Clueless doctor and patient

[CarlosSemiDanger]

I'm 41yrs old male 5"11 220lbs w/ BF 18% and been pumping iron for the last 25 years without using any steroids. I have no problems in having sex expect that a bit more would be better

During my physical I complained the lack of energy during this spring but recently been feeling better after starting new training cycle and improving my diet a lot (I was around BF22% prior at mid-July). Doctor took T-test and I'm in 200ng/dl. This was taken in the morning after heavy 5 week training cycle at the last training day (had sex with wife, hit the gym and then to doctor to be specific :-)).

My first reaction after hearing the news was that I cannot believe it as I thought some insulin resistance could be the cause of lack of energy during afternoons. I also thought that it shouldn't be possible for me to make any muscle and strength gains that I have done during this the last spring and now after summer vacation. Libido is still good (not as good as when I was in my early 20s but not far off).

Doctor's comment was that it seems that my T is low and asked if would I like to start hormone replacement therapy for the next 6 months using depo-Testosterone injections every four weeks. Only risk factor that I have according to him was that I'm "obese" based on BMI. Since then I have been doing a lot research on the topic as I have understood that HRT is one way street so there is no coming back from there.

Doctor is still looking at my serum levels and I'm waiting PSA prior we can start the injections so I have some time make up my mind on the whole thing. He didn't want to try Clomid with me as kick-starter as "Clomiphene is not approved in the US for treating hypogonadism".

Sorry about the lengthy intro and here are the specific questions:
- Based on my story, do you think I should ask doctor to do some other tests or try something else?
- If I start HRT, then will there really ever be way to get off from the cycle? Eg. even if doctor is not 'in' for giving me Clomid after cycle, I could acquire it some via some other means and do it on my own and have him just monitor my test-levels?
- Should I try to find another doctor? This guys seemed to agree into moving every two weeks shots just by me arguing over email about the four week cycle so the guy doesn't seem to have strong opinion on how to move forward (all experts have strong opinions :-)) - other alternative is to get things started with him and then move to another doctor

Any help is appreciated and I tried to avoid hitting FAQ stuff by reading them first but didn't find the exact matches

[Low Testosterone]

It would be beneficial to find a doctor that prescribes you to inject testosterone 1-2x per week. Based on the protocol the doctor has laid out for you, your testosterone levels will peak in 48-72hrs after your injection and by the end of the week fall back towards your baseline. From there, you'll have to wait another week before you have another shot.

There's really not a lot to fear regarding TRT and having to come off. If you have low testosterone, you need testosterone, so there's no reason to cycle off of it. Coming off makes no sense. However, if for some reason you're forced to discontinue treatment, it's not going to kill you. If you're forced to come off, you'll simply revert to where you were before you began. Of course, you'll probably be a little lower since you'll be a little older.

[CarlosSemiDanger]

Thanks for the answer. If somebody would be telling me that I have a shortage on my B12, then I would be eating those pills like I do turkey on thanksgiving but when it comes to my testicles somehow I get more cautious.

Does anybody think that my low 200 levels could have be just caused by overtraining and low calorie diet and I should ask Dr. to re-do the test? Even if my normal levels would be doubling, they still wouldn't be that high so should I just conclude that TRT is the way to go? I don't mind doing it but I just don't want to start it unless I'm certain I need it (but it kind of looks that I do).

Doctor was saying that my upcoming dosage will be based on my current levels but when reading the articles it makes me wonder if the current level matters at all after few months of TRT as essentially the hormone controls are a closed loop managed so when I get some inserted outside my body, the current production will automatically go down, right?

I guess I need to lobby my doctor to monitor my testosterone levels right before injecting another shot to ensure that the lowest point is high enough. Of course, this would mean that the peak values would be much higher than the normal levels.

[powerlifterty16]

Thanks for the answer. If somebody would be telling me that I have a shortage on my B12, then I would be eating those pills like I do turkey on thanksgiving but when it comes to my testicles somehow I get more cautious.

Does anybody think that my low 200 levels could have be just caused by overtraining and low calorie diet and I should ask Dr. to re-do the test? Even if my normal levels would be doubling, they still wouldn't be that high so should I just conclude that TRT is the way to go? I don't mind doing it but I just don't want to start it unless I'm certain I need it (but it kind of looks that I do).

Doctor was saying that my upcoming dosage will be based on my current levels but when reading the articles it makes me wonder if the current level matters at all after few months of TRT as essentially the hormone controls are a closed loop managed so when I get some inserted outside my body, the current production will automatically go down, right?

I guess I need to lobby my doctor to monitor my testosterone levels right before injecting another shot to ensure that the lowest point is high enough. Of course, this would mean that the peak values would be much higher than the normal levels.

you should always do a retest..but i think trt is in your future. im like u i put trt off for a long time, and still am...but it's time to get some trt...im 23 though never used roids either...and t is in the low to mid 3's....if our t level is below 500 you probably have low t symptoms.