Doctor had this to say

[CF10]

They cant find anything wrong with me other than low T and some mild elevations in BUN and AST. I did the 24 hr urine for creatine clearance and results will be in later this week but he said he really doesnt think I have renal failure. I also was able to talk him into a glucose tolerance test to address my postprandial low glucose readings. But like I assumed, he didnt sign off on the adrenal fatigue idea because my cortisol again easily within normal range for the second time in as many tests.

Here's the concerning part though. I'll do numbers so it's easier to read:

1. My TSH is now within normal range on the last two tests, no medication involved it just came down. Used to be 7.7, then 6.1, recently it was 2.5 and 3.5. Concerning thing is that the thyroid upper normal range stops at 3.5 and the doc is still using the 5.5 limit. So my thyroid has been deemed normal and it may not be.

2. I asked about getting estradiol checked but since my total estrogens came out normal, I was told there is no need to measure estradiol because if it was high, total estrogens would show it. Is this true?

3. I'm being referred to an endo for further analysis. I'm sure there are many endos out there that know what they are doing but it scares me to think of some of the horror stories Ive read about terrible treatment from endos.

The doc also prescribed me Testim. After all this time wishing the doctors would give me some testosterone to make me feel better, I have it and now I am scared to use it because I am afraid I am in the care of people who arent sure how to proceed from here. But my only alternative is feel like ****, so I guess today marks day 1 of TRT for me. Just wanted to update you guys.

 

[JanSz]

They cant find anything wrong with me other than low T and some mild elevations in BUN and AST. I did the 24 hr urine for creatine clearance and results will be in later this week but he said he really doesnt think I have renal failure. I also was able to talk him into a glucose tolerance test to address my postprandial low glucose readings. But like I assumed, he didnt sign off on the adrenal fatigue idea because my cortisol again easily within normal range for the second time in as many tests.

Here's the concerning part though. I'll do numbers so it's easier to read:

1. My TSH is now within normal range on the last two tests, no medication involved it just came down. Used to be 7.7, then 6.1, recently it was 2.5 and 3.5. Concerning thing is that the thyroid upper normal range stops at 3.5 and the doc is still using the 5.5 limit. So my thyroid has been deemed normal and it may not be.

2. I asked about getting estradiol checked but since my total estrogens came out normal, I was told there is no need to measure estradiol because if it was high, total estrogens would show it. Is this true?

3. I'm being referred to an endo for further analysis. I'm sure there are many endos out there that know what they are doing but it scares me to think of some of the horror stories Ive read about terrible treatment from endos.

The doc also prescribed me Testim. After all this time wishing the doctors would give me some testosterone to make me feel better, I have it and now I am scared to use it because I am afraid I am in the care of people who arent sure how to proceed from here. But my only alternative is feel like ****, so I guess today marks day 1 of TRT for me. Just wanted to update you guys.

Get
FreeT3
FreeT4

get Depo-testosterone (shots) plus all necesary blood tests and anciliary meds that go with it.
or the road may be long in front of you.

 

[CF10]

Get
FreeT3
FreeT4

get Depo-testosterone (shots) plus all necesary blood tests and anciliary meds that go with it.
or the road may be long in front of you.

I agree 100%. If I had my way I would, but it's easier said than done. When you live 1500 miles from Dr. John, need to have things covered by insurance, and your doc only knows to test TSH and total T, and only knows to prescribe synthroid and androgel/testim...I dont know what to do. Maybe just keep my fingers crossed and pray that my endo will be well informed.

I could go and get free T3 and T4 done independently but when you go to the doc and wave it in their face, who's to say they wont ignore it and say TSH looks good you're fine.

 

[cpeil2]

I agree 100%. If I had my way I would, but it's easier said than done. When you live 1500 miles from Dr. John, need to have things covered by insurance, and your doc only knows to test TSH and total T, and only knows to prescribe synthroid and androgel/testim...I dont know what to do. Maybe just keep my fingers crossed and pray that my endo will be well informed.

I could go and get free T3 and T4 done independently but when you go to the doc and wave it in their face, who's to say they wont ignore it and say TSH looks good you're fine.

A transdermal is a better option than IM for a lot of reasons. You should not assume that you are not a good candidate for a TD without giving it a fair trial.

 

[CF10]

A transdermal is a better option than IM for a lot of reasons. You should not assume that you are not a good candidate for a TD without giving it a fair trial.

I know, and I am giving it a fair run because it is what I expected to be given. The prescription of gel over shots is not a concern, the concern is the lack of complete knowledge of all areas of the TRT process that I have encountered thus far.

 

[JesusReagan]

A transdermal is a better option than IM for a lot of reasons. You should not assume that you are not a good candidate for a TD without giving it a fair trial.

Agreed. I am on compounded cream, 10%, and it is working well thus far. And, I have relatively thick skin.

 

[Hank Vangut]

interesting outcome.

so is your doctor is blamming your low T for the blood sugar imbalance?

 

[hardasnails1973]

interesting outcome.

so is your doctor is blamming your low T for the blood sugar imbalance?

All hormones intereact. One thing that I can speculate is that if you had predisposed blood suagr problems genetically this would be some thing to further investigate. Bodybuilders lifes style keeping bodyfat so low constant eating every 2 hours could have triggered it or brought it on ..

 

[plymouth city]

I know, and I am giving it a fair run because it is what I expected to be given. The prescription of gel over shots is not a concern, the concern is the lack of complete knowledge of all areas of the TRT process that I have encountered thus far.

Do not start T cream yet.

Awesome, you have got the ball rolling - a prescription for T.

Step one.

Lets get t3 and t4 checked out.

They are complete idiots for basing TSH on thyroid functioning.

Print out tons of data and studies from stopthethyroidmadness page to get them to write BW for T4 and T3.

Do same for hcg, get Dr Johns paper.

Educate yourself, you can convience anyone to do anything in this world with the power of persuasion. Get good enough and you can sell ice to an eskimo.

You can get these Dr's to work with you.

 

[CF10]

Do not start T cream yet.

Awesome, you have got the ball rolling - a prescription for T.

Step one.

Lets get t3 and t4 checked out.

They are complete idiots for basing TSH on thyroid functioning.

Print out tons of data and studies from stopthethyroidmadness page to get them to write BW for T4 and T3.

Do same for hcg, get Dr Johns paper.

Educate yourself, you can convience anyone to do anything in this world with the power of persuasion. Get good enough and you can sell ice to an eskimo.

You can get these Dr's to work with you.

They did Thyroxine and Free T3 uptake which is not the same as free t3 and t4 from my understanding. I did take in a bunch of paper but I was told my TSH along with T4 and T3 uptake showed my thyroid is working well now.

Same goes for E2. I brought in Dr John's papers and printouts from the AACE about TRT. But "total estrogens measure normal and if E2 was high then total estrogens would be high too". I said can you test it anyway to ease my mind, and he said it was not necessary.

After that I didnt know what the hell to say. I didnt push for hcg yet, even Dr John doesnt start hcg and gel simultaneously so Ill bring that up next time. And when I see the endo I will take all the same paperwork and hopefully he will know some more about it.

I am gonna take the gel now, I need to feel better or at least start the road to feeling better. I dont have any more time to dedicate to being lethargic and moody with zero libido. Its been 7 months.

 

[JanSz]

I agree 100%. If I had my way I would, but it's easier said than done. When you live 1500 miles from Dr. John, need to have things covered by insurance, and your doc only knows to test TSH and total T, and only knows to prescribe synthroid and androgel/testim...I dont know what to do. Maybe just keep my fingers crossed and pray that my endo will be well informed.

I could go and get free T3 and T4 done independently but when you go to the doc and wave it in their face, who's to say they wont ignore it and say TSH looks good you're fine.

Thyroid Panel (Tsh, T4, Free T3): Blood Tests

THYROID PANEL (TSH, T4, FREE T3)
Non-members $85.33
Members $64.00

======================================
Thyroxine Free, Direct (T4): Blood Tests

Thyroxine (T4) Free, Direct
Non-members $37.33
Members $28.00
=============================================
If you start with LEF I suggest investing in membership.

You can get Isocort and Armour from internet.

===============================================
Estradiol: Blood Tests
Estradiol
Non-members $44.00
Members $33.0

not the best test, but better than nothing.

Estradiol theoretically is a part of estrogens.
That does not mean you can take individually tested estrogens add them and get Total estrogen.

Each one is assayed differently, methods, accuracy, play a role, bottom line each number is to be viewed separately.

 

[JanSz]

They did Thyroxine and Free T3 uptake which is not the same as free t3 and t4 from my understanding. I did take in a bunch of paper but I was told my TSH along with T4 and T3 uptake showed my thyroid is working well now.

Same goes for E2. I brought in Dr John's papers and printouts from the AACE about TRT. But "total estrogens measure normal and if E2 was high then total estrogens would be high too". I said can you test it anyway to ease my mind, and he said it was not necessary.

After that I didnt know what the hell to say. I didnt push for hcg yet, even Dr John doesnt start hcg and gel simultaneously so Ill bring that up next time. And when I see the endo I will take all the same paperwork and hopefully he will know some more about it.

I am gonna take the gel now, I need to feel better or at least start the road to feeling better. I dont have any more time to dedicate to being lethargic and moody with zero libido. Its been 7 months.

Good decission, Do the blood test two week from first gel application.
You need 10gram of 1%gel, say two packets of Androgel, one packet does not work.
Well, you gona get messed up first, untill your balls are really out, better than without.


""I didnt push for hcg yet, even Dr John doesnt start hcg and gel simultaneously so Ill bring that up next time.""

This and the fact that he used Tgel first always made me wonder about his reasons.

I think Dr Shippen works similarly.

There was a large number of people who eventually ended using injections.

Well, for me Androgel actually worked good, Tcream did not.

I use injections now, feel good and reliewed from daily scheduling around Androgel.

In a hind side I wish I got script for Depo-t, hcg and Arimidex, four or five years ago. Would have save me tonns of grief. The only draw back, I would have not appreciated the two tiny subq injections E3D that I am doing now.
==============================================

Any body familiar with insuline pens?
Is there a way to use them for my Depo-T and hcg injections.

 

[plymouth city]

This and the fact that he used Tgel first always made me wonder about his reasons.

I think Dr Shippen works similarly.

There was a large number of people who eventually ended using injections.

Well, for me Androgel actually worked good, Tcream did not.

I.

JansZ JansZ JansZ!

TD's are beyond superior to injects in every way possible.

There is NOT a large number of people who switched from gel to injects. Dr John can further back me up on this.

This board and message boards like it represent a fraction of people on HRT.

A overwhelming majority of people on TD's never switch to injects.

Remember BB's respresent alot who are still having issues. Many happy customers never posted here in the first place.

 

[plymouth city]

Thyroid Panel (Tsh, T4, Free T3): Blood Tests

THYROID PANEL (TSH, T4, FREE T3)
Non-members $85.33
Members $64.00

======================================
Thyroxine Free, Direct (T4): Blood Tests

Thyroxine (T4) Free, Direct
Non-members $37.33
Members $28.00
=============================================
If you start with LEF I suggest investing in membership.

You can get Isocort and Armour from internet.

===============================================
Estradiol: Blood Tests
Estradiol
Non-members $44.00
Members $33.0

not the best test, but better than nothing.

Estradiol theoretically is a part of estrogens.
That does not mean you can take individually tested estrogens add them and get Total estrogen.

Each one is assayed differently, methods, accuracy, play a role, bottom line each number is to be viewed separately.

Awesome post, JansZ good job as usual.

Labcorp is ok, better than nothing. The E2 test is worthwile, Ksman and others can attest to its reliableness.

 

[AnotherOldGuy]

Agreed. I am on compounded cream, 10%, and it is working well thus far. And, I have relatively thick skin.

How much of this 10% do you apply daily?

Are you doing anything to keep the "jewels" from shrinking?

 

[JesusReagan]

How much of this 10% do you apply daily?

Are you doing anything to keep the "jewels" from shrinking?

It comes in a plastic syringe graduated in mL's. I put on 1 ml/day in the morning, equivalent of 2 packets of androgel. The cream, once squeezed out of the syringe, is about the size of a quarter, maybe a little bigger.


No, I'm not. I'm 50, married to a woman who doesn't care and I don't care, so I'm just letting them shrink.

 

[AnotherOldGuy]

Just curious on your dosage rather than yer balls, but thought I'd ask anyway. My answer my be the same, just something about 'em getting smaller is scary to me. Maybe I'll get over it.

I started on 1ml of 5%, now on 2ml of 5%, and awaiting my refill scrip for 10% (at 1ml)

 

[plymouth city]

No, I'm not. I'm 50, married to a woman who doesn't care and I don't care, so I'm just letting them shrink.

This sounds very appealing to me.

I do not want kids.

No more pregnancy scares, condoms, and a life of decadent sex with no worries sounds fun to me.

I really don't wanna cough up the cash for a vascectomy either.

Who cares about balls anyways.

I havent been able to find a reputable answer to fertility on HRT with no hcG......Noone can give me a straight answer. My brain is telling me that one would become infertile.....Wonder how long, if thats true, etc etc.

 

[SilkPhantom]

Hey CF10,

Glad to hear you finally got your script for Test!

I just had my MRI done yesterday...that was a strange experience. I don't know if you guys have ever been in one of those machines but it's kinda cramped for us larger guys and the experience is something like listening to a cd skip at max volume for 30 minutes. I don't know whether i want them to find a pituitary adenoma so i know what the cause of this mess is or not because surgery scares me.

Anyway, it's good to know you are making progress in your quest to feel better. I'm still waiting for my endo to figure things out and either address the root cause or start me on TRT. Let me know how the cream is working for you since i'll probably start on that too if it goes that route.

-TL

 

[JesusReagan]

This sounds very appealing to me.

I do not want kids.

No more pregnancy scares, condoms, and a life of decadent sex with no worries sounds fun to me.

I really don't wanna cough up the cash for a vascectomy either.

Who cares about balls anyways.

Agreed, those days are behind me. Actually, having the balls shrink up a bit might be just fine. I don't know about the rest of you guys, but it seems my balls grew as I aged, and frankly, they are kind of a pain in the ass.

I havent been able to find a reputable answer to fertility on HRT with no hcG......Noone can give me a straight answer. My brain is telling me that one would become infertile.....Wonder how long, if thats true, etc etc.

I would think the result would be infertility too, like you though, I haven't been able to get a definitive answer on this.

 

[CF10]

Hey CF10,

Glad to hear you finally got your script for Test!

I just had my MRI done yesterday...that was a strange experience. I don't know if you guys have ever been in one of those machines but it's kinda cramped for us larger guys and the experience is something like listening to a cd skip at max volume for 30 minutes. I don't know whether i want them to find a pituitary adenoma so i know what the cause of this mess is or not because surgery scares me.

Anyway, it's good to know you are making progress in your quest to feel better. I'm still waiting for my endo to figure things out and either address the root cause or start me on TRT. Let me know how the cream is working for you since i'll probably start on that too if it goes that route.

-TL

I will let you know how it goes. I can tell you this now though, it's day 3 and putting the gel on is an annoyance already . And it kinda smells all day, it never really fades. But I'm not complaining as long as it works.

 

[plymouth city]

I will let you know how it goes. I can tell you this now though, it's day 3 and putting the gel on is an annoyance already . And it kinda smells all day, it never really fades. But I'm not complaining as long as it works.

How much liquid is it? We talking about 1ml(the size of a quarter)

 

[plymouth city]

I would think the result would be infertility too, like you though, I haven't been able to get a definitive answer on this.

This is one issue I plan on talking to Dr John with and I will get back to all of you on.

Oh to be infertile! I am jumpy at the excitement.

 

[cpeil2]

This is one issue I plan on talking to Dr John with and I will get back to all of you on.

Oh to be infertile! I am jumpy at the excitement.

Don't count on it.

 

[CF10]

How much liquid is it? We talking about 1ml(the size of a quarter)

No it's a lot more than that. I spread it out over my shoulders, traps, and upper arms, and I still run out of space so I have to move to my upper chest as well. I would say if you squeezed out the whole tube you could make 4 or 5 quarter-sized blobs.

 

[plymouth city]

Don't count on it.

Ah, way to go and ruin my fun :drunk:

 

[plymouth city]

No it's a lot more than that. I spread it out over my shoulders, traps, and upper arms, and I still run out of space so I have to move to my upper chest as well. I would say if you squeezed out the whole tube you could make 4 or 5 quarter-sized blobs.

Your on compounded T cream right?

I never realized it was that much liquid

 

[CF10]

Your on compounded T cream right?

I never realized it was that much liquid

What's compounded mean? I'm on Testim, so if that's a compounded cream then yes.

 

[JesusReagan]

What's compounded mean? I'm on Testim, so if that's a compounded cream then yes.

Androgel is 1% T, so you have to put a lot more on. The cream is 10% so you put on less, and the cream rubs in better and over a smaller surface area.

 

[CF10]

Androgel is 1% T, so you have to put a lot more on. The cream is 10% so you put on less, and the cream rubs in better and over a smaller surface area.

Gotcha thanks. Therefore I am not on a compounded cream but wish I was

 

[JanSz]

Gotcha thanks. Therefore I am not on a compounded cream but wish I was

Do not be so sure.

Androgel worked for me.

Compounded T cream 100mg/1mg did not worked.

I am on shots now.

I have infant grandson at my home, worry about transfer.

 

[cpeil2]

Gotcha thanks. Therefore I am not on a compounded cream but wish I was

I used a compounded cream. Thought it was great option. Much cheaper than a-gel or testim. - probably 20% of what a-gel and/or testim cost. Couldn't be beat for ease of application.

 

[JesusReagan]

I used a compounded cream. Thought it was great option. Much cheaper than a-gel or testim. - probably 20% of what a-gel and/or testim cost. Couldn't be beat for ease of application.

Yep, mine is $10 w/copay for 20 days worth.

 

[plymouth city]

I will let you know how it goes. I can tell you this now though, it's day 3 and putting the gel on is an annoyance already . And it kinda smells all day, it never really fades. But I'm not complaining as long as it works.

:whiner:

Ask Dr about compounded cream.

Apparently a stronger strength, MUCH less liquid.

Compounding pharmacies are everywhere, any reasonably sized city will have one. Try google or post zip code and I will find one for ya

 

[CF10]

:whiner:

Ask Dr about compounded cream.

Apparently a stronger strength, MUCH less liquid.

Compounding pharmacies are everywhere, any reasonably sized city will have one. Try google or post zip code and I will find one for ya

Hey plymouth city you seem to know a lot about transdermals so could you answer this for me: It's day 5 on Testim and yesterday I noticed that my urine was more yellow than usual and it had a funky kind of smell to it (sorry dont know how else to describe it ). Also, today I noticed that I was sweating much more than usual on the areas I applied it to. What do you make of this?

 

[ItsHectic]

Hey plymouth city you seem to know a lot about transdermals so could you answer this for me: It's day 5 on Testim and yesterday I noticed that my urine was more yellow than usual and it had a funky kind of smell to it (sorry dont know how else to describe it ). Also, today I noticed that I was sweating much more than usual on the areas I applied it to. What do you make of this?

Urine smell seems like pheremones from hormone breakdown.
Dr. John, preferes a compounded gel rather than a cream.
How much water are you drinking per day?

 

[CF10]

Urine smell seems like pheremones from hormone breakdown.
Dr. John, preferes a compounded gel rather than a cream.
How much water are you drinking per day?

Lots and lots of water.

 

[plymouth city]

Hey plymouth city you seem to know a lot about transdermals so could you answer this for me: It's day 5 on Testim and yesterday I noticed that my urine was more yellow than usual and it had a funky kind of smell to it (sorry dont know how else to describe it ). Also, today I noticed that I was sweating much more than usual on the areas I applied it to. What do you make of this?

This is due to changes in the bodies ph.

"Due to the Ph change, urine and other body fluids may also change in appearance as well" - http://www.forge-forward.org/socialsupport/hormones-april2004.html

 

[SilkPhantom]

Hey CF10,

Are you feeling any better? How is the transdermal working for ya?

 

[plymouth city]

Cf10 you definitely need some compounded gel. Putting on all that liquid every day has got to be a pain in the as s.

 

[plymouth city]

Dr. John, preferes a compounded gel rather than a cream.

Elaborate, what are differences between the two.

Consistency, amount of liquid?

Why gel over cream?

Costs?

 

[CF10]

Hey CF10,

Are you feeling any better? How is the transdermal working for ya?

Nothing to note yet, maybe a slight elevation in mood but no changes in my energy or libido which sucks cause I was hoping for the libido to be reversed rather quickly by a transdermal, but not yet. It's only been 1 week though, and my dose is just 1 tube a day. Maybe more time and a higher dose will do the trick so we'll see what my next labs look like and go from there I guess.

 

[JesusReagan]

Nothing to note yet, maybe a slight elevation in mood but no changes in my energy or libido which sucks cause I was hoping for the libido to be reversed rather quickly by a transdermal, but not yet. It's only been 1 week though, and my dose is just 1 tube a day. Maybe more time and a higher dose will do the trick so we'll see what my next labs look like and go from there I guess.

Maybe give it a little time. I didn't notice that much change in the first month; slight increase in libido and maybe a little mood elevation. In the past two-three weeks, things have really picked up. Libido is much improved, mood is much improved, and energy is greatly increased.

 

[cpeil2]

Elaborate, what are differences between the two.

Consistency, amount of liquid?

Why gel over cream?

Costs?

Costs are about the same. The T is absorbed differently depending on the carrier. I preferred a cream to a gel. The effect seemed evener and more gradual. I have also seen discussions of the differing E2 and DHT responses between the two carriers.