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Dr. John, Phil, & Anyone Else...Help!!!

mikandrea

New member
Hello everyone,
I've been a lurker on this thread for a while, but decided to post after my Endo. appointment this morning. A little background, I started on Androgel 5g/day back at the end on November after my Test levels came back as 277 total test
& 8.6 free. After 2 weeks on Androgel, my GP re-tested and my levels dropped to 158 total & 4.8 free. My GP and I agreed to start Test Cyp injections at 100mg/week, but he was reluctant to prescribe hCG (despite me giving him Dr. John's papers) and, instead, sent me to an Endo.
The Endo today sat down and said, "why are you on test replacement, your levels are fine?" After explaining to the doc that my levels were not fine and my symptoms of fatigue, ED, lack of libido, and brain fog (I normally have a near-photographic memory), would also fit this category of low test. He stated that I gave up on Androgel too early (I again disagreed...just look at the labs!!!) and that I should stop my injections for the next 6 weeks, so that he could run a "workup". He wants to check FSH, LH levels. I mentioned an Estradiol check and he said "why?", but finally agreed. I think he knew I was ready to blow. He also saw my notes to ask about an anti-E and he said "Why would you ever need an anti-E"? We are going on a family vacation in 6 weeks, so I do not want to be feeling like sh%$ while on vacation. I agreed to go off of injections for 4 weeks, then run the tests he wants to run. He said that any tests performed while on TRT are not valuable (that isn't true, is it?).
I am beyond frustrated. I know many others have gone through this, but it is discouraging. I was starting to feel better, but still had some ED stuff and have recently been having some testicular soreness (probably from them atrophying...hence why I asked about hCG and the Estradiol check)). Does this make sense to go off of the test and see where I'm at in 4 weeks? He also said that hCG should only be used in cases of infertility. What the fu%^!! I handed him your papers and requested that he read them, so that we are on the same page. I will get the labs done, but I think I need to look for a new Endo. Please share your thoughts on this. I'm beating the hell out of my keyboard so I'm probably leaving stuff out, but I'll clarify anything that I may have left confusing.
Dr. John, is there anyone in the Minneapolis area that shares your philosophies? I doubt this guy will ever give me hCG or treat me the "cutting-edge" way. Any help would be very much appreciated.

Yours in health,
Mike
 
I feel the frustration....I went through it w/ my local endocrinologist(s) and physician(s)....

If I were you, geography would not be a determining factor....I'd find the doc that I wanted to use and schedule for the earliest available, and also ask to be added to the cancellation list....

Peace of mind/mental and physical well-bieng are worth a round trip ticket....

Good Luck
 
Hi Mike,

Go back to the Dr. that sent you to this Endo and tell him you don't want to be off TRT for 4 weeks only to see the same test results. I have been down this road 7 times with Endo's and I feel they are not good Dr.'s for TRT. Each time I went to one and showed him all my tests they would lay them down with out looking at them and tell me I have to stop my TRT for 2 to 12 weeks yes one had me off TRT for 12 weeks I ended up on sick leave could not work. All they ever found out was how sick they made me.

And after all of this crap they still missed that I am not Primary but Secondary. I feel if they don't look for why you low to start they are not good enough to find out why after you on TRT by taking you off it.

When I went on HCG and my levels doubled I asked why are my testis working. I got crap like my Adrenals can make T but not from a total T of 600 then adding HCG going up to 1000. Dr. John told me in a post never seen me I am secondary. All the dam Endos and Dr.'s I have seen missed this. Do waste your time, this Dr. and most Endos are not good at treating low T. One did just did a bunch of labs that were for someone with High Sugar. I could not believe it. Others tested my thyroid and I have a bad thyroid and they missed it. You need to stay with your Dr. that put you on the Androgel. The reason your levels went down on 5 grams of Androgel is your brain seen the T in your blood and stopped sending the LH and FSH to your testis to make T. So your levels before Androgel went down and the 5 grams of Androgel was not enough to keep your levels higher. You should have went to 10 grams and tried this.

Tell your Dr. you want him to treat you with Dr. John if he will do this then call Dr. John and set it up he will test and treat you with your Dr. over the phone. Or come to MI. and see him.

I just posted to a Dr. posting he can find a good Dr. he has low T and went to some Endo's now he is posting on the boards for help. I told him to come here I hope he dose. So a Dr. can't find a good Dr. to treat his low T.
Phil
 
get a new doctor.. The End..
seriously.. Phil has had bad luck with Endos.. I have had great luck with them..
But the trick is to finding a good doctor who actually knows what they are doing.. Not one that will just write you a prescription..

The first tip off would be the asking why he would want to run E2 tests.. If the Doc doesnt know how test will run up Estrogen then he is probably not the doc you want!

Good luck!
 
Phil & Christopher,
Thanks for the replys. Do you think that I should just ask my Primary for the tests for Estradiol, FSH, LH? I'm not worried about paying for a round-trip ticket to see Dr. John, I am worried about how that works with an out-of-state doc writing scripts. In other words, I'm wondering if my insurance will cover it as a out-of-network deal or they will not pay all together. Then, how do the meds work. If you know, great. If not, perhaps I'll put a call in to the Man-Cave. Thanks so much for the help. You've been there before and your knowledge is greatly appreciated.

Mike
 
We all "feel your pain!" I got so frustrated with my doctors that I recently bought the plane tickets for Lansing and made an appt. w/ Dr. John. Isn't it incredible that there are so few doctors who specialize in this field that one has to fly half way across the country to see a doctor?!?!?!! Be VERY careful of endos and urologists. Generally the urologists give you a perscription for Androgel (which doesn't work for a lot of guys) and send you on your way, and the endos test a few things, tell you you're fine (when you're not), and send you on your way. It's enough to make one sick....er.
 
mikandrea said:
Phil & Christopher,
Thanks for the replys. Do you think that I should just ask my Primary for the tests for Estradiol, FSH, LH? I'm not worried about paying for a round-trip ticket to see Dr. John, I am worried about how that works with an out-of-state doc writing scripts. In other words, I'm wondering if my insurance will cover it as a out-of-network deal or they will not pay all together. Then, how do the meds work. If you know, great. If not, perhaps I'll put a call in to the Man-Cave. Thanks so much for the help. You've been there before and your knowledge is greatly appreciated.

Mike
Click to expand...
Why test Lh and FSH you have been on TRT some times it comes back up and other times it does not for a long time.

Here is what works for a lot of men keep your Total T and Free T levels up into the upper 1/3 of your labs range for a young man and keep your E2 down between 10 to 30 best at 20 pg/ml. Then see how you feel and work from there. As for seeing Dr. John you need to call your heath care and ask if they will cover meds. Best to try and get your Family Dr. to work with Dr. John this way you pay Dr. John and your Dr. does the rest.

As for TRT read this link by LEF I still find this to be a dam good read.
Invalid Link Removed
Phil
 
Quote:
Originally Posted by mikandrea
Phil & Christopher,
Thanks for the replys. Do you think that I should just ask my Primary for the tests for Estradiol, FSH, LH? I'm not worried about paying for a round-trip ticket to see Dr. John, I am worried about how that works with an out-of-state doc writing scripts. In other words, I'm wondering if my insurance will cover it as a out-of-network deal or they will not pay all together. Then, how do the meds work. If you know, great. If not, perhaps I'll put a call in to the Man-Cave. Thanks so much for the help. You've been there before and your knowledge is greatly appreciated.

Mike
------------------------------------


pmgamer18 said:
Why test Lh and FSH you have been on TRT some times it comes back up and other times it does not for a long time.

Here is what works for a lot of men keep your Total T and Free T levels up into the upper 1/3 of your labs range for a young man and keep your E2 down between 10 to 30 best at 20 pg/ml. Then see how you feel and work from there. As for seeing Dr. John you need to call your heath care and ask if they will cover meds. Best to try and get your Family Dr. to work with Dr. John this way you pay Dr. John and your Dr. does the rest.

As for TRT read this link by LEF I still find this to be a dam good read.
Invalid Link Removed
Phil
Click to expand...
Mike; you already got good advice, so you may skip the rest of my writting.
my 2c (my personal understanding)
Looking at testosterone/ estrogen picture,
what one really want is to have FreeT and Bio-avalable T in a good range,
at the moment I am not completely satisfied of what that level is,
probably upper range but not over it. If one gets to the right level in one
or both of them, Bio-T being more important,
most likely his estrogen problems are minimized, possibly also his DHT is helped.
Blood tests for FreeT and Bio-T are less than useles,
if they are done, they are most likely incorect, see this:
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But they can easily be calculated since they are dependend on law of physics or chemistry.
All one need is to know T, Albumin and SHBG from the same blood draw.
If one do the blood work at Quest Diagnostics they also will do the calculation.
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If not one can do the calc himself.
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This link is handy to convert T units
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----------------------
If you want to nit pick some more on accuracy of FreeT and Bio-T calculations,
read this 2006 work, (remove red dashes)
http--------://www.atypon-link.com/WDG/doi/pdf/10.1515/JLM.2006.050
----------------------
Next, high E2 and DHT
DIM looks like it is first choice. The one Phil recomends looks like it is working.
I use one from LEF, just check the content.
(My current guess is that half a tablet daily probably wont change E2 much but still may be helpfull with DHT.
But here they make distinction between dfferent DIM's
"Why is it necessary to take DIM in an absorportion-enhancing formulation"
Invalid Link Removed
I'll have to read some more on this, or somebody please chime in.
-----------------------
Low DHT,
I do not want to get flamed so I will stop here,
anyhow it does not happen too often.
----------------------------------------------------
The real advice can be given by (dedicated) doctors,
all of the above is just my personal day dreaming
(hopefully wet dreams when my hormones are at just the right level).
 
Today I got refused anymore medication, just because of itchy and sore nipples wich subsided over a week ago.
 
ItsHectic said:
Today I got refused anymore medication, just because of itchy and sore nipples wich subsided over a week ago.
Click to expand...

If you were taking a DHT inhibitor like finastride that might have been the cause of the itchy sore nipples.

and also if you were taking testosterone without an aromatase inhibitor
 
Amazing some times guys are lucky that once their free t and testosterone levels are in the optimal range then estrogen actually will fall into balance as well. Then some times they have to resort to other measure such as anti estrogens ect. its luck of the draw. How much does dr john charge for consutlation with a dr over the phone? I can get my test ran by insurance no problem :) and his advice would be well worth it thats for sure :)
 
hardasnails1973 said:
Amazing some times guys are lucky that once their free t and testosterone levels are in the optimal range then estrogen actually will fall into balance as well. Then some times they have to resort to other measure such as anti estrogens ect. its luck of the draw. How much does dr john charge for consutlation with a dr over the phone? I can get my test ran by insurance no problem :) and his advice would be well worth it thats for sure :)
Click to expand...

$300, but you can do virtual visits thereafter for $50 (I believe). It's all on his website. Email him - His assistant, Kim, will get back to you w/ all the info. I got a r.t. ticket for only $158 to Lansing from DC! I was shocked at low low the fare was. Blue Cross Blue Sheild, in my case, will pay for about half of the fee when I submit the receipt to them.
 
MacDonnell said:
$300, but you can do virtual visits thereafter for $50 (I believe). It's all on his website. Email him - His assistant, Kim, will get back to you w/ all the info. I got a r.t. ticket for only $158 to Lansing from DC! I was shocked at low low the fare was. Blue Cross Blue Sheild, in my case, will pay for about half of the fee when I submit the receipt to them.
Click to expand...


Thanks bro
I will look further into this getting the tests done is no biggie its just interrepting them that is the hardest part and coming up with protocol to get one balanced again. That is where the experts come in at :)
 
hardasnails1973 said:
Thanks bro
I will look further into this getting the tests done is no biggie its just interrepting them that is the hardest part and coming up with protocol to get one balanced again. That is where the experts come in at :)
Click to expand...

hardasnails1973
You are naturopath,
I guess, or your thinking it is along that line,
(forgive me if I am mistaken);

http------://www.digitalnaturopath.com/index.html

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they have computerized ANALYST
US $29.00 for the Standard Report
and $74.00 for the Full Report when revieved by licensed Naturopathic Physician.

What to think about it?

Answering 9 pages of questions must be a royal PITA
Invalid Link Removed
---------------------------------------------------------
to find licensed Naturopathic Physician
Invalid Link Removed
---------------------------------------------------------

Anyhow, most of our hormonal adjustments is based on published research
and then digested into mathematical/chemical formulae,
somebody somewhere already have it,
where is it?
 
JanSz said:
hardasnails1973
You are naturopath,
I guess, or your thinking it is along that line,
(forgive me if I am mistaken);

http------://www.digitalnaturopath.com/index.html

Invalid Link Removed
they have computerized ANALYST
US $29.00 for the Standard Report
and $74.00 for the Full Report when revieved by licensed Naturopathic Physician.

What to think about it?

Answering 9 pages of questions must be a royal PITA
Invalid Link Removed
---------------------------------------------------------
to find licensed Naturopathic Physician
Invalid Link Removed
---------------------------------------------------------

Anyhow, most of our hormonal adjustments is based on published research
and then digested into mathematical/chemical formulae,
somebody somewhere already have it,
where is it?
Click to expand...

over past 3 years i have been to the worlds so called best drs and have learned a gerat deal of information and have 3-4000 hours of research I did my self to understand what and where the imbalances are. i can look at any organic acids test, amino urinaliysis test and pin point where the probable cause is and back it by scientific research. Alot of information and cure, prevention and treatment of many diseases comes from study specific diseases such as autism, aids, cancer, MS, parkinsons and you start to see a pattern to things and little changes here and there. I focus more on idea of find the problem not treat the symptoms (but to support systems while the main cause is being is targeted) i went to a naturopath paid 700 bucks just to be told I had secondary adrenal fatigue. I was like no CRAP. I told the endo this as well said adrenals are perfectly fine !! little did I know my free cortisol was in the crapper but serum was fine. Then i was label i hypochondriac. Well thanks to there screw ups i did not give in and just started resarching stuff on my own. i am not talking reading goofy web sites, but started to look at nurtiton and enzymatic reactions they cause. I beleive if you find out what you are lacking as well as why (majority time leaky gut/dybiosis/candida/ mineral imbalance / yadda yadda) and then give body what it needs then it will rebalance it self over time. For exmaple i have a zinc defieincy and can not find out why I am not absorbing it. i have came up with theories but do not have the insurance to prove them just yet. Estrogen imbalnces is at top of my list as well as leaky gut. Something is jamming up mitochondrion and I am going to figure out why and I know estrogen and fatty liver can do that. Thats why I focus on balancing the liver, but this can only be done with evasive testing which acutally backs up slight deviatioin in blood work, but its enough to throw my body out of wack..
 
hardasnails1973 said:
over past 3 years i have been to the worlds so called best drs and have learned a gerat deal of information and have 3-4000 hours of research I did my self to understand what and where the imbalances are. i can look at any organic acids test, amino urinaliysis test and pin point where the probable cause is and back it by scientific research. Alot of information and cure, prevention and treatment of many diseases comes from study specific diseases such as autism, aids, cancer, MS, parkinsons and you start to see a pattern to things and little changes here and there. I focus more on idea of find the problem not treat the symptoms (but to support systems while the main cause is being is targeted) i went to a naturopath paid 700 bucks just to be told I had secondary adrenal fatigue. I was like no CRAP. I told the endo this as well said adrenals are perfectly fine !! little did I know my free cortisol was in the crapper but serum was fine. Then i was label i hypochondriac. Well thanks to there screw ups i did not give in and just started resarching stuff on my own. i am not talking reading goofy web sites, but started to look at nurtiton and enzymatic reactions they cause. I beleive if you find out what you are lacking as well as why (majority time leaky gut/dybiosis/candida/ mineral imbalance / yadda yadda) and then give body what it needs then it will rebalance it self over time. For exmaple i have a zinc defieincy and can not find out why I am not absorbing it. i have came up with theories but do not have the insurance to prove them just yet. Estrogen imbalnces is at top of my list as well as leaky gut. Something is jamming up mitochondrion and I am going to figure out why and I know estrogen and fatty liver can do that. Thats why I focus on balancing the liver, but this can only be done with evasive testing which acutally backs up slight deviatioin in blood work, but its enough to throw my body out of wack..
Click to expand...

It is your choice to take that label or not.
Glad you did not.

Wonder if in your research you have come across study
that would end with mathematical/chemical equations,
and deal simultaneously with at least this five variables
(or more):

Total T
Albumin
SHBG
E2
DHT
---------------------------
I already have two of them that deal with first three,
but that is not enough, I am afraid.
 
JanSz said:
It is your choice to take that label or not.
Glad you did not.

Wonder if in your research you have come across study
that would end with mathematical/chemical equations,
and deal simultaneously with at least this five variables
(or more):

Total T
Albumin
SHBG
E2
DHT
---------------------------
I already have two of them that deal with first three,
but that is not enough, I am afraid.
Click to expand...


This is something that is left better for experts to deal with. What right for one person is not right for another. I am finding out if your shbg is low and your e2 is above 20 or more it COULD give signs of estrogen domaince, but also it may be wise to get a 24 hour urine test suggested by dr john to see if find ratio of good to bad estrogen and then if your ratios are altered then you might want to look into taking some DIM. But it is always good to have a valid resaon for taking a supplement other then just sake for taking it.
 
Bump...Dr. John, any advice would be much appreciated. I also left a VM at your office requesting more information re: consults. I look forward to speaking with you or your staff.

Mike
 
JanSz said:
Wonder if in your research you have come across study
that would end with mathematical/chemical equations,
and deal simultaneously with at least this five variables
(or more):

Total T
Albumin
SHBG
E2
DHT
---------------------------
I already have two of them that deal with first three,
but that is not enough, I am afraid.
Click to expand...


hardasnails1973 said:
This is something that is left better for experts to deal with. What right for one person is not right for another. I am finding out if your shbg is low and your e2 is above 20 or more it COULD give signs of estrogen domaince, but also it may be wise to get a 24 hour urine test suggested by dr john to see if find ratio of good to bad estrogen and then if your ratios are altered then you might want to look into taking some DIM. But it is always good to have a valid resaon for taking a supplement other then just sake for taking it.
Click to expand...

Great observation.
The idea behind my thinking is to adjust body in such a way that there is no need or minimized need for DIM.
If excess E2 is not produced in the first place then there is no need to fight it.
I think many people are using excessive amounts of T.
I know I did.
==========================
Invalid Link Removed

Recommendations for Elevated SHBG:
SHBG's may be lowered by two of the artificially generated progesterones, norgestrel and norethisterone.

Have anybody heard about this drugs?
------------------------------
Invalid Link Removed
Modest reductions in SHBG levels may be encountered in individuals receiving glucocorticoids such as prednisone.
 
JanSz said:
Great observation.
The idea behind my thinking is to adjust body in such a way that there is no need or minimized need for DIM.
If excess E2 is not produced in the first place then there is no need to fight it.
I think many people are using excessive amounts of T.
I know I did.
Click to expand...

Also thinking out of the box if your intestinal flora is altered this will have a major impact on estrogen metabolism even despite normal estrodial level. If one would take a good look probably from all the stress caffine,and any other chemicals we place in our body no wonder we are probably running around with imbalanced flora.
 
hardasnails1973 said:
Also thinking out of the box if your intestinal flora is altered this will have a major impact on estrogen metabolism even despite normal estrodial level. If one would take a good look probably from all the stress caffine,and any other chemicals we place in our body no wonder we are probably running around with imbalanced flora.
Click to expand...

also:
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Modest reductions in SHBG levels may be encountered in individuals receiving glucocorticoids such as prednisone.
 
Invalid Link Removed

Not many options when it comes to trying to lower SHBG levels
Supplements that lower SHBG:
-Proviron
-GH
-Avena Sativa Extract/Green oat that contains Avenacosidas-supposedly there is none of this product out on the market that shows that it works.
-Carao Extract-Theory only-has not been proven yet
-Utica Dioca aka Stinging Nettles
-Muira Puama

Clomid and Nolvadex increas SHBG levels.
==============
Good discussion latter on on that thread.
 
JanSz said:
Invalid Link Removed

Not many options when it comes to trying to lower SHBG levels
Supplements that lower SHBG:
-Proviron
-GH
-Avena Sativa Extract/Green oat that contains Avenacosidas-supposedly there is none of this product out on the market that shows that it works.
-Carao Extract-Theory only-has not been proven yet
-Utica Dioca aka Stinging Nettles
-Muira Puama

Clomid and Nolvadex increas SHBG levels.
==============
Good discussion latter on on that thread.
Click to expand...

What about increasing thyroid out put low out put increases shbg. If there is not enough cortisol that would cause elevated shbg as much as elevated due to fact that it low cortisol inhibits thryoid function. From what you are recommending supplement wise that increasing free -t and nto total t will actually reduce shbg
 
Why I always end up at LEF.org
They do not worry about TotalT
they worry about FreeT and SHBG.
Nice case history description.
Invalid Link Removed

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Normally, testosterone can convert to dihydrotestosterone (DHT), androstanediol, and estradiol. With age, the conversion of testosterone to DHT and estradiol increases, as does the production of sex hormone binding globulin (SHBG). These factors contribute to a reduced amount of free testosterone in the body. To help restore youthful physiology, we aimed to prevent the conversion of testosterone to DHT by using supplements that block the 5-alpha reductase enzyme. Furthermore, we used the natural aromatase inhibitors progesterone and zinc to help prevent the conversion of testosterone to estradiol.41,42 Additionally, we used an herbal extract that inhibits the binding of testosterone to SHBG. Through these interventions, we sought to achieve a higher level of endogenous testosterone.

The following supplements have some potential use for testosterone metabolism:

saw palmetto: 5-alpha reductase inhibitor in the prostate gland43,44
nettle root: 5-alpha reductase inhibitor; inhibits the binding of testosterone and SHBG45-47
Pygeum africanum: has an inhibitory effect on prostate cell proliferation48,49
zinc: aromatase inhibitor41
progesterone: 5-alpha reductase inhibitor; aromatase inhibitor.42,50
 
hardasnails1973 said:
What about increasing thyroid out put low out put increases shbg. If there is not enough cortisol that would cause elevated shbg as much as elevated due to fact that it low cortisol inhibits thryoid function. From what you are recommending supplement wise that increasing free -t and nto total t will actually reduce shbg
Click to expand...
Adrenals and Thyroid adjustment is next on my list.

My FreeT3=2.9 (2.3-4.2), upper 1/3 range starts at 3.7, long way to go. Probably 1. to 1.5 grains of Armour.
Usually my body temperature is about 97.1F
In my earlier years I know I always had 36.6C=97.9F or even slightly higher.
The little extra of Cortef and Armour probably will also do good for my SHBG.

Overall tuneup is the game.
===================================

In
Invalid Link Removed

12-11-2006, 09:03 AM
you have posted nice recipe for shake.
----
I use it, something makes me constipated,
would that be brewers yeast or lecithin?
Reason for cinamon is....
I am also adding half of teaspoon of turmeric.
 
JanSz said:
Adrenals and Thyroid adjustment is next on my list.

My FreeT3=2.9 (2.3-4.2), upper 1/3 range starts at 3.7, long way to go. Probably 1. to 1.5 grains of Armour.
Usually my body temperature is about 97.1F
In my earlier years I know I always had 36.6C=97.9F or even slightly higher.
The little extra of Cortef and Armour probably will also do good for my SHBG.

Overall tuneup is the game.
===================================

In
Invalid Link Removed

12-11-2006, 09:03 AM
you have posted nice recipe for shake.
----
I use it, something makes me constipated,
would that be brewers yeast or lecithin?
Reason for cinamon is....
I am also adding half of teaspoon of turmeric.
Click to expand...

This is screaming adrenal imbalances
Possible you could be allergic to the type of whey are using or artifical sweetner. Fiber per drink should range between 5-8 grams other wise excess fiber can cause constipation.
Cinamon helps to balance blood sugar levels this is documented scientifically.

i use shiloh farms rice bran 1/4 cup as fiber source in shakes and also making protein pancakes

protein pancakes
Blend in blender
1/2 cup of shiloh rice bran
2 whole eggs
5-6 egg whites

pam in pan

35 proteins
11 grams of fat
10 grams of fiber
27 grams of carbs
 
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