urologists and hormones

hyperCat

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Just curious if anyone has had any luck with using a urologist to treat hormone deficiencies/libido issues? There are not any reputable endos I can find locally (at least within a reasonable distance). Seems they're all hit and miss based on reviews, anyway. My primary care doc is very reluctant to address any kind of hormone-related issue I might have, and suggested a urologist. The most recent bloods showed borderline low T, but he basically scoffed at the mention of TRT.

So just wondering if anyone uses a urologist vs an endo for hormonal-related issues, as I do have an upcoming appt to see one.
 

kisaj

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No, I went to one before I started "interviewing" endos and they knew nothing outside of the very basics that you could pick up on after 10 minutes of Google searching. I've talked to my dad's and their group is very wise, but admittedly know that this is not an area of expertise for them and will often refer out.

Give it a shot and see if the experience is any different and at least you have an idea of what you have to work with.
 
EasyEJL

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I do mine through my urologist. Like anything else, your mileage may vary
 

hyperCat

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Alright, thanks guys. Guess I'll find out next week. Not sure if I really need TRT or not at this point, but it would be nice to find a doc who at least doesn't seem to have a negative opinion about it, and may consider it an option at some point. My primary doc seemed to fall into the camp that thinks it elevates the risk of heart attacks and causes more problems than it helps. May be true for some people, I suppose...
 

hyperCat

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One other question. I just found some blood work from close to a year ago. It only has a free test reading, along with some other lipid results, TSH, etc. My free test reading was 7.7 pg/mL, and the reference range is 6.8 - 21.5. It's certainly on the low end. I've done some reading, and it appears that this is the average for a 70 yr. old man. Not sure how much to buy into this, but do you recall if your free T was below the reference range, or whether it was just on the low end when you went on TRT?
 

kisaj

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You can't tell the whole picture by just looking at total and free test.
 

hyperCat

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You can't tell the whole picture by just looking at total and free test.
Understood - but seems if the free test were well into the normal range, this wouldn't even be a topic of conversation. So I guess the question is - what other hormones are contributing to my free test being on the low end? I understand there is a whole cascade of hormonal interactions, and perhaps low free test is just a result of some other hormonal deficiency or possibly not even hormonally induced at all? In your case, how did they determine that TRT was appropriate, and did they try addressing any other potential causes before going with TRT? Just curious as to what your experience was.
 

kisaj

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I've posted the long version several times, but basically it went like this:

At 36-37, I noticed that I really had no libido to speak of, I was agitated a lot, couldn't sleep, had bad brain fog all the time, and started gaining some fat around my mid-section. I have been very athletic and trained in the gym since 16, so I noticed when I started to look softer, which was an ego hit.

Went to my PCP and discussed. We decided to run a CBC w/lipids and order a total and free test lab as well. Initial CBC came back with slightly elevated tris and LDL and total test was in the mid 200s, with correlating free test (aprox 2% of total). We decided that I would concentrate on lifestyle to try and see if we could adjust this. Over the next 8 months, I altered diet, sleep patterns, tried to reduce stress, etc and would go in for labs every 8 weeks. I corrected my cholesterol, but test continued to lower and all symptoms were still there. So he referred me to an endo. Keep in mind that I was studying everything I could get my hands on, talking to hormone therapists, and consulting with people I know in the sports/supplement industry.

I ended up seeing 3 endos because they quite honestly didn't seem to have the same care as I was demanding. I ended up finding one that really wanted to be thorough and we initially ordered a DEXA, full hormone panel, and an MRI. DEXA and MRI came back normal, but I was low DHEA, pregnenolone, high cort, low total and free test. Thyroid was fine. So, at that point, we got started on TRT. The endo wanted me to try gels, but with kids I was against it, so I went back to my PCP and he prescribed me injections.

That is how I got there. The journey in the first year or so is a whole other journal as I had a lot of trial and error before settling in.
 

hyperCat

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I've posted the long version several times, but basically it went like this:

At 36-37, I noticed that I really had no libido to speak of, I was agitated a lot, couldn't sleep, had bad brain fog all the time, and started gaining some fat around my mid-section. I have been very athletic and trained in the gym since 16, so I noticed when I started to look softer, which was an ego hit.

Went to my PCP and discussed. We decided to run a CBC w/lipids and order a total and free test lab as well. Initial CBC came back with slightly elevated tris and LDL and total test was in the mid 200s, with correlating free test (aprox 2% of total). We decided that I would concentrate on lifestyle to try and see if we could adjust this. Over the next 8 months, I altered diet, sleep patterns, tried to reduce stress, etc and would go in for labs every 8 weeks. I corrected my cholesterol, but test continued to lower and all symptoms were still there. So he referred me to an endo. Keep in mind that I was studying everything I could get my hands on, talking to hormone therapists, and consulting with people I know in the sports/supplement industry.

I ended up seeing 3 endos because they quite honestly didn't seem to have the same care as I was demanding. I ended up finding one that really wanted to be thorough and we initially ordered a DEXA, full hormone panel, and an MRI. DEXA and MRI came back normal, but I was low DHEA, pregnenolone, high cort, low total and free test. Thyroid was fine. So, at that point, we got started on TRT. The endo wanted me to try gels, but with kids I was against it, so I went back to my PCP and he prescribed me injections.

That is how I got there. The journey in the first year or so is a whole other journal as I had a lot of trial and error before settling in.
Gotcha - thanks for sharing. So in your experience, has TRT completely changed your quality of life, or has it just been a small piece of the solution? Any regrets about going that route?

Your symptoms sound a lot like mine - lack of focus, low libido, mental sluggishness, no motivation, etc... I'm not nearly as sharp at work these days, missing details that I normally would've been locked in on.
 

kisaj

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I am the poster child for everything good about TRT and don't regret it for a second. I supplement DHEA and pregnenolone with it and that brought it to another level.
 
EasyEJL

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I am the poster child for everything good about TRT and don't regret it for a second. I supplement DHEA and pregnenolone with it and that brought it to another level.
reminds me, I've run out of pregnenelone. I keep meaning to buy some as raw powder to mix with DMSO just to try too.
 
Blergs

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I do mine through my urologist. Like anything else, your mileage may vary
Totally agree!
OP, Check it out and see the vibe. plus we can help you here also as long as he knows the basics and will give you the meds
 
Whacked

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I am the poster child for everything good about TRT and don't regret it for a second. I supplement DHEA and pregnenolone with it and that brought it to another level.
Can you share the brands and doses? Gels or pills? Thanks brother.
 

hyperCat

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Well, blood tests came back and it's official - my test level is low. Urologist gave me a script for Androgel, so I'm officially on TRT now. I asked about injections, although I'm not against the gels, but he really felt like Androgel was the better way to go. He said just about every one of his patients who are on it are doing really well, and hasn't seen any significant issues with it.

At this point, my biggest concern is the transfer to my wife. Don't need or want a wife with a beard! I can't seem to find a conclusive answer to how long this stuff actually stays active on your skin. If I apply it early morning, will there still be active testosterone on my skin 10 hours later? I know the packet insert says to wait at least 2 hours before swimming or showering, which leads me to believe most of it has absorbed by then, but just not sure what to make of the transfer issue...
 

kisaj

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So what did they test and why didn't they attempt to address without TRT?
 

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