Testosterone Clinic in Dubai for male, age 35 test levels 288

[Lowtuk]

Hi All,

New to the forum and low t. Been feeling exhausted, anxious with no libido for 6 months and had an increase in fat. So went to the doctors and got t levels of 288 so being referred to an endocrinologist tomorrow.

Is anyone else based in Dubai and had a successful diagnosis and treatment? My faith in the health system out here is not the strongest after previous dealings.

Also any general pointers on what to expect going forward would be great.

Nice to meet you all.

 

[OMI100]

1. Get Nelsons book "Testosterone: A Mans Guide".
2. I have just started reading Lee Myer's book "Natural Versus Testosterone Therapy". So far looking to be another great book. You might get this one second.
3. Download the attached files. The TRT file can be given to your DR.

 

[Vince]

My thought would be are you on any meds that's lowering your testosterone, any SSRIs.

 

[Lowtuk]

Thanks Orrin. I will get those.

Vince, I don't take any medication at all

 

[Nelson Vergel]

I would try calling this clinic:

http://dranishaddad.com/services/testosterone-replacement-therapy/

I would also call this compounding pharmacy and ask them who the main testosterone prescriber in Dubai is:

http://revitalifecompoundingpharmacy.com/



Also, you can download my book here:

https://nelsonvergel.com/testosteroneguide/

 

[Lowtuk]

Hi All,

So have had my first visit with endocrinologist.

He said my test was low/normal range but for my age it was low and needed to be 350+ (which still sounds low)

He has ordered the following tests and wants to find out if it is primary or secondary.

FSH
LH
Prolactin
Estradiol
Total tes and free
Beta HCG
Vit D
Vit B12

Will receive the results in next 48 hours so will see what he says.

He seemed like a nice guy and from some of the horror stories I've heard here, at least he agreed it was low for my age and wanted to test for free test levels.

He did offer me a test injection for straight after my blood tests which I declined and didn't seem hugely clued up on the fertility issues (I'm married and don't have children yet so need to stay fertile)

Thanks for following the journey guys

 

[Lowtuk]

Sorry, 2nd question. Is it better to see a urologist or an endocrinologist?

Thanks

 

[OMI100]

Kinda sounds like the guy you are seeing is asking the right questions and ordering the right test to start off. You need to educate yourself so you can ask the right questions next time and see if you get the right answers. Things like self injection, office injection, once a month, every 2 weeks, weekly, etc. READ NELSONS BOOK.

 

[Lowtuk]

Hi All,

test results are back and if I'm right then it looks as though I am very low on total and free test? I have a follow up in 5 hours, Any points I should raise?

ENDOCRINOLOGY
Test / Parameters Result Units Reference Range Methodology
FREE TESTOSTERONE CALCULATION
Albumin (S), serum 4.5 g/dL 3.5 - 5.2 Colorimetric
SHBG, serum 35.00 nmol/L 18 - 54 ECLIA
Testosterone (total) 2.74 ng/mL 2.49 - 8.36 ECLIA
274.00 ng/dL 249 - 836
Free Testosterone 0.051 ng/mL 0.090 - 0.30 Calculation
Test result to be interpreted in the light of clinical history and to be investigated further if necessary.

 

[CoastWatcher]

Hi All,

test results are back and if I'm right then it looks as though I am very low on total and free test? I have a follow up in 5 hours, Any points I should raise?

ENDOCRINOLOGY
Test / Parameters Result Units Reference Range Methodology
FREE TESTOSTERONE CALCULATION
Albumin (S), serum 4.5 g/dL 3.5 - 5.2 Colorimetric
SHBG, serum 35.00 nmol/L 18 - 54 ECLIA
Testosterone (total) 2.74 ng/mL 2.49 - 8.36 ECLIA
274.00 ng/dL 249 - 836
Free Testosterone 0.051 ng/mL 0.090 - 0.30 Calculation
Test result to be interpreted in the light of clinical history and to be investigated further if necessary.

There is no question that you are hypogonadal. However, there are many, many more labs that should be run in order to determine just where this ought to go. LH, FSH, PSA, estradiol (though being outside the United States you are unlikely to have access to the sensitive e2 test), CBC, CMP, TSH, ft3, ft4, rt3, and both thyroid antibody panes, DHT, and DHEA.

 

[Lowtuk]

Hi coastwatcher,

Apologies, I didn't post the other results, please see underneath the post.

So to update everyone, I went for my follow up appointment today. I'm kind of pushing this through quite quickly with the hospital as I'm feeling terrible 24/7 and it's starting to really get me down.

The Endocrinologist reviewed my tests and said I have Low Test and Low Free Test along with low B12.

Testes ultrasound was done during this visit and was all clear, awaiting approval for MRI to check for a pituitary tumour.

So the doctor prescribes me Vit B tablets, fertility test (on my request) and a Nebido injection (Test Undecanoate 1000mg/4ml) to raise my test as I've been feeling so rubbish and he says if I am secondary then the test will just give me a boost anyway and we can discontinue.

I will update again after the MRI and fertility test, but I wanted to get people's views on the below if possible please:

- Doc does not seems phased about the fertility issues arising from test injections, but this is big for me as I will be trying for children in the next 2 years.
- Is Nebido a good option (it is the only option this hospital has but read that long gaps between injections isn't good)
- Any thoughts on the care and results so far

Calcium 9.1. ref range 8.5-10.5
Magnesium 2.02. ref range 1.6-2.6
Vit B12 303.4. Ref Range 174-878
Vit D25 51.35. Ref Range > Sufficiency 30
FSH 5.45. Ref Range 1.5-12.4
LH 7.32. Ref Range 1.7-8.6
Prolactin 9,47. Ref Range 3.6-16.3
Beta HCG Quanti <5.0. Ref Range <2
Estradiol 22.92. Ref Range 7.0 - 42.6

 

[CoastWatcher]

Hi coastwatcher,

Apologies, I didn't post the other results, please see underneath the post.

So to update everyone, I went for my follow up appointment today. I'm kind of pushing this through quite quickly with the hospital as I'm feeling terrible 24/7 and it's starting to really get me down.

The Endocrinologist reviewed my tests and said I have Low Test and Low Free Test along with low B12.

Testes ultrasound was done during this visit and was all clear, awaiting approval for MRI to check for a pituitary tumour.

So the doctor prescribes me Vit B tablets, fertility test (on my request) and a Nebido injection (Test Undecanoate 1000mg/4ml) to raise my test as I've been feeling so rubbish and he says if I am secondary then the test will just give me a boost anyway and we can discontinue.

I will update again after the MRI and fertility test, but I wanted to get people's views on the below if possible please:

- Doc does not seems phased about the fertility issues arising from test injections, but this is big for me as I will be trying for children in the next 2 years.
- Is Nebido a good option (it is the only option this hospital has but read that long gaps between injections isn't good)
- Any thoughts on the care and results so far

Calcium 9.1. ref range 8.5-10.5
Magnesium 2.02. ref range 1.6-2.6
Vit B12 303.4. Ref Range 174-878
Vit D25 51.35. Ref Range > Sufficiency 30
FSH 5.45. Ref Range 1.5-12.4
LH 7.32. Ref Range 1.7-8.6
Prolactin 9,47. Ref Range 3.6-16.3
Beta HCG Quanti <5.0. Ref Range <2
Estradiol 22.92. Ref Range 7.0 - 42.6

This doctor doesn't know what he is doing. There is no such thing as a "boost" of testosterone via injection which you can then "discontinue." Any introduction of exogenous testosterone begins shutting down the body's natural production through suppression of the HPTA axis. His comments about "secondary" make no sense, either. The vast majority of us are men with a diagnosis of secondary hypogonadism - it means the problem isn't with the testicles, it's a pituitary/axis issue.

You had no thyroid testing and a PSA wasn't run. He may not be phased about your fertility, but if it's important to you he ought to be discussing HCG.

Nebido, by its nature, is only injected infrequently. We have a few members who have used it with success and some who have found the lack of control to be frustrating. Once it's injected you go where it takes you, it's not designed for subtle interventions.

 

[Lowtuk]

Hi Coastwatch,

Thank you for your continued support an feedback, it's much appreciated.

I went for a second opinion with a urologist who i researched and he specialised in Sexology and TRT.

This doctor was far more reassuring and took 30 minutes to take me through everything and spelled it out for me.

He ordered a blood test to check for prostate cancer and discussed my fertility concerns with me.

So my treatment plan is below.

Follow up shot of Nebido in 6 weeks
then a shot in 12 weeks an then every 9-12 weeks dependent on how I feel.
A follow up visit in Mid April to consult with the doctor to take bloods and see how I feel

HCG will be 3 times in one week Eod and then 3 weeks off each month at 500 IU. (i'd like thoughts on this and will be doing my research)

When I am trying for a family he will take me off the trt and put me on clomid and then restart when my wife is pregnant.

All in all I feel far more positive about the treatment and feel like I have a doctor who is clued up and actually seems to care.

Hopefully be posting some updates on feeling better in the next few weeks

 

[CoastWatcher]

Hi Coastwatch,

Thank you for your continued support an feedback, it's much appreciated.

I went for a second opinion with a urologist who i researched and he specialised in Sexology and TRT.

This doctor was far more reassuring and took 30 minutes to take me through everything and spelled it out for me.

He ordered a blood test to check for prostate cancer and discussed my fertility concerns with me.

So my treatment plan is below.

Follow up shot of Nebido in 6 weeks
then a shot in 12 weeks an then every 9-12 weeks dependent on how I feel.
A follow up visit in Mid April to consult with the doctor to take bloods and see how I feel

HCG will be 3 times in one week Eod and then 3 weeks off each month at 500 IU. (i'd like thoughts on this and will be doing my research)

When I am trying for a family he will take me off the trt and put me on clomid and then restart when my wife is pregnant.

All in all I feel far more positive about the treatment and feel like I have a doctor who is clued up and actually seems to care.

Hopefully be posting some updates on feeling better in the next few weeks

I'm a little unclear about your followup visits. No labs for nine weeks? Why does he want you to vary your HCG schedule?

 

[Lowtuk]

Sorry if i was unclear Coastwatcher. I will try and write clearer.

Week 1: Nebido injection
Week 6: Nebido Booster
Week 18: Nebido follow up shot and next visit with the doctor and blood tests
Week30: Nebido shot
Week 42: Nebido shot visit with dr and blood tests
Week: 54 Nebido Shot

That is the schedule but he has said the shots will be 9-12 weeks dependent on how I am feeling.

On the HCG I am going to email him and ask why he is cycling it 1 week on and 3 weeks off, i wanted to get peoples thoughts on that and I'm doing research but I can't find info on that kind of cycle anywhere (which I'm assuming isn't good)

I can buy HCG over the counter here so I can does how i see fit if there are suggestions?

 

[CoastWatcher]

Sorry if i was unclear Coastwatcher. I will try and write clearer.

Week 1: Nebido injection
Week 6: Nebido Booster
Week 18: Nebido follow up shot and next visit with the doctor and blood tests
Week30: Nebido shot
Week 42: Nebido shot visit with dr and blood tests
Week: 54 Nebido Shot

That is the schedule but he has said the shots will be 9-12 weeks dependent on how I am feeling.

On the HCG I am going to email him and ask why he is cycling it 1 week on and 3 weeks off, i wanted to get peoples thoughts on that and I'm doing research but I can't find info on that kind of cycle anywhere (which I'm assuming isn't good)

I can buy HCG over the counter here so I can does how i see fit if there are suggestions?

Eighteen weeks without lab work, nearly five months, in the initial stages of therapy, seems foolish. True, once the Nebido is on board you have limited ability to tweak, but you and your doctor need to know where it peaks, how fast it peaks, what your estradiol level is (even in the absence of the sensitive e2 test). Suppose your libido surges and then disappears. Estradiol? Elevated prolactin? Has DHT jumped the fence? What about your hematocrit and hemoglobin? Have they soared? If so, better donate blood. And a booster...oh, sure, why not boost an unknown value?

 

[Lowtuk]

Hi Coastwatcher,

Is there a standard protocol to follow for blood tests then? If my doctor isn't ordering enough or the right ones then I can just order any blood test I want every time I go for my injection as the nurse will take blood and do the tests as much as I want and email me the results the next day.

 

[OMI100]

As noted above you are already in a protocol but read this for the standard test that should have been ran. You can always run them now and at least you will have come data points to start with:

 

[OMI100]

Also for HCG:

 

[Lowtuk]

Hi All,

So spoke to my doctor as he said I can have blood tests when ever I want, I just need to book with the nurse and he will review. So I booked one that day and will do monthly tests now.

Good news it that my test is upto 365 from 274 12 days before and my free eat is up for .051 to . 056 and I'm feeling a bit better with less exhaustion and mood better so looking forward to getting in the normal range for free and the 600+ for test!

Also had a good convo about hcg and sent him the research from here and he will discuss other protocols with me.

All in all feeling a lot more positive about the treatment.

Hope everyone has had a good xmas