Guest guest Posted June 26, 2006 Report Share Posted June 26, 2006 I see a urologist too. He's the 1 who told me I need to be on TRT. I went to him after my previous endo did the labs and told me that my T was low on them but that I don't need TRT. So when the urologist saw the labs he said 100% I need TRT. I then went to another endo to get a 2nd opinion on that b/c I felt uncomfortable that the previous endo (who is the reviewr for the AACE guidelines) and this urologist were looking at the same labs, yet the endo who is supposedly the expert told me i don't need trt and the urologist told me I absolutely need it. so when i went to the new endo i explained the whole situation to him, and he told me that it can't hurt trying it but that he doesn't think it's going to take care of my symptoms. Now, as I previously posted, he's telling me to stick with it for a few more months and then discontinue if no improvement. I just emailed him today asking why he's saying that the Androgel is working as it should if my T levels are in the low- normal range. I'll let y'all know what he says. I did fell great for almost 2 weeks when I first started the Androgel, which leads me to blv that if my levels were much higher, as they likely were during that time period, then maybe this trt could actually help my mood symptoms. > > > > It's great advice but it's easier said than done. I've spent hours > > and hours reading this site and researching this stuff, but when I'm > > functioning at such a low capacity it's nearly impossible for me to > > actually absorb most of it, and then when I do go to the Dr. I'm so > > disconnected that I can't assert myself anyway. > > > > > > You're correct. It isn't easy. It is time-consuming, costly, > inconvenient, and mind-bendingly frustrating. I don't think you need > to necessarily see an endocrinologist. A urologist might be as good > or better. Unfortunately, doc shopping is about the only good weapon > we have. You may need to make some notes for yourself to carry into a > consultation so you can fall back on them in case you get confused. > The initial goal is to ask enough questions to see if the doc is even > a possibility. If the answers aren't promising, cut it off and don't > waste time and energy. You might be able to call the office and find > out how many men are currently under the doc's care for hypogonadism. > > I hope you'll take a close look at the anti-aging clinic website > before committing yourself. It looks like it might be rather costly. > Initial labs ~$600 > Initial consult $695 > Program maintenance fee $50/month > Followup labs 2 to 3 times/year $100 - $300 > Medication $75 to $200/month > > Plus they seem to emphasize compounded transdermal products which I > don't think will do you much good since you've already failed on > transdermals. I always find it troubling when a doctor steers you to > their own pharmacy instead of letting you choose for yourself. > Assuming you have the money, it might be fine. The good side is that > they'll probably have a positive or at least non-negative view of > testosterone therapy and that's a considerable benefit. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 26, 2006 Report Share Posted June 26, 2006 Try this link. http://www.tuneupyourt.com/ load it then hit Frind A Dr. then put in your state. Make sure you call them first some Dr.'s that sined up are not good. A lot of guys have found a good Dr. doing this call them and ask how many men does the Dr. treat for low T and does he test for high Estradiol if one is high does he use Arimidex to keep there Estradiol down and ask if the Dr. uses HCG to treat men that are secondary. You will know when you have found a good one. Phil jonnyblog <jonnyblog@...> wrote: New York > > > > > > Jonny, > > > > > > > Been there done that. THese are the " Top Doctors " who don't > take > > > > insurance and charge 500 bucks a visit who tell me this. > > > > > > This has been my approach, which seems to be working: > > > 1. Educate yourself until you know all aspects of TRT. Know the > best > > > treatments, the proper lab tests, etc. I personally have spent > > > probably 80+ hours on this. > > > 2. Utilize the incredible knowledge and experience that can be > found > > > in this group. > > > 3. Find a doctor who is under your insurance plan and who is > > > cooperative. I approached my doctor with exactly what I wanted, > and > > > he has prescribed it every time. I am doing self-injections of > T cyp, > > > Arimidex, and HCG. > > > > > > Eugene > > > > > > > Great advice. Glad the group was helpful. That's precisely why I > > contribute some of my time here. > > > > Brad > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 26, 2006 Report Share Posted June 26, 2006 I say go back to your Urologist he sounds like he knows what he is talking about. What happens when you go on gels is your levels go up on top of what they were befor the gels. Then your brain sees this and stops sending the messages to your Testis to make T when this happens your T levels go back down some times it goes lower then what you were before starting the gel. This is why Androgel says in the insert to get tested after 2 week on the gel and if your still low to up the dose. Your on 10 grams if I remember right and your levels are this low you need to try shots go back to the Urologist and tell him you should have listened to him. Phil jonnyblog <jonnyblog@...> wrote: I see a urologist too. He's the 1 who told me I need to be on TRT. I went to him after my previous endo did the labs and told me that my T was low on them but that I don't need TRT. So when the urologist saw the labs he said 100% I need TRT. I then went to another endo to get a 2nd opinion on that b/c I felt uncomfortable that the previous endo (who is the reviewr for the AACE guidelines) and this urologist were looking at the same labs, yet the endo who is supposedly the expert told me i don't need trt and the urologist told me I absolutely need it. so when i went to the new endo i explained the whole situation to him, and he told me that it can't hurt trying it but that he doesn't think it's going to take care of my symptoms. Now, as I previously posted, he's telling me to stick with it for a few more months and then discontinue if no improvement. I just emailed him today asking why he's saying that the Androgel is working as it should if my T levels are in the low- normal range. I'll let y'all know what he says. I did fell great for almost 2 weeks when I first started the Androgel, which leads me to blv that if my levels were much higher, as they likely were during that time period, then maybe this trt could actually help my mood symptoms. > > > > It's great advice but it's easier said than done. I've spent hours > > and hours reading this site and researching this stuff, but when I'm > > functioning at such a low capacity it's nearly impossible for me to > > actually absorb most of it, and then when I do go to the Dr. I'm so > > disconnected that I can't assert myself anyway. > > > > > > You're correct. It isn't easy. It is time-consuming, costly, > inconvenient, and mind-bendingly frustrating. I don't think you need > to necessarily see an endocrinologist. A urologist might be as good > or better. Unfortunately, doc shopping is about the only good weapon > we have. You may need to make some notes for yourself to carry into a > consultation so you can fall back on them in case you get confused. > The initial goal is to ask enough questions to see if the doc is even > a possibility. If the answers aren't promising, cut it off and don't > waste time and energy. You might be able to call the office and find > out how many men are currently under the doc's care for hypogonadism. > > I hope you'll take a close look at the anti-aging clinic website > before committing yourself. It looks like it might be rather costly. > Initial labs ~$600 > Initial consult $695 > Program maintenance fee $50/month > Followup labs 2 to 3 times/year $100 - $300 > Medication $75 to $200/month > > Plus they seem to emphasize compounded transdermal products which I > don't think will do you much good since you've already failed on > transdermals. I always find it troubling when a doctor steers you to > their own pharmacy instead of letting you choose for yourself. > Assuming you have the money, it might be fine. The good side is that > they'll probably have a positive or at least non-negative view of > testosterone therapy and that's a considerable benefit. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 26, 2006 Report Share Posted June 26, 2006 > > I see a urologist too. He's the 1 who told me I need to be on TRT. > I went to him after my previous endo did the labs and told me that > my T was low on them but that I don't need TRT. So when the > urologist saw the labs he said 100% I need TRT. I then went to > another endo to get a 2nd opinion on that b/c I felt uncomfortable > that the previous endo (who is the reviewr for the AACE guidelines) > and this urologist were looking at the same labs, yet the endo who > is supposedly the expert told me i don't need trt and the urologist > told me I absolutely need it. so when i went to the new endo i > explained the whole situation to him, and he told me that it can't > hurt trying it but that he doesn't think it's going to take care of > my symptoms. Now, as I previously posted, he's telling me to stick > with it for a few more months and then discontinue if no > improvement. I just emailed him today asking why he's saying that > the Androgel is working as it should if my T levels are in the low- > normal range. I'll let y'all know what he says. I did fell great > for almost 2 weeks when I first started the Androgel, which leads me > to blv that if my levels were much higher, as they likely were > during that time period, then maybe this trt could actually help my > mood symptoms. > I think you have a good reason to be optimistic that some or all of your symptoms will be improved when you get your t level up. If the AG was in the middle of the range or so, I'd say yeah, wait it out a few months. But the level is too low. Waiting ain't gonna change that. And he's not going to escalate your dose even after some months. He's just going to discontinue your treatment. Apart from getting copies of your medical records, I see no reason to see that guy again. Go back to the uro. Show him your labs and explain that the AG isn't effective in getting your levels up. Ask him to try you on injections. If it works well, learn to give them to yourself. My level when diagnosed was 415ng/dl. I felt terrible. Within a week or so of starting testosterone, I felt much better. The idea that 1ng/dl over the lower limit of the ref range is enough is just a big pile of crap. Wing up your energy and call the uro for an appointment asap. Brad Brad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 26, 2006 Report Share Posted June 26, 2006 yblog, You said something very interesting in one of your posts... " I feel like my personality has been stolen from me. " That is so suspicious for antidepressent medication side effects. Your complaints sound very familiar to those expressed by others I've encountered who take anti-D's. Since the drugs do cause varying degrees of sexual dysfunction and are even related occasionally to lower T levels....Could you speak to you perscribing Doc about slowly coming off them for a time? Some folks can't. They need them. It can be dangerous to just stop the meds so don't even think of trying it without medical supervision. I definately had depression problems while hyopgonadal. I tried effexor for 2 years. It did little. My wife, who's a weed eater uses nothing but homeopathic/natural remedies. She convinced me to talk to her Doc about weening off the effexor and trying a simple 50mg. dose of 5HTP twice a day. What an amazing relief that was! It didn't solve my low T problem but it did help a lot with anxiety and depression. Since getting back onto Androgel, I have no need for even the 5HTP now. Being hypo does cause an aray of S/S, including depression. Within a week I stopped taking the 5H and haven't looked back. I will say getting through the rough spots was eased quite a bit by my wife's suggestion. In fact it is she who does all the research for me since she's a whiz at it. My Uro was suprised that I wanted my E2 checked but he didn't refuse at all. He just said no one ever asks for E2 monitoring and thought my wife was pretty on the ball. My Uro will do about anything I ask as long as I rationalize my request. Since keeping E2 within reason lessons the risk of prostate cancer, in my case the recurrence of....that was all he needed to hear. Every Doc I encountered at least asked if I felt like I were depressed. I hadn't felt depressed or anxious using the 5HTP. What I felt was exhausted, sore joints/muscles, virtually no libido and generally lousey all over all the time. I began by using 5gms and felt 100% better than I did but that wasn't to say I felt 100%. Anything was better than lousey! Now I use 5gms.in the morning and 5gms around 3-4 in the afternoon. Been on this routine for 2 weeks now and boy, do I feel better! I use DIM to keep my E2 under control. So far so good. Feeling better than I have in a decade. It's impossible to perfectly balance body chemistry but it can be kept in better harmony. I couldn't function on a low of 197-240 but my free was also in the basement too. I responded to 5 but 10 is more like it for a 49 year old. I'm not going to check my levels again unless there's a concern until November. The goal was to function in a healthy way and so far that goal is being met. I hope you find the right mix that'll work for you soon. Be safe, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2006 Report Share Posted June 27, 2006 I think maybe I have some better advice for you, which is based on what you've already been told here. Make a list of the doctors in your area, and call each one and ask if they will offer the treatment you want IF you test out as hypogonadal. Don't accept a doctor who won't treat you the way you want. I go to a doctor 1200 miles away because he gives me the treatment I want (I do weekly t-cyp + hCG). It is a thousand thousand times worth it - TRT has changed my life. Not to mention which NOBODY pushes me around anymore. You won't believe how much easier it makes it to speak up. Regards, Louis Nardozi >> 2d. Re: Need Help with Labs >> Posted by: " jonnyblog " jonnyblog@... jonnyblog >> Date: Mon Jun 26, 2006 2:15 pm (PDT) >> >> The endo I saw before this 1, who wouldn't agree that I needed to treat my Low-T, is 1 of the Dr.s whose name is listed as a Reviewer on that AACE link (http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf) >> These were the results from the labs that he based his decision on done back in Feb. and March. Now, are you going to tell me that he knows enough about Low-T for the AACE to hire him to review their own guidelines, but he was so misinformed in telling me that I don't have Low-T problems? Maybe he knows something about all these #s that indicates that My T is not a factor in my symptoms and that's why I'm still feeling crappy eventhough I got another " top " endo who agreed to treat me???? Something just doesn't make sense here, and it seems crazy for me to now go to another endo. I am going to go see these guys (http://www.antiagingnyc.com/about_us.htm), maybe they'll have a different strategy that will be more helpful. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2006 Report Share Posted June 27, 2006 Great Post but I feel very strong about going that long with out testing. In all the 22 yrs. I have been on TRT I have been tested every 4 to 6 weeks. Things can go wrong that you will not feel like your blood getting thick, your liver needs to be watched and DHT can go off the top of the range on gels. I do get my blood work payed for 100% and for the guys that have to pay then at least every 90 days have blood work done. Phil Vickie or <plp40@...> wrote: yblog, You said something very interesting in one of your posts... " I feel like my personality has been stolen from me. " That is so suspicious for antidepressent medication side effects. Your complaints sound very familiar to those expressed by others I've encountered who take anti-D's. Since the drugs do cause varying degrees of sexual dysfunction and are even related occasionally to lower T levels....Could you speak to you perscribing Doc about slowly coming off them for a time? Some folks can't. They need them. It can be dangerous to just stop the meds so don't even think of trying it without medical supervision. I definately had depression problems while hyopgonadal. I tried effexor for 2 years. It did little. My wife, who's a weed eater uses nothing but homeopathic/natural remedies. She convinced me to talk to her Doc about weening off the effexor and trying a simple 50mg. dose of 5HTP twice a day. What an amazing relief that was! It didn't solve my low T problem but it did help a lot with anxiety and depression. Since getting back onto Androgel, I have no need for even the 5HTP now. Being hypo does cause an aray of S/S, including depression. Within a week I stopped taking the 5H and haven't looked back. I will say getting through the rough spots was eased quite a bit by my wife's suggestion. In fact it is she who does all the research for me since she's a whiz at it. My Uro was suprised that I wanted my E2 checked but he didn't refuse at all. He just said no one ever asks for E2 monitoring and thought my wife was pretty on the ball. My Uro will do about anything I ask as long as I rationalize my request. Since keeping E2 within reason lessons the risk of prostate cancer, in my case the recurrence of....that was all he needed to hear. Every Doc I encountered at least asked if I felt like I were depressed. I hadn't felt depressed or anxious using the 5HTP. What I felt was exhausted, sore joints/muscles, virtually no libido and generally lousey all over all the time. I began by using 5gms and felt 100% better than I did but that wasn't to say I felt 100%. Anything was better than lousey! Now I use 5gms.in the morning and 5gms around 3-4 in the afternoon. Been on this routine for 2 weeks now and boy, do I feel better! I use DIM to keep my E2 under control. So far so good. Feeling better than I have in a decade. It's impossible to perfectly balance body chemistry but it can be kept in better harmony. I couldn't function on a low of 197-240 but my free was also in the basement too. I responded to 5 but 10 is more like it for a 49 year old. I'm not going to check my levels again unless there's a concern until November. The goal was to function in a healthy way and so far that goal is being met. I hope you find the right mix that'll work for you soon. Be safe, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2006 Report Share Posted June 27, 2006 Phil, I am 49 years old and my body has had cancer twice. This body isn't going to ever be in perfect balance! Chasing a perfect balance is like chasing a rainbow...there is no pot of gold in the end. I desire a good quality of life with a body chemistry that is in good harmony, not perfect balance....since there is no such thing! If I find I feel poorly or something has gone haywire, then I'll go sooner, but I won't be a slave to test results. Hormones go up and down, sometimes dramatically in the same 24 hours. While morning wood may be a few people's way of knowing their E2 is off, the actual fact of the matter is...morning wood primarily has to do with bladder fullness, not with nocturnal erections. Gauging morning erections by how much of an invasive drug to use sounds like playing with fire to this coward! You are certainly one to take a challenge. What works for me is to not be a slave to tests or what others say is normal. What works for one won't necessarily work for everyone. In fact labs are age and or size related in many cases. Life styles, stressors, so may things skew tests from one day to the next. Comorbidities make a difference in results...there are a lot of reasons why people are different. Different is why some will and some won't take to transdermals for example. Oddly, most TCa patients do well on transdermals. Wonder why that is? I would encourage all men to seek a good Urologist who deals with ED and male disorders then follow up with an Endo. It may be wise to stick to Doc's directly involved with larger hospitals rather than small town independent Doc's. They are likely to be the most up to date on things. nyblog's Doc isn't wrong. He does need to give it time. 3 months is nothing if it gets things done. Instead of spending 30+ years sticking needles into tissues that eventually stop absorbing the drug because tissues turn fibrous, he needs to try his Doc's idea first. Long term use of shots can cause tissues to become scarred and fibrous thus reducing the effectiveness of injectables. That complication was one of reasons the transdermals were developed. It is also the reason I plan on using transdermals unless / until they become ineffective. That can only be determined in time. Air and time are free! Be safe, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2006 Report Share Posted June 27, 2006 One thing, I want to sound off about doing the whole baseline thing. Phil will agree with me on this one that the baseline for T is not accurate if the patient has been on HRT any length of time. Unless the H/P axis is restarted using clomid or HcG after meds are stopped the results fall off the scale. Removing the meds only crashes the patient since it may take as long as a year for the body to react IF it does at all. I've been here before - t levels dropped from 560 to 95. Depression and side effects at this level are VERY real! There are plenty of body builders who've done a cycle of steriods and their pituitary cease LH and FSH forever. If a doc tells me to stop the meds it tells me one or two things (or both) - 1- he doesn't know anything about HRT or 2- he doesn't want to treat me and hope I won't return. And that's all I have to say about that. L > I think maybe I have some better advice for you, which is based on what > you've already been told here. Make a list of the doctors in your area, > and call each one and ask if they will offer the treatment you want IF > you test out as hypogonadal. Don't accept a doctor who won't treat you > the way you want. I go to a doctor 1200 miles away because he gives me > the treatment I want (I do weekly t-cyp + hCG). It is a thousand > thousand times worth it - TRT has changed my life. Not to mention which > NOBODY pushes me around anymore. You won't believe how much easier it > makes it to speak up. > > Regards, > Louis Nardozi > > > >> 2d. Re: Need Help with Labs > >> Posted by: " jonnyblog " jonnyblog@... jonnyblog > >> Date: Mon Jun 26, 2006 2:15 pm (PDT) > >> > >> The endo I saw before this 1, who wouldn't agree that I needed to treat my Low-T, is 1 of the Dr.s whose name is listed as a Reviewer on that AACE link (http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf) > >> These were the results from the labs that he based his decision on done back in Feb. and March. Now, are you going to tell me that he knows enough about Low-T for the AACE to hire him to review their own guidelines, but he was so misinformed in telling me that I don't have Low-T problems? Maybe he knows something about all these #s that indicates that My T is not a factor in my symptoms and that's why I'm still feeling crappy eventhough I got another " top " endo who agreed to treat me???? Something just doesn't make sense here, and it seems crazy for me to now go to another endo. I am going to go see these guys (http://www.antiagingnyc.com/about_us.htm), maybe they'll have a different strategy that will be more helpful. > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2006 Report Share Posted June 27, 2006 Yep I am with you on this one. Phil patrolbase19 <patrolbase19@...> wrote: One thing, I want to sound off about doing the whole baseline thing. Phil will agree with me on this one that the baseline for T is not accurate if the patient has been on HRT any length of time. Unless the H/P axis is restarted using clomid or HcG after meds are stopped the results fall off the scale. Removing the meds only crashes the patient since it may take as long as a year for the body to react IF it does at all. I've been here before - t levels dropped from 560 to 95. Depression and side effects at this level are VERY real! There are plenty of body builders who've done a cycle of steriods and their pituitary cease LH and FSH forever. If a doc tells me to stop the meds it tells me one or two things (or both) - 1- he doesn't know anything about HRT or 2- he doesn't want to treat me and hope I won't return. And that's all I have to say about that. L > I think maybe I have some better advice for you, which is based on what > you've already been told here. Make a list of the doctors in your area, > and call each one and ask if they will offer the treatment you want IF > you test out as hypogonadal. Don't accept a doctor who won't treat you > the way you want. I go to a doctor 1200 miles away because he gives me > the treatment I want (I do weekly t-cyp + hCG). It is a thousand > thousand times worth it - TRT has changed my life. Not to mention which > NOBODY pushes me around anymore. You won't believe how much easier it > makes it to speak up. > > Regards, > Louis Nardozi > > > >> 2d. Re: Need Help with Labs > >> Posted by: " jonnyblog " jonnyblog@... jonnyblog > >> Date: Mon Jun 26, 2006 2:15 pm (PDT) > >> > >> The endo I saw before this 1, who wouldn't agree that I needed to treat my Low-T, is 1 of the Dr.s whose name is listed as a Reviewer on that AACE link (http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf) > >> These were the results from the labs that he based his decision on done back in Feb. and March. Now, are you going to tell me that he knows enough about Low-T for the AACE to hire him to review their own guidelines, but he was so misinformed in telling me that I don't have Low-T problems? Maybe he knows something about all these #s that indicates that My T is not a factor in my symptoms and that's why I'm still feeling crappy eventhough I got another " top " endo who agreed to treat me???? Something just doesn't make sense here, and it seems crazy for me to now go to another endo. I am going to go see these guys (http://www.antiagingnyc.com/about_us.htm), maybe they'll have a different strategy that will be more helpful. > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 27, 2006 Report Share Posted June 27, 2006 nice to hear a voice of reason. i'm sure this is what my Dr.s have in mind. I guess I'll stick it out a little longer and then commadeer the situation when all else fails. > > Phil, > > I am 49 years old and my body has had cancer > twice. This body isn't going to ever be in perfect > balance! Chasing a perfect balance is like chasing > a rainbow...there is no pot of gold in the end. I desire > a good quality of life with a body chemistry that is > in good harmony, not perfect balance....since there > is no such thing! If I find I feel poorly or something > has gone haywire, then I'll go sooner, but I won't be > a slave to test results. Hormones go up and down, > sometimes dramatically in the same 24 hours. While > morning wood may be a few people's way of knowing > their E2 is off, the actual fact of the matter is...morning > wood primarily has to do with bladder fullness, not with > nocturnal erections. Gauging morning erections by how > much of an invasive drug to use sounds like playing with > fire to this coward! You are certainly one to take a challenge. > > What works for me is to not be a slave to tests or what > others say is normal. What works for one won't necessarily > work for everyone. In fact labs are age and or size related > in many cases. Life styles, stressors, so may things skew > tests from one day to the next. Comorbidities make a difference > in results...there are a lot of reasons why people are different. > Different is why some will and some won't take to transdermals > for example. Oddly, most TCa patients do well on transdermals. > Wonder why that is? > > I would encourage all men to seek a good Urologist who deals > with ED and male disorders then follow up with an Endo. It may > be wise to stick to Doc's directly involved with larger hospitals > rather than small town independent Doc's. They are likely to > be the most up to date on things. nyblog's Doc isn't wrong. > He does need to give it time. 3 months is nothing if it gets things > done. Instead of spending 30+ years sticking needles into tissues > that eventually stop absorbing the drug because tissues turn fibrous, > he needs to try his Doc's idea first. Long term use of shots can > cause tissues to become scarred and fibrous thus reducing the > effectiveness of injectables. That complication was one of reasons > the transdermals were developed. It is also the reason I plan on > using transdermals unless / until they become ineffective. That > can only be determined in time. Air and time are free! > Be safe, > > > Quote Link to comment Share on other sites More sharing options...
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