Boston Area Doctors

[atsaaa]

Hi ExcelMales, I was recently diagnosed with low T (~250) while my age is 35 yo. The endocrinologist is not prescribing T as she considers that level normal even though I have almost all the symptoms of low T (including ED).

Anyway, long story short, I did my research and decided to start treatment with another Dr. since the benefits outweigh the risks. I live in Boston and looking for a doctor who is familiar with all the different option (i.e. hCG). I have heard nothing but good thinks about Men's Health Boston but I am wondering whether they are familiar on prescribing anastrozole as well. I am particularly concerned about estradiol levels as I am overweight (BMI ~30) with high fat %. I have already lost a significant amount of weight in the last 4-5 months, but as many of you know, having low T and trying to exercise more and lose weight is like swimming against the stream.

I am committed to making changes in my life for the first time after many years of neglect and I would appreciate any ideas you might have for practices in the Boston area.

Thanks

 

[HarryCat]

Of course Dr. Morgentaler is a legend in the field. I don't personally know anyone who is a patient of his, but I have read that in general he does not like to use HCG (see NO HCG: Dr. Abraham Morgentaler, Dr. Rand McClain, and Jay Campbell??) and I also believe he is hesitant to use an AI unless E2 levels are really high. I haven't heard if he is allowing patient to inject subQ yet. You could try calling the office and asking.

 

[SuperDutyDave]

Don't waste time with docs just starting in field. Dr. Crisler is the source. Cutting edge treatment.

Sub-q T-cyp with HCG and E control is the way to fly.

Don't waste a year in Boston like I did.....head to MI right away. You won't regret it

 

[Dr Justin Saya MD]

Don't waste time with docs just starting in field. Dr. Crisler is the source. Cutting edge treatment.

Sub-q T-cyp with HCG and E control is the way to fly.

Don't waste a year in Boston like I did.....head to MI right away. You won't regret it

Dr Morgentaler just starting in the field?!?!?!

Now I have my differences with what Dr Morgentaler prefers as a go-to regimen, but that is a fundamental difference between the "front lines" and academia/research based medicine...but he is, by far, not "starting" in the field...

 

[SuperDutyDave]

Not trying to inpune the doctor but I went to another doctor in Boston very well respected etc etc but at end of the day his treatment plans etc were far from what I was hearing from other docs on boards such as this. I spun my wheels for a year with no results. Dr. Crisler was recommended and really got me fixed and I was a tough case. I guess I'm biased but rather go to a doctor who is doing it right in all aspects

No offense meant just personal advise and expirence

 

[HarryCat]

With all due respect to Dr. Morgentaler, he has done great things for us to be able to access TRT. I went to a colleague of his who is co-author on many of Dr. Morgentaler's research papers. He was very insistent that pellets were the state of the art in TRT.

I'm with Defy now.

 

[Dr Justin Saya MD]

Agreed, I certainly wouldn't consider most of their protocols "cutting edge" as some of us other providers, however they are trying to pull the REST of the TRT world up out of the Stone Ages...and it is a noble effort.

 

[Bobby Boots]

Hello - new to the forum, tested for low T by PCP two weeks ago, and also looking for a Dr. in Boston - have an appt w/ Mens Health Boston (William Connors) on Nov. 9th - who did you end up seeing? Any feedback?

I'm VERY new to this, and trying to find a good doc - drinking from the firehose here, don't fully understand all of the factors and differences in methodologies yet and it seems everyone has very different opinions they're quite passionate about.

Thoughts on your experiences in Boston?

 

[Vince]

Hello - new to the forum, tested for low T by PCP two weeks ago, and also looking for a Dr. in Boston - have an appt w/ Mens Health Boston (William Connors) on Nov. 9th - who did you end up seeing? Any feedback?

I'm VERY new to this, and trying to find a good doc - drinking from the firehose here, don't fully understand all of the factors and differences in methodologies yet and it seems everyone has very different opinions they're quite passionate about.

Thoughts on your experiences in Boston?

Welcome to ExcelMale, if you don't get the answer you're looking for. You may like to start a new thread. This one's pretty old. I hope you continue posting and good luck in your journey.

 

[atsaaa]

Hi Bobby Boots, I did see Dr Connors at MHB. He was very pro hCG and not T gel or injection because of my age. However, he acknowledged that at some point I will have to use T. I started with 1500IU x3 for two months. My T skyrocketed from 250 to 1250 (normal range 300-1000). I was feeling great at that level and my ED started to improve. I did blood tests on the 2-month mark and my hematocrit was slightly abnormal (47.7 before treatment and 50.8 after (normal range 38.5-50)). Estradiol was also high (from 25 to 96.3, normal range 20-75). That being said I had all the side effects of high estradiol, i.e. nipple pain and cold water feeling down under. However, my erections started to improve. We cut down the dose to 1000IU x3. I can say that I feel the difference in T. Probably got lower and I can feel that my stamina is not as high as it was with the initial dose. Also, estradiol must have gone down since I don't feel any nipple pain. However, my erections got worst since we changed the dose. I know that ED is the last thing to improve on TRT and I have hope on this, that it will start improving again.

Another side effect (on the good side) I noticed with TRT is that my legs stopped feeling swell (or like hanging them from a chair for some time). I was feeling them much lighter. However, as soon as we dropped the dose, that swelling feeling just got back. Too disappointed. Is this something others have noticed?

I would like to go back to my old dose. Most likely this is not gonna happen because of the high hematocrit. Probably the senior members can confirm that everybody is different and don't see results at the same level of T. I was much happier with the overdose T than now (even though I suspect that my T will be at the 600-800 range and doctor will be happy as well).

MHB I can say that are really proactive with lab tests etc. To be honest, though. I haven't discussed the use of AI. I might bring it up on my next appointment.

 

[CoastWatcher]

Hi Bobby Boots, I did see Dr Connors at MHB. He was very pro hCG and not T gel or injection because of my age. However, he acknowledged that at some point I will have to use T. I started with 1500IU x3 for two months. My T skyrocketed from 250 to 1250 (normal range 300-1000). I was feeling great at that level and my ED started to improve. I did blood tests on the 2-month mark and my hematocrit was slightly abnormal (47.7 before treatment and 50.8 after (normal range 38.5-50)). Estradiol was also high (from 25 to 96.3, normal range 20-75). That being said I had all the side effects of high estradiol, i.e. nipple pain and cold water feeling down under. However, my erections started to improve. We cut down the dose to 1000IU x3. I can say that I feel the difference in T. Probably got lower and I can feel that my stamina is not as high as it was with the initial dose. Also, estradiol must have gone down since I don't feel any nipple pain. However, my erections got worst since we changed the dose. I know that ED is the last thing to improve on TRT and I have hope on this, that it will start improving again.

Another side effect (on the good side) I noticed with TRT is that my legs stopped feeling swell (or like hanging them from a chair for some time). I was feeling them much lighter. However, as soon as we dropped the dose, that swelling feeling just got back. Too disappointed. Is this something others have noticed?

I would like to go back to my old dose. Most likely this is not gonna happen because of the high hematocrit. Probably the senior members can confirm that everybody is different and don't see results at the same level of T. I was much happier with the overdose T than now (even though I suspect that my T will be at the 600-800 range and doctor will be happy as well).

MHB I can say that are really proactive with lab tests etc. To be honest, though. I haven't discussed the use of AI. I might bring it up on my next appointment.

High hematocrit can be typically managed with blood donations and/or therapeutic phlebotomy. Was,this an option presented? Are you monitoring estradiol with the sensitive lab test? What were your results?

 

[atsaaa]

CoastWatcher, does this mean that you believe it's safe to go above the normal range of T as long as you manage the other symptoms?

I haven't been tested with the sensitivie essay. I bet it would have been abnormal since I had symptoms of high E. MHB use Quest D but when I asked for the sensitive E test, the NP didn't know anything about it. He just filled the regular form that includes the regular E test.

 

[CoastWatcher]

CoastWatcher, does this mean that you believe it's safe to go above the normal range of T as long as you manage the other symptoms?

I haven't been tested with the sensitivie essay. I bet it would have been abnormal since I had symptoms of high E. MHB use Quest D but when I asked for the sensitive E test, the NP didn't know anything about it. He just filled the regular form that includes the regular E test.

You said your hematocrit was elevated. Typically, patients on TRT manage elevated hematocrit by donating blood or having their doctor schedule a therapeutic phlebotomy. This pulls the HCT back into normal range. A regular CBC keeps an eye on the levels on an ongoing basis. Pulling your testosterone back was probably wise in light of the reference range, but I wanted you to be aware that HCT can be managed in ways other than by dose manipulation should this be an issue in the future.

As as for estradiol, the standard test is of little value for men. The sensitive test, LC, MS/MS, is the only way to measure E2 in men.

 

[atsaaa]

Thanks CoastAtcher.
What the others think of above the normal range T? I forgot to mention that my Free T was 0.85 before and 2.89 after treatment (normal range 0.87-5.47). Is it OK if the total T is above the normal range while the free T is normal? At the moment I am at about 29% BF (dropped few pounds since I started and continue losing weight) and we know that T bounds to fat cells. If my BF is high then many of the total T is not bioavailable. Could I go back to my old prescription as far as Free T is normal and control HCT?

 

[Mountain Man]

I am a patient at men's health Boston. They've been great so far. T levels run at 800-1000. I am 62 and haven't felt this good since my early 40's. My body fat has dropped considerable and I have had visible responses from my workouts for the first time in 20 years. . I see a PA there guess they all follow Morganthaler's protocols. I've been very pleased that they want my levels as close to 1000 at the trough as possible.

I'm new to the site and will be interested to learn what other MDs are doing. I find it hard to believe i could get a better response but, if it is possible, I'm in!

 

[Vince]

I am a patient at men's health Boston. They've been great so far. T levels run at 800-1000. I am 62 and haven't felt this good since my early 40's. My body fat has dropped considerable and I have had visible responses from my workouts for the first time in 20 years. . I see a PA there guess they all follow Morganthaler's protocols. I've been very pleased that they want my levels as close to 1000 at the trough as possible.

I'm new to the site and will be interested to learn what other MDs are doing. I find it hard to believe i could get a better response but, if it is possible, I'm in!

Welcome,
Testosterone and Men’s Health Forum - ExcelMale

 

[atsaaa]

Hi Mountain Man. What TRT protocol are you using? Gel, T injection or HCG?

 

[Mountain Man]

Hi Mountain Man. What TRT protocol are you using? Gel, T injection or HCG?

I'm on Testosterone Cypionate : 200 MG/ML 0.5 ml Intramuscular weekly. My diet has been very clean, but it always has been. My initial total t was 377 from a reference range of 375-1000 ng/dl. I was at 1175 the next visit. They bumped me down to .4 and I came in at 720. They settled on .475 -.48 to keep me around 900-1000. These readings were at the lowest point in the week, Tuesday and I inject Wednesday evenings. All my blood work was good. They offered me pellets, but I didn't want to, as this has worked well for me.Was at 17% body fat and am down under 15 currently.

 

[atsaaa]

Thanks, Mountain Man. You had no issues with high estradiol? Probably your low fat % helps on that. Do you inject the T yourself or you go to their office?

 

[Mountain Man]

I inject at home. They show you how to do it in the office, and they showed me a discount program to get in as I was apying out of pocket for the testosterone. Cost is something like $30 per month, including needles.