Help me understand more than I do now

[RAtticus]

I like this answer. You should become an expert on yourself, certainly depending on other qualified people for testing and advice. But when it comes to your own body, YOU are the only one that's truly going to be concerned and paying close attention.

I've been playing the "up and down" game with my health for a number of years. I'm 71, been on TRT for just over 10 years. Some days I feel like I'm 30, but many days I feel my age. It's a constant battle trying to figure out which foods are upsetting the stomach, or did this last round of antibiotics affect me, or am I just stressed out??? Finding the root causes of my issues has been most frustrating, and I'm still not quite there.

Perfect health (which we all want) is an incredibly complex thing, bordering on the surreal. There are so many things that can go wrong, it's a wonder we live as long as we do. Just get in there and start testing and learning. Pay attention to what you are eating and how you feel afterwards. Some exercise may help. Getting enough sleep? Stress levels under control?? etc, etc, etc..... Good luck!

I really like this feedback, thank you

 

[RAtticus]

To add here, with possible secondary hypo., you need a brain MRI check pituitary area. Some tumors mostly benign can cause this, like prolactinoma.

See, this is helpful for me. I wouldn’t have ever thought to check. Now I’m sure it’s gonna cost me $1k plus to do this test though

 

[RAtticus]

To add here, with possible secondary hypo., you need a brain MRI check pituitary area. Some tumors mostly benign can cause this, like prolactinoma.

My prolactin levels have been 8ng/ml. Prolactinoma should show much higher/elevated prolactin right?

 

[Gladiator]

Wouldn’t this “give it a go” be a semi-life long commitment?

6 week of being on trt is when people have first bloods taken. Your natural production might not have fully shut down. You will have an idea on how you feel , be able to see what your bloods look like.
You can stop cold Turkey or pct and then see how you feel.

Sone people call it a trt cycle. Some call it a life changer

 

[RAtticus]

Had another consult with clinic today. They recommended 210mg test over 3 injections weekly. .25mg anastrazole day after injection.

Doing more tests and MRI with Kaiser tomorrow. I ordered the meds from clinic and will start depending on results.

 

[Systemlord]

They recommended 210mg test over 3 injections weekly. .25mg anastrazole day after injection.

*To clarify: I have never attempted TRT or anything else*

That's strange, an AI was prescribed without knowing whether or not you even need it and your starting dosage is too high. A more sensible protocol would be a lower weekly dosage (120 mg) to where the AI isn't needed.

I can tell you with absolute certainty that there is no one at this clinic that will be able to direct treatment effectively should you encounter problems and you'll be left trying to figure things out of your own.

A lot of doctors and these private clinics just don't know how to prescribe TRT.

 

[MIP1950]

I have Kaiser and all the endo's I've encounted are braindead and shockingly clueless when it comes to TRT.

Kaiser is in the business of collecting premiums, is the provider and insurance company rapped into one.



Your testosterone is low, but good luck finding a doctor that is well versed in male hormones at Kaiser.

Your estrogen is kind of low as well, and have seen men with estrogen is the mid teens diagnosed with osteoporosis.

A normal healthy estrogen level for an adult male is 20> pg/mL, but the ranges cover children before puberty as well.

Majority of men with low-T have diabetes, metabolic syndrome that is lowering the testosterone.

As far as the diagnosis of hypogonadism, everyone has their own normal range for everything, sadly doctors treat everyone the same.

Kaiser's criteria for testosterone replacement is 240 or less, so if you're 241, in their eyes, you're normal. Hated Kaiser but it was my wife's health insurance years ago in Maryland, until I qualified for Social Security Disability, then received Medicare and obtained my own insurance.

 

[Systemlord]

Kaiser's criteria for testosterone replacement is 240 or less, so if you're 241, in their eyes, you're normal.

Thats fine, but Kaiser doctors need to tell these men that while they don't cover treatment above 240, that these men aren't normal according to the endocrine society.

Its one thing to not have enough coverage for treatment and quite another to mis a correct diagnosis.

 

[MIP1950]

Thats fine, but Kaiser doctors need to tell these men that while they don't cover treatment above 240, that these men aren't normal according to the endocrine society.

Its one thing to not have enough coverage for treatment and quite another to mis a correct diagnosis.

I learned this when I read one man's experience with Kaiser on another site, years ago. When his doctor left the exam room, the computer was still open, so this man looked and the criteria for prescribing testosterone was 240 or less. Agree with what you're saying and if a Kaiser doctor told that to a patient it would leave Kaiser in a grey legal position of acknowledging that you need treatment but they won't provide it and you can't go outside of Kaiser unless you pay cash, so unless that man can afford outside treatment, he's stuck with low T and no way to get treatment from Kaiser. Catch-22? Then you have to sue them. I had a similar problem with their psychiatric service. I was told they couldn't prescribe certain drugs that are used off label. Glad I'm not with them.

 

[madman]

Had another consult with clinic today. They recommended 210mg test over 3 injections weekly. .25mg anastrazole day after injection.

Doing more tests and MRI with Kaiser tomorrow. I ordered the meds from clinic and will start depending on results.

This is overkill!

Starting someone on such dose let alone throwing in an AI off the hop is ridiculous.

Trust me when I tell you that diving in head first is a big mistake.

Start low and go slow we say.

Much easier going up if need be than coming down.

They are going to jack your T levels up well beyond what will most likely be needed.

Most can easily achieve a healthy, high let alone absurdly high FT level running <200mg T/week.

 

[Systemlord]

Agree with what you're saying and if a Kaiser doctor told that to a patient it would leave Kaiser in a grey legal position of acknowledging that you need treatment but they won't provide it and you can't go outside of Kaiser unless you pay cash, so unless that man can afford outside treatment, he's stuck with low T and no way to get treatment from Kaiser. Catch-22? Then you have to sue them.

Someone needs to sue Kaiser for refusing treatment and show data which shows low-T occurs higher than their cutoff. There is a ton of data out there and now Dr. Mohit Khera MD has shown that testosterone sensitivity differs in men.

 

[MIP1950]

Someone needs to sue Kaiser for refusing treatment and show data which shows low-T occurs higher than their cutoff. There is a ton of data out there and now Dr. Mohit Khera MD has shown that testosterone sensitivity differs in men.

I'll have to read Dr. Khera.

 

[Systemlord]

I'll have to read Dr. Khera.

Why read when you can watch? This video covers everything.

Testosterone Controversies in Men's Health: Lecture by Dr. Khera​

 

[RAtticus]

This is overkill!

Starting someone on such dose let alone throwing in an AI off the hop is ridiculous.

Trust me when I tell you that diving in head first is a big mistake.

Start low and go slow we say.

Much easier going up if need be than coming down.

They are going to jack your T levels up well beyond what will most likely be needed.

Most can easily achieve a healthy, high let alone absurdly high FT level running <200mg T/week.

What’s the recommended response or course I should take? Different clinic? I want the treatment, but want to do it the right way.

 

[Match]

Reduces the dose and eliminates AI because it has no high E. It is your right to talk to the doctor, your most conservative treatment option

 

[RAtticus]

Update***:

On three weeks, doing .25ml x 3 a week, no AI. Had a few days where I felt great, morning erections, energy, you name it. Feel right back to how I was, and no retaining water and have some chest tenderness, but no nipple tenderness.

Bloods in 9 weeks.

What should I do. Stay for the course and see what labs say and adjust after? Tweak something now?

 

[RAtticus]

Now** retaining water.

 

[Systemlord]

On three weeks, doing .25ml x 3 a week, no AI.

Your levels haven't even reached a steady state, 3 weeks is too early to be making changes.

What you're experiencing is common.

 

[RAtticus]

Updated labs: Thoughts? Libido has improved. I feel like I radiate substantially more heat. Slightly increased mental focus and a little more daily motivation. Otherwise don’t really notice a difference. Just had a baby so that might be a factor.

https://ibb.co/z6yjbgT

 

[Systemlord]

Updated labs: Thoughts? Libido has improved. I feel like I radiate substantially more heat. Slightly increased mental focus and a little more daily motivation. Otherwise don’t really notice a difference. Just had a baby so that might be a factor.

7518-EDBD-5-E4-F-4604-8233-361652-C40-BBD

Your levels are too high and with the low SHBG, Free T is almost double the normal ranges.

Given the Total T and SHBG level, I have no doubt that your Free T is very high.

The direct Free T measurement is known to be inaccurate, and in the future use the Equilibrium Dialysis method.

You should lower your dosage.