First appt. with Endo

[quietasamouse]

Hey,

I've got my first appointment with Endo coming up. My doc referred me after my Test scores came back: Free 8.0 (8.7-25.1 normal range), Serum 324 (280-800 normal range). Estradiol is 16.2 (7.6-42.6), LH is 3.0 (1.7-8.6).

Any tips for making sure I get a decent 'script?

Qaam

[Vettester]

The only tip I have is crossing your fingers that you get a good doctor. Your "T" score is in the range where some docs will say you're just fine and send you home with nothing, but the doc down the street might put you on 200mg of Cyp w/HCG.

Also, your E2 score looks a little low (IMO) even though it's in the range. 20's & 30's seem to be the sweet zone for most.

[EZ E]

A lot of docs are going to be cautious prescribing a lot of drugs to start. Don't be surprised if he just wants to put you on test only, especially to see how your numbers improve. The important thing is to question him about what he does if estrogen starts to get too high; what are his thoughts on the use of HCG to keep you fertile. He may not prescribe these drugs right away or often, but make sure he is open to the possibility if needed. If you don't like what you hear, find another doc.

Good luck.

[quietasamouse]

Your "T" score is in the range where some docs will say you're just fine and send you home with nothing, but the doc down the street might put you on 200mg of Cyp w/HCG.

Also, your E2 score looks a little low (IMO) even though it's in the range. 20's & 30's seem to be the sweet zone for most.

I understand the serum "T" score is borderline, but wouldn't the low free "T" imply that action is needed?

With regards to the E2, what is the line of action they take on that? Or is it just part and parcel of HRT with "T"?

Thanks for the info!

Qaam

[subnet]

hey qaam, as vette said, cross your fingers that you get a good doc. The endo I went to held fast to a rule that you had to be outside of the 'magic' range for her to even consider treatment. My first test from my GP was outside of range and he then referred me to the endo. Her (the endo) labtest had my total T slightly in the range but my free was high and she wanted to retest, only to validate the free-T level. A third test had my free-T high but my total T was again low, so she threw gel at me. I had to plead with her to get her to test E2 as she didn't think it was even necessary. Note, I had signs of high E, including hot flashes etc.

So the result was that I found a new doctor who actually believed in TRT. Not trying to be a pessimist here but just relaying my story. Really hope you get someone who wants to help you and just doesn't go solely by the numbers. Good luck!

[Vettester]

I understand the serum "T" score is borderline, but wouldn't the low free "T" imply that action is needed?

With regards to the E2, what is the line of action they take on that? Or is it just part and parcel of HRT with "T"?

Thanks for the info!

Qaam

Qaam, you're trying look at this like there's a rationalized standard system with this stuff. The first thing you need to realize is that the field of HRT and treatment thereof is still in the dark ages for the most part with modern medicine.

A good portion of the members here were sitting in your shoes with the same presumptions. It's all a roll of the dice with the doc your dealt. A good portion of the basic docs/endos only look at the total serum. Some will discount their patients when it's in the 200's. Some will give them a monthly shot. Some will jam the gel on you because they think injections are for steroid mongers and they hate the thought of anyone trying to get healthy on the stuff. It's all over the place!

Go through with your appointment. Listen to him/her. See if they listen to you. Do your homework when you leave and decide if that is good for you or not. If not, make the next move to cover your needs.

[quietasamouse]

Okay, I hear you. Thank you for the information. This board is a great place to get informed about this stuff.

Cheers,
Qaam

[oakdad]

If you increased your LH it looks like everything might end up falling in place. HCG might be the ticket for you.

[quietasamouse]

One more test score to add to the bunch: IGF I: 116 (ref range: 115-307).

Any reason they'd prescribe HGH to someone in mid-thirties?

Qaam

[quietasamouse]

The first appointment went well. The doc seemed really engaged, took my concerns seriously. Currently waiting to see how the second round of Tests for T come back, but he was already talking TRT in the first appointment, mostly on the basis of libido and scores.

[zaggahamma]

dont book an appt without first asking and confirming that the doctor will treat you with test...you can maybe even ask over the phone if the doc is an agressive prescriber or conservative or maybe even what his starting protocol maybe...

either way youre looking at another blood test, an mri of the pituitary, a finger up your arse to test for prostate abnormalities(get a female endo for this at least or during the phone interviews ask the doctors ring size)...

if prostate checks out and your second labwork confirms low-T and consistent with your symptoms you can get a script..

btw, what are your symptoms, goals from obtaining this "script"?

[quietasamouse]

As far as reasons/symptoms, I'd love to get jacked- but I don't think it's in the cards. For the last few years I've been seriously fatigued, no ability to put on muscle, start of high blood pressure etc. And now a libido that is dropping like a rock too. Seemed like TRT might be an answer, especially with my scores being in that neighborhood.

Maybe the door to "getting big" will open up farther down the road, but right now, I just want to feel better.

Not looking forward to that finger.

Qaam

[zaggahamma]

As far as reasons/symptoms, I'd love to get jacked- but I don't think it's in the cards. For the last few years I've been seriously fatigued, no ability to put on muscle, start of high blood pressure etc. And now a libido that is dropping like a rock too. Seemed like TRT might be an answer, especially with my scores being in that neighborhood.

Maybe the door to "getting big" will open up farther down the road, but right now, I just want to feel better.

Not looking forward to that finger.

Qaam

you'll be surprised what you can do when youre running with adequate to upper hormone levels

[Vettester]

jpkman is right, you'll really notice a difference with the increased hormone levels.

Definitely keep on track with taking the steps to get healthier.

[SlimmerMe]

your IGF-1 level seems low to me and an aggressive doctor would agree!

[zaggahamma]

One more test score to add to the bunch: IGF I: 116 (ref range: 115-307).

Any reason they'd prescribe HGH to someone in mid-thirties?

Qaam

if you had a lot of cash/credit and you went to an anti aging clinic...those WOULD BE THE/ARE the 2 reasons

[quietasamouse]

if you had a lot of cash/credit and you went to an anti aging clinic...those WOULD BE THE/ARE the 2 reasons

Lol.... okay, point taken. I won't worry about it. Thanks for the words of wisdom

[quietasamouse]

Well, so much for that. My second round of tests came back all in the "low normal" and I got told to take a hike: "Come back in six months for retest. Sorry you feel lousy. We ain't gonna do jack."

Didn't seem real interested in my symptoms anymore.

Not sure what the next step is. Thoughts?

[zaggahamma]

Well, so much for that. My second round of tests came back all in the "low normal" and I got told to take a hike: "Come back in six months for retest. Sorry you feel lousy. We ain't gonna do jack."

Didn't seem real interested in my symptoms anymore.

Not sure what the next step is. Thoughts?

think we said to go to a clinic...if you can?

[Vettester]

QAM, when you made your initial post, I responded with "Cross your fingers for a good doc". Now you know what I was talking about. Looks like you got a doc who treats the score, not the patient.

Your next step is to find a place that will treat you, or you cut bait and go 6 months to just have this same doc waste your time again.

[quietasamouse]

Alright, I guess I'll start looking into clinics then.

I had really hoped to stick with the insurance-pays plan, as I don't think I can afford TRT long term paying on my own.

That said, feeling better would worth a ton.

-Qaam

[Vettester]

Trust me when I say that I know exactly how you feel. I've been down the same stretch of road before. It's real frustrating knowing that you could purchase a full HRT program for less than cable TV if only the doctor was more in tune with the patient's health.

Honestly, I probably wouldn't even be a member on this forum if my primary doc was somewhat up to speed on what the variables are with HRT.

[zaggahamma]

Alright, I guess I'll start looking into clinics then.

I had really hoped to stick with the insurance-pays plan, as I don't think I can afford TRT long term paying on my own.

That said, feeling better would worth a ton.

-Qaam

thats wut i was asking...you CAN find a doc to rx test and arimidex and possibly hcg...but you'll never(99% unlikely) get deca, growth hormone, etc.

but at least insurance will cover it...but if YOU HAVE THE MONEY...the clinics will save you time

[quietasamouse]

jpkman,

Sorry I misunderstood. Yeah, finding a good doc would still be my first choice. I want to feel healthy, and not have to worry about my numbers being the end of the conversation.

I don't know how folks can afford TRT otherwise.

-Qaam

[zaggahamma]

jpkman,

Sorry I misunderstood. Yeah, finding a good doc would still be my first choice. I want to feel healthy, and not have to worry about my numbers being the end of the conversation.

I don't know how folks can afford TRT otherwise.

-Qaam

some ppl have more dollars plain and simple fact of life sounds to me like you should call around maybe a few calls a day and do a little search...YOU CAN find a trt doc and it will all be covered with your insurance

[quietasamouse]

All right, I will. Thanks for the encouragement.

Qaam

[quietasamouse]

Got an appointment for doctor #2! Keep 'em crossed for me.

-Qaam

[Epic Ed]

Good luck. If you fail to find one who will put you on TRT the clinics really aren't that expensive for a basic test cyp maintenance program. If you're just running 100mg EW a 10mL vile will last you 20 weeks. Call around to different pharmacies in your area and get a "cash price" for a script of test cyp. If you shop around you'll be surprised how inexpensive it can be, and then you factor the cost of that vile over 20 weeks -- comes out to peanuts, really.

[RNMOVR]

Well, so much for that. My second round of tests came back all in the "low normal" and I got told to take a hike: "Come back in six months for retest. Sorry you feel lousy. We ain't gonna do jack."

Didn't seem real interested in my symptoms anymore.

Not sure what the next step is. Thoughts?

It could be worst. instead of giving me a script, my family Dr recommend Wellbutren and a phsyc eval. I'm somewhat in the same boat except i'm looking for a closer Dr. I have been calling around and talking to either the receptionist or a nurse and I ask them straight up if deals with a lot of TRT. Ask them what he typically prescribes. If they don't know or you don't like the answer move. If they keep test on hand at the office. Score... No co-pay, no foul. Also, check your local compounding pharmacies as they can probably tell you who they see a lot of script for test from.

[zaggahamma]

It could be worst. instead of giving me a script, my family Dr recommend Wellbutren and a phsyc eval. I'm somewhat in the same boat except i'm looking for a closer Dr. I have been calling around and talking to either the receptionist or a nurse and I ask them straight up if deals with a lot of TRT. Ask them what he typically prescribes. If they don't know or you don't like the answer move. If they keep test on hand at the office. Score... No co-pay, no foul. Also, check your local compounding pharmacies as they can probably tell you who they see a lot of script for test from.

i'd really love to fill their fvcking mouths with that wellbutrin mother fvcking bullshit

[RNMOVR]

i'd really love to fill their fvcking mouths with that wellbutrin mother fvcking bullshit

I take it you have had the same coversation..

[quietasamouse]

Yeah the link between low-T and depression certainly gets them scrambling. I went to a shrink first, 'cause people kept asking me if I was depressed. I'm not. I'm really pretty happy overall. I just want to feel better. Shrink agreed. Not depressed.

[zaggahamma]

I take it you have had the same coversation..

actually not from any of the medical doctors that i've seen but i've seen MANY ppl post here and see it everday life people talk of being on AD's or their docs pushing them

[quietasamouse]

Saw my second Endo.... As soon as he saw my scores he put me on 150mg a week. I'm hoping this does the trick.

Thanks for the encouragement to go for another endo.

Qaam

[zaggahamma]

Saw my second Endo.... As soon as he saw my scores he put me on 150mg a week. I'm hoping this does the trick.

Thanks for the encouragement to go for another endo.

Qaam

bro thats great news and a perfect starting dose in my opinion...best of luck bro...let us know how well youre doing

[Jadam]

actually not from any of the medical doctors that i've seen but i've seen MANY ppl post here and see it everday life people talk of being on AD's or their docs pushing them

Same thing here. Dr said I was despressed and sent me to a psych. Offered me some prozac. Seemed really excited about it's off label sexual benefits. Needless to say, I'm still looking for a competent dr.