Low T

[Guest guest]

I want to introduce myself. I am a 47 year old male with type 2

diabetes, previously high cholesterol, depression, anxiety attacks,and

had a breast cancer scare last fall. Two weeks ago I was diagnosed

with low free T 10.1 on a scale of (11-40. Starting taking IM

treatment last week (once every 3 weeks for 3 times and then once a

month) 200mg per shot. I was at my doctors yesterday for my diabetic

checkup and asked him when he wanted me to have another blood test for

my T. He said that I would not need one, that unless I did not get to

feeling better we would just continue this regimen for the rest of my

life. He said that if (and probably wouldn't) my T level went over

the top and strated feeling bad again then we would look at it. So I

said to him " What about my E2 level? " and he said " What is that? " So I

explained that to him and about my having hot sweats. But he didn't

seemed concerned. I think I need to see an endo and find out what is

going on. He said that if we didn't get the results that " we " wanted

he would send me to one. I guess I will give the T time to get into

my system and then go from there. He has been my doctor for about 17

years and this is the first time that I have disagreed with his

assessment. Any comments or observations?

[Guest guest]

Hi,

If you've known your doc for 17 years I would guess that you have a

good relationship with him and can talk to him honestly about your

concerns. From your description your doctor seems a little old

school on T treatment. A lot of new information has been discovered

regarding low T over the past 5 years. Some people adapt

differently to different treatment protocols. Some people like

patches, some like topical gels while other's like injections.

I'm new to this myself but some doctors now prefer to start someone

on patches and/or topical gels because they are closer at mimicking

the body's natural testosterone circadian rhythm. Some people who

can handle injecting themselves feel better doing it that way on a

weekly basis. They effectively become experts on their own body and

can immediately adjust treatments based on their experience. Some

really knowledgeable doctors like to add hCG to the protocol to

stimulate the testies and keep them active, especially if you're

interested in fertility. Even without fertility concerns some

people feel better with a combination of testosterone and hCG

treatments.

Also, from what I understand, the older we are the less important

circadian rhythm is to testosterone levels because as we get older

the testosterone concentration variation throughout the day get less

and less variable than when we were younger. Of course everyone's

situation is very individualized and what works for some doesn't

work for others. You'll need to find what will work for you.

First thing is not to stress out on this as you learn what your

options are. You need to educate yourself about this disorder and

your options. Make another appointment with your doc before your

next injection, print out some material that you can take to him and

just explain that you're interested in trying some of these other

treatments. Most good TRT docs will agree that three or four week

injections are too long and cause big testosterone highs and lows at

the beginning and end of each injection timeline. Sadly many old

doctors still use this protocol and are just not educated as to why

that treatment may not be as good as weekly injections or the use of

patches or topical gels.

One suggestion I would have is to only present your doctor with

clinically validated material. This is likely to get his attention

more than you printing out a thread on one a message board and

giving it to him or telling him that you read it on the Internet.

The AACE guidelines for hypogonadism can be found on the AACE

website (http://www.aace.com/clin/guidelines.) Read it, understand

it and print out a copy for your doc as it has a lot of good

information in it. As far as getting the absolute cutting edge TRT

treatment it generally takes a minor miracle to get a doctor to be

open to it and to care enough to really spend the time necessary to

learn it and monitor the patient properly.

Unfortunately, your doctor doesn't seem like he's that into worrying

about your TRT treatment. Especially if he doesn't plan to do

anymore blood tests on you unless you clearly aren't feeling well.

I also don't need to tell you it's a bad sign that he didn't know

what Esterdiol (E2) was. Scary!

Finally, depending on what type of insurance you have perhaps you

can ask your insurance carrier if you can get a second opinion from

at Endocrinologist. Of course you may want to keep that a secret

from your PCP as he may get his feelings hurt. That of course

assumes you want to remain friendly with him. Perhaps you should

try to convince him to adapt before seeking a second opinion.

Sadly, finding a good second opinion doctor is hard to do as well.

Many people go through doctor after doctor looking for one that

understand TRT treatment.

For me, I'm just starting down this road of TRT but I think I have

enough information to defend myself to the docs. Like you I started

having panic attacks, constant mental foggy feeling and

depression. I've spent years trying to figure out what is wrong

with me and am relieved that it appears my search is coming to an

end. For me I'm willing to start out with the patch or gel form of

treatment just to see what happens and go from there. I will be

testing my blood at appropriate intervals to see what's going on.

Also, if this turns out to be a long term thing I do plan to start

hCG to preserve fertility. From what I hear hCG is best used in

conjunction with regular testosterone therapy.

Of course I'm still learning so this is all dynamic, nothing is set

in stone nor should it be with you or your doctor.

> > I want to introduce myself. I am a 47 year old male with type 2

> > diabetes, previously high cholesterol, depression, anxiety

> attacks,and

> > had a breast cancer scare last fall. Two weeks ago I was

diagnosed

> > with low free T 10.1 on a scale of (11-40. Starting taking IM

> > treatment last week (once every 3 weeks for 3 times and then

once a

> > month) 200mg per shot. I was at my doctors yesterday for my

> diabetic

> > checkup and asked him when he wanted me to have another blood

test

> for

> > my T. He said that I would not need one, that unless I did not

get

> to

> > feeling better we would just continue this regimen for the rest

of

> my

> > life. He said that if (and probably wouldn't) my T level went

over

> > the top and strated feeling bad again then we would look at it.

So

> I

> > said to him " What about my E2 level? " and he said " What is

that? "

> So I

> > explained that to him and about my having hot sweats. But he

didn't

> > seemed concerned. I think I need to see an endo and find out

what

> is

> > going on. He said that if we didn't get the results that " we "

> wanted

> > he would send me to one. I guess I will give the T time to get

> into

> > my system and then go from there. He has been my doctor for

about

> 17

> > years and this is the first time that I have disagreed with his

> > assessment. Any comments or observations?

> ---------------------------------

> Hello, and welcome! I am sure others will tell you to go to the

> FILE section and print out the Hypo guidlines to educate your

doctor.

> You will also find from reading the posts here that your doctor is

> wrong, repeat wrong, about your dosage and if is up to you to tell

> him that you should be giving yourself shots every seven days or

so

> of 100mg of depotestosterone. I can tell you from the personal

> experience of 33 years of self injecting depoT that three weeks is

> too long between shots, and four weeks is plain rediculous. These

> intervals are too far apart, and the harm is that they cause your

T

> level to " cycle " up and down, up and down, instead of being at a

> steady level like weeklies of smaller dosages will give you. This

> thinking is old school on this, and can lead you to depression and

> bad bad mood swings as your T goes up and then way, way down.

> You have to take control now before it gets worse. You have to

learn

> to self inject, piece of cake, so you yourself are in control of

the

> juice and when you get it. I cannot tell you how serious this is.

> best wishes

> norton