First Appt expectations

[StinkyFinga]

I have my first endo appt ever in hopes to be put on TRT. I have to be honest and say I'm expecting to be tested and told there is nothing they can do, OR, tested and have to go through rounds of every other treatment possible. Am I being to negative? I guess I'm just use to getting the run around with doctors.

I'm guessing the first appt will be questions. Me explaining my symptoms/history and she will order up blood work. After that, I'm a bit nervous. I know people may think I'm crazy but I will be disappointed if I am treated based on a number and not symptoms.

[clarky.]

Well mine was lot's off Q's a examination bloods then went to the hospital for one day so they could give me different drugs to stimulate different hormones and pulled bloods at diff times had to wait for mri scan then went back to see the endo after she had all the results took months

[bass]

is your doc up to date on TRT?

[StinkyFinga]

honestly bass, I highly doubt it. I was referred to the endo by my PCP. She is younger and from what I've heard is more current so I'm hoping that's a good thing but as far as TRT goes, no clue. I really just don't want to be yanked around for months. I'm 38. Not 21. My levels aren't going to get better on as I age.

[bass]

remember you are still ultimately responsible for your health, meaning if you think your doc is not up to date with TRT, find a new one. if she dose once a month protocols, and if she says no hCG when you complain about your boys hurting, and if she says no AI when your E2 is through the roof, that's a good sign for you to move on. she can put you through lots of unnecessary misery if she is not the right doc for you. so ask all these question before she puts you on medication, don't be afraid to ask question, and of course always be nice and respectful

[StinkyFinga]

Great advice. Thank you. I wasn't going to ask on the first appointment because I don't want to sound pushy or like a know it all but the reality is, I'm educated enough to know what's needed (ai/hcg /test) for the best shot of success. Why should I have to hide that and like you said, as long as I'm respectful about it I would hope it would be ok.

My fear is having to find another doc. I just don't want to have to shop around like I'm buying a pair of sneakers.

Man I'm stressed out over this. I've thought long and hard about this and I'm ready to commit. I'm also prepared to self-medicate. I don't want to but if it means being happier then I'll do whatever I have to do. On a normal day, not being energetic enough to play with my daughter is a HUGE problem. That's just one prime example of low test symptoms affecting ones well being. I'm sick of hearing I'm depressed. I'm not freakin depressed. I'm not sad, I'm not suicidal, I'm not crying over a lame commercial (well, maybe once in a while ) . I just feel BLAH. I feel great in the morning, as the day goes on I fade away into never never land. I need me some pixie dust...yeah, sorry, my daughter is obsessed with tinkerbell. LMAO

[FRDave]

I did a lot of research prior to starting TRT so I didn't have many questions. My questions were more so based on protocol.

I asked if he was open to me injecting via sub-Q twice a week to keep serum levels stable.

I asked if my E2 were to raise would he write script for an AI such as Arimidex .

I asked if he would ok and write script for HCG to help with fertility and to keep the boys from shrinking/hurting.

He was ok with all of the above so I went with him :-)

Just don't be pushy and act like a know it all. Write down a list and ask all your questions. If you are in doubt, move on.

[bass]

I did a lot of research prior to starting TRT so I didn't have many questions. My questions were more so based on protocol.

I asked if he was open to me injecting via sub-Q twice a week to keep serum levels stable.

I asked if my E2 were to raise would he write script for an AI such as Arimidex .

I asked if he would ok and write script for HCG to help with fertility and to keep the boys from shrinking/hurting.

He was ok with all of the above so I went with him :-)

Just don't be pushy and act like a know it all. Write down a list and ask all your questions. If you are in doubt, move on.

all good questions but I'd hold on the one in read since its not that critical, and it might sound as you are telling your doc how to do the protocol. just my opinion. what's important is to get it once a week.

[StinkyFinga]

So from what I'm reading, you think it would be best to go in there educated and not play dumb? Do I flat out tell her I want TRT or should I only ask these questions if she mentions it as a treatment option. Or is this best served on the follow up appt to review labs

What's the chance she is going to then send me for more lab tests to reconfirm.

[bass]

i'd say take it as it comes, let her know that you've been educating yourself and talking to friends that have been on TRT for years, but i'd still ask the three questions Dave listed because they will let you know what kind of doctor you're dealing with.

[FRDave]

So from what I'm reading, you think it would be best to go in there educated and not play dumb? Do I flat out tell her I want TRT or should I only ask these questions if she mentions it as a treatment option. Or is this best served on the follow up appt to review labs

What's the chance she is going to then send me for more lab tests to reconfirm.

Like Bass mentioned, go in there with the knowledge and ask questions, but don't request TRT. I already knew I needed TRT and was going to an A4M anti aging clinic, so it was more so if I wanted TRT or not vs a diagnosis.

I should have been more clear in my first post, sorry.

[powerlifterty16]

I have my first endo appt ever in hopes to be put on TRT. I have to be honest and say I'm expecting to be tested and told there is nothing they can do, OR, tested and have to go through rounds of every other treatment possible. Am I being to negative? I guess I'm just use to getting the run around with doctors.

I'm guessing the first appt will be questions. Me explaining my symptoms/history and she will order up blood work. After that, I'm a bit nervous. I know people may think I'm crazy but I will be disappointed if I am treated based on a number and not symptoms.

Your appt will depend on several things; These things include, your symptoms, the doctors' perception of your symptoms being related to t, your blood work, your t level, your age, your past frug use, and your workout history.
A good endo will order you a total test, free test, estradiol, shbg, and thyroid(tsh, ft3 ft4), psa, and cholesterol. if your total t comes back below 500, a good endo would look at symptoms. Below 400 though, it's a crime not to treat.

If the normal range is 348-1197, a bad endo will not treat a guy who is at 348, while a good endo will treat a guy much higher but still not optimal.

You also should have a prostate exam prior to treatment, and a pituitary mri. These are done to rule out contraindications and get a baseline, and to look for causative factors.

When in doubt tell the endo that your libido sucks and your gf/wife is thinking of leaving you bc she thinks you're cheating on her.

[Megalodon6]

remember you are still ultimately responsible for your health, meaning if you think your doc is not up to date with TRT, find a new one. if she dose once a month protocols, and if she says no hCG when you complain about your boys hurting, and if she says no AI when your E2 is through the roof, that's a good sign for you to move on. she can put you through lots of unnecessary misery if she is not the right doc for you. so ask all these question before she puts you on medication, don't be afraid to ask question, and of course always be nice and respectful

Great advice

[StinkyFinga]

Your appt will depend on several things; These things include, your symptoms, the doctors' perception of your symptoms being related to t, your blood work, your t level, your age, your past frug use, and your workout history.
A good endo will order you a total test, free test, estradiol, shbg, and thyroid(tsh, ft3 ft4), psa, and cholesterol. if your total t comes back below 500, a good endo would look at symptoms. Below 400 though, it's a crime not to treat.

If the normal range is 348-1197, a bad endo will not treat a guy who is at 348, while a good endo will treat a guy much higher but still not optimal.

You also should have a prostate exam prior to treatment, and a pituitary mri. These are done to rule out contraindications and get a baseline, and to look for causative factors.

When in doubt tell the endo that your libido sucks and your gf/wife is thinking of leaving you bc she thinks you're cheating on her.

That's one of my concerns. I believe my low normal test is due to a few things, years of opiate abuse (started with back problems and became physically dependent). That led to a few years of suboxone treatment. I have been free of both for a few years. During suboxone treatment I was put on anti-depressants. Basically, I've never felt the same. I was lost in that long road and can't find my way back. I know it's wrong for me to think this way but I'm old enough to know what I want. I'm a month shy of being 38. I've seen enough in my life to be 70. I will go through testing to be sure but sometimes, maybe there is just nothing causing it other than a long bumpy road that your body just says "screw you...I'm done trying to help you"

My off cycle libido does suck, sadly, so does my wifes. LOL. We can go weeks without. She has her own issues to battle. At least when I'm on test I have an urge and I am a bit more aggressive in getting what I want

My last test showed levels at 423. As you can see, not low, but what's low for someone my age. my SHBG/Free Test was not tested. I posted a while back but I ran some test prop, stopped my injections and am basically crashing. It's making me a bit more stressed out than normal. Again, I know I'm wrong to try this but if they are going to treat a number, which I know they will, I'll give them a number.

We'll see what happens. It's going to be a long week waiting/stressing.

Thanks for all the advice. I will definitely be following it. I just have to make sure I speak up for myself and not walk out of there wishing I said more.

[dreadnok89]

I skip every female doctor. I had bad encounters with all of them. At least you didn't start hrt yet so you really should go the MRI route and really find the main cause. If they push andro gel on you on your first visit refuse it. They don't get that when you use that it shuts your own production down then your really screwed.

On a side note, a lot of the really disregard estrogen and yet its the cause of so many ailments. Doesn't estrogen feed breast cancer? And now studies are pointing towardsit being the main culprit of prostate cancer in older men

[StinkyFinga]

I have concerns with this being a female doctor but I can only hope she is compassionate instead of like a male attitude of "suck it up". There is no chance of gel, I have a 3 year old. I'm not risking exposure like that.

[dreadnok89]

Oh my god I hate suck it up nonsense!!! Or man up lol.

[bass]

I have concerns with this being a female doctor but I can only hope she is compassionate instead of like a male attitude of "suck it up". There is no chance of gel, I have a 3 year old. I'm not risking exposure like that.

I guess I am very lucky, my doc is female and she is awesome, she and her husband are on TRT, so she understands TRT very well. you never know, you might have a good one, we'll see!

[dreadnok89]

Of course there is exceptions. I heard internists are pretty good with hrt

[StinkyFinga]

I guess I am very lucky, my doc is female and she is awesome, she and her husband are on TRT, so she understands TRT very well. you never know, you might have a good one, we'll see!

damn I'm moving to your city!

[bass]

what city are you're in?

[StinkyFinga]

20 minutes outside boston. I found a place that Dr. Mortlanger (sp?) runs but I was hoping to stay local. City commute is rough but do-able if necessary.

[bass]

way to far from me. my doc it like 6 minutes from where I live, and 5 minutes from my work! I live in southern cali.

[powerlifterty16]

That's one of my concerns. I believe my low normal test is due to a few things, years of opiate abuse (started with back problems and became physically dependent). That led to a few years of suboxone treatment. I have been free of both for a few years. During suboxone treatment I was put on anti-depressants. Basically, I've never felt the same. I was lost in that long road and can't find my way back. I know it's wrong for me to think this way but I'm old enough to know what I want. I'm a month shy of being 38. I've seen enough in my life to be 70. I will go through testing to be sure but sometimes, maybe there is just nothing causing it other than a long bumpy road that your body just says "screw you...I'm done trying to help you"

My off cycle libido does suck, sadly, so does my wifes. LOL. We can go weeks without. She has her own issues to battle. At least when I'm on test I have an urge and I am a bit more aggressive in getting what I want

My last test showed levels at 423. As you can see, not low, but what's low for someone my age. my SHBG/Free Test was not tested. I posted a while back but I ran some test prop, stopped my injections and am basically crashing. It's making me a bit more stressed out than normal. Again, I know I'm wrong to try this but if they are going to treat a number, which I know they will, I'll give them a number.

We'll see what happens. It's going to be a long week waiting/stressing.

Thanks for all the advice. I will definitely be following it. I just have to make sure I speak up for myself and not walk out of there wishing I said more.

opuates can cause it but u mention uve taken steroids before so that is a cause too...you should try an hcg /clomid pct.

[EverettCD]

I have my first endo appt ever in hopes to be put on TRT. I have to be honest and say I'm expecting to be tested and told there is nothing they can do, OR, tested and have to go through rounds of every other treatment possible. Am I being to negative? I guess I'm just use to getting the run around with doctors.

I'm guessing the first appt will be questions. Me explaining my symptoms/history and she will order up blood work. After that, I'm a bit nervous. I know people may think I'm crazy but I will be disappointed if I am treated based on a number and not symptoms.

My first appointment about TRT was with my Primary Care Physician. At that time I had no idea I was going in to be evaluated for TRT. I had been dealing with the signs/symptoms for a few years, they progressively got worse & my Doc started asking my what seemed like 1000 questions. He came to the conclusion that I probably had LowT. More than likely caused from being Hypothyroid since I was about 12 years old but he didn't just jump on the TRT bandwagon. He ran BW (the results looked like the telephone book), had an MRI done to rule out a Pituitary tumor & then finally before starting me on Axiron ran another round of BW. This was over the course of about 2 weeks or so. It seemed like forever but good things come to those who wait . My PCP has treated me for 10+ years so he knows my history with Hypothyroid & has prescribed me every prescription med I have taken in that time period. Needless to say after the research I have done this past 10 months I have realized that he approached my treatment correctly, he tested for everything HE knows to test for prior to starting me on TRT. Now keep in mind that my PCP is not a TRT specialist or an A4M Doc. After I learned about the need for HCG to maintain fertility & keep my grapes from shriveling into raisins I asked my PCP about it. He shot me straight & told me he's not up to date or trained in HCG use (he's currently working on that now to better serve his PT's) & to go see a Urologist. Good enough for me, he maned up & didn't try to go above his level of training.

If I was to start off with a new Dr today I would go into the appointment asking a few things:

1. What type of Testosterone do you prefer to prescribe & why? Some do better with injections vs topicals & visa versa.
2. If the Doc prescribes Testosterone Cype or Enanthate , am I permitted to go home with a script & self inject after being trained on the proper techniques?
3. Fertility preservation, do you prescribe HCG? What protocol?
4. What are you going to do to find the cause of my LowT? A lot of people don't have a choice, but many can be "fixed" without TRT for life.
5. Do you monitor E2 levels? If my levels are out of range what do you do to control this?
6. If I am placed on injections what dose frequency do you suggest & why?
7. If needed, can you help me optimize my diet & supplements to improve my health? If not can you refer me to someone that you would send your family member to?
8. Since this current drought we are in my money tree out back has died. I'm a Fireman, not a recent lottery winner. Do you accept my insurance? If not what will it cost out of pocket?
9. Can I contact your office if I have necessary questions? Phone and/or email? My PCP & my Urologist are great about this. I can call my PCP anytime & he calls me back quickly 98.6% of the time. My Urologist returns my emails within a day or so, that's good enough for me.

Like Bass stated, if you're not completely comfortable & have trust with your Dr, fire him/her & hunt on until you find one that puts your wellbeing over money. Too many Dr's these days have gotten lost & allow the money to dictate how they perform as a medical professional. I don't make all that great of a paycheck but when I go to work the customers well being is at the top of the list. Actually number 2, me & my brothers safety is number 1. Plain & simple, just like a Doc that's what we get paid to do, people don't dial 911 or go to their Doc because they are having a fabulous day, do your job to the best of your ability or find another job.

That's all I can think of at the moment. I'm sure as soon as I walk away from my laptop I'll think of some other questions I would ask.

[gatornate97]

My first appointment about TRT was with my Primary Care Physician. At that time I had no idea I was going in to be evaluated for TRT. I had been dealing with the signs/symptoms for a few years, they progressively got worse & my Doc started asking my what seemed like 1000 questions. He came to the conclusion that I probably had LowT. He ran BW (the results looked like the telephone book), had an MRI done to rule out a Pituitary tumor & then finally before starting me on Axiron ran another round of BW. This was over the course of about 2 weeks or so. It seemed like forever but good things come to those who wait . My PCP has treated me for 10+ years so he knows my history with Hypothyroid & all. Needless to say after the research I have done this past 10 months I have realized that he approached my treatment correctly, he tested for everything HE knows to test for prior to starting me on TRT. Now keep in mind that my PCP is not a TRT specialist or an A4M Doc. After I learned about the need for HCG to maintain fertility & keep my grapes from shriveling into raisins I asked my PCP about it. He shot me straight & told me he's not up to date or trained in HCG use (he's currently working on that now to better serve his PT's) & to go see a Urologist. Good enough for me, he maned up & didn't try to go above his level of training.

If I was to start off with a new Dr today I would go into the appointment asking a few things:

1. What type of Testosterone do you prefer to prescribe & why? Some do better with injections vs topicals & visa versa.
2. If the Doc Testosterone Cype or Enanthate , is the PT permitted to go home with a script & self inject after being trained on the proper techniques?
3. Fertility preservation, do you prescribe HCG? What protocol?
4. What are you going to do to find the cause of my LowT? A lot of people don't have a choice, but many can be "fixed" without TRT for life.
5. Do you monitor E2 levels? If my levels are out of range what do you do to control this?
6. If I am placed on injections what dose frequency do you suggest & why?
7. If needed, can you help me optimize my diet & supplements to improve my health? If not can you refer me to someone that you would send your family member to?
8. Since this current drought we are in my money tree out back has died. I'm a Fireman, not a recent lottery winner. Do you accept my insurance? If not what will it cost out of pocket?
9. Can I contact your office if I have necessary questions? Phone and/or email? My PCP & my Urologist are great about this. I can call my PCP anytime & he calls me back quickly 98.6% of the time. My Urologist returns my emails within a day or so, that's good enough for me.

Like Bass stated, if you're not completely comfortable & have trust with your Dr, fire him/her & hunt on until you find one that puts your wellbeing over money. Too many Dr's these days have gotten lost & allow the money to dictate how they perform as a medical professional. I don't make all that great of a paycheck but when I go to work the customers well being is at the top of the list. Actually number 2, me & my brothers safety is number 1. In a nutshell that's what we get paid to do, do your job to the best of your ability or find another job.

That's all I can think of at the moment. I'm sure as soon as I walk away from my laptop I'll think of some other questions I would ask.

Great post!!! Thanks for the input

[EverettCD]

Thanks Gator. My brain decides to kick in a be useful a few times a year. I think I just used up all my useful braincell allotment for 2013, see y'all next year Maybe Austinite knows of a supplement for that.

[StinkyFinga]

power: I've done PCT and my baseline was low 400's. Always early morning. I'm curious to see what my levels are later in the day (12 or later) because that's when I usually start feeling worse.

Everett: Thanks, that is helpful. I will keep those in mind. I'm pretty shy so I hope I can get the courage to ask these things. I'm so use to having to play dumb with doctors this will be a completely new experience. I know what I want, so why should I have to act like I don't have a clue about my options.

[StinkyFinga]

Do you guys think I would be wrong to email my PCP and tell him how my psychiatrist thinks I could benefit and how I think I could from this treatment?

[powerlifterty16]

what was ur pct?

[StinkyFinga]

clomid/nolva/aromasin . During PCT my levels went to 600, a week after stopping, they dropped down and stayed that way. Problem was, either the clomid or nolva really messed with my head.

[StinkyFinga]

Today is my appointment. I'm nervous as heck. Expecting the worst, hoping for the best.

[bass]

good luck Stinky! keep us posted.

[EverettCD]

Don't sweat it stinky. You're not on trial for murder, it's a Drs appt. It will be fine.

Sent from my iPhone that was manufactured in a sweat shop in China