Recommendations for help in Dallas Texas

[cschutzki]

I'm new to the forum and am looking for help and guidance regarding low libido and most recently ED. Attached are blood work results from about 6 weeks ago.

I was diagnosed with low test in November of 2016 and prescribed shots of test cyp. 200 mg every other week. It seemed to help with energy levels but not with libido. At the time, I wasn't experiencing any ED issues, but my libido was slightly below normal. I had just finished a bodybuilding competition 3 weeks earlier and thought the low t might have been from the dieting. Either way, I believe it was below normal to begin with. Competing in bodybuilding comps, I was all natural up until the doctor prescribed test cyp.

In May and June of this year I competed again. For this show, I increased my test cyp dosage to help build more muscle without my doctor's knowledge. After finishing the shows, I was taking around 200 mg a week... not a big increase.

In July, I switched to a keto diet as I heard of the benefits of health with this diet. I did this for 4 months and had some issues along the way with digestion, but have went back to my former ways of eating... carbs, protein, fats.

In October, I had lab work done which is attached from a functional medicine doctor. My main concern is the thyroid and horomone levels. My libido over the last 2-3 months has been extremely low to non-existent and within the last month I've had problems with erections. I stopped taking the test cyp completely 9 weeks ago, but started this past week to hope to remedy the ED issues. Any help would be greatly appreciated.

I'm a 34 year old male who weight trains 5 days a week along with cardio. Body fat is anywhere between 9-14%. I consider myself extremely healthy in terms of lifestyle. Hardly drink and try to optimize all aspects of the my life. Can anyone take a look at the labs and make suggestions or suggest a legit doctor in Dallas who can help balance out my horomones?

 

[CoastWatcher]

Welcome to Excelmale. You're in need of a good doctor - the protocol you were prescribed, 200mg every two weeks is years out of date. You essentially doubled that dose by shifting to a schedule calling for 200mg every week despite the fact that your SHBG sits under 20, low by any standard. Large, single doses are simply not indicated for men unless they have high SHBG. Smaller, more frequent doses are far more likely to bring you success. Your estradiol was measured with the incorrect lab test (the reference range is a dead giveaway). You want to use the sensitive/ultrasensitive test, LC, MS/MS, to measure a man's e2 levels. Your thyroid got a solid workup and you're right to be concerned. Not addressing thyroid problems means you're fighting an uphill battle.

Are you only open to a referral to a doctor who accepts insurance or are you able to select a physician who operates ona a fee-for-service basis?

 

[cschutzki]

Thanks for the indepth response. I'm open to both, but cost is a factor. I've spent a lot of money on these tests already along with the functional med doctor.

 

[CoastWatcher]

Thanks for the indepth response. I'm open to both, but cost is a factor. I've spent a lot of money on these tests already along with the functional med doctor.

The problem is the best doctors in this field all work outside the insurance network. That isn't to say that it's impossible to find a good doctor who will accept your insurance, it's just much, much harder.

 

[cschutzki]

Any recommendations would be greatly appreciated.

 

[CoastWatcher]

Any recommendations would be greatly appreciated.

Start with Defy Medical and Prime Body. They are site sponsors, but I am not a patient (I'm a Canadian) and have no vested interest in their success. Many of our members here are patients of one or the other of these national practices (who do not participate in any insurance network). Defy is a tele-health practice and can treat you no matter where you live in the US. The medical director, Dr. Justin Saya is one of the leading doctors in the field of men's health. He is a member here, a moderator (put "Saya" in the search box to read some of his contributions). Call them - they may not be as expensive as you fear and they will answer all the hard questions about cost and treatment delivery. No pressure.

Prime Body operates on a different model, and I'd be astonished if they didn't have a local physician in the Dallas area. Call them, ask them the same hard questions. They won't duck any of them. Again, they may not be as expensive as you fear. You should contact both to get some sense of the cost you would be absorbing.

Finally, I hope we hear from some members in the Dallas area who may have the name of other doctors in the area.

 

[cschutzki]

Thank you so much for the recommendation. I'll reach out to them. I've also reached out to some Dallas doctors and will keep you informed as to what I find out.

 

[Sean Mosher]

Feel free to email me directly for any and all PrimeBody related questions.
Would be happy to talk with you!
[email protected]

 

[BradsHellcat]

Dr. E at Integrative medical in coppell would be who I would reccomend. I am currently seeing him as well.

 

[cschutzki]

Thank you so much... I'll look into his office!

 

[Systemlord]

Originally I was on the same protocol and have the same SHBG level (18), these cookie cutter protocols do not work for everyone, the protocols we were put on do not work for anyone. This is the type of care you can expect from doctors who take insurance, they're too busy triaging people and fail to properly monitor all your hormone levels. It's the insurance companies who place restrictions on what tests doctors can run, this makes for a doctor who can't do his job to the best of his abilities and the patients are the ones who suffer.

 

[cschutzki]

I agree with you 100%... I am going to see a hormone doctor who specializes in these types of things. Thank you for providing some feedback! I'll update on what my next steps are after seeing the doc tomorrow.

 

[cschutzki]

I wanted to give an update. I went to see a hormone specialist and he looked at my labs. He prescribed me hcg for six weeks to see if that helps before trying anything else. For the first 10 days, he wanted me to inject 1ml every day then switch to 3x a week for the remainder time... 6 weeks total.

I have been following this for 6 days now and have not noticed a difference. My libido is still non-existent and have a hard time having an erection when around my gf. Any advice as to next steps?

 

[BradsHellcat]

Did you go to the doctor I recommended?

If so, he has to try this first before ceasing your natural production. If you still do not feel better it is likely he should proceed with TRT, as the good doctors will treat symptoms, not numbers.

Best of luck!

 

[cschutzki]

No I didn't, he wasn't covered by my insurance and there was a few week wait. I was able to get in with Dr. Fein who had good reviews and was able to speak to me before having me come into his office.