Re: Looking for a Dr. and/or encouragement and ideas

[Guest guest]

> My biggest fear about T replacement is that my already small

> testicles would shrink even more and I'm wondering if the tradeoff

> in secondary sex characteristics and demeanor are worth it. I'm

> hoping that there is some alternative that might include HCG and/or

> an aromatase inhibitor to counter that effect and, for that, I need

> a doctor who is more up on the literature and on the latest

> developments in the field.

>

> I'm in South Florida and what I really need is a good doctor. So if

> anyone has a recommendation, I'd love to hear it.

>

> I've read the post on finding a Dr. and have called all of the names

> on the AAAS web site for my area with no success. Any suggestions

> from anyone on how to proceed?

I don't think free levels are all that helpful. LH and FSH are

usually within the reference range even in those with hypogonadism. I

suspect a combination of hcg and testosterone will be your best bet.

You can try hcg alone and add testosterone later if needed. There is

a doctor in Boca Raton who might be helpful. I believe he used to

post here.

Allyn A. Brizel

He has a website:

http://www.natural-hrt.com/home.html

Good luck,

Brad

[Guest guest]

>

> > My biggest fear about T replacement is that my already small

> > testicles would shrink even more and I'm wondering if the

tradeoff

> > in secondary sex characteristics and demeanor are worth it. I'm

> > hoping that there is some alternative that might include HCG

and/or

> > an aromatase inhibitor to counter that effect and, for that, I

need

> > a doctor who is more up on the literature and on the latest

> > developments in the field.

> >

> > I'm in South Florida and what I really need is a good doctor. So

if

> > anyone has a recommendation, I'd love to hear it.

> >

> > I've read the post on finding a Dr. and have called all of the

names

> > on the AAAS web site for my area with no success. Any

suggestions

> > from anyone on how to proceed?

>

> I don't think free levels are all that helpful. LH and FSH are

> usually within the reference range even in those with

hypogonadism. I

> suspect a combination of hcg and testosterone will be your best

bet.

> You can try hcg alone and add testosterone later if needed. There

is

> a doctor in Boca Raton who might be helpful. I believe he used to

> post here.

>

> Allyn A. Brizel

>

> He has a website:

>

> http://www.natural-hrt.com/home.html

>

> Good luck,

>

> Brad

Thank you, Brad.

I just spoke to Dr. Brizel and so far, so good.

[Guest guest]

It would be drive for you but Dr. Hall in Ocala is great. He may also

work with you over the phone, I've done both office visits and phone visits.

In brief, he is an OB/GYN who now also treats hypogonadism after his own bout

with the problem. He is the only doctor I have found that was willing to treat

with HCG. You may be pleasantly surprised what HCG could do for you.

Dave

bassack1961 <bassack1961@...> wrote:

Hello all,

This post is assembled from a variety of posts that I've made in the

past couple of days on the mesomorphosis.com Men's Health forum. It

was suggeted to me by someone over there that I post it here as

well. Here goes.

I'm 43 years old and haven't had a regular physician since my

pediatrician. The only doctor that I've seen is a dermatologist. (I

have a history of non-melanoma skin cancers). I finally bit the

bullet, found a nearby DO who's accepted by my insurance and got a

check-up. My medical history is as follows:

I was born with an undescended left testicle which wasn't diagnosed

until I was 15. My pediatrician missed it and I had just assumed

that I was born with only one testicle. When I learned in Biology

about testicles starting out in the abdomen and then descending I

brought it up with my father. I had an orchiopexy performed in which

the undescended testicle was found to be viable and was brought down

and sutured into my scrotum.

My puberty, which started very late (I didn't have my first

ejaculation until I was almost 16) never really seems to have

finished. My testicles have always been small. I have very little

ejaculate with a long replenishment period. I can easily go a week

without shaving and not look like I need a shave. I've grown a beard

through persistence but it is very slow growing, sparse and doesn't

cover a large area of my face. I'm 6'3 and weigh 255 lbs. which is

mostly fat as I have very poor musculature. I am blessed to be

fertile and to have a family.

I recently started having some difficulty achieving and maintaining

erections and brought this up with my new doctor at my check-up. He

did a digital prostate exam which was normal and ordered some lab

work with the following results:

Testosterone, Serum 241 nd/dL (241-827)

Free Testosterone (Direct) 10.5 pg/mL (6.8-21.5)

PSA, Serum 0.3 ng/mL (0.0-4.0)

TSH 1.490 uIU/mL (0.350-5.500)

He was reluctant to do anything because he said my " Free

Testosterone is in the normal range. " I told him about secondary

hypogonadism and my concerns so he ordered a test of my LH and FSH.

I haven't seen the lab report so I don't know the specifics, but he

told me on the phone that both were in the normal range (LH at 3.5

and FSH at 5.8. I don't know units or normal limits, having not seen

the report.) and he suggested I hold off and reevaluate in six

months.

I've seen a big drop-off in my mental acuity over the past six

months to one year. I'm also more easily fatigued and depressed. I

did, however, attribute these things and the ED to unknown other

factors as I feel that the hypogonadism, if any, has been a lifelong

condition manifested by the other physical characteristics that I

described above.

Incidentally, in the two years that I had my weight down to 176 (by

a switch to a vegetarian, macrobiotic diet when I was age 24) there

was no positive effect on my masculinization that I was able to

discern.

As far as not completing puberty, I don't have a deep voice. In

fact, it still cracks once in a while. I've never in my life had

a " wet dream " and only very rarely, and with prolonged excitement

produce any pre-ejaculate and, at that, it may be only one drop. I

do have long arms, even for my height. I wear a 37-38 " sleeve

shirt. My chin and adam's apple are also not pronounced. On the

other hand, I am fertile. I do have some body hair and I do present

as a male.

My biggest fear about T replacement is that my already small

testicles would shrink even more and I'm wondering if the tradeoff

in secondary sex characteristics and demeanor are worth it. I'm

hoping that there is some alternative that might include HCG and/or

an aromatase inhibitor to counter that effect and, for that, I need

a doctor who is more up on the literature and on the latest

developments in the field.

I'm in South Florida and what I really need is a good doctor. So if

anyone has a recommendation, I'd love to hear it.

I've read the post on finding a Dr. and have called all of the names

on the AAAS web site for my area with no success. Any suggestions

from anyone on how to proceed?

[Guest guest]

Hi and welcome I sent you hear. I feel you will get some go input here and

have a link you can try to find a Dr. click on Find a Dr. and then put in your

state. But I need to worn you a lot of the Dr.'s that signed up for this site

are not any good but you can call and ask them if they treat a lot of men for

low T and do they check for high E2 Estradiol. Ask if they test to find out

why one is low and if they are secondary do the treat the men with HCG. Also if

the use Arimidex to keep E2 down. You will know if you found a good one.

http://www.tuneupyourt.com/

Also did you check the database section there are Dr.'s names and numbers in

there of Dr.'s the guys here see. I was telling you I felt you Free T is low

and could not send you this link. It has ranges for men by age and this other

link is one of the first I read when I first joined here. I don't buy there

products but find it to be a dam good read.

http://www.natural-hrt.com/andropause04.html

http://www.lef.org/protocols/prtcls-txt/t-prtcl-130.html

This last link is the AACE Guildlines all ways a good reference.

http://www.aace.com/clin/guidelines/hypogonadism.pdf

If you go on TRT and get you levels stable in say 4 to 6 months you can add HCG

and you testis will not get smaller.

Phil

bassack1961 <bassack1961@...> wrote: Hello all,

This post is assembled from a variety of posts that I've made in the

past couple of days on the mesomorphosis.com Men's Health forum. It

was suggeted to me by someone over there that I post it here as

well. Here goes.

I'm 43 years old and haven't had a regular physician since my

pediatrician. The only doctor that I've seen is a dermatologist. (I

have a history of non-melanoma skin cancers). I finally bit the

bullet, found a nearby DO who's accepted by my insurance and got a

check-up. My medical history is as follows:

I was born with an undescended left testicle which wasn't diagnosed

until I was 15. My pediatrician missed it and I had just assumed

that I was born with only one testicle. When I learned in Biology

about testicles starting out in the abdomen and then descending I

brought it up with my father. I had an orchiopexy performed in which

the undescended testicle was found to be viable and was brought down

and sutured into my scrotum.

My puberty, which started very late (I didn't have my first

ejaculation until I was almost 16) never really seems to have

finished. My testicles have always been small. I have very little

ejaculate with a long replenishment period. I can easily go a week

without shaving and not look like I need a shave. I've grown a beard

through persistence but it is very slow growing, sparse and doesn't

cover a large area of my face. I'm 6'3 and weigh 255 lbs. which is

mostly fat as I have very poor musculature. I am blessed to be

fertile and to have a family.

I recently started having some difficulty achieving and maintaining

erections and brought this up with my new doctor at my check-up. He

did a digital prostate exam which was normal and ordered some lab

work with the following results:

Testosterone, Serum 241 nd/dL (241-827)

Free Testosterone (Direct) 10.5 pg/mL (6.8-21.5)

PSA, Serum 0.3 ng/mL (0.0-4.0)

TSH 1.490 uIU/mL (0.350-5.500)

He was reluctant to do anything because he said my " Free

Testosterone is in the normal range. " I told him about secondary

hypogonadism and my concerns so he ordered a test of my LH and FSH.

I haven't seen the lab report so I don't know the specifics, but he

told me on the phone that both were in the normal range (LH at 3.5

and FSH at 5.8. I don't know units or normal limits, having not seen

the report.) and he suggested I hold off and reevaluate in six

months.

I've seen a big drop-off in my mental acuity over the past six

months to one year. I'm also more easily fatigued and depressed. I

did, however, attribute these things and the ED to unknown other

factors as I feel that the hypogonadism, if any, has been a lifelong

condition manifested by the other physical characteristics that I

described above.

Incidentally, in the two years that I had my weight down to 176 (by

a switch to a vegetarian, macrobiotic diet when I was age 24) there

was no positive effect on my masculinization that I was able to

discern.

As far as not completing puberty, I don't have a deep voice. In

fact, it still cracks once in a while. I've never in my life had

a " wet dream " and only very rarely, and with prolonged excitement

produce any pre-ejaculate and, at that, it may be only one drop. I

do have long arms, even for my height. I wear a 37-38 " sleeve

shirt. My chin and adam's apple are also not pronounced. On the

other hand, I am fertile. I do have some body hair and I do present

as a male.

My biggest fear about T replacement is that my already small

testicles would shrink even more and I'm wondering if the tradeoff

in secondary sex characteristics and demeanor are worth it. I'm

hoping that there is some alternative that might include HCG and/or

an aromatase inhibitor to counter that effect and, for that, I need

a doctor who is more up on the literature and on the latest

developments in the field.

I'm in South Florida and what I really need is a good doctor. So if

anyone has a recommendation, I'd love to hear it.

I've read the post on finding a Dr. and have called all of the names

on the AAAS web site for my area with no success. Any suggestions

from anyone on how to proceed?

[Guest guest]

Call Bartor Pharmical (Rye NY) 914-967-4219 and ask if they can recommend three

docs

near you who do testosterone pellet implants (Bartor makes pellets). Then call

the docs

and ask if they also do hCG or similar stimulation therapy. Most docs who know

pellet

implants know the other treatments too. That's how I found my doc, a D.O. who's

great.

You probably need to add some tests of estradiol and total estrogens.

T 241 (241-827) is just too low for a 43-year-old man. Or an 83-year-old man.

Good luck,

Bruce

..

>

> I'm in South Florida and what I really need is a good doctor. So if

> anyone has a recommendation, I'd love to hear it.

>

> I've read the post on finding a Dr. and have called all of the names

> on the AAAS web site for my area with no success. Any suggestions

> from anyone on how to proceed?

[Guest guest]

Guys,

I'm no expert, but does his case sound like it could be one of the

genetic conditions, such as Kleinfielters, etc?

Mark

[Guest guest]

> Guys,

>

> I'm no expert, but does his case sound like it could be one of the

> genetic conditions, such as Kleinfielters, etc?

>

> Mark

I agree.

He has described many of the symptons of Klinefelter's Syndrome & its

varients.

The test is very expensive, and not always conclusive if it is

Klinefelter's Mosaic 47-xy/xxy. But the treatment is the same as

hypogonadism. Increase the testosterone, keep the Estrogen E2 in

check, & keep the hemocrit levels low by giving blood donations.

[Guest guest]

bassack1961

Try www.www.endo-society.org/about/contact.cfm

I too am 43yo Happy birthday.

Boz

[Guest guest]

> Hello all,

>

> This post is assembled from a variety of posts that I've made in

the

> past couple of days on the mesomorphosis.com Men's Health forum.

It

> was suggeted to me by someone over there that I post it here as

> well. Here goes.

>

> I'm 43 years old and haven't had a regular physician since my

> pediatrician. The only doctor that I've seen is a dermatologist.

(I

> have a history of non-melanoma skin cancers). I finally bit the

> bullet, found a nearby DO who's accepted by my insurance and got a

> check-up. My medical history is as follows:

>

> I was born with an undescended left testicle which wasn't

diagnosed

> until I was 15. My pediatrician missed it and I had just assumed

> that I was born with only one testicle. When I learned in Biology

> about testicles starting out in the abdomen and then descending I

> brought it up with my father. I had an orchiopexy performed in

which

> the undescended testicle was found to be viable and was brought

down

> and sutured into my scrotum.

>

> My puberty, which started very late (I didn't have my first

> ejaculation until I was almost 16) never really seems to have

> finished. My testicles have always been small. I have very little

> ejaculate with a long replenishment period. I can easily go a week

> without shaving and not look like I need a shave. I've grown a

beard

> through persistence but it is very slow growing, sparse and

doesn't

> cover a large area of my face. I'm 6'3 and weigh 255 lbs. which is

> mostly fat as I have very poor musculature. I am blessed to be

> fertile and to have a family.

>

> I recently started having some difficulty achieving and

maintaining

> erections and brought this up with my new doctor at my check-up.

He

> did a digital prostate exam which was normal and ordered some lab

> work with the following results:

>

> Testosterone, Serum 241 nd/dL (241-827)

> Free Testosterone (Direct) 10.5 pg/mL (6.8-21.5)

> PSA, Serum 0.3 ng/mL (0.0-4.0)

> TSH 1.490 uIU/mL (0.350-5.500)

>

> He was reluctant to do anything because he said my " Free

> Testosterone is in the normal range. " I told him about secondary

> hypogonadism and my concerns so he ordered a test of my LH and

FSH.

> I haven't seen the lab report so I don't know the specifics, but

he

> told me on the phone that both were in the normal range (LH at 3.5

> and FSH at 5.8. I don't know units or normal limits, having not

seen

> the report.) and he suggested I hold off and reevaluate in six

> months.

>

> I've seen a big drop-off in my mental acuity over the past six

> months to one year. I'm also more easily fatigued and depressed. I

> did, however, attribute these things and the ED to unknown other

> factors as I feel that the hypogonadism, if any, has been a

lifelong

> condition manifested by the other physical characteristics that I

> described above.

>

> Incidentally, in the two years that I had my weight down to 176

(by

> a switch to a vegetarian, macrobiotic diet when I was age 24)

there

> was no positive effect on my masculinization that I was able to

> discern.

>

> As far as not completing puberty, I don't have a deep voice. In

> fact, it still cracks once in a while. I've never in my life had

> a " wet dream " and only very rarely, and with prolonged excitement

> produce any pre-ejaculate and, at that, it may be only one drop.

I

> do have long arms, even for my height. I wear a 37-38 " sleeve

> shirt. My chin and adam's apple are also not pronounced. On the

> other hand, I am fertile. I do have some body hair and I do

present

> as a male.

>

> My biggest fear about T replacement is that my already small

> testicles would shrink even more and I'm wondering if the tradeoff

> in secondary sex characteristics and demeanor are worth it. I'm

> hoping that there is some alternative that might include HCG

and/or

> an aromatase inhibitor to counter that effect and, for that, I

need

> a doctor who is more up on the literature and on the latest

> developments in the field.

>

> I'm in South Florida and what I really need is a good doctor. So

if

> anyone has a recommendation, I'd love to hear it.

>

> I've read the post on finding a Dr. and have called all of the

names

> on the AAAS web site for my area with no success. Any suggestions

> from anyone on how to proceed?

Firt of all thank you to all of you who posted replies to my

original post. It's very encouraging to know that there are others

out there who are not only concerned, but willing to offer help and

suggestions.

I visited Dr. Brazel yesterday. Prior to seeing him, he ordered

some lab work for me. Unfortunately, the lab screwed up and didn't

include Free T, only Total T, even though it had been ordered.

Here are the other significant results:

SHBG 13 7-50 nmol/L

FSH 5.9 1.6-8.0 MIU/ML

LH 5.0 1.5-9.3 MIU/ML

PROLACTIN 21.0 H 2.0-18.0 NG/ML

TESTOSTERONE, TOTAL 287 241-827 NG/DL

ESTRADIOL 27 13-54 PG.ML

The Prolactin is the only thing that is out of range, while the T

was just in range. More blood was drawn in order to recheck levels,

including the Prolactin.

The doctor, by the way, said that he thought my

testicles were a normal size. Maybe my self-image is screwed up

after being the last in my peer group to develop at all.

At any rate, I started a Clomid sensitivity test today (50 mg x

twice/day x 7 days). We'll see what effect, if any, comes about?

[Guest guest]

>

> Firt of all thank you to all of you who posted replies to my

> original post. It's very encouraging to know that there are others

> out there who are not only concerned, but willing to offer help and

> suggestions.

>

> I visited Dr. Brazel yesterday. Prior to seeing him, he ordered

> some lab work for me. Unfortunately, the lab screwed up and didn't

> include Free T, only Total T, even though it had been ordered.

>

> Here are the other significant results:

>

> SHBG 13 7-50 nmol/L

> FSH 5.9 1.6-8.0 MIU/ML

> LH 5.0 1.5-9.3 MIU/ML

> PROLACTIN 21.0 H 2.0-18.0 NG/ML

> TESTOSTERONE, TOTAL 287 241-827 NG/DL

> ESTRADIOL 27 13-54 PG.ML

>

> The Prolactin is the only thing that is out of range, while the T

> was just in range. More blood was drawn in order to recheck levels,

> including the Prolactin.

>

> The doctor, by the way, said that he thought my

> testicles were a normal size. Maybe my self-image is screwed up

> after being the last in my peer group to develop at all.

>

> At any rate, I started a Clomid sensitivity test today (50 mg x

> twice/day x 7 days). We'll see what effect, if any, comes about?

I'm glad we got you past the " wait six months and re-test " bull. The

clomid test seems reasonable. I had one myself. I think you have

primary hypogonadism but, as you say, we'll see in a week or so.

Brad

[Guest guest]

>

> >

> > Firt of all thank you to all of you who posted replies to my

> > original post. It's very encouraging to know that there are

others

> > out there who are not only concerned, but willing to offer help

and

> > suggestions.

> >

> > I visited Dr. Brazel yesterday. Prior to seeing him, he ordered

> > some lab work for me. Unfortunately, the lab screwed up and

didn't

> > include Free T, only Total T, even though it had been ordered.

> >

> > Here are the other significant results:

> >

> > SHBG 13 7-50 nmol/L

> > FSH 5.9 1.6-8.0 MIU/ML

> > LH 5.0 1.5-9.3 MIU/ML

> > PROLACTIN 21.0 H 2.0-18.0 NG/ML

> > TESTOSTERONE, TOTAL 287 241-827 NG/DL

> > ESTRADIOL 27 13-54 PG.ML

> >

> > The Prolactin is the only thing that is out of range, while the

T

> > was just in range. More blood was drawn in order to recheck

levels,

> > including the Prolactin.

> >

> > The doctor, by the way, said that he thought my

> > testicles were a normal size. Maybe my self-image is screwed up

> > after being the last in my peer group to develop at all.

> >

> > At any rate, I started a Clomid sensitivity test today (50 mg x

> > twice/day x 7 days). We'll see what effect, if any, comes about?

>

> I'm glad we got you past the " wait six months and re-test " bull.

The

> clomid test seems reasonable. I had one myself. I think you have

> primary hypogonadism but, as you say, we'll see in a week or so.

>

> Brad

>

Well. The results of the Clomid test are back. My doc called me

today and told me the numbers but I didn't write them down. I do

know that my total T went up to 400 and my LH and FSH both went up

about 70% from their earlier pre-Clomid levels.

At any rate, I guess this means I'm secondary. The doctor agreed to

start me on HCG beginning at the end of this month. I still think I

have arrested puberty and I'm hoping that HCG will kick-start the

completion. Any recommended protocols for HCG to achieve that?

By the way, here's a link to a medical journal article on someone

for whom HCG seemed to work in that way:

http://jcem.endojournals.org/cgi/content/full/86/6/2470

[Guest guest]

>

>

> Well. The results of the Clomid test are back. My doc called me

> today and told me the numbers but I didn't write them down. I do

> know that my total T went up to 400 and my LH and FSH both went up

> about 70% from their earlier pre-Clomid levels.

>

> At any rate, I guess this means I'm secondary. The doctor agreed to

> start me on HCG beginning at the end of this month. I still think I

> have arrested puberty and I'm hoping that HCG will kick-start the

> completion. Any recommended protocols for HCG to achieve that?

>

> By the way, here's a link to a medical journal article on someone

> for whom HCG seemed to work in that way:

> http://jcem.endojournals.org/cgi/content/full/86/6/2470

>

Sounds like a promising start. Since your LH and FSH were half way

(or more) up the range, they must be near the upper limit of the range

post-clomid. 400 doesn't seem particularly impressive to me give such

high levels of LH & FSH. Any improvement in symptoms? Of course it

would be hard to assess since you won't have been at the 400 level for

long. 400 may be as much as your testes will produce. You'll find

out with the hcg. Responses to hcg are individualized. You'll just

have to pick a starting dose and adjust it from time to time. If it

were me, I'd start with 500iu three times/week and adjust as needed.

As long as he's going to titrate the dose, it won't matter that much

where you start.

Apart from people coming off a steroid cycle the vast majority of us

require on-going treatment. Although he remained asymptomatic, the

fellow in the article eventually went back to below normal

testosterone levels.

Good luck,

Brad

[Guest guest]

>

> Sounds like a promising start. Since your LH and FSH were half way

> (or more) up the range, they must be near the upper limit of the

range

> post-clomid. 400 doesn't seem particularly impressive to me give

such

> high levels of LH & FSH. Any improvement in symptoms? Of course

it

> would be hard to assess since you won't have been at the 400 level

for

> long. 400 may be as much as your testes will produce. You'll find

> out with the hcg. Responses to hcg are individualized. You'll

just

> have to pick a starting dose and adjust it from time to time. If

it

> were me, I'd start with 500iu three times/week and adjust as

needed.

> As long as he's going to titrate the dose, it won't matter that

much

> where you start.

>

> Apart from people coming off a steroid cycle the vast majority of

us

> require on-going treatment. Although he remained asymptomatic, the

> fellow in the article eventually went back to below normal

> testosterone levels.

>

> Good luck,

> Brad

>

Brad,

Thanks for your comments. The fact that someone is reading and

responding to what I'm writing is very heartening.

Does anyone have any personal experience with virilization after HRT?

I'm specifically referring to virilization effects that were absent

prior to HRT, rather than effects that had once been present but had

diminished or disappeared due to decreased hormone levels. Things

like body hair, thickness of voice, musculature, bone density.

I'd love to hear from you.

[Guest guest]

> >

> > Sounds like a promising start. Since your LH and FSH were half way

> > (or more) up the range, they must be near the upper limit of the

> range

> > post-clomid. 400 doesn't seem particularly impressive to me give

> such

> > high levels of LH & FSH. Any improvement in symptoms? Of course

> it

> > would be hard to assess since you won't have been at the 400 level

> for

> > long. 400 may be as much as your testes will produce. You'll find

> > out with the hcg. Responses to hcg are individualized. You'll

> just

> > have to pick a starting dose and adjust it from time to time. If

> it

> > were me, I'd start with 500iu three times/week and adjust as

> needed.

> > As long as he's going to titrate the dose, it won't matter that

> much

> > where you start.

> >

> > Apart from people coming off a steroid cycle the vast majority of

> us

> > require on-going treatment. Although he remained asymptomatic, the

> > fellow in the article eventually went back to below normal

> > testosterone levels.

> >

> > Good luck,

> > Brad

> >

>

> Brad,

>

> Thanks for your comments. The fact that someone is reading and

> responding to what I'm writing is very heartening.

>

> Does anyone have any personal experience with virilization after HRT?

>

> I'm specifically referring to virilization effects that were absent

> prior to HRT, rather than effects that had once been present but had

> diminished or disappeared due to decreased hormone levels. Things

> like body hair, thickness of voice, musculature, bone density.

>

> I'd love to hear from you.

I developed more body hair and in places that I didn't have it before.

The other things I had had anyway.

Brad