My Dr. Appt. tomorrow.....TRT guys in here please.

[BoneDaddy]

So tomorrow I have an appt at a local Dr.'s office that is 1 of those premium, for men, by men men's health type places. I don't know how else to describe it. (link is Erectile Dysfunction, Low Testosterone - Charlotte & Raleigh - Vitality Health Services (http://www.vitalitymen.com/) ). I'm hitting this place up because it is taking me forever to get in to see my regular doc and I have some immediate concerns, primarily the possibility of low T and Thyroid issues. This place will take bloods tomorrow and the lab is on site so I get an immediate 'diagnosis' of sorts. We know the usual things to ask for lab-wise for Low T, but for thyroid I've come up with this:

TSH
Free T4
Free T3
Reverse T3
Thyroid Peroxidase Antibodies (TPOAb)
Thyroglobulin Antibodies (TgAb)

I'm also going to ask that E and E2 and such be checked. Can any of you guys chime in and maybe suggest anything to ask or have checked while I'm there. Never really been down this road before and in my attempt at this comeback, shit just isn't moving at nearly the pace it used to or even remotely close.

[Jelisej]

Bro' you cannot just check thyroid, as thyroid is just a part of endocrine system and is very closely related with adrenals and together they create "metabolic rate"
also if anything goes wrong with your body- thyroid has to "slow down" reason being to reduce "damage" and if you test your thyroid hormones it will show low levels- but actually there is nothing wrong with thyroid
likewise your blood can show good levels- and you will asume that its all fine with thyroid but if there is not enough cortisol- that thyroid hormones are not being used up, so basically you are hypothyroid

so basically you have to test adrenals, thyroid and sex hormones to see whats really going on


Thyroid labs you plan to do for thyroid are good.
If you add these, we will get lot of good info


Progesteron Prolactin E2
Cortisol LH Total testosterone
ACTH SHBG Albumin or free test.

And checking fasting insulin may be good idea

[BoneDaddy]

Bro' you cannot just check thyroid, as thyroid is just a part of endocrine system and is very closely related with adrenals and together they create "metabolic rate"
also if anything goes wrong with your body- thyroid has to "slow down" reason being to reduce "damage" and if you test your thyroid hormones it will show low levels- but actually there is nothing wrong with thyroid
likewise your blood can show good levels- and you will asume that its all fine with thyroid but if there is not enough cortisol- that thyroid hormones are not being used up, so basically you are hypothyroid

so basically you have to test adrenals, thyroid and sex hormones to see whats really going on


Thyroid labs you plan to do for thyroid are good.
If you add these, we will get lot of good info


Progesteron Prolactin E2
Cortisol LH Total testosterone
ACTH SHBG Albumin or free test.

Thanks Jel, as always you are a damn wealth of knowledge. Adding those to the list.

[Jelisej]

Also- make sure you're feeling ok before blood tests, if you had some illness recently better skip it for a week or two, make sure you get a decent sleep during night, make sure you're awake for an hour before tests, and in mean time have around two glasses of water to be properly hydrated to get more accurate results
obviously make sure you dont drink coffee, also eat 3 hrs before sleep latest,
Good luck bro'

[ryhigh]

Intelligent man is very intelligent

[weekend]

Jel's got it!

[burlyman30]

J knows his stuff... I don't really have anything to add to the list of tests beyond what you and J came up with.

I will say this, though: those TRT clinics make a lot of money by getting guys on TRT. My friend went in with a level of 550 (considered in middle of range), and they jacked him up to over 1000 with a full TRT protocol. He goes back every 4 months to get testosterone pellets implanted and it costs him pretty dearly between that and the ancillary meds. So go in there with both eyes wide open.

[BoneDaddy]

J knows his stuff... I don't really have anything to add to the list of tests beyond what you and J came up with.

I will say this, though: those TRT clinics make a lot of money by getting guys on TRT. My friend went in with a level of 550 (considered in middle of range), and they jacked him up to over 1000 with a full TRT protocol. He goes back every 4 months to get testosterone pellets implanted and it costs him pretty dearly between that and the ancillary meds. So go in their with both eyes wide open.

Yeah, the wife and I have had several long conversations about this. This particular clinic seems to want to cater to the upper class or people with disposible income so we are both leaning a little cynical. I've promised her not to make any decisions or start any treatments tomorrow. I'm not doing that without fully talking to either my personal Dr or an endo. I'm asking for those particular panels and I'm asking for a copy when I leave of all my results. It'll be fun (I think? lol0 to post them here and discuss, too. And that pellet shit? Not for me....if I actually need TRT I'll stick to old school, thanks. lol

[burlyman30]

The implanted pellets aren't required, of course. It's a convenience because its only 3 times a year. I do know he pays a lot for his ancillary drugs like hcg, and his AI. Through the nose. I get my stuff at a fraction of those prices. And of course injectable testosterone is significantly cheaper (I pay $10 for 10ml). It is readily available at any pharmacy and there is no surgical procedure necessary.

[BoneDaddy]

The implanted pellets aren't required, of course. It's a convenience because its only 3 times a year. I do know he pays a lot for his ancillary drugs like hcg, and his AI. Through the nose. I get my stuff at a fraction of those prices. And of course injectable testosterone is significantly cheaper (I pay $10 for 10ml). It is readily available at any pharmacy and there is no surgical procedure necessary.

Yeah, it's going to be interesting to see what insurance covers and what it doesn't......

[burlyman30]

Yeah, it's going to be interesting to see what insurance covers and what it doesn't......

In the case of my friend's clinic, they do not bill insurance, so it's all out of pocket for him. He has insurance, but I don't think he submits the clinic's charges to them for reimbursement.

May want to find out how much they are going to charge you for those tests before you go. I can guarantee it would be significantly cheaper to go through privatemdlabs.

[Scope75]

Private MD - Buy Lab Tests Online (http://www.privatemdlabs.com/)

Code for 15% off
ke8gbah

[burlyman30]

BD, don't keep us wondering... what happened??

[booklifter]

BD, don't keep us wondering... what happened??

They offered to inject him with a gram of test undecanoate, he couldn't resist, then he got home and told his wife. He was never heard from again.

[BoneDaddy]

In the case of my friend's clinic, they do not bill insurance, so it's all out of pocket for him. He has insurance, but I don't think he submits the clinic's charges to them for reimbursement.

May want to find out how much they are going to charge you for those tests before you go. I can guarantee it would be significantly cheaper to go through privatemdlabs.

We have a decent amount of money still in our FSA so i just paid the $300 that way. They gave me a coded receipt to turn into insurance for reimbursement. Even if they don't pay, we still came out ahead with the FSA card.

BD, don't keep us wondering... what happened??

Sorry, my appt ran late, then I got caught in traffic, then we interviewed a housekeeper and she was a chatty bitch.......


Private MD - Buy Lab Tests Online (http://www.privatemdlabs.com/)

Code for 15% off
ke8gbah

Thanks man, I considered that but I like the immediate gratification aspect and the face time with the Dr. The good thing about this place was he never ever once rushed or tried to stick with his 15 minute mandated time limit you see in a lot of practices. We talked for at least 45 minutes.


They offered to inject him with a gram of test undecanoate, he couldn't resist, then he got home and told his wife. He was never heard from again.

I wish I knew what to do with this....lol

So I was cynical going in, but this guy was fucking fantastic. He They tookl my blood, and ran the total and free T which took about 18 minutes and sent the others I listed earlier off to the lab. 'Norma'l range is 300 -1,000 ng/dL. Mine was well......300. He says while they run a squeaky clean practice, they do tend to push the envelope. He says the 300 doesn't accurately tell the whole story as my ADAM score says I need to be treated and we are going to do just that. SO, he gave me the options of the gels, the shots, or the implants. I'm choosing shots. 200mg/week of Test Cypionate. So I have a script for the Test Depot, 18g pins and 23g pins. Here comes the interesting part........I will also be taking HCG and an AI.....but both compounded together in a sublingual thingie. He assured me it was far better than pinning regular hcg and cheaper. So 1st shot or so they'll show me how to do it then I'll start on my own. Fucking 42 and on TRT........So yeah, there ya go!

Updated: Just checked my insurance coverage and Both the Test and the Axiron stuff won't cost me anything. I'm doing the smarter thing by going injections, yeah?

[Jelisej]

You're moving too fast...
After meeting did your doc rub his hands with glee?
You got your treatment sorted without finding cause, or finding if you're primary or secondary... Or if you're hypopituary... And what is state of your adrenal or thyroid etc...
Brilliant....


Another one bites the dust Queen - YouTube (http://www.youtube.com/watch?v=hMenB9Ywh2Q)

[BoneDaddy]

You're moving too fast...
After meeting did your doc rub his hands with glee?
You got your treatment sorted without finding cause, or finding if you're primary or secondary... Or if you're hypopituary... And what is state of your adrenal or thyroid etc...
Brilliant....


Another one bites the dust Queen - YouTube (http://www.youtube.com/watch?v=hMenB9Ywh2Q)

Not that brilliant....I haven't taken a shot nor filled the script. I'm awaiting the rest of the results. Don't be a dick.

[Jelisej]

Not that brilliant....I haven't taken a shot nor filled the script. I'm awaiting the rest of the results. Don't be a dick.

It's a dirty job, but someone has to do it.

[BoneDaddy]

It's a dirty job, but someone has to do it.

Try another thread then.

[Jelisej]

Try another thread then.

As you wish.

Good luck bro'.

[weekend]

BEEFIN

[Scope75]

Not that brilliant....I haven't taken a shot nor filled the script. I'm awaiting the rest of the results. Don't be a dick.

I think Jelisej can just see threw the smoke and knows your already going to be pinning because you've been posting about wanting to pin for a while and now you have a reason to without the wife getting mad or busting you.

Now I don't mind TRT or if you choose to start it either because your a grown ass man and if your able to get all your ducks in a row I'm all for it and happy for you. If anything stock up on some cheap test and do what you want with it. Lol

[BoneDaddy]

I think Jelisej can just see threw the smoke and knows your already going to be pinning because you've been posting about wanting to pin for a while and now you have a reason to without the wife getting mad or busting you.

Now I don't mind TRT or if you choose to start it either because your a grown ass man and if your able to get all your ducks in a row I'm all for it and happy for you. If anything stock up on some cheap test and do what you want with it. Lol

He can see through all the smoke he wants, but that doesn't mean he has to be an absolute douche about it. I'll readily agree the guy is a plethora of knowledge, but he always has to throw in a dig or a sarcastic ass comment, whether here or other threads, I can do without it personally. Who's smoke exactly? Mine or the Dr.'s? If mine, there are none to speak of. True, I have been talking about pinning for awhile now. However, I put that off so i could get my shit together and do right by myself by not pinning when i had other shit to take care of. So now it's actually part of getting my shit straight and not for recreational purposes pending the remaining test results. Trust me when i say i don't want to be on TRT. If it were simply an excuse to pin, I wouldn't have asked for input on the gel route.

[Grape Ape]

Sublingual HCG?...IDK.

[weekend]

^sublingual hcg will not work for reasons of basic biology and chemistry. It just won't work. It doesn't make any sense.

[burlyman30]

^sublingual hcg will not work for reasons of basic biology and chemistry. It just won't work. It doesn't make any sense.

I concur. The amino peptide strand is too large to be absorbed sublingually or transdermally, and would be totally destroyed once it hits stomach acid. It's similar to insulin in this way.

What happened in that office is exactly what I expected. They are there to sell TRT, and that is precisely what they did.

Now, I'm not saying you were not a candidate, because the numbers show that you are. I think J's frustration is not just with you, or the docs, but probably the entire medical establishment. They love to treat a symptom prior to discovering the actual problem. A TRT clinic is, by their very nature, in the business of getting guys on TRT.

200/WK is very high for actual TRT, BTW. Standard is more likely half of that amount, and would most likely put the majority of guys outside the upper range.

[weekend]

^200 a week puts my dad above 1500 heh. 150 was at 1350 ish

his doctor thinks it puts him at 550 lololol he didn't take a shot for 15 days before his doctor bloods.

[burlyman30]

^200 a week puts my dad above 1500 heh. 150 was at 1350 ish

his doctor thinks it puts him at 550 lololol he didn't take a shot for 15 days before his doctor bloods.

There can be risks associated with a chronic high testosterone level, which is what actually surprises me about the high starting dosage recommended by a clinic who should know better.

Has your dad ever had a RBC or hemoglobin or platelet test? Blood that is over oxygenated can cause problems and high platelet count can cause a stroke.

[weekend]

i'm getting him in there asap for another female hormone panel. he only was tested after recently starting trt, so things may no longer be in range.

[booklifter]

At the risk of piling on, I wanted to get a little more specific about the diagnostic significance. If they were really interested in treating your medical problem, before prescribing T, they would have (among other things) attempted to differentiate secondary from primary hypogonadism. If it was secondary, they might have tried a completely different, essentially opposite treatment. For example, an extended clomid 'restart' protocol, which instead of further suppressing your own endogenous T production would have supported it (and rendered their dubious formulation of hcg irrelevant). Speaking of that hcg+ai juice, why would they compound a sublingual AI when exemestane tablets are about as ubiquitous, cheap, and well-tested as aspirin, and the long drug half-life combined with irreversible aromatase binding makes time-based dose modulation easy? The only reason that comes to mind is secondary revenue from the in-house/affiliated compounding...
Getting back on topic, another example of 'opposite' therapy in response to true diagnosis would be if they found and addressed an adrenal or thyroid problem without even touching your sex hormones directly (either endogenous or exogenous).

Now, how you proceed simply depends on your goals, which I don't presume to know (beyond what you posted) or judge:
Option 1: If my goal were to find a reliable source for the purpose of hoard and cycle and get big like the creature from Alien, and I didn't care about underlying disorders, I would jump for joy, probably make out with the doc a little, then race to the pharmacy before they closed. That's a great prescription to blast and, well, blast some more. HOWEVER, the only reason it would be safe...-ish in this context is because I'd be on it maybe 120 days out of the year.
Option 2: If my goal were to solve my existing health problem, I would be very skeptical about the whole operation for two reasons:
2a: Even if you don't inject until the rest of that blood-work comes back, the fact that they were so eager to prescribe it (and their in-house ancillaries) pre-diagnosis suggests they aren't going to be too serious about analyzing the results and evaluating alternative scenarios and so forth. In which case you might as well have gotten a lab referral from privatemdlabs and taken the results to your PCP (or friendly neighborhood forum)
2b: TRT means being on this dose 365 days a year. Even if there are no surprises from the detailed blood-work or other follow-ups, staying that highly dosed on a long-term/terminal basis is clearly trading long-term quantity and overall quality of life for a short-term specific quality of life (getting jacked). I don't doubt that on 200/wk I'd feel great right up until my heart attack. Okay, granted, I might also develop trouble urinating, acne, insomnia, etc., but I'd feel great anyway. Right up until the heart attack. If the goal is just sustained normal to high-end levels, half that dose would probably suffice, and not distort your body's other dependent variables so badly.

Being a bit of an option 1 guy myself, like I said, I won't presume to judge you either way, but I think it's important that whatever our motivations, we move forward with eyes wide open and an honest assessment of the goal, the reasons for the goal, and whether the current path leads to the goal.

[Cobalt]

You guys are just mad because BD is getting free test :cool:

[burlyman30]

You guys are just mad because BD is getting free test :cool:

Lol

[Haritec]

I know the pain / frustration of finding out your test is at the bottom end of the range - and you want a solution right away. Struggled with it for two years trying dietary and supplements

I didn't want to go with exogenous testosterone and be shut down for good - so went the clomid route. 25 mg daily for a while and it got my total testosterone up towards the high end of the range. Have reduced to 25 mg 3x weekly and that seems to keep me at about 80% of the range. I have added daily tadalafil 5mg as this is supposed to help test production as well, plus be cardioprotective and reduce lower urinary tract symptoms. going to stay on this program for a while - and then may go to the tadalafil only as it is known to both increase testosterone and improve T/E ratio.

If the clomid works for you - it will raise LH and increase testosterone. That tells you the boys are still working - they just need a whip to get them working hard.

Just an FYI as a possible option to TRT.

[weekend]

^have you tried this pman?

Definitely an option.

[xxiv]

You guys are just mad because BD is getting free test :cool:

I would rather see BD not need the test and be able to live a happy, swole life without the need for exogenous test. In the meantime he should fill the script and let me hold onto any goodies he gets for safe keeping.......

seriously, BD, i wish you the best of luck no matter what you do and just want you make the best choice for you. You seem like a really nice guy.

[burlyman30]

I've been meaning to follow up on this thread....

BD, where'd you go, bud? You took all 10ccs at once, didn't you?!?! Get back here, bro.