Going to see Endocrinologist

[4aces]

I'm 56, last t test was a month ago. Level was at 212 total. I feel like crap, no sex drive, ect. Ect. All of the symptoms of low test. Going to see my HMO endocrinogist. And it's s woman doctor. My question is this- what should I tell her? Just tell her all my symptoms? Pled and beg for trt? Hope and pray she will give me test and a estgren blocker?? Just tell her the truth, or should I make my situation sound worse than it is.

I'm just concerned that a HMO doctor will throw me out on my low testosterone ass.

Thanks for any input.

 

[kenpoengineer]

I'm 53 and my test was 379. Doc told me he wouldn't do TRT until 250. He added that he doesn't believe in TRT. If you want TRT I think I'd add to your story.

 

[4aces]

That's what I'm thinking. And then I see that I'm getting a female doctor, I'm thinking the cards are stacked against me. Im not going to beg. Hopefully when she hears my sob story, she will hook me up so kaiser pays for test.

 

[bigt405]

Just tell her the truth and hope for the best......

Then if it goes bad do not give up do what I did ask around at your gym. I can assure you that all the older in shape guys will know the right doctor to go too. In just one morning i had three references and now I am very happy with my new doctor.

 

[pappybay]

I recommend you take research and be prepared to review a summary of that research. Tell her exactly what you want, for example, tell her you want to inject two times per week at 80 MG per injection and want to take 3 MG of anastrozole. Worse case, get your labs done and you will be prepared for the next provider. If she is under financial pressure for your HMO, you may have to pay cash (it is worth it I promise you). There are literally hundreds of very good articles from credible sources. If you visit fails,my suggestion is to pursue alternative legitimate sources. Call your local compounding pharmacies and talk to the manager or owner. He/She should tell you which providers in town are prescribing for HRT, but be nice and not overly aggressive. Remember, they have a profit incentive......

I wish you the very best. Do not give up, it will be worth it.

 

[threeFs]

NO, F all that. Keep trying doctors until you find one who is decent at best. Gender shouldn't matter with doc. Don't lie. If you feel like garbage (which at your low test level, I know what it feels like) and you have bloodwork showing that, just bring that to all the docs you see. It's your life and you need to run it, not be at the mercy of 1 doctor and their opinion. I've gone to all kinds of docs. I can't put a price on my quality of life and neither should you.

 

[pappybay]

NO, F all that. Keep trying doctors until you find one who is decent at best. Gender shouldn't matter with doc. Don't lie. If you feel like garbage (which at your low test level, I know what it feels like) and you have bloodwork showing that, just bring that to all the docs you see. It's your life and you need to run it, not be at the mercy of 1 doctor and their opinion. I've gone to all kinds of docs. I can't put a price on my quality of life and neither should you.

Your point is well made, i.e., don't quit until you get a doc that can help. I do think calling the compounding pharmacies is an effective tool to find that doc.......

 

[texas_archer]

Mine was 295 and my free test was 50. My Dr just asked me when I wanted to start the treatments.

 

[threeFs]

Mine was 295 and my free test was 50. My Dr just asked me when I wanted to start the treatments.

Did you say 5 minutes ago??

 

[texas_archer]

Did you say 5 minutes ago??

No, waiting two weeks because I'm about to go overseas for work.

 

[Dogsoldier]

Screw endos. Endos are arrogant and jaded by every muscle head in the world sniffing around for a scrip for Test. Go to a urologist. A good number are into the TRT big time. These docs are more open to TRT lately. My Urologist (history of kidney stones) and I had a heart to heart one day and I walked out with a scrip for Test.

 

[bigt405]

I too use a urologist.......

 

[w8lifter]

I'm 56, last t test was a month ago. Level was at 212 total. I feel like crap, no sex drive, ect. Ect. All of the symptoms of low test. Going to see my HMO endocrinogist. And it's s woman doctor. My question is this- what should I tell her? Just tell her all my symptoms? Pled and beg for trt? Hope and pray she will give me test and a estgren blocker?? Just tell her the truth, or should I make my situation sound worse than it is.

I'm just concerned that a HMO doctor will throw me out on my low testosterone ass.

Thanks for any input.[/QUOTE

I see endo May 28. She's middle eastern female young endo. I convinced my doc to up my test cyp dose to 400 mg e2w, although I do a bit less than that e3.5days. He stipulates that to continue with that dose he wanted me to see an endo and get her "blessing". and so I will and also press for hcg and adx since latest bloods show high estrogen and low pregnenalone and dhea.
Please post results of your endo experience as will I. Good luck.

 

[napalm]

Screw endos. Endos are arrogant and jaded by every muscle head in the world sniffing around for a scrip for Test. Go to a urologist. A good number are into the TRT big time. These docs are more open to TRT lately. My Urologist (history of kidney stones) and I had a heart to heart one day and I walked out with a scrip for Test.

Nice blanket statement.

My endo is awesome, lets me do whatever I want to keep things in order. He knows my background in research and trusts I won't do anything stupid - which I don't...

 

[trn450]

I'm 56, last t test was a month ago. Level was at 212 total. I feel like crap, no sex drive, ect. Ect. All of the symptoms of low test. Going to see my HMO endocrinogist. And it's s woman doctor. My question is this- what should I tell her? Just tell her all my symptoms? Pled and beg for trt? Hope and pray she will give me test and a estgren blocker?? Just tell her the truth, or should I make my situation sound worse than it is.

I'm just concerned that a HMO doctor will throw me out on my low testosterone ass.

Thanks for any input.

If you're symptomatic and test is a low, then I can't imagine an endocrinologist not giving you some form of TRT. What they might do is try to sell you on alternative therapies to weekly IM. However, you can always make the argument that for the sake of cost and convenience, giving yourself weekly IM injections is the best option for you. And, really, it's true. Even without insurance Test cyp is like $60 for a 20 week supply (assuming 100mg/wk) at Costco and once weekly dosing is infinitely better than many of the other options, especially like androgel which could get on your significant other, etc.

If you're seeing an endocrinologist, they'll want to treat your endocrinopathy. That's practically guaranteed. But, how they approach it is a different story, and whether they'll start you after the review your blood work or perform additional testing is a different story.

I'm 53 and my test was 379. Doc told me he wouldn't do TRT until 250. He added that he doesn't believe in TRT. If you want TRT I think I'd add to your story.

What about FSH, LH, prolactin? That's lower than average, but still well within normal limits for your age and low T symptoms are very vague and many other things can mimic it. However, your doc does sound quit ignorant. I'm assuming your doc was a primary care doctor. If that's the case, ask him to refer you to an endocrinologist because anybody who says they don't believe in TRT is an idiot. That's like telling an anemic that you don't believe in hemoglobin. I'd honestly be completely flabbergasted if those words came from the mouth of an endocrinologist. Endocrinologists don't have an uninformed fear of a relatively harmless sex hormone, let alone in the face of life-altering symptomology, which low energy, low libido, increase fat storage, poor sleep, etc all definitely fall under.

 

[trn450]

Screw endos. Endos are arrogant and jaded by every muscle head in the world sniffing around for a scrip for Test. Go to a urologist. A good number are into the TRT big time. These docs are more open to TRT lately. My Urologist (history of kidney stones) and I had a heart to heart one day and I walked out with a scrip for Test.

No, they're really not like that. I'm not necessarily saying this is your case, but on the whole endo's are probably less likely to start T on someone requesting it because they actually know when someone doesn't have hypogonadism and won't treat a disorder that isn't there because their license is on the line. This is in contrast to other specialties who often have no idea WTF they're doing because they're not endocrinologists. Urologists are surgeons--they really on the whole do not know medicine very well. Unfortunately, you'll never truly appreciate that statement until you're on a medicine service acting as a consultant for a surgeon.

Test is given out to SOOO many people these days who don't need it. The greatest part is, many of these eugonadal men will have their T levels titrated to physiologic and really not feel much different if they're doing weekly dosing since there is no huge T spike (eg a person receiving 300mg / 3wks tends to "feel it" more because they're considerably supraphysiologic for a while). Now they're just damaging their endocrine system, sometimes irreversibly, to have physiologic test levels which they had in the first place. I guess if you're a BB'er and are going to exploit your Rx and run higher cycles it makes some sense, or if you can convince your doc to let you run at the high end of physiologic you'll get some benefit. But, then at that point you often end up having to take anti-e's, etc to balance otu the hormonal imbalance you've created and it just becomes a mess that can last a lifetime if you completely shut down your HPTA.

I killed my HPTA in my early 20s with OTC androgens like superdrol. Had to start TRT and it was an absolute live-changer for me. So, I'm a huge fan. But, I still don't think people should be doing TRT when they're eugonadal, and whether the patient realizes it or not, the endocrinologist is doing the right thing by not treating eugonadal individuals for hypogonadism.

 

[pappybay]

For what it is worth, I'll bet (and this is a bit naive maybe......) that many people on this forum are more educated on the topic of TRT than most physicians. While I am not one of those people, I am very comfortable debating this topic with my physician. I fill out my lab order, I track my results and I lead the conversation with my physician. I also listen intently when he speaks.

 

[trn450]

For what it is worth, I'll bet (and this is a bit naive maybe......) that many people on this forum are more educated on the topic of TRT than most physicians. While I am not one of those people, I am very comfortable debating this topic with my physician. I fill out my lab order, I track my results and I lead the conversation with my physician. I also listen intently when he speaks.

A lot of general practitioners, especially family practitioners, really don't do much formal training in this topic. So, in a way, you're right that they'll often be misinformed. That is changing now as TRT becomes more accepted (and profitable) again. Internests who practice primary care are often a bit more informed as their training is more specific to adult medicine and not quite as broad as family medicine. Also keep in mind that while they may not be informed on safety, efficacy, or even latest recommendations on regimens they typically have a far deeper understanding still.

But, endocrinologists are a completely different story altogether. They're internests with 2-3 years of full-time academic training specific to endocrinology. So, this is after their BS. After 4 years of medical school. After 3 years of internal medicine training. THEN they do 2-3 more years of intensive academic and clinical training and research with an intense focus on the endocrine system.

 

[pappybay]

A lot of general practitioners, especially family practitioners, really don't do much formal training in this topic. So, in a way, you're right that they'll often be misinformed. That is changing now as TRT becomes more accepted (and profitable) again. Internests who practice primary care are often a bit more informed as their training is more specific to adult medicine and not quite as broad as family medicine. Also keep in mind that while they may not be informed on safety, efficacy, or even latest recommendations on regimens they typically have a far deeper understanding still.

But, endocrinologists are a completely different story altogether. They're internests with 2-3 years of full-time academic training specific to endocrinology. So, this is after their BS. After 4 years of medical school. After 3 years of internal medicine training. THEN they do 2-3 more years of intensive academic and clinical training and research with an intense focus on the endocrine system.

All points well made.