30 YO on TRT, Doctor is Clueless

Pharma TRT
1

Okay, I am 30 years old, turning 31 next week. I have been on TRT since July. I originally had a testosterone level of 212 before treatment. I did all of the research prior to starting TRT, as I knew it was a lifelong commitment. The problem I’m running into, is my doctor has no idea what he is doing. I’m from a town with a population of about 25k, and he is the only dr in the area that does TRT.

He told me upfront that he has never treated anyone near my age. He never requested bloodwork for anything but test and free test. When I asked about monitoring Estradiol, he said not to worry about it. When I said I was worried about keeping sperm production, he said TRT won’t affect that. I did convince him to order a test for sperm count though.

My big issue now, I am gaining weight (20 lbs since starting TRT four months ago), and I still don’t feel great. I do feel better, just not like I thought. I don’t nearly fall asleep at my desk anymore, at least. Sex drive came back after a month or so, but is dwindling again.

Also, my testes are shriveled, and almost seem to be drawing up inside the scrotum. I went and had an independent lab check my Estradiol. Results came back above the normal range. I informed my dr of this, and his response, through his nurse on the phone, was “we don’t treat that”. I asked about an aromatase inhibitor, and was told I didn’t need one, and that they don’t prescribe it anyways.

My dr is just a urologist, as there are no endocrinologists within an almost four hour drive. What do I do? I am strongly considering treating myself, but don’t know where to start, doses, etc. My doctor started me on 100 mg every two weeks of test cyp, but I convinced him to do half that dose every week, to avoid drop offs. After 8 weeks, I had bloodwork done, and my test was in the mid 600’s.

I still didn’t feel a change at this point, and my dr didn’t think anything of it. He said the numbers were good, so that was that. Since the office made a mistake on my script, labeling it 100mg every week instead of half that, I decided to take that much every week. Since then, I have felt better. Still not great, but better than before. Like I mentioned above, sex drive returned briefly, but has fallen off again.

Working out at the gym is harder again. I am sore more often, and can’t do as much, just like before I started TRT. I had my test numbers done when I had the Estradiol tested. Test came back slightly above 1000. I know that if I go back to the dr he will cut back my dosage if he sees numbers that high, but it’s the only way I feel good.

What can I do? I know this dr is a quack, but don’t have any real options. Any help is GREATLY appreciated. Again, I am ONLY taking test cyp, 100 mg per week, one injection on Tuesdays. No other meds, such as HCG or aromatase inhibitor. Thanks in advance everyone.

Wanted to put my most recent labs up. I ordered these myself, as my doctor wouldn’t order Estradiol.

Estradiol, Normal range 11-44. Result = 47
Total Testosterone, Normal range 240-950. Result = 1030
Free Testosterone, Normal range 9-30. Result = 50

2

Your doc is horrible.

Read the stickies then you have these options:

Travel to another doctor and get a script for Adex for E2 and HCG to recover your balls. This may even require a trip out of state and cost money but hey, what is your health and quality of life worth to you?

Or

Source your own adex and hcg from the web. Also syringes for 2x/week T dosing. This would be easier.

Goodluck.

3

If you split your dose to 50mg 2 times a week…every 3.5 days, you won’t need an AI.

HCG can be bought easy enough online without a script.

4

I’d strongly suggest finding another doctor no matter how far away he/she is. Many doctors and clinics will work with you via email/phone consults after you have your initial appointment and bloodwork.

5

methos,

Why does splitting the dose up prevent the need for an ai? I hadn’t read this before. I knew that it can make injections less painful, and also help avoid test drops from it wearing off. That’s why I wanted to do once a week, opposed to bi-weekly.

6

[quote]arrowheadcase wrote:
methos,

Why does splitting the dose up prevent the need for an ai? I hadn’t read this before. I knew that it can make injections less painful, and also help avoid test drops from it wearing off. That’s why I wanted to do once a week, opposed to bi-weekly.[/quote]

Injecting more often avoids the T spikes that increase E2 levels VS weekly injections. But you would still need to use anastrozole.

Start by reading these stickies:

  • advice for new guys
  • protocol for injections
  • finding a TRT doc
7

Thanks KSman. I’ve read many of your posts, and they are VERY informative. You definitely seem to know more about TRT than my doctor. Are you located in Kansas, as your name may imply? I only ask since that is where I live, and am unable to find a physician who knows what he is talking about. Thought maybe you’d have a suggestion or two.

8

What Ksman said is true, except that you will need an AI with 2 50mg shots a week.

You simply won’t accumulate that much estradiol with that dosage. I take more than that and don’t need an AI. I take two 64mg shots a week.

9

methos0123 - Everyone’s different regarding the need for AI. Most guys that are doing 100mg (50mg 2x per week) of test cypionate a week will need some. It’s great that you didn’t need it, but I certainly did. Not a lot, but I would’ve been in trouble without it.

10

well Friedman, I suppose we will have to agree to disagree. 100mg/week in 2 divided doses is a low dose. Most people will do better without AI at that dose.

At least start without it, and take labs 4 to 6 weeks later to confirm before you start it. That would be my advice.

11

Doc’s hate this approach, but depending on the guy, he might go for it.

Walk in and tell him he’s a fuck-up. Say, “Doc, by your own admission, you haven’t dealt with a case like mine and I’m not happy with the results your methods have produced. This is the protocol I’m going to do . You can be a part of it and learn from my experiences or you can wash your hands of me and I’ll leave right now. Make no mistake, though, this is what I’m going to do and that is non-negotiable. Are you on board?”

He’ll be taken-aback, but if the guy has even a luke-warm IQ he’ll be interested a patient that is actually engaged when it comes to their health.

If he tells you to walk, the do so, you don’t want to be treated by the guy in the first place.

If he tells you he’ll do it, then congrats.

Regardless, this unwarranted doctor worship has got to come to an end at some point. It’s ridiculous. They simply do not have all the answers and we treat them as if their poo comes out shrink-wrapped. They’re just a guy that has a little bit of knowledge about the human body, and that little bit of knowledge is anything but complete. The sad thing is that a lot of time you can go down to Planet Muscle and talk to a ‘bro-science’ guy doing curls in the squat rack that gives you better ‘real-world’ information.

12

Fat Boy, I have done just that. His response was, “I don’t treat that”. When I asked why not, he said, “We just don’t do it here”. I asked why no other TRT patient of his had my concerns with AI, and he said it hadn’t ever come up. I asked how many patients he had my age, and he said they had lots of younger patients.

When I asked if any of those younger patients were on TRT, he said, “well no”. So why the f#ck are you treating me, a 30 year old man, the same way you treat a 60 year old man? “Well, there’s no reason to do anything differently”.

That was all I needed to hear. He wasn’t going to change his mind, and I wasn’t going to continue being the patient of someone who CLEARLY had less grasp of the subject matter than I did. The funny thing is, I went there on a referral from my family Dr. I had my labs ordered by the family Dr, and when the results were in went to my first appt with this guy.

He walked in the door, said “okay, we’re going to start you on this”. So I had NO problem getting put on test, which is the opposite problem of most guys. However, the prescribing doc put me only on test and has no idea what he is doing. I should note that he is a urologist, and the only doctor in my town that does TRT. I feel bad for his other patients that don’t any better.

13

Okay, so I have gotten a referral to a different doctor (an endo this time) 3+ hours away in Kansas City. However, the soonest appointment they have is in January. I can’t do this for another three months. Does anyone have any suggestions on sourcing HCG and Arimidex online? I have looked for hcg previously, but so much of it seemed like crap weight loss scams that weren’t even hcg. I need to do something immediately. Any help/suggestions are appreciated.

14

Update 11/25/14

Drove the 3 1/2 hours to Kansas City yesterday. The Dr wanted to know why I had been started on TRT. He said that 212 was not a low number for T. Keep in mind I’m 31. He also said that he would never have put me on T, as low T symptoms and a number of 212 is not sufficient enough evidence for it as a treatment. I explained to him that for the past three weeks I had been sourcing my own AI and HCG. He was pissed about this. He said there is no evidence that HCG would help maintain sperm production while on test, and that I am most likely sterile already after only 5 months of TRT. Also, he thought an AI was a waste, as supposedly there is no direct correlation between T and Estrogen. He wants me to stop the T cold turkey and let my levels bottom out, then he’ll put me on Clomid.

I drove 7 hours out of my day to see this quack. KSman, or anyone else, do you have suggestions for Dr’s in Kansas? I don’t know what else to do, as I don’t really want to keep buying the HCG and AI from India. Also, my wife is an RN and absolutely threw a shit fit when she found out I was doing it without a Dr script. Thanks guys!