Anyone ran into this issue? I had arthroscopic surgery scheduled for my knee on Friday, but today the surgeon's office called and canceled the surgery. Why? He won't risk the surgery because I'm on TRT. My PCP forwarded him information that I had high levels of testosterone. My PCP didn't do any blood work other than CBC and CMP for the pre-surgery physical so there is no way that he knows my levels. He said he might reach out to Defy Medical, but very doubtful if he did. Defy would have to have a release from me before they would talk to him. I think I just lost two doctors in one day. Time to search for new ones.
Systemlord
Member
This is stupid, there is no risk and you will need good hormone levels to recover from surgery, so androgen deprivation therapy is the recommended course of action?
This just goes to show you how our medical system is so uninformed with regards to TRT, it's a blind spot for many doctors.
swoops36
Active Member
When I had my gyno surgery the Dr said it was very important that I was off cycle for the surgery. He had concerns about suppressing the HPTA and using the correct anesthesia. I didn’t do any research on it cos I was years off by that point. But there may be something there
Yeah, I guess I can't blame the surgeon. He just made his decision based on the information given him whether it was factual or not. But he could have also told me to go off for a week or so before the surgery, then maybe there wouldn't be an issue. But what the PCP did was inexcusable!!!! He did not have facts.
mooseman109
Active Member
Time to move on for sure espresso from PCP.
Vince Carter
Banned
ya how does any one know?
Vince Carter
Banned
Otherwise Dr is worried about being sued and/or the insurance company won't pay him. Your health isn't what he's concerned about (overall).
Systemlord
Member
This doctor is causing harm, there is no benefit to TRT at this dosage. This dosage will keep men at or lower than pre-TRT levels.
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Systemlord
Member
I'm the exception, I am not the norm. I don't know many men who have a libido let alone erections at 97-119 ng/dL.
Besides the doctor refuses to prescribe more than 50mg weekly and this is ignorance driven by fear.
I thought doctors would be more concerned with actual hormone levels and not the dosage. If you're a guy with high SHBG, you are basically screwed.
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DragonBits
Well-Known Member
I would file a complaint with the state medical board about unethical behavior for making an assumption about your T levels without a blood test.
I am surprised the pcp did this.
I wonder what the issue with surgery would be if your testosterone levels were high. And what does he mean by high?? How high is high?
Systemlord
Member
A lot of these TRT clinics are causing men more harm than good, but Defy is in a different class and acts responsibly. Perhaps if the OP shows him his most recent labs and that his levels are within ranges, maybe that would be enough to ease the doctors mind.
I've had three sinus surgeries fully sedated while on TRT (while iron deficient) and I'm still alive.
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Vince Carter
Banned
harmful isn't quite the word but a high SHBG guy it would not even approach being a therapeutic dose, basically just keeping some one in a quasi-low T state.
I will again quibble with this assumption. If two guys on TRT are identical except for SHBG, then the same testosterone dose will yield the same free testosterone in each. The one with higher SHBG will have higher total testosterone. The reason why is that the metabolic clearance rate of testosterone (MCRT) is nearly proportional to free testosterone. At steady state the MCRT must equal the rate of absorption from injections. This rate of absorption is the same in the two guys. If there are flaws in this line of reasoning then do point them out. The one possible weakness I see is that SHBG-bound testosterone is used directly in some instances. But I suspect the relative magnitude of this effect in MCRT is not large.
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