newbie research question

[makingwaves]

What makes a doctor a leader in TRT? I want to do research on it, my doc is not doing what I read here. Who is respected in this field?

I have read crisler stuff, not all...have read endo society protocals and some other book, but a smart quack could still sound good to the layman.

A few names or links would be appreciated.

I go for test cyp every two weeks 350mg IM. Still have "low t".

[bass]

welcome here bro! as you mentioned dr. Crisler is one of the leading docs, if you keep reading his stuff you will learn allot, also you can read the stickies in the this section, kind of quick links as you said to good educational reading. your protocol is terrible because you're doing it once eow and no mention of AI's and hCG. you probably have high E2 and possibly binding your to SHBG, you could also have high RBC, Hemoglobin and Hematocrit.

at a minimum for a good TRT protocol you need,

Testosterone once or twice a week
AI (aromatase inhibitor) like Anastrozole, roughly 0.5 mg to 1 mg per 100 mgs test
hCG to keep your testis functioning and prevent them from atrophy, other benefits comes with it as well.
donate blood every two months

finally BW to see how your protocol is doing and adjust from there until you find your sweet spot.

[makingwaves]

You're right my BW has not inspired confidence as no baseline of certain things. I did gel for 6 mo with no change. Once shots started I felt better as I went through "androgen curve" and recently went back down to low t (250).

That's when I asked for test results, joined forum, read books, and got serious.

From the profile I read on Crisler I was unsure of his medical credentials. That's why I asked about what separates quacks from leaders. Thanks for the welcome.

[kelkel]

Crisler is at the top of his field when it comes to TRT. Also Abraham Morgantaler: http://www.lef.org/magazine/mag2010/...or-Life_01.htm Get his book "Testosterone for Life" and read it. As well as Dr. Shippen from Reading, PA. has left his mark in the field. Look for an A4M Certified Doc if possible but titles really mean little. Some understand it, some don't.

Like Bass said, your protocol is horrible and shows your Dr does not understand TRT whatsoever. Test has a half life of roughly 5-7 days so after that your sinking fast and by the end of the second week your feeling like crap. And if that is when your getting your blood work done it will show as low as it's run its course and is basically out of your system by then. At a minimum switch to once a week injections and adjust via bloodwork. Proper bloodwork is in the stickies.

Hey, a Vette sighting below.....

[Vettester]

A lot of what separates these guys is just their training credentials and firm understanding of how to diagnose and treat patients effectively who need HRT.

Currently (IMO), the best standard to seek out is a physician that has achieved their A4M certification. Most A4M doctors are very much up to speed with current therapies and technologies regarding HRT, as well as other related treatments. Here's a link to the A4M site ... http://www.a4m.com/

[Vettester]

Kelk, looks like we were reading each others minds!!

[flatscat]

Welcome

[HRTstudent]

I really suggest you readthe book Testosterone for Life by Morgentaler. Its a great primer for getting started from a medical expert.

[makingwaves]

Thanks, Shippen is the author I have read. I talked to my doc about a referral and he said he didn't know who he trusted to do good work. I am going to see him soon loaded with info and control over my medical future. (At least as much as managed care and the gov will allow)

[makingwaves]

So here is the update. A4m.com produced 6 referrals. None were covered by my ins. A couple are Osteopathic Doctors, nurse practioners, and medicaldoctors running weight loss clinics or medispas. I called several endos and they are not taking TRT patients.

I asked my doc to tx with weekly IM from home and to test what I ask for or ref to someone who will. Waiting to hear back.

I also have appt with medispa for TRT antiaging tx. They don't do ins. But willgive info for me to submit it. He is an md with HRT clinic on side.

What document/protocal should I ask to be tx with? Crisler has a lot out there.

[steroid.com 1]

Many of the top Doc's in this field don't take insurance but will provide the codes for you to submit the claim IF your policy covers the protocol.

Read the sticky on how to find a TRT Doc.

I like the strategy of contacting compounding pharmacies in your area (Google Maps is great for this) and they may be able to tell you who will accept insurance.

Here's another option; a number of top TRT Docs will consult with your Doc for a small fee...here you get the best of both worlds and your current DOc will learn as well.

IM/Email me and I can help you if you like this option.

[Oldhighlander]

Does Morganthalers book address E2?I was looking at it on amazon and one of the customers comments was it was not addressed .I am trying to get my doc to address mine and was looking for more ammo.I did order Dr.Shippers book so I have one source .

[steroid.com 1]

^^^Morgentaler is very weak on the discussion on the use of AI in managing E2.

In fact, the book is very weak in this regard and some other things now that I look this over in my office.

Funny thing is I read this book a few years ago and now looking it over there are things in here that aren't explained correctly.

He does talk to the use of Anastrozol in managing gyno and Testicular Atrophy (WTF?) but it's very short and non-specific.

I'd be more inclined to use Crisler's paper in this regard it's much more technical and very well positioned.

Crisler should write a book in my opinion...he'd make a fortune on top of the fortune he's making now LOL!

[Oldhighlander]

Thanks.Do you have any feedback on Shippens book?

[Times Roman]

another thought is to start reading here:

http://www.lef.org/

[Oldhighlander]

Thanks I have found a few things there.

[makingwaves]

From my reading I gathered LH and SHBG were important to test for esp If the test was a baseline.

A4m doc said that is old school unless a pituitary issue exists. I am trying to put together good info to educate my pcp. Sadly I think managed care is driving tx protocals rather than what is best practice for a given condition.

Tangent
If T avg is dropping within population then managed care will say its normal no tx needed. If obesity is at 60% then its normal no tx needed. Diabetes...no tx needed. Eventually everyone will be denied tx unless it is life threatening. If you have $$$ then you will buy what you want or need. I wish I had the $$$ for a4m type care.

Do you guys see these "texts" as legitimately sources? They seem almost like pop psychology or self help books rather than true resources for the profession. Also the websites look like fronts for supplement sales. Someone recently posted if you see they are selling supplements run away.