Explaining Blood Work & Other Common Questions Again

[2Sox]

Blood Work - LowTestosterone.com

Good clarification. I assume one reason for your post is the result of a great many bizarre email inquiries and/or phone conversations.

I'm curious. From my knowledge, in order to keep a close watch on one's progress in TRT, especially in the beginning of treatment (for the first year), labs ought to be taken - at the minimum - every six weeks. (Correct me if I'm wrong but countless men on this forum has made it clear that this is a common practice.) How can physicians at LowT.com keep close tabs on patients with only one initial lab and another taken six months into treatment? In my opinion, this doesn't seem like prudent medicine. (OR is LowT.com actually counting on its patients to get their own outside bloodwork?)

I began TRT at Ageless Men's Health, in NYC. Testosterone Cypionate, hCG, and Anastrozole all included - AND blood work every month. All inclusive, $200. (I left because I was able to find a private TRT doctor who prescribes Testosterone and takes Medicare. And by the way, I opt to get complete lab workups done every month by my GP - so I can keep tabs on things with him.)

My point is this: If Ageless Men's can do all of the above for $200/month, why can't Lowtestosterone.com?

[kelkel]

Good clarification. I assume one reason for your post is the result of a great many bizarre email inquiries and/or phone conversations.

I'm curious. From my knowledge, in order to keep a close watch on one's progress in TRT, especially in the beginning of treatment (for the first year), labs ought to be taken - at the minimum - every six weeks. (Correct me if I'm wrong but countless men on this forum has made it clear that this is a common practice.) How can physicians at LowT.com keep close tabs on patients with only one initial lab and another taken six months into treatment? In my opinion, this doesn't seem like prudent medicine. (OR is LowT.com actually counting on its patients to get their own outside bloodwork?)

I began TRT at Ageless Men's Health, in NYC. Testosterone Cypionate, hCG, and Anastrozole all included - AND blood work every month. All inclusive, $200. (I left because I was able to find a private TRT doctor who prescribes Testosterone and takes Medicare. And by the way, I opt to get complete lab workups done every month by my GP - so I can keep tabs on things with him.)

My point is this: If Ageless Men's can do all of the above for $200/month, why can't Lowtestosterone.com?

Every month 2Sox, damn?

[2Sox]

Every month 2Sox, damn?

Well... maybe I'll stretch it out to six weeks.

Anyway, maybe it's been saving me some trips to the Red Cross.

[FRDave]

Well... maybe I'll stretch it out to six weeks. Anyway, maybe it's been saving me some trips to the Red Cross.

I get blood work every 6-8 weeks. Don't see how it would be possible to get dialed in with blood work at only the 6 week mark then 6 months later. I would have been a hot mess with that protocol.

[2Sox]

Don't see how it would be possible to get dialed in with blood work at only the 6 week mark then 6 months later. I would have been a hot mess with that protocol.

Got that right!

[Low Testosterone]

Good clarification. I assume one reason for your post is the result of a great many bizarre email inquiries and/or phone conversations.

I'm curious. From my knowledge, in order to keep a close watch on one's progress in TRT, especially in the beginning of treatment (for the first year), labs ought to be taken - at the minimum - every six weeks. (Correct me if I'm wrong but countless men on this forum has made it clear that this is a common practice.) How can physicians at LowT.com keep close tabs on patients with only one initial lab and another taken six months into treatment? In my opinion, this doesn't seem like prudent medicine. (OR is LowT.com actually counting on its patients to get their own outside bloodwork?)

I began TRT at Ageless Men's Health, in NYC. Testosterone Cypionate, hCG, and Anastrozole all included - AND blood work every month. All inclusive, $200. (I left because I was able to find a private TRT doctor who prescribes Testosterone and takes Medicare. And by the way, I opt to get complete lab workups done every month by my GP - so I can keep tabs on things with him.)

My point is this: If Ageless Men's can do all of the above for $200/month, why can't Lowtestosterone.com?

Posted because there are non-stop phone calls and emails about these things.

But on the issue of blood testing - This is what the program covers. That's the point, that's what the program covers. You can buy more blood test if you want. We have a guy that buys one every 4wks. I've tried my best to explain to him how unnecessary that is. He asked me if he was being stupid, I said yes, lol! There's just no reason. If you need blood work every 4-6wks for a year you have some severe problems far beyond low testosterone. LowT is easy to treat in most cases. It's not complicated yet many men over complicate it.

Ageless Male, they do that because they require you to go to the office weekly for your shots. Same as LowT Center. Having to go in every week for an injection is a bit insane but by saying you need blood work regularly too and making a big stink about it helps you get away with it.

MOST IMPORTANT PART: LowTestosterone.com is not a clinic. We are not a doctors office, we are not a doctor, we are not a hospital. We are a client management provider. For the most part (closest example I can think of) we provide the same service Cenegenics does without the fluff stuff and faster and round the clock customer service for 90% less than they do.

[kelkel]

Posted because there are non-stop phone calls and emails about these things.

But on the issue of blood testing - This is what the program covers. That's the point, that's what the program covers. You can buy more blood test if you want. We have a guy that buys one every 4wks. I've tried my best to explain to him how unnecessary that is. He asked me if he was being stupid, I said yes, lol! There's just no reason. If you need blood work every 4-6wks for a year you have some severe problems far beyond low testosterone. LowT is easy to treat in most cases. It's not complicated yet many men over complicate it.

Ageless Male, they do that because they require you to go to the office weekly for your shots. Same as LowT Center. Having to go in every week for an injection is a bit insane but by saying you need blood work regularly too and making a big stink about it helps you get away with it.

MOST IMPORTANT PART: LowTestosterone.com is not a clinic. We are not a doctors office, we are not a doctor, we are not a hospital. We are a client management provider. For the most part (closest example I can think of) we provide the same service Cenegenics does without the fluff stuff and faster and round the clock customer service for 90% less than they do.

2Sox I'm picturing your BP rising.....

[2Sox]

2Sox I'm picturing your BP rising.....

Nahhh...

[2Sox]

Posted because there are non-stop phone calls and emails about these things.

But on the issue of blood testing - This is what the program covers. That's the point, that's what the program covers. You can buy more blood test if you want. We have a guy that buys one every 4wks. I've tried my best to explain to him how unnecessary that is. He asked me if he was being stupid, I said yes, lol! There's just no reason. If you need blood work every 4-6wks for a year you have some severe problems far beyond low testosterone. LowT is easy to treat in most cases. It's not complicated yet many men over complicate it.

Ageless Male, they do that because they require you to go to the office weekly for your shots. Same as LowT Center. Having to go in every week for an injection is a bit insane but by saying you need blood work regularly too and making a big stink about it helps you get away with it.

MOST IMPORTANT PART: LowTestosterone.com is not a clinic. We are not a doctors office, we are not a doctor, we are not a hospital. We are a client management provider. For the most part (closest example I can think of) we provide the same service Cenegenics does without the fluff stuff and faster and round the clock customer service for 90% less than they do.

Thanks for the reply. From the education I've been getting on this forum, I'm learning more the truth to your statement I've bolded above. But I disagree with your policy of such infrequent blood work. I personally think it's not wise and not careful - and I suspect is somewhat driven by your bottom line.

From my own experience it seems that monthly blood work is not uncommon (at least here in NYC). My urologist (with whom I originally began TRT) took blood when writing my monthly script for gel. (Could be he did so to increase his bottom line.) Now I'm with a TRT doctor who writes for my test cyp every two months. Would take blood then but I just hand him the lab report from my GP that I get every 4-5 weeks. My wife is a P.A. in general medicine and cardiology and feels frequent BW is a very good idea.

Monthly may be excessive, but twice yearly, in my view, is neglectful. I personally feel more comfortable with more frequent blood work because I need to know if I am supplementing correctly and I need to know where my E2 levels are, not to mention total and free T and hematocrit - especially in this first year of injections and finding my way. Labs have showed me things that I needed to adjust immediately. To me it's simple too: Monthly is pro-active. Every six months is re-active.

And I'll bet if you honestly ask the opinions of your clients on this matter, you'll get a great number of similar responses.

[Low Testosterone]

Thanks for the reply. From the education I've been getting on this forum, I'm learning more the truth to your statement I've bolded above. But I disagree with your policy of such infrequent blood work. I personally think it's not wise and not careful - and I suspect is somewhat driven by your bottom line.

From my own experience it seems that monthly blood work is not uncommon (at least here in NYC). My urologist (with whom I originally began TRT) took blood when writing my monthly script for gel. (Could be he did so to increase his bottom line.) Now I'm with a TRT doctor who writes for my test cyp every two months. Would take blood then but I just hand him the lab report from my GP that I get every 4-5 weeks. My wife is a P.A. in general medicine and cardiology and feels frequent BW is a very good idea.

Monthly may be excessive, but twice yearly, in my view, is neglectful. I personally feel more comfortable with more frequent blood work because I need to know if I am supplementing correctly and I need to know where my E2 levels are, not to mention total and free T and hematocrit - especially in this first year of injections and finding my way. Labs have showed me things that I needed to adjust immediately. To me it's simple too: Monthly is pro-active. Every six months is re-active.

And I'll bet if you honestly ask the opinions of your clients on this matter, you'll get a great number of similar responses.

I hear everything you're saying. And I've thought somewhat the same in the past. I'll simply go through some of the high points and possible points of interest.

*Our program is based on the Harvard Protocol. This is the protocol developed by Dr. Abraham Morgentaler. He's also the physician who finally collapsed the hysteria surrounding testosterone and prostate cancer.

*The most important factor is how the patient feels, not the numbers.

*Numbers that could be alarming, particularly hematocrit as you mentioned - Let's say you start TRT, in 6wks you have another test and now you have an initial and followup reading on your hematocrit based on your current dose of testosterone. Hematocrit has not gone up significantly, that's often the case. Assuming the dose is the same, should we expect the level to sky rocket over the next few months? No. If the dose is increased a bit and it's never going to go up a massive amount, this is TRT not bodybuilding, hematocrit should not increase to insane levels in a few months time. Could it increase to where a man needs a blood draw? Possibly and if that happens he can have blood drawn and everything will be fine.

*How often does a man on TRT need a blood draw? A man actually on TRT and who is not using other steroids or items that might increase hematocrit (which many do without telling their physician) I would say 1% at most and that's a liberal estimate.

Last point, and I think this will help what we do hit home a little more.
If you go buy a car, there is a price for that car as is. If you want to add things, other features to the car the cost of the car will go up. You may want these things or you may even consider them essential and that's fine, but the cost will go up. To buy the car as is you will pay the price on the sticker and you will get the car as is.

[2Sox]

I hear everything you're saying. And I've thought somewhat the same in the past. I'll simply go through some of the high points and possible points of interest.

Low T,

We've both presented our cases. I stand by my position. Others can comment.

By the way, I think you could have chosen a better analogy than that of purchasing a car. In my view, it doesn't hit home at all. I know you tried to illustrate an idea but comparing a vehicle to a man's health just doesn't work. At least not for me. Slightly absurd and sort of an anticlimax. It just detracts from impact of your earlier well made points. And it also reinforces the implication that there is a profit motive built into your protocol - something I'm sure you didn't intend to do.

Can you answer this for me: Although your protocol is "based" on the Harvard Protocol, can you tell me how closely you follow it? I'd be grateful if you gave me fast link to it. Thanks.

[2Sox]

Posted because there are non-stop phone calls and emails about these things.

But on the issue of blood testing - This is what the program covers. That's the point, that's what the program covers. You can buy more blood test if you want. We have a guy that buys one every 4wks. I've tried my best to explain to him how unnecessary that is. He asked me if he was being stupid, I said yes, lol! There's just no reason. If you need blood work every 4-6wks for a year you have some severe problems far beyond low testosterone. LowT is easy to treat in most cases. It's not complicated yet many men over complicate it.

Ageless Male, they do that because they require you to go to the office weekly for your shots. Same as LowT Center. Having to go in every week for an injection is a bit insane but by saying you need blood work regularly too and making a big stink about it helps you get away with it.

MOST IMPORTANT PART: LowTestosterone.com is not a clinic. We are not a doctors office, we are not a doctor, we are not a hospital. We are a client management provider. For the most part (closest example I can think of) we provide the same service Cenegenics does without the fluff stuff and faster and round the clock customer service for 90% less than they do.

Low T,

In my view, here is a perfect example of the point I was trying to make and, IMO, makes LowTestosterone.com's practice of infrequent bloodwork (as standard policy) impractical at best, and terribly unsafe at worst. What is the oath? "First do no harm."

I just got my lab work back and, in part, these are the results:

Pregnenolone <5 Range: 13-208 ng/dL

Estradiol 41 Range <OR=29 pg/mL

Tot. Testosterone 1307 Range: 250-1100 ng/dL

Testosterone, Free 359.04 Range: 35.0-155.0 pg/mL

SHBG 31 Range: 22-77 nmol/L

Five weeks earlier, my Estradiol was <2. On Dec. 16th, I then stopped my low dose AI -.25mg E3D - and continued a DIM, Zinc, Copper daily regimen. Apparently this didn't do the trick.

My protocol is fairly straightforward:
32mg Test Cyp, subQ, EOD

hCG: 250iu 3xweek

100mg DIM, 50mg Zinc, 4mg Copper daily


My point is this: If a patient's values are not monitored closely for the first year, how is it possible to know how to adjust his dosages - and prevent problems? OR to improve treatment? BOTH would have to wait for six months. This is crazy to me.

I can only imagine what the results would have been if I let this go for six months.

And while I'm on the subject, I'd be grateful for anyone's advice on how to address these results above. Thanks.

My idea is to lower my dose to 30mg Test Cyp EOD and .25mg adex every 4/5 days. (I took a dose as soon as I got this lab report!) But I'm thinking it might be better to dose .25mg adex every week. What do you all think?

[Low Testosterone]

Low T,

In my view, here is a perfect example of the point I was trying to make and, IMO, makes LowTestosterone.com's practice of infrequent bloodwork (as standard policy) impractical at best, and terribly unsafe at worst. What is the oath? "First do no harm."

I just got my lab work back and, in part, these are the results:

Pregnenolone <5 Range: 13-208 ng/dL

Estradiol 41 Range <OR=29 pg/mL

Tot. Testosterone 1307 Range: 250-1100 ng/dL

Testosterone, Free 359.04 Range: 35.0-155.0 pg/mL

SHBG 31 Range: 22-77 nmol/L

Five weeks earlier, my Estradiol was <2. On Dec. 16th, I then stopped my low dose AI -.25mg E3D - and continued a DIM, Zinc, Copper daily regimen. Apparently this didn't do the trick.

My protocol is fairly straightforward:
32mg Test Cyp, subQ, EOD

hCG: 250iu 3xweek

100mg DIM, 50mg Zinc, 4mg Copper daily


My point is this: If a patient's values are not monitored closely for the first year, how is it possible to know how to adjust his dosages - and prevent problems? OR to improve treatment? BOTH would have to wait for six months. This is crazy to me.

I can only imagine what the results would have been if I let this go for six months.

And while I'm on the subject, I'd be grateful for anyone's advice on how to address these results above. Thanks.

My idea is to lower my dose to 30mg Test Cyp EOD and .25mg adex every 4/5 days. (I took a dose as soon as I got this lab report!) But I'm thinking it might be better to dose .25mg adex every week. What do you all think?

Again, we're not a clinic. We're a client management provider. That's a BIG difference. On our website it even says in big capital letters in several places WE ARE NOT A CLINIC.

Our service, we have pre-negotiated prices with doctors, pharmacies and labs. Our job is to set you up with those things. Could you see the same doctor for the same treatment outside of our system? Absolutely, but you'd pay a good bit more. That's the entire point, to be able to use those doctors, pharmacies and labs for the discounted rate. And at the discounted rate, what you get is what's been described.

Do we help guide our clients through their TRT process? Absolutely, and if they do need more than what the package includes we make it available to them and do our best to do so at a more affordable rate.

Let's also keep in mind, our job at lowtestosterone.com is not to tell you why you have low testosterone. Again, we're not a clinic. Absolutely, there are hundreds of reasons why a man might have low testosterone, but around 95% of men that have it do so because of age or past drug use, that's it. Those are the men that will benefit from our program. They'll receive treatment from physicians who understand TRT, who care that their TRT is successful and they'll receive good meds they need to help with that.

Have you ever used an insurance broker to help you get a better deal on car insurance or some type of insurance? I'm sure many here have, I have. The broker presents the various plans available from different providers and states this is what you get for that price. If you want more than that, absolutely, you can receive more than that, but you won't for the stated price, it will cost a little more. There's really no difference here.

Finally, so far we have an almost 90% retention rate with our clients. As the message board knows, our business is not that old and it's also the only model like it in the country. A retention rate of 90% that's unheard of and something we're very proud of. If the program was terrible and the men on the program weren't getting the benefits they needed, you can guarantee it would be lower. Have their been those who didn't care for the program? Of course, otherwise we'd be at 100% but there's no such thing anywhere. People lose their jobs, hit hard times, find that they have a unique problem that is beyond simply low testosterone or get upset when they don't get 84000mg per week.

[2Sox]

Again, we're not a clinic. We're a client management provider. That's a BIG difference. On our website it even says in big capital letters in several places WE ARE NOT A CLINIC.

Our service, we have pre-negotiated prices with doctors, pharmacies and labs. Our job is to set you up with those things. Could you see the same doctor for the same treatment outside of our system? Absolutely, but you'd pay a good bit more. That's the entire point, to be able to use those doctors, pharmacies and labs for the discounted rate. And at the discounted rate, what you get is what's been described.

Do we help guide our clients through their TRT process? Absolutely, and if they do need more than what the package includes we make it available to them and do our best to do so at a more affordable rate.

Let's also keep in mind, our job at lowtestosterone.com is not to tell you why you have low testosterone. Again, we're not a clinic. Absolutely, there are hundreds of reasons why a man might have low testosterone, but around 95% of men that have it do so because of age or past drug use, that's it. Those are the men that will benefit from our program. They'll receive treatment from physicians who understand TRT, who care that their TRT is successful and they'll receive good meds they need to help with that.

Have you ever used an insurance broker to help you get a better deal on car insurance or some type of insurance? I'm sure many here have, I have. The broker presents the various plans available from different providers and states this is what you get for that price. If you want more than that, absolutely, you can receive more than that, but you won't for the stated price, it will cost a little more. There's really no difference here.

Finally, so far we have an almost 90% retention rate with our clients. As the message board knows, our business is not that old and it's also the only model like it in the country. A retention rate of 90% that's unheard of and something we're very proud of. If the program was terrible and the men on the program weren't getting the benefits they needed, you can guarantee it would be lower. Have their been those who didn't care for the program? Of course, otherwise we'd be at 100% but there's no such thing anywhere. People lose their jobs, hit hard times, find that they have a unique problem that is beyond simply low testosterone or get upset when they don't get 84000mg per week.

Maybe this is going over my head. Does "client management" mean you're not required to do what's medically prudent, and this way you won't get in trouble for it because of the label. In contrast, a "clinic" must do what's medically prudent or they will get in trouble? I'd be grateful if you cleared this up for me.

[2Sox]

LowT,

Let me be clear: I have absolutely no doubt that you provide an excellent service and you clients are very satisfied with it. If I was not able to get treatment, I'd most likey give you a call myself. That's not what I'm questioning at all. I'm merely questioning this practice of infrequent blood work that I think not only short changes your clients - but puts their health at risk, which I have tried to make clear. I'm talking about what I believe would be ethical medicine. I'm not sure I know what you are talking about when you try to differentiate between "client management" and "clinic".

[Low Testosterone]

Maybe this is going over my head. Does "client management" mean you're not required to do what's medically prudent, and this way you won't get in trouble for it because of the label. In contrast, a "clinic" must do what's medically prudent or they will get in trouble? I'd be grateful if you cleared this up for me.

Saying we're not a clinic isn't a loophole or anything like that. We're in no shape or form a clinic. We're not the ones doing your treatment. For $199 per month you receive what's laid out in the program. That's the base plan. If you want other things, more blood testing, methylcobalamin, sermorelin, etc. we can help you with that, but that's not covered by the $199. Staying on the topic of blood work, if you feel you need blood work every 6 or so weeks the first year, we can help you with that. If you wanted to have blood work every day (not saying you're saying that) we can help you with that too.

I think the issue here is that what we do is not something anyone else does and that makes it confusing. But if you step back for a minute, read what's on the website, it's all there and explained in detail.