe in? What if the loss of hormones is tumor or trauma related? Would he agree to it then? I imagine if he developed a pituitary tumor that shut down his own T production he'd be on TRT in a heartbeat.

A doctor ignoring a simple bio-identical medicine is frightening. He needs to crack open a book and do some reading.

Well, he certainly isn't here to defend himself. I would think that if the cause for hormone treatment was tumor or trauma related, etc. That those patients would have different symptoms than me and likely much lower levels than my 390. His comments to me, which I don't remember verbatim, is that he doesn't believe that I need hormone treatment and that if I needed it, he would refer me as he doesn't do that. His staff was also relaying some on this info as I tried to dig deeper into this comment later.

**kelkel** · 04-10-2016, 08:04 PM

Oh I'd love to debate him on the efficacy and ethics of it all. Be fun. Pituitary tumors are not that uncommon (I have one) and trauma can be from a simple accident or sports related injury that slowly impacts your endogenous production. The symptoms are basically the same.

At least he'd refer you for the treatment, which is good if he's not comfortable administering it. Best thing, you're here self-educating.

**majoro4** · 04-17-2016, 06:28 PM

My doc tells me my test is within normal range for a man my age. My wife is not what a man my age usually marries, so I need the test level to be within the range of a 42 year old. Anybody know anybody in Tampa I should see?

**kelkel** · 04-17-2016, 08:23 PM

Do you have any labs you can post? With ranges? Be more helpful if we knew exactly what we were dealing with.

Welcome to the forum major!

Also, if you would paste your post in a new thread in this forum you'd get many more responses.