Different schools of thought between doctors

[atlien2488]

I am 29. I started TRT about a month ago with a T clinic because I couldn't get in to see an endocrinologist until today. My numbers upon testing go as follows:

Total test: 291 (264-916) Not low by labcorp but low by endocrine society under 300
LH: 2.2 (1.7-8.6) on the low side
Prolactin: 5.1 (4.0-15.2)
Estradiol: 6.4 (7.6- 42.6) low
SHBG: 32 (16.5-55.9)
free test: 5.8 (9-30) very low
TSH: .472 (.450- 4.500)
Bioavailable Test: 137 ng/DL

I had a variety of lipids, CBC, CMP....everything else came back pretty well within range.

Besides this, I had taken multiple other tests where my testosterone came back at 379, 421 and 282. She claimed that since these scores were "within range," They were normal and that the low scores were barely under the minimal amount needed. She also said taking arimidex and HCG were completely wrong and that if you are on TRT, you should ONLY be taking testosterone. I am kind of at a loss right now because the T clinic doctor who is apparently trying to take money from me, seems way more knowledgeable and forthright about everything, whereas someone that went to medical school seems like a quack.

I just don't know who to trust? She wouldn't even test me for estradiol and so on because she didn't want to be responsible for interpreting the test results.....I am seeing a urologist in a week to see what he thinks but I'm just so confused about everything. I definitely have definite signs of low T, my scores are low but someone who is supposedly a specialist on the matter thinks things look good and that I never should have started therapy.....

 

[blackebob]

How do you feel?

 

[atlien2488]

Quite a bit better tbh....my endo was like of course youre gonna feel better its testosterone im like yeah....thats the point

 

[RLW]

Well to be fair, the T clinic doctor stands to make more money off you if he gives good service and you feel good. On top of which that doctor has treated lots of people with testosterone. Your other doctor, it's a toss up what kind of care you will receive.

 

[atlien2488]

Well to be fair, the T clinic doctor stands to make more money off you if he gives good service and you feel good. On top of which that doctor has treated lots of people with testosterone. Your other doctor, it's a toss up what kind of care you will receive.

back to square one i guess

 

[Re-Ride]

Atllen, When it comes to TRT/HRT we have to learn to trust what our body is telling us. This only comes with experience. In a prior post you expressed regret for not exploring all possible options for strengthening endogenous hormones prior to beginning TRT. Uncovering the cause of h. hypogonadism is highly challenging. Perhaps your money would be better spent at this time working with someone who has expertise in boosting the axis. No you did not damage yourself by trying T for 30 days. Very unlikely. Yes you do need to assure yourself that you've done all that is possible so that you will not have lingering regrets. A telemed practice might be a good choice. They can help you explore alternatives like injectable aminos.

You inquire about men with 20 to 30 years experience on TRT. Proper protocols are only now coming to light. Whether you already have or will eventually decide that HRT is right for you it is you who will be discovering which protocol is correct. Nelson's guide is sound as you will find anywhere. Hopefully you've seen his chart depicting how the benefits slowly manifest themselves over many months and that the time to benefit varies widely. Patience and consistency are required as is a doc who will support you and one who adheres to most of the methods laid out in Nelson's guide. We'd like to think that most doctors have expertise in the TRT and are up to date in best practices for male hormonal health. Fact is the good ones are few in number. Even these will be of limited help without the patient's own careful observation and self training.

 

[Virginian]

Your course of action should be based on your symptoms. Your total T is borderline low, but many men do just fine with the same T as you. By itself, that is not enough to justify TRT. However, your free T and is quite low, and is probably the more important number.

The problem with TRT is that it is for life and it will not fix everything. It is for life because TRT steadily decreases your body's ability to make its own T. In my opinion, you are rather young to be needing injections for the rest of your life. TRT is only suitable if your symptoms are really bad.

That said, I am on TRT and it's been great for me. It has greatly improved my strength, physique, and energy. But I started at age 70 and am now 75. So injecting for life may not be so long.

 

[Dave B.]

I am 29. I started TRT about a month ago with a T clinic because I couldn't get in to see an endocrinologist until today. My numbers upon testing go as follows:

Total test: 291 (264-916) Not low by labcorp but low by endocrine society under 300
LH: 2.2 (1.7-8.6) on the low side
Prolactin: 5.1 (4.0-15.2)
Estradiol: 6.4 (7.6- 42.6) low
SHBG: 32 (16.5-55.9)
free test: 5.8 (9-30) very low
TSH: .472 (.450- 4.500)
Bioavailable Test: 137 ng/DL

I had a variety of lipids, CBC, CMP....everything else came back pretty well within range.

Besides this, I had taken multiple other tests where my testosterone came back at 379, 421 and 282. She claimed that since these scores were "within range," They were normal and that the low scores were barely under the minimal amount needed. She also said taking arimidex and HCG were completely wrong and that if you are on TRT, you should ONLY be taking testosterone. I am kind of at a loss right now because the T clinic doctor who is apparently trying to take money from me, seems way more knowledgeable and forthright about everything, whereas someone that went to medical school seems like a quack.

I just don't know who to trust? She wouldn't even test me for estradiol and so on because she didn't want to be responsible for interpreting the test results.....I am seeing a urologist in a week to see what he thinks but I'm just so confused about everything. I definitely have definite signs of low T, my scores are low but someone who is supposedly a specialist on the matter thinks things look good and that I never should have started therapy.....

I just went through this myself, and my Endo asked me any number of questions to try to get to the root of secondary hypogonadism. What was the result of that conversation? It is unusual for a 29 year old to be low, but not impossible. Are you overweight, taking other meds, have sleep apnea? It could be lots of things and at 29 you'd probably want to explore every other option before TRT. Did they ask if you wanted an MRI to rule out a tumor?

 

[atlien2488]

Nope, none of the above. Taking a very small amount of lexapro 5mg. However i did not recieve an mri. That could be another option.

 

[Systemlord]

Nope, none of the above. Taking a very small amount of lexapro 5mg. However i did not recieve an mri. That could be another option.

Regardless of the dosage of Lexapro it will work against you and will diminish TRT, Lexapro is known for wrecking a guys testosterone levels. It might even be why your hormones levels are low to begin with as these drugs cause pituitary disorders. Lexapro also causes pituitary tumor benign, you're playing with fire there buddy.

 

[atlien2488]

I came off of it for a few months to eat healthy fats, meditate, practice ways to naturally raise testosterone....and it went down in value so i doubt it

 

[Systemlord]

I came off of it for a few months to eat healthy fats, meditate, practice ways to naturally raise testosterone....and it went down in value so i doubt it

Come on, seriously?

 

[atlien2488]

Systemlord, lexapro has a 28 hour half life.....its completely out of your system within the week and completely stops affecting the brain within a month. At a sub clinical dose of 5 mg and months after being off of it, yes i do doubt it played a factor.
What i do believe played a factor was a head trauma in my early twenties and illicit drugs i used in college as well. Unfortunately i cant go back in time....all i can do is be as healthy as i can and do what i can for my mental state of wellbeing

 

[Vince Carter]

Id' avoid that female Dr, sounds like a similar experience I had a few years ago just starting on all this. A more specialized Dr even if its a dedicated clinic is going to come out ahead just based on what you said about option #1. But expenses can pile up really quick in that scenario, too. Best prices and medical care I've found is thru Defy. Of course it's out of pocket and everyones money situation is different.

 

[atlien2488]

Thanks vince....yeah id like to find an endo or urologist who went to medical school vs. A naturopath, as well as the fact its way cheaper for me. Im just blown away how uninformed they are about treating people..at one point the endo i saw described taking testosterone to opiates and amphetamines as well as saying that hcg and arimidex were only used with steroid users....just baffles me

 

[CoastWatcher]

Thanks vince....yeah id like to find an endo or urologist who went to medical school vs. A naturopath, as well as the fact its way cheaper for me. Im just blown away how uninformed they are about treating people..at one point the endo i saw described taking testosterone to opiates and amphetamines as well as saying that hcg and arimidex were only used with steroid users....just baffles me

Most doctors have had very little training in managing male hormone issues. Not because they chose not to, but because it simply isn't part of either the medical school curriculum or their fellowship training once they enter their residency. my own doctor told me she wound up wondering why most of the patients she referred to big-time endocrinologists and urologists go no better. Realizing she needed to take control, she began to teach herself how this game is played. She has become a first-class doctor in this field. Sadly, most of the medical community isn't even aware of what they don't know.

 

[Checkdis]

@atlien2488 I feel like I am in a similar situation as you. I waited just about a year for my testosterone to naturally rebound after a crappy cycle of stacked steroids (tri tren, sust, Test E, peptides..etc). I have pretty much abused my body and now suffer because of it. My T levels were down to 86, luckily my MRI of the pituitary came back great. But as a repercussion to my actions, I suffer now a severe anxiety which more than likely has physically disrupted my bladder muscles. I have been dealing with an OAB bladder for 9 months now, I have good days and bad days. Bad days I will go 20 times a day within 15 minute intervals just about. And other days I can go hours. I have exhausted all possibilities to the bladder that anyone can think of and I am clean (UTI, STD, prostate, abdominal ultra sound, MRI, diabetes, diabetes insipidus..etc).

I just started a protocol of 50mg of Cypionate twice a week with 350iu of HCG. It may take months to fix my anxiety levels (which benzodiazepines seem to fix my bladder) but from everything I may have portrayed to you, things could be a lot worse. I would say keep looking for an answer and you know yourself better than anyone else. If you feel like going through my threads and posts feel free to. But from everything I have gone through I truly think testosterone will help me. And if it doesn’t fix my bladder, at least it will fix my anxiety.

Sticking with the anti aging doctor who specializes in testosterone is your best option in my opinion.

 

[Dr Justin Saya MD]

Thanks vince....yeah id like to find an endo or urologist who went to medical school vs. A naturopath, as well as the fact its way cheaper for me. Im just blown away how uninformed they are about treating people..at one point the endo i saw described taking testosterone to opiates and amphetamines as well as saying that hcg and arimidex were only used with steroid users....just baffles me

Just to clarify as this may be a misunderstanding based on your response to Vince’s post. There isn’t a naturopath at Defy Medical. We have two medical school/residency trained physicians - myself and Dr Calkins, as well as 3 masters-level trained providers (2 physician assistants, and 1 nurse practitioner), as well as 2 RNs and multiple MA’s. Personally, I attended one of the best Medical Schools in the country - University of North Carolina at Chapel Hill!

 

[atlien2488]

Just to clarify as this may be a misunderstanding based on your response to Vince's post. There isn't a naturopath at Defy Medical. We have two medical school/residency trained physicians - myself and Dr Calkins, as well as 3 masters-level trained providers (2 physician assistants, and 1 nurse practitioner), as well as 2 RNs and multiple MA's. Personally, I attended one of the best Medical Schools in the country - University of North Carolina at Chapel Hill!

I was saying that I am currently with a doctor who is a NA and got a degree in homeopathy, nutrition, etc....I'd like to find a MD with a masters degree or an endo/urologist as they might have more extensive knowledge. The irony from what I've seen so far is it turns out that the ones I've gone to don't know enough when it comes to TRT....However, this comes from just my own research, which could be short sighted. For all I know, the doctor I went to, who said my testosterone level, well under 300 is still in the "normal range" and that TRT is dangerous, might actually be right and reading all these forums is pointless for me to do. I hope that's not the case because I surely feel 100 percent better a month on TRT.

Defy Medical is your clinic? Do you guys have one or do you know of similar physican's that you described in Seattle?

 

[blackebob]

You can do all of your labs and doctor's appointment remotely(off site) through Defy.