High T & estradiol levels on testosterone pellets

[Jay-Jay]

Your experience is very similar to my experience. I feel great the first 8 weeks or so, then only OK for 4-6 weeks, and marginal for the 2 weeks before the next insertion. This site is such a great education in some very critical issues, especially for guys like me, happily cruising through the 4th quarter. I am getting a sensitive E2 this week and then I'll talk to the doctor about transitioning to self injections. Depending on the doctor's response, I now know there's an option with Defy. Thank you for the input.

 

[Zxy]

If DHT is too high, I.e., out of healthy youthful ranges, saw palmetto helps reduce DHT. That was precisely my point. OP mentioned his E is out of range. I mentioned watch the DHT too.

If it's OK, no need to do anything. An Avodart scrip or Saw palmetto helps lower DHT

 

[CoastWatcher]

Your experience is very similar to my experience. I feel great the first 8 weeks or so, then only OK for 4-6 weeks, and marginal for the 2 weeks before the next insertion. This site is such a great education in some very critical issues, especially for guys like me, happily cruising through the 4th quarter. I am getting a sensitive E2 this week and then I'll talk to the doctor about transitioning to self injections. Depending on the doctor's response, I now know there's an option with Defy. Thank you for the input.

In terms of injections: smaller amounts of testosterone injected more frequently are the ticket to success. A typical starting protocol would be 50mgs of testosterone injected every 3.5 days. Adjustments can be made from there. Depending on your Sex Hormone Binding Globulin value you may discover you need even more frequent injections, every other day or - in my own case - daily injections to feel your best. Don't fret on that point, the payoff in terms of how you feel is worth the few minutes dedicated to the shot itself. If you only take one point away from this particular post...don't be told that an injection every two weeks, usually 200mgs every 14 days is quoted, will work. It's a ticket to disaster.

 

[Jay-Jay]

Thank you for this critical information. I feel so much better after this thread, better understanding my E2 and the advantages of self-injection vs. pellets. A good friend since we were freshmen in college lives in VA and after hearing how happy I was with the pellets, decided to ask for a T test. His level was similar to mine, low 300's. But, he couldn't find a doctor in VA that used pellets. But, his urologist prescribed the disaster you describe, 200mgs every 14 days. His experience has not been good.
My Sex Hormone Binding was done once, about 1 1/2 years ago. I don't know the significance, but here is the result.

Results Order: Sex Horm Binding Glob,
Serum ‐ 082016
Date Value Units Range Source Sex Hormone Binding Globulin
12/3/2014 33.10 13.3‐ 89.5

Thank you for the correct protocol. I am hopeful that my doctor sees a place for patient preferences.

 

[Jackie Treehorn]

I am hopeful that my doctor sees a place for patient preferences.

You should dump his ass for talking you into implanting Test pellets. That alone, is enough right there. Horrible protocol, outdated, piss poor medical care.

When I first started reading this thread, I saw the words "test pellets," and I literally cringed. I really felt bad for you. Then, using the wrong E2 test, and stating that injections were a "back up" to the pellets put me over the top. You need to find a new doctor...preferably one that knows what the hell he is doing. Please look into Defy Medical. You won't be sorry that you did.

 

[Jay-Jay]

I greatly appreciate the sympathy. After this thread, I'm feeling empowered with information and knowing I have to take a different course. I can't let anger be a part of the change process because I'm not sure what physician options I have. It's difficult now, thinking back over 7 pellet procedures, which are about the same as a root canal, with the worst part being the 5-7 days following. It did seem worth it because the testosterone has been a "life changer" for me, and a direct quote from my pre-menopausal wife. It's not just about libido and potency but many other physical things and the mental change was huge. My general outlook on life changed. Instead of accepting that the 4th quarter was underway, I now feel "we're going into overtime!". I know what I must do. Today, I wrote to him about the sensitive E2 test and transitioning to self injection. At least he has an email for "routine medical questions" and usually responds in 48 hours.
If the changes don't happen, I will get another provider. This is about quality of life and I can't go back.

 

[CoastWatcher]

I greatly appreciate the sympathy. After this thread, I'm feeling empowered with information and knowing I have to take a different course. I can't let anger be a part of the change process because I'm not sure what physician options I have. It's difficult now, thinking back over 7 pellet procedures, which are about the same as a root canal, with the worst part being the 5-7 days following. It did seem worth it because the testosterone has been a "life changer" for me, and a direct quote from my pre-menopausal wife. It's not just about libido and potency but many other physical things and the mental change was huge. My general outlook on life changed. Instead of accepting that the 4th quarter was underway, I now feel "we're going into overtime!". I know what I must do. Today, I wrote to him about the sensitive E2 test and transitioning to self injection. At least he has an email for "routine medical questions" and usually responds in 48 hours.
If the changes don't happen, I will get another provider. This is about quality of life and I can't go back.

Don't be surprised if your doctor reacts poorly to your inquiries about injections. It is in his financial interests to continue implanting pellets. Patients who self inject wind up providing a doctor far less opportunity to bill. That is a generalization, but one with a great deal of truth to support it.

I suggest you you contact Defy Medical, either a phone call or email through their website and ask for a fee schedule. I am not their patient, I have nothing to gain from anyone seeking treatment with them, but I do respect them. They are masters of full financial disclosure. Questions are answered and they will not try to upsell you. This will help you determine what your financial options actually are (reducing anxiety).

 

[ERO]

I would second the advice to check into Defy Medical. I am a patient of theirs, but not otherwise affiliated. They know what state-of-the-art TRT is and they will treat you right.

 

[Jay-Jay]

I have emailed Defy Medical asking for fee and treatment information. When my doctor answers my inquiry to him, I'll have all the info to make an informed decision. Thank you, gentlemen. I'll post as soon as I know.

 

[Jay-Jay]

Emailed Defy and they responded with a phone call. The rep was very helpful. Waiting to hear from my doctor, but if he does not respond positively to my requests, I will be working with Defy. Greatly appreciate the referral made by several members, CoastWatcher, Jackie Treehorn, ERO, and Fireproof.

 

[1Draw]

Jay Jay I can tell you from experience, you are doing the right thing for YOUR health and quality of life. I was on pellet therapy for 9 months and it was a roller coaster ride - feel good for a while then feel awful. I then switched to Defy and I am very well pleased with the results.

After doing a lot of research and reading books by very respected MD'S in the field prior to any Testosterone therapy, I'm of the opinion Defy Medical and staff are the most qualified and experienced hormone specialist in the US today. And also, very reasonably priced for the services and products they provide.

I will give you a heads up - they will not start treating you until your T levels justify. I had my last pellets inserted in March and didn't start the injections until September so, I had a short period of no energy, etc. but it was well worth the wait!

 

[Jay-Jay]

You were absolutely right, my doctor answered after 6 days that he's prefer for me to stay on the pellets. I also asked him about the sensitive E2 test. He replied that he has confidence in the standard test. I've already contacted my primary care doc by email about having an impasse with the urologist, hoping he'll refer me to another local urologist. If there's not another referral, I'll contact Dr. French in Dallas. If these options don't work, I have the P/W from Defy, and will go with them, self-pay.

Question: Based on what I now know from this site & other resources, plus what my primary care doc (internal med) knows about me and medicine in general, could or should I ask him to manage my TRT?

 

[CoastWatcher]

You were absolutely right, my doctor answered after 6 days that he's prefer for me to stay on the pellets. I also asked him about the sensitive E2 test. He replied that he has confidence in the standard test. I've already contacted my primary care doc by email about having an impasse with the urologist, hoping he'll refer me to another local urologist. If there's not another referral, I'll contact Dr. French in Dallas. If these options don't work, I have the P/W from Defy, and will go with them, self-pay.

Question: Based on what I now know from this site & other resources, plus what my primary care doc (internal med) knows about me and medicine in general, could or should I ask him to manage my TRT?

That is a question we really can't answer; you have nothing to lose by having the discussion. It is not, however, something I would do unless I had no other options. It can be done, and I am sure others will have different views, just my own perspective.

 

[Jay-Jay]

1Draw, thank you for the great input. Honestly, I've had no negative effects from the pellet modality except for bruising, swelling, and the inability to sit or lie on the cheek for 10-14 days. I didn't have the ups & downs except the time they let my go 4 mos., 3 weeks. Other than that, the main catalyst for my dissatisfaction was trying to educate myself on low T, the therapies, and constantly seeing the warnings about poorly managed E2. My E2 has swung between <5 to 62. The 1st time I asked the doc, he said "I'm not worried". But, I kept reading, eventually found this site and discovered he wasn't even giving me the correct E2 test. Of course, my confidence is gone. If, because of my insurance, I can't connect with a urologist that is pretty much in agreement with this board, I'll go with Defy. My last pellets were May 9, so I have a little time to get it right. Thanks for the comment about the short period of low energy. It's part of the price of getting it right. On the other hand, I'm so happy that I've had the last pellet procedure.

 

[Jay-Jay]

Received response today from primary-care doctor about my concerns on E2 levels and not wanting to continue with the urologist who wants to continue pellets. Doc referred me to a local Endocrinologist. Initially, I was surprised, but now see it as a step in the right direction. But, I'm wondering if the Endo. will simply evaluate my situation, maybe prescribe something, and then refer me to a urologist, or will he evaluate and himself manage the TRT?

 

[CoastWatcher]

Received response today from primary-care doctor about my concerns on E2 levels and not wanting to continue with the urologist who wants to continue pellets. Doc referred me to a local Endocrinologist. Initially, I was surprised, but now see it as a step in the right direction. But, I'm wondering if the Endo. will simply evaluate my situation, maybe prescribe something, and then refer me to a urologist, or will he evaluate and himself manage the TRT?

It could go either way. Don't be surprised to be sent down another winding road where you are likely to encounter dismissive attitudes, poorly designed protocols, and general frustration.

 

[Jay-Jay]

Unfortunately, I won't be surprised by bad attitudes and protocols, but have to check this option, then the Doc. in Dallas. It could be the road I have to take to Defy. At least I can now recognize a poorly designed protocol. Yes, I do have a bad after-taste from 2+ years on pellets and more importantly, bad management of E2. I don't think I posted this but the last words from the pellet Doc. were "We don't work with patient directed treatment plans". You've been very accurate with predictions. I'll update.

 

[CoastWatcher]

Unfortunately, I won't be surprised by bad attitudes and protocols, but have to check this option, then the Doc. in Dallas. It could be the road I have to take to Defy. At least I can now recognize a poorly designed protocol. Yes, I do have a bad after-taste from 2+ years on pellets and more importantly, bad management of E2. I don't think I posted this but the last words from the pellet Doc. were "We don't work with patient directed treatment plans". You've been very accurate with predictions. I'll update.

You were taking money out of his pocket. That was the unspoken variable.

 

[Nelson Vergel]

1Draw, thank you for the great input. Honestly, I've had no negative effects from the pellet modality except for bruising, swelling, and the inability to sit or lie on the cheek for 10-14 days. .

Jay

These sound like significant side effects to me. I am glad you have received top notch advice by guys here.

 

[Jackie Treehorn]

Received response today from primary-care doctor about my concerns on E2 levels and not wanting to continue with the urologist who wants to continue pellets. Doc referred me to a local Endocrinologist. Initially, I was surprised, but now see it as a step in the right direction. But, I'm wondering if the Endo. will simply evaluate my situation, maybe prescribe something, and then refer me to a urologist, or will he evaluate and himself manage the TRT?

Jay,

I'm going to go ahead and concur with Coastie, except I'll give it about a 2% chance of it going in the right direction, and a 98% chance of you meeting another Dr. Pellets, or someone similar. The end result being: you chasing your tail, and receiving sub-standard medical care.

I just love Dr. Pellet's statement, "we don't work with patient directed treatment plans." What an arrogant prick. It would be one thing if Pellets knew WTF he was doing, but that's been proven not to be the case.

At any rate, I wish you luck in your Endo/Urologist search adventure, because you're going to need it. I'm going to make a prediction here...you will eventually end up going to Defy Medical, and you will be kicking yourself in the ass and asking why you didn't do it sooner.