Low libido and a visit to the Endocrinologist
- Thread starter Traildude
- Start date
That sounds like a relief, what are my options other than test shots/test cream then?
Ya you can use testosterone cream if you don’t want to do shots.
Defy can treat you no matter what state you’re in. Just need a physical from your primary doctor, and fax it to them. It’s all over the phone.
You can try working with your primary, but the chances of him knowing how to treat both your low testosterone and low thyroid properly, is slim to none. If I were you, I would be calling Defy on Monday. That’s coming from someone who struggled for years with other so called “TRT specialists”. Even they were a joke. Having a primary that knows how to treat testosterone and thyroid properly is like hitting the lottery. I would just call defy. They’ll be able to treat both for you, and treat them both properly. Like another guy said, treating your low thyroid is just as, if not more important than treating your testosterone deficiency. Don’t make the mistake of treating one without treating the other.
Defy can treat you no matter what state you’re in. Just need a physical from your primary doctor, and fax it to them. It’s all over the phone.
You can try working with your primary, but the chances of him knowing how to treat both your low testosterone and low thyroid properly, is slim to none. If I were you, I would be calling Defy on Monday. That’s coming from someone who struggled for years with other so called “TRT specialists”. Even they were a joke. Having a primary that knows how to treat testosterone and thyroid properly is like hitting the lottery. I would just call defy. They’ll be able to treat both for you, and treat them both properly. Like another guy said, treating your low thyroid is just as, if not more important than treating your testosterone deficiency. Don’t make the mistake of treating one without treating the other.
Ok , I will be more speciffic. Is there any way to lower shbg without getting shots or cream? IOW, is there anything I can be prescribed that would focus on lowering SHBG alone? excuse my ignorance I am new to all of this. Also, Ok , if I need testosterone shots or cream, do I have to send my endo results to a place like Defy and wouldn't I need to monitor my levels periodically to know what to do from there.........back off...........add........maintain the medication? I understand that this can be done over the phone and my mail, but I have read that the monitoring of my total hormonal profile during the usage of this medicine is necessary and if so, how can I do this with a place like Defy?
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No worries. There’s no dumb questions. And the short answer is no. Trust me, I tried EVERYTHING! Even on this forum, it’s a resounding no when it comes to options to lower SHBG. There’s a medication called danazol. I tried it, but what it will do is not only lower SHBG, but lower testosterone levels. So it’s kind of pointless. The best way to lower SHBG is by going on TRT. I wish there was another way, trust me, but there just isn’t. I’m a high SHBG guy too, so I really wish there was options when it comes to this.
Don’t be afraid of hopping on hormone replacement though. If I were you, I’d be excited, not worried. HRT can give you your life back. Don’t focus on the negative stories. Those people are the outliars. Most guys on HRT do very well. Based on how low your numbers are, and your age, things can only get better for you on HRT. What’s your other options, continue to decline and feel worse? Plus, with your levels of testosterone and thyroid hormones, you’re doing immense damage to your health on a daily basis. You’re chances of getting diabetes, dementia, heart disease, cancer, etc. are all through the roof with your levels. Some damage can be irreversible. If I were you, I would be looking to get on HRT like yesterday.
And monitoring levels with defy is extremely easy. I use them, and I’m in Massachusetts. They just send me a lab requisition through email, and I go to quest to get my labs drawn. Quest sends a copy directly to defy, and sends a copy to me. Your endo will be out of the picture. No results need to get sent to them. You can fax them the results if you want. And ya you can probably send defy your recent labs you had done at your endo. If they were done recently, you can probably use those in your initial consult with defy. Defy might have you get a few more labs done if your endo left certain labs out that defy requires.
Trust me, 5-6 years ago I was right where you are. I spent years wasting time and money with crappy doctors. Just call deft on Monday. You won’t regret it. Just trying to save you from the wasted years that I went through. The only thing worse than suffering with low hormones is suffering while spending a ton of money to get horrible treatment. If I could go back and do it all over, I would of called defy as soon as I knew I had low testosterone. Would of saved me years and a bunch of money, and a bunch of headaches dealing with doctors that thought they knew what they were doing, but really just made things worse. Who you are getting treated by makes all the difference. You have to remember, a lot of the horror stories you’ve probably heard could be from guys getting treated by doctors that aren’t the best.
And monitoring levels with defy is extremely easy. I use them, and I’m in Massachusetts. They just send me a lab requisition through email, and I go to quest to get my labs drawn. Quest sends a copy directly to defy, and sends a copy to me. Your endo will be out of the picture. No results need to get sent to them. You can fax them the results if you want. And ya you can probably send defy your recent labs you had done at your endo. If they were done recently, you can probably use those in your initial consult with defy. Defy might have you get a few more labs done if your endo left certain labs out that defy requires.
Trust me, 5-6 years ago I was right where you are. I spent years wasting time and money with crappy doctors. Just call deft on Monday. You won’t regret it. Just trying to save you from the wasted years that I went through. The only thing worse than suffering with low hormones is suffering while spending a ton of money to get horrible treatment. If I could go back and do it all over, I would of called defy as soon as I knew I had low testosterone. Would of saved me years and a bunch of money, and a bunch of headaches dealing with doctors that thought they knew what they were doing, but really just made things worse. Who you are getting treated by makes all the difference. You have to remember, a lot of the horror stories you’ve probably heard could be from guys getting treated by doctors that aren’t the best.
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I found a place near me, here is the link, is this the kind of place I need to go to?
David Edelson, M.D. - Long Island New York Bioidentical Doctor
David Edelson, M.D. - Long Island New York Bioidentical Doctor
Not sure. Never heard of them, and unless I used them personally, I would never comment on them. But I’m telling you, defy is your answer. There are so many factors that you don’t even think about when trying to find a TRT doctor. I’ve had to figure them all out the hard way. Even if that doctor is good, they’re not gonna be better than defy. Defy is the gold standard in my opinion. And I don’t work for them or anything. They just have the best customer service you could ever ask for. They send me lab requisitions whenever I want. They send out my medication orders very quickly. If I can get a medication cheaper at my local pharmacy, they charge me like $25-$30 to send it to that specific pharmacy. Then my insurance covers it from there. So I only end up paying the $25-$30. And they send it with a 3 month supply. There’s just a bunch of things that they do perfectly. I literally couldn’t be happier with them.
So you could try that place, but why not just go where you know you’ll be getting the best experience possible? To me, it doesn’t make sense to go somewhere and take a chance, when you have the option to go to the best TRT clinic.
So you could try that place, but why not just go where you know you’ll be getting the best experience possible? To me, it doesn’t make sense to go somewhere and take a chance, when you have the option to go to the best TRT clinic.
Defy you fill out forms online, send physical, pay 250 then they order labs. Labs come back and setup appointment. The physical is the problem and some doctors will not go for it. You can use one you have if you have it. The only reason you would need to go to a doctor close to you is because you can't get the physical. I know some endos and doctors would show you the door if they knew you was trying to get help elsewhere. They do not agree on these treatments. They don't want to take on the risk they think you are taking.
You guys are great thanks for your input. I would like to know how you all feel now that you have been on the TRT. I will call Defy , you guys sound like you have alot of experience with this. I'll go to my MD , get a regular physical and then ask him to give me exactly what kind of form? saying that I'm ok? ......................I assume that I will have to tell the doctor what I need it for?
Systemlord
Member
TRT lowers SHBG and is the standard treatment for men with high SHBG. As far as doctors learning about sex hormone therapies, it's optional after graduating medical school most don't even bother because TRT is low cost, low profit.
It's crazy when you think about it, TRT prevents and treats type 2 diabetes, metabolic syndrome, cardiovascular and heart disease, so you would expect doctors to become educated in sex hormones and therefore TRT.
If you run into resistance getting the required physical form filled out by your GP, you can go to a CVS Minute Clinic for a sports physical which is what I did.
We do have a lot of experience with all of this TRT stuff, we have all been in your shoes learning our so called hormone doctors are sex hormone ignorant by choice.
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madman
Super Moderator
Your TT is definitely sub-par but your FT is low due to your high SHBG and although TT is important.....FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive benefits.
Most men need FT 2-3% of TT or in the 20-30 ng/dL range and yes some can do well slightly lower.
Your endo is an idiot.....who tests FAI (free androgen index)?
Table 3.
The Relative Merits and Demerits of Various Methods of Measuring Free and Bioavailable Testosterone Levels
Free androgen index
• Represents the ratio of total testosterone/SHBG • Has been shown to correlate with free testosterone measurements • Simple to obtain
• Overly simplistic and inaccurate measure of free testosterone concentrations • Poor indicator of gonadal status • Dependent on accurate measurements of total testosterone and SHBG • Most experts do not favor its use
Technical remark
• Testosterone concentrations exhibit significant diurnal and day-to-day variations and may be suppressed by food intake or glucose. Therefore, clinicians should measure total testosterone concentrations on two separate mornings when the patient is fasting. Clinicians should use an accurate and reliable method, optimally, an assay that has been certified by an accuracy-based standardization or quality control program [e.g., Centers for Disease Control and Prevention (CDC) Hormone Standardization Program for Testosterone].
• In men who have conditions that alter sex hormone–binding globulin (SHBG) (Table 2), or whose initial total testosterone concentrations are at or near the lower limit of the normal range (Fig. 1), clinicians should determine free testosterone concentrations either directly from equilibrium dialysis assays or by calculations that use total testosterone, SHBG, and albumin concentrations. Clinicians should not use direct analog-based free testosterone immunoassays, as they are inaccurate.
• Clinicians should not test men for testosterone deficiency who have or are recovering from an acute illness or are engaged in short-term use of medications (e.g., opioids) that suppress testosterone concentrations.
I will make this point below
- THIS NEEDS TO BE STRESSED:
*Clinicians should not use direct analog-based free testosterone immunoassays, as they are inaccurate.
- FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive benefits.....why everyone is still using the direct analog-based free testosterone immunoassays is beyond me.
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Judging from all the low numbers on my test at the endo, AND his comment that " your problem appears not to be hormonal"...................I mean, it's like saying " You have bills to pay which are in excess of 1000,00, you only have a hundred bucks but you're good to go" so I agree, that my endo is being very ignorant and it was my first and last visit to him. The only good that came out of it is that I have the information in hand showing without a doubt that I have a problem.
Because it's cheap and often bundled with total T, so in part blame it on the labs. But also lack of education about it, which you are working to correct.
Systemlord
Member
The majority of sick care doctors (GP's, endocrinologists, urologists) don't know what testing to order or even how to interpret lab values. Going to a doctor that doesn't actually specialize in TRT pretty much ensures you'll get someone who is a pretender of medical skills when in reality they know very little or nothing at all.
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madman
Super Moderator
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