How to get a Doc to take me seriously?

[ZoomyR6]

Hey fellas,

I have been hopping doctor to doctor with no luck... I am 31 and have felt like crap for the past ten years. Depression, lack of libido, difficulty losing the remaining fat around my belly, very difficult building muscle, and lack of motivation to do anything. I finally went from blood work twice and the results were:
Total Test-332 and 422
Free Test- 64 and 79

It is CLEARLY on the low end and explains all the above symptoms. Despite this, every doc tells me I am fine because it is still within "normal". Yeah, normal for a 70 year old.

Wtf do I need to do to be taken serious? Are there any good docs in the nyc area? I have insurance so I want to stay away from those out of pocket clinics.

Thank guys

[MuscleScience]

Hey fellas,

I have been hopping doctor to doctor with no luck... I am 31 and have felt like crap for the past ten years. Depression, lack of libido, difficulty losing the remaining fat around my belly, very difficult building muscle, and lack of motivation to do anything. I finally went from blood work twice and the results were:
Total Test-332 and 422
Free Test- 64 and 79

It is CLEARLY on the low end and explains all the above symptoms. Despite this, every doc tells me I am fine because it is still within "normal". Yeah, normal for a 70 year old.

Wtf do I need to do to be taken serious? Are there any good docs in the nyc area? I have insurance so I want to stay away from those out of pocket clinics.

Thank guys

I think the answer is clear, since your ranges are within normal ranges. The doctors won't put you any type of medication because the insurance companies will not pay for it. Remember the insurance company is footing the bill, if their internal reviewers see your lab results which are objective measures. They will ignore your subjective complaints and deny payment.

The best thing to do is go to an HRT/men's health clinic. Pay 200 bucks a month and be done with it.

[ZoomyR6]

I think the answer is clear, since your ranges are within normal ranges. The doctors won't put you any type of medication because the insurance companies will not pay for it. Remember the insurance company is footing the bill, if their internal reviewers see your lab results which are objective measures. They will ignore your subjective complaints and deny payment.

The best thing to do is go to an HRT/men's health clinic. Pay 200 bucks a month and be done with it.

Thanks for taking the time to reply. Even without insurance, Costco has 200mg/ml 10ml vial for $63. I definitely don't need insurance for that. Just the initial prescription I suppose

[ZoomyR6]

Double post

[kelkel]

Take a minute and read the Finding A Doc Sticky and see if any of the ideas there help you. You should be treated based on symptoms, not simply by a number on a chart. And that price seems high for Costco. I've seen it in the $40 range.

[CobraMustangSVT]

Joseph Olivieri in NYC

[kelkel]

Joseph Olivieri in NYC

Great tip Cobra! Found this through a quick search:


Dr. Joseph Olivieri is an HIV Specialist who also administers TRT. I found him in NYC through my insurance company. He accepts insurance and prescribes hCG and AI's if needed. He is located on 139 Fulton St., NYC, NY 10038 and the phone is (212) 406-0134. I think he's a great doctor.

Here is his bio:
http://ageonicsmedical.com/all-docto...ieri-md-faafp/


Saw also that Nelson Vergel recommends him. That should be enough for anyone. He will prescribe HCG and AI's if needed as well per Nelson.

[ZoomyR6]

No shit... You guys are the best!
I originally looked at the Finding a TRT doc but it didn't seem to help much.
Aside from being truthful, is there any specific way to go about it to increase my odds of taking me serious and not look to prescribe me clomid or some other shit? I already have done a lot of research but it seems that the other docs I have been to aren't on their game when it comes to this.
I already have two separate blood work done. Should that be enough or is there anything else needed to solidify my case here? (I read it somewhere and its true. Its crazy a woman can take hormones to become a guy and a guy to become a woman but its a no no to use it for a man to feel like a man...)

[kelkel]

Well, one of the important parts of the Doc sticky is to call the doc's offices and ask how the doc treats guys and avoid wasting your time. You can eliminate a lot that way. When it comes to being taken seriously you need to focus on symptoms, not numbers with the docs. The type of treatment should be up to you.

Clomid is more often than not used for guys worried about fertility. Other than that the subjective benefits of clomid are anecdotally not as good as testosterone . If testosterone is used then HCG should be used which in turn will maintain testicular function to a degree and thus, fertility. And yes, most docs don't know hormones as they're not trained in them in school.

If you can, redact your name and post up your blood work so we can review it. Maybe something is suppressing you that your docs missed (happens all the time) that can be corrected, restoring better T levels.

[ZoomyR6]

The first pic is of the first blood work early afternoon. The second pic is within 3hrs upon waking

Attachment 169053Attachment 169054

[kelkel]

Attachments won't open for me Zoomy.

[ZoomyR6]

First blood work in afternoon



Second blood work in the morning

[ZoomyR6]

I don't know why the images are so damn big!

[AR's King Silabolin]

Could be simple. This worked for me. Use some anavar , sarms or something other supressive thing which do not also destroy too much of other values. Then show up at the docs office whining couple of weeks later and ask for bloods. Your test will come out in the 100 f.i
Then do the same thing some months later (the doc need two tests to be aloved) and then your doc are not alloved to not put you on trt.
Ofcourse doc cannot know what u are doing so dont get big. And dont forget to read up on the symptoms related to 100ng/dl, memorize and tell doc.
And eas up on your knowledge on HCG and AIs. Not important in the beginning anyway.

[ZoomyR6]

Could be simple. This worked for me. Use some anavar , sarms or something other supressive thing which do not also destroy too much of other values. Then show up at the docs office whining couple of weeks later and ask for bloods. Your test will come out in the 100 f.i
Then do the same thing some months later (the doc need two tests to be aloved) and then your doc are not alloved to not put you on trt.
Ofcourse doc cannot know what u are doing so dont get big. And dont forget to read up on the symptoms related to 100ng/dl, memorize and tell doc.
And eas up on your knowledge on HCG and AIs. Not important in the beginning anyway.

Won't I have to do a slight pct because of gyno, which I have very little of from puberty?

[kelkel]

Note that on your test earlier in the morning your T was higher, which is normal. I wonder how much higher it would be if you tested it immediately upon waking? It is just a snapshot in time but earlier is always better re hormones.

Your shbg is at a good level so that's not binding to much test. Nothing is jumping out as obviously suppressing you. Even your LH isn't bad. We'd need to see prolactin, cortisol and a thyroid panel (TSH, FT3, FT4) to look further into this. Great chol and psa values!

Agree with Musclescience that most docs would be hard pressed to offer you TRT. That said, your numbers could be low for you and presenting you with the sypmtoms you described.

[-Ender-]

Could be simple. This worked for me. Use some anavar , sarms or something other supressive thing which do not also destroy too much of other values. Then show up at the docs office whining couple of weeks later and ask for bloods. Your test will come out in the 100 f.i
Then do the same thing some months later (the doc need two tests to be aloved) and then your doc are not alloved to not put you on trt.
Ofcourse doc cannot know what u are doing so dont get big. And dont forget to read up on the symptoms related to 100ng/dl, memorize and tell doc.
And eas up on your knowledge on HCG and AIs. Not important in the beginning anyway.

This is horrible advice.

[geezuschrist]

At 31 you should have no problem finding a doc. The low t centers are popping up everywhere.

[fit_deskjocky]

With no red flags on the bloodwork. Do you get outside enough? Workout, self-esteem issues, work night-shift and lack sleep, stressful job? Basically do you suffer from season depression? Which could be anything from lack of sunlight to lack of sleep.

I kind of struggled with your same symptoms and all my bloodwork came back as good as yours have. Doc put me on very low dose, 20mg of Celexa for seasonal depression due to the shorter days, cold winters and long work hours. Getting up before the sun and leaving work after the sun has gone down was having an effect on me in the winter.

[ZoomyR6]

With no red flags on the bloodwork. Do you get outside enough? Workout, self-esteem issues, work night-shift and lack sleep, stressful job? Basically do you suffer from season depression? Which could be anything from lack of sunlight to lack of sleep.

I kind of struggled with your same symptoms and all my bloodwork came back as good as yours have. Doc put me on very low dose, 20mg of Celexa for seasonal depression due to the shorter days, cold winters and long work hours. Getting up before the sun and leaving work after the sun has gone down was having an effect on me in the winter.

I workout on 5/3/1 strength program 3x week. I work the day shift outside, zero stress at work. Mind seems to start racing at night, nothing bad, just nonsense and random stuff. Was on meds years ago and nothing ever helped with sleep

[Sh0tsf1red]

Hey fellas,

I have been hopping doctor to doctor with no luck... I am 31 and have felt like crap for the past ten years. Depression, lack of libido, difficulty losing the remaining fat around my belly, very difficult building muscle, and lack of motivation to do anything. I finally went from blood work twice and the results were:
Total Test-332 and 422
Free Test- 64 and 79

It is CLEARLY on the low end and explains all the above symptoms. Despite this, every doc tells me I am fine because it is still within "normal". Yeah, normal for a 70 year old.

Wtf do I need to do to be taken serious? Are there any good docs in the nyc area? I have insurance so I want to stay away from those out of pocket clinics.

Thank guys

Tell your doctor to "treat the patient and not the numbers", if you are having symptoms and borderline it seems pretty clear...

[ZoomyR6]

Finally found a doc. He agrees whole heartedly about treating the patient and not the number. Just submitted a claim for pre-approval for insurance otherwise I will just pay out of pocket. Now, for the syringe shopping...
Thanks for the help guys and will keep you posted. Will ask if he prescribes hcg next visit

[kelkel]

Finally found a doc. He agrees whole heartedly about treating the patient and not the number. Just submitted a claim for pre-approval for insurance otherwise I will just pay out of pocket. Now, for the syringe shopping...
Thanks for the help guys and will keep you posted. Will ask if he prescribes hcg next visit

Congrats. Ask about Arimidex as well for E2 control if needed.

[ZoomyR6]

Congrats. Ask about Arimidex as well for E2 control if needed.

Will do. Based on my blood work, do you think I will have any issues whatsoever without an AI? Do I really need Hcg ?
How much can I expect my estrogen to go up from 26 on trt? Isn't my Free Test kind of low?
Sorry for all the questions. Shit just got real since finding a doc willing to prescribe trt and trying to read as much as I can.

[kelkel]

When TRT is implemented and your test level rises your E2 naturally will follow. Where it lands will be anyones guess. You should not start out taking an AI as it's not warranted. That said, know that the proper test would be a Sensitive E2 Assay, not standard as listed on your BW above as it can be wildly inaccurate in men as it's geared for women. After 4-6 weeks on TRT BW should be pulled and evaluated. If an AI is warranted, implement it at the lowest dose possible, such as .25 once or twice per week. Depending on need and protocol.

Simply put, if you care about your testicals then you need HCG . Personally, I can't think of any body part I'd let whither away and cease functioning. Get the point?

Yes, your FT is low imho. I prefer FT near the top of the scale for obvious reasons.

No worries about the questions. It's why we're here. Please report back on this thread with how your first appointment goes!

Continue self educating. You are your best advocate!

[ZoomyR6]

I just found out he prescribed Test E. I don't think he does HCG so I will have to order online. What is the normal dosing protocol and how long to run it? How does someone raise their FT?

[kelkel]

Ask him for it and explain why. Google HCG Package Inserts and find one that lists "Hypogonadic Hypogonadism" as a use, many do and present it to him. Normal dosing is about 250 iu's x 2 per week. You run this the entire time you're on TRT. Read the sticky thread on it at the top of this forum.

Implementing TRT will increase serum T and thus FT. Vit D is also one of the most important supps to take which will help with FT levels by reducing SHBG levels.

[ZoomyR6]

NYS sucks with controlled substances. I have mail order and they only fill 1 month at a time. So that means every 2 weeks, call the Doc and have him submit the script online (hopefully he does this in a timely manor), wait for it to be filled, shipped out, and wait for it to arrive. And the medication needs to be re-approved every year.

My biggest worry is having trouble getting it in the future or it not arriving on time once I start because there is no going back. Im about to say fuck it a stay feeling like shit.

[CobraMustangSVT]

NYS sucks with controlled substances. I have mail order and they only fill 1 month at a time. So that means every 2 weeks, call the Doc and have him submit the script online (hopefully he does this in a timely manor), wait for it to be filled, shipped out, and wait for it to arrive. And the medication needs to be re-approved every year.

My biggest worry is having trouble getting it in the future or it not arriving on time once I start because there is no going back. Im about to say fuck it a stay feeling like shit.

Wait until you have to deal with NY and needles. The grief you have to go though.....

[ZoomyR6]

What kind of grief? You can just order syringes online dirt cheap. No issues

[ZoomyR6]

I noticed HCG comes in 5,000 and 10,000iu vials. If you are taking 500iu a week, that will last you months. I thought bacteriostatic water will keep it good for a few weeks. How does this work so you don't waste the rest of the vial?

[kelkel]

5k IU's should last 10 weeks. No worries at all with the bac water when refrigerated.

[canadian77]

I thought bacteriostatic water will keep it good for a few weeks.

This is such a myth. I've seen one particular study although I don't have a link where someone left HCG out of the fridge at 25ºC for 6 weeks and it was still at 100% potency.

I just recently used some premixed HCG from an India Pharmacy that was over 2 years old mixed with excipients (and it's over 6 months expired), and it's still keeping my nuts from shrinking. So HCG is way more versatile than people think.

The myths of the fragility of HCG and how quickly it loses potency came from the HCG weight loss community full of anecdotal experiences where people just "feel" that it's no longer potent. Such BS and a huge disservice to those who use HCG for a legit reason.

[Obs]

This is such a myth. I've seen one particular study although I don't have a link where someone left HCG out of the fridge at 25ºC for 6 weeks and it was still at 100% potency.

I just recently used some premixed HCG from an India Pharmacy that was over 2 years old mixed with excipients (and it's over 6 months expired), and it's still keeping my nuts from shrinking. So HCG is way more versatile than people think.

The myths of the fragility of HCG and how quickly it loses potency came from the HCG weight loss community full of anecdotal experiences where people just "feel" that it's no longer potent. Such BS and a huge disservice to those who use HCG for a legit reason.

Wow, news to me, thanks kel.

[ZoomyR6]

Alright so heres the update.

Its been a week and I still don't have my meds. The doc keeps sending the script to the pharmacy but express scripts is giving me a hard time because it isn't written to their liking. Being from NY, I can only get a 30 day supply with no refills which means no 10ml vial. It also means to call the Doctor every 2 weeks to remind him to send in the script, wait for it to be filled, and then wait for it to ship which in itself can take 4-6 days to get to me.
I need to get the 1ml 200mg/ml vial that are single use only so I would need 4 of them because I would have to use half a vial and toss the other half.

This is exactly the thing I am scared most about. It's starting and then running into issues like this where I will be without my meds and crash. Anyone know what I am talking about that can offer advice? I am contemplating ordering online to have a emergency stash. I really want that 10ml vial so It will last me 20 weeks. God I hate NY.

[kelkel]

What about reaching out to the doctor mentioned in post 6 & 7?
That or request Aveed instead. With Aveed you have an intial injection followed by a 6 week booster. Then shots are once every 10 weeks (more or less) based on blood work.

[ZoomyR6]

Unfortunately, it wouldn't matter what doctor it is. Its the NYS law and was wondering if anyone knows any loop holes around this or what they do to get that larger vial

[CobraMustangSVT]

I told you to go to Olivieri. He give me a script and I get a 10mL vial every month!!!

He writes out the script as 2.5mL a week. I've been getting a 10mL vial every month for the past 3 years....in NYC of all places!! He hands me a paper script, I go to CVS, Pathmark, Walmart, Duane Reed.....whichever....they order it, and I pick up my vial the next day. I've got like 8 extra vials stacked up here.

[ZoomyR6]

Wtf?!? It's usually the pharmacies that knock down that amount from what I hear.
He will write it but do you have any specific locations you use to fill it? I'm in Queens

[CobraMustangSVT]

I go anywhere. I've used CVS in Manhattan by my job, or Queens by my girl, or Brooklyn by my house. It's a paper script. It can go anywhere. I've gone to Pathmark, CVS, Duane Reed, etc. They fit what he orders. Nobody's ever questioned hims script. I give it to them, they tell me to come back the next day and I pick up my 10mL bottle. He'll even write me a script for 100, 3mL 26 gauge needles. He writes scripts for arimidex , deca , hCG , etc.

I would have had more than 8 vials stacked up if I weren't running 600mg cycles every 6-8 months.