I see the Urologist tomorrow and this will be the first Doctor that I see that trats people with TRT. What should i exspect from him and what should I look out for.
Thank You
Well, he’s a urologist, so you’re going to get your boys examined. 
He’s going to ask about your symptoms and any prior blood tests. It behooves you to take those tests with you if your prior Dr’s have not already done so.
He will likely order another blood test to confirm the results of the other tests. Try to get him to establish your baseline Estradiol with that test. He may also order an MRI to ensure there are no abnormalities with your pituitary.
There are other threads here about what to ask, but I will try to list what I can remember:
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How many other patients does he have undergoing TRT?
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Does he prefer lab results or patient symptoms to gauge the effectiveness of treatment?
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Is he open to using aromatase inhibitors and HCG to keep the testicles functioning during TRT?
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What are his protocols for moving to new treatment if the initial treatment fails?
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Does he have any patients who are self-injecting intramuscular testosterone?
That’s all I can think of right now. Good luck at the appointment.
Ok here is the update
Went to see the Urologist today and he wouldn�??t even take the time to talk to me about the treatment he was going to give me. Hell I had to ask 2 times what he was giving me and how much. He gave me 200mg T-CYP and it s every 2 weeks.
I ask for 100mg a week and he said no that 200mg/2 weeks is the proven way. He also ask me if I was allergic to horse�??s right before he gave me the shot. I have no idea what that was about. He said I would feel great in 5 days. So I will continue to get the injections from him until I find a good Doctor. I am going to talk to my GP to see if she will consult Dr. Crisler.
I see a Endo 2/12/2008 so maybe he will help me better also. I need a doctor that will talk to me and not just get me in and out as fast as possible. He didn’t even talk about the blood work I had done. The only thing he did was feel my nuts and say i was secondary. I need more than testosterone injections what about the side effects the T-CYP will bring.
One more thing how long before I start to feel better?
You let a doctor who isn’t willing to talk to you about something as serious as hormone therapy treat you?
Are you crazy?
[quote]jakeman124 wrote:
I see a Endo 2/12/2008 so maybe he will help me better also. I need a doctor that will talk to me and not just get me in and out as fast as possible. He didn’t even talk about the blood work I had done. The only thing he did was feel my nuts and say i was secondary. I need more than testosterone injections what about the side effects the T-CYP will bring.[/quote]
You may want to ditch this idiot urologist and stick with the endocrinologist if the new doctor will at least discuss things with you. My endo doctor is much better about providing info to me and my other doctors. Maybe he is afraid that if he messes up, I will just tell my oncology and hematology doctors to do the blood tests and write the prescriptions. It helps for a doctor to know that they can be easily replaced with someone else if they act like a jerk.
[quote]jakeman124 wrote:
Ok here is the update
Went to see the Urologist today and he wouldn�??t even take the time to talk to me about the treatment he was going to give me. Hell I had to ask 2 times what he was giving me and how much. He gave me 200mg T-CYP and it s every 2 weeks.
I ask for 100mg a week and he said no that 200mg/2 weeks is the proven way. He also ask me if I was allergic to horse�??s right before he gave me the shot. I have no idea what that was about. He said I would feel great in 5 days. So I will continue to get the injections from him until I find a good Doctor. I am going to talk to my GP to see if she will consult Dr. Crisler.
I see a Endo 2/12/2008 so maybe he will help me better also. I need a doctor that will talk to me and not just get me in and out as fast as possible. He didn’t even talk about the blood work I had done. The only thing he did was feel my nuts and say i was secondary. I need more than testosterone injections what about the side effects the T-CYP will bring.
One more thing how long before I start to feel better?
[/quote]
Bummer.
Do you get to self-administer or do you have to go in for each injection?
The problem with 200mg every two weeks is you will feel a “high” (a good feeling) probably days 3-5, then as your body converts that Testosterone to Estrogen, you will feel crappy for the second week. The half-life of T-Cyp is 8 days, so 14 days is too long to wait. In 8 days, half of that T will be gone and you will feel the slump.
You would be better off 100mg every week, and an aromatase inhibitor. Unfortunately, you got an un-thorough urologist who is not prescribing a complete protocol.
You could print out Dr. Crisler’s TRT A Recipe for Success document and show it to him, or you could show it to her and ask her to consult with Dr. Crisler. I believe Dr. C. still does that as a courtesy.
Advocate for yourself bro. You’re part way there. I’d be pleasantly surprised if the endo you see would actually be an improvement over the urologist. If the urologist diagnosed you with secondary hypogonadism only because on palpating (feeling) your testes, and not from labs, he’s cutting corners.
Keep us updated.
[quote]bigdawg011 wrote:
jakeman124 wrote:
Ok here is the update
Went to see the Urologist today and he wouldn�??t even take the time to talk to me about the treatment he was going to give me. Hell I had to ask 2 times what he was giving me and how much. He gave me 200mg T-CYP and it s every 2 weeks.
I ask for 100mg a week and he said no that 200mg/2 weeks is the proven way. He also ask me if I was allergic to horse�??s right before he gave me the shot. I have no idea what that was about. He said I would feel great in 5 days. So I will continue to get the injections from him until I find a good Doctor. I am going to talk to my GP to see if she will consult Dr. Crisler.
I see a Endo 2/12/2008 so maybe he will help me better also. I need a doctor that will talk to me and not just get me in and out as fast as possible. He didn’t even talk about the blood work I had done. The only thing he did was feel my nuts and say i was secondary. I need more than testosterone injections what about the side effects the T-CYP will bring.
One more thing how long before I start to feel better?
Bummer.
Do you get to self-administer or do you have to go in for each injection?
The problem with 200mg every two weeks is you will feel a “high” (a good feeling) probably days 3-5, then as your body converts that Testosterone to Estrogen, you will feel crappy for the second week. The half-life of T-Cyp is 8 days, so 14 days is too long to wait. In 8 days, half of that T will be gone and you will feel the slump.
You would be better off 100mg every week, and an aromatase inhibitor. Unfortunately, you got an un-thorough urologist who is not prescribing a complete protocol.
You could print out Dr. Crisler’s TRT A Recipe for Success document and show it to him, or you could show it to her and ask her to consult with Dr. Crisler. I believe Dr. C. still does that as a courtesy.
Advocate for yourself bro. You’re part way there. I’d be pleasantly surprised if the endo you see would actually be an improvement over the urologist. If the urologist diagnosed you with secondary hypogonadism only because on palpating (feeling) your testes, and not from labs, he’s cutting corners.
Keep us updated.
[/quote]
Thanks
I think after a couple months I will get to do self injections.
Yea I know thats why I ask for 100mg a week. I also believe that after a month I will get that also.
The Urologist will not consult with the good Dr. but I believe my GP would. Got to feel things out next appointment. And I think Dr. Crisler charges 300.00 for a consult, which is in my price range.
The Urologist is the only 1 around where I live that does TRT besides the GP’s. I think I can get him to come around to my way of thinking it’s just going to take some time. And if he doesn’t then I still got started and hopefully in a couple more days I will have at least 5 days feeling better.
I do have a question. I have AndroGel would taking that when the half-life of T-Cyp is gone help until the next injection. If so, how would 1 go about taking it.
The injections are going to shut down your natural production of testosterone, so you become totally dependent on them for all of your testosterone. Most guys find that on the two week cycle, they crash before the end of the second week and the yo-yo effect is a real bitch, especially if it is combined with elevated E2 levels because the “proven way” is to not think about E2 or administer an AI.
By the way, he’s simply spouting drug company advertising when he says you only need injections every two weeks. He may very well have patients that are getting the two week cycle and telling him that they feel lousy after a week, but he seems to be fine with ignoring what patients say. The again, some guys figure that feeling good half the time is better than feeling bad all the time and they don’t say anything and/or simply accept what is being shoved down their throat. If TRT is done correctly, you should be feeling good all the time. Who knows, you may get lucky and feel good all the time on the two week cycle.
Androgel is a topical that you apply to your skin every day. In your case, you’d probably want to use it during the second week to offset the falling test from the injection.
[quote]happydog48 wrote:
The injections are going to shut down your natural production of testosterone, so you become totally dependent on them for all of your testosterone. Most guys find that on the two week cycle, they crash before the end of the second week and the yo-yo effect is a real bitch, especially if it is combined with elevated E2 levels because the “proven way” is to not think about E2 or administer an AI.
By the way, he’s simply spouting drug company advertising when he says you only need injections every two weeks. He may very well have patients that are getting the two week cycle and telling him that they feel lousy after a week, but he seems to be fine with ignoring what patients say. The again, some guys figure that feeling good half the time is better than feeling bad all the time and they don’t say anything and/or simply accept what is being shoved down their throat. If TRT is done correctly, you should be feeling good all the time. Who knows, you may get lucky and feel good all the time on the two week cycle.
Androgel is a topical that you apply to your skin every day. In your case, you’d probably want to use it during the second week to offset the falling test from the injection.[/quote]
Thanks Happydog48
You are absolutly correct.
I am going to try and work with this guy for maybe a couple months and if it doesn’t get better I am going to go to Dr. Crisler. I have 3 more refills on my AndroGel and will use it the second week. I am pretty sure my GP will consult with him, but she is getting pretty old.
So I think I should just take the 6 hour drive and see him in person. I belive it is very important also to do this correctly. After all its my body, mind, and soul that is being effected. I never liked Doctors to begin with. They liie to play God and are never wrong.
I started down this road myself. I came up against the “I know what I’m doing and you don’t know shit” attitude from the doctor. Well I took a long hard look at the situation and just decided to do it on my own. Yes I am aware that I could get in trouble. But the reality is if I left my health up to the self absorbed MDs I would be in trouble also. SO I picked my poison and did my own trt therapy. It turned out to be a lot cheaper also. I use directlabs for all my blood work and have had no problems at all. My wife sees first hand what I have done and wants me to write a book about it to help others do the same.
I did about a year and a half of watching different sites to see if they were legit. I then placed a small order and it came through. I then placed a very large order so I wouldn’t have to do it again for some time. Now I’m set and am on my own routine. And I feel great.
[quote]ArkRoyal wrote:
I started down this road myself. I came up against the “I know what I’m doing and you don’t know shit” attitude from the doctor. Well I took a long hard look at the situation and just decided to do it on my own. Yes I am aware that I could get in trouble. But the reality is if I left my health up to the self absorbed MDs I would be in trouble also. SO I picked my poison and did my own trt therapy. It turned out to be a lot cheaper also. I use directlabs for all my blood work and have had no problems at all. My wife sees first hand what I have done and wants me to write a book about it to help others do the same.
I did about a year and a half of watching different sites to see if they were legit. I then placed a small order and it came through. I then placed a very large order so I wouldn’t have to do it again for some time. Now I’m set and am on my own routine. And I feel great.[/quote]
It’s a shame people have to treat themselves because of MD’s not knowing or knowing and not treating properly. Of coarse our Gov. has a lot to do with this also. It goes on these Cursades and scares the hell out of everybody. Trust me it’s all for the love of money.
My hats off to you ArkRoyal a mans got to do what a mans got to do. I would do the same thing but I am still hopeful yet I can get treatment. I will have to do most of the work but in the end maybe and I mean maybe I’ll be set for life. But I do know 1 thing if any part of this treatment is not being done I will go the same route as you. I will not suffer because some @$$%*!#$ want to play GOD.
This scenario seems to just keep repeating itself over and over everywhere in this country. When I first got started on this TRT “crazy train” I thought the exact situation as stated above that I had with my former doctor was just an isolated incident. I soon realized that this is going on everywhere it seems. My doctor just tossed me the Testim prescription and called it good. He would answer very few questions and most of the time walked out of the room when I was right in the middle of asking something.
I brought him copy of medical studies that had been done along with my own new gained knowledge from what I had learned here and other places. The more I learned the more he became threatened. When I would ask him about further blood testing to check estradiol he would simply look at me and say, “Don’t worry about” and walk out of the room.
He didn’t think having an estradiol level of 53 was a big deal and when I brought up the idea of starting me on HCG for my shrinking testicles he gave me a referral to a urologist to have my testicles removed! Of course, I didn’t do it.
Even though I have excellent insurance that would pay for any blood work that I need, I have had to pay out of pocket for my own and have had to treat myself buying my own meds and conducting never ending experiments on myself to get the most out of the meds that I can.
I finally ditched my former doctor and I should have done it long ago and I recommend that others do the same thing. Just like the OP, I thought I could bring my former doctor around and teach him something. After over a year it was a waste of time. Time is of the essence when you are faced with serious hormone deficiencies. Just ditch the doctor and go somewhere else. I found an LEF doctor here where I live and will see him next week. I’m keeping my fingers crossed. These LEF doctors are supposed to have their heads out of their butts when it comes to TRT - I hope.
Ok went to a different doctor today. He seems to be a good 1. He talked to me for a while and explain alot to me. He put me on 200mg T-CYP per week and said I can go 2 times a week at 100mg if need be. But to stay at 2oomg a week for 1 month. He sent me home with T-CYP and a 20 X 1 1/2 gauge needle and a 22 1/12 gauge needle. I drawn the T-CYP with the 20 gauge and changed needles to the 22 gauge.
Had the woman do the injecting. Had a little bit of blood after the injection maybe 1 drop. Had a little pain but not that bad. I told her to bury the needle all the way to the end. Is this the correct way to do this? She looked where the Urologist stuck me and put it in the same location other side. The needle looked pretty darn long to me.
Second he told me I had diabetes and put me on Metformin 500mg daily. He has me checking my sugar with a meter 2 times a day and I have to keep a log and we will go over it when I see him in a month. He ordered some test also
IGF-1
Estradiol
Testosterone Total
Testosterone Free
Thyroxine Free
said he will put me on a Estrogen drug when he sees me next appointment. Said he wants to get some base lines. He was also concerned with my Growth hormone. Wanted me to research it and we will talk about it when I go back.
He also said he will put me on HCG when he gets my Test levels leveled out.
Any thoughts and advice is needed
Thanks
Here are my tests results he was looking at
Total Testoserone 209 L REF (241-827) ng/dl
Free Testosterone 10.6 REF (6.8-21.5) pg/ml
DHEA 1679 g REF 107-745 ng/ml
SHGB 10 REF 13-71 nmol/l
Estradiol 14.8(a) REF (10.0-50.0) pm/ml
HB AIC 6.7 H REF (4.8-6.0) %
LH 3.3 (b)
TSH 0.96 REF (0.35-5.50)
PSA 0.5 REF (0.0-4.0) ng/ml