The reference ranges were not supposed to be the ultimate deciding factor is getting treatment, it is a guide, nothing more and it seems the reference ranges are replacing good old fashion critical thinking and analytical thought processes.
Your previous doctor lacked knowledge and is why he fixates on lab ranges.
That is if you are on insurance. Go private otherwise or tell him to give you self pay rate and screw insurance.
More so that he was taught in medical school and during residency to use lab ranges, because the business doesnāt make money if they cannot get insurance to pay. Beyond this it pains me to think they are so close minded they forget exactly what you just stated. Its truly sad how screwed folks are with health insurance.
Healthcare died in the 70ās when Medicare rolled out, back then it was about treating the symptoms and doctors were compassionate and now they are more robotic and if the doctor thinks insurance wonāt pay for TRT, he turns around and say your levels are normal or your levels are low, but not that low.
State healthcare in Canada or the UK is even worse.
Thanks studhammer. Having read other threads i think ive learned that self injection more frequently is the best route to go. I have a suspicion that IF im treated the Dr will try and go the gel/cream route ( i have a coworker who was given this first before the biweekly injections you mentioned) and even then they are not self administered.
Any advice on how to gently persuade a physician to initiate the treatment(s) you and others suggest without making it sound like im seeking trt for the wrong reasons. during the first visit he had specifically asked if i had taken anything in the past during my sports career that may have damaged my levels, which is a no. i was lucky enough to be big and strong up until @ 4 years ago when things went downhill in a hurry. Im to the point where ive felt like crap long enough and dont want to feel just āOKā but in that optimal level you mention to make up for the last 4 years of crap.
Others will have to chime in. About 5 years ago, I had had it with my Dr and I took matters into my own hands and began my own treatment and now I cruise and blast.
ok thanks. Ive browsed some threads over on the pharma forum that youve been active in. not to put the cart before the horse but may have to do research over there depending on how this all works out. like i said, after the last 4 years i dont really care to feel just āOKāā¦
You need to vet your doctor and test his knowledge, like what ranges does he target for therapy, does he target symptoms and is FT an important factor is deciding protocol success. If your doctor says you levels are not that bad and/or are within range, well this is a bad sign the doctor is clueless and you may have to fight with him during the course of your treatment.
TRT/steroids isnāt a popular subject in modern medicine, there is a lot of conflicting information about the risks, in reality all the high quality studies show it to be safe. You just have to weed through all the junk studies.
Thanks.
I have more trust in this current dr. as he actually ordered free T and Bio T to be checked instead of just relying on my total T the other 2 doctors had. He also ordered prostate levels (PSA)? which i may be reading into to much but why would he be concerned of those if TRT wasnāt a possibility if blood work revealed a deficiency. PSA levels came back fine.
Now that its confirmed i have clinically low ( free T ) i plan on gently insisting that both symptoms and bloods be optimal through treatment, not normal. Again hopefully optimistic.
This is not common and is a good sign, mostly the bio and FT is ignored especially in Canada.
Some habits die hard, we latch on to the only thing we know until something better comes along.
There are men on TRT with prostate cancer over the last 20 years and have shown no progression of the disease for those that already had it or new diagnosis of prostate cancer in those on TRT.
Probably just covering his you know whatā¦ heād be in a world of hurt if he prescribed T and you had high PSA and/or prostate cancer and he didnāt even bother doing a simple test to check first
We know one doesnāt cause the other, but that doesnāt mean you couldnāt sue him and find an expert to say he was at fault for not doing a basic test before starting you on T
For my American friends on here, heās in Canada. In Ontario, so heās on OHIP. There is no āself-payā option at a doctorās office and you cannot particularly sue him. You can sue for some forms of malpractice, but the payouts are limited by law and minor. The doctor is likely to offer what the guidelines say, because that is what doctors do. He is near a world class medical research university though, McMaster. There are informed and progressive doctors in Ontario, but donāt give advice based on the American medical system, itās extremely different to deal with OHIP, but that system is in my experience infinitely superior to the normal experience in the US. It bears no resemblance to Medicaire or Medicaid, and I would take it over the US system, based on my personal experience with both.
thanks for the insight hardarteryā¦ not alot of information about ohip and trtā¦ definatley one of the questions I have for my follow-up appt. as to what is covered if diagnosis is backed by lab results. assuming work benefits will cover cost of whatever is prescribed as wellā¦
Endocrinologist office just called. Said Dr looked at blood work this morning and would like to see me this afternoon. Hopefully things start moving forward. Cant imagine the doctor would squeeze me in so quickly if he was just going to say everything look fine.
Prescribed 2, 5 gram packets of ANDROGEL a day. Blood work redo in 2 months to see how it is working. Asked about estrogen levels, he wasnāt concerned about them at this time. Endocrinologist seemed sincere when saying that this is the start of a long road to get things correct and get me feeling to where i want to be. Iāve read a lot of posts about people not liking androgel and eventually being place on injections. wondering if androgel does work for some and serve a purpose, or if Im just enduring option āAā before moving onto option āBā?
You endocrinologist is not choosing the more effective option, injectable testosterone is more effective in every regard. It would seem the some endocrinologist are just not educated when it comes to TRT and your endo seems to be of the typical that is clueless and is common.
The injectable testosterone requires more skill to manage and most doctors donāt know how to administer injectable TRT and choose the easy way out by using androgel, also you will not find many forum members on any of the TRT boards on androgel, this should give you pause.
This happened to me and if I had known then what I know now, I would have dropped my endo like a bad habit, you are wasting time on androgel, it just doesnāt have enough percentage of testosterone to show optimal results.
The T-cream being used by the anti-aging clinics is 20%/200mg strength, androgel if Iām not mistaken is 1.62 percent. You will only absorb a fraction of it. Your doctor has planned a long and painful road ahead for you, you need to seek a doctor that specializes in TRT because you are on the wrong path.
None of the experienced TRT doctors would bother with androgel, more often than not itās ineffective and a waste of time because eventually most men end up on injectable T-cypionate.
Yes, andro gel is about 2% strength, it just isnāt enough for most people to get their levels where they need to be to feel normal.
There are compounded creams now that are 20%, and they can be applied more places (i.e. scrotum) for better absorption on top of that. They will def. get levels as high as they ever need to be but most docs donāt know about them. For most the options they would consider are gel, injections or pellets.
Iām sure heās just going with the easiest thing firstā¦ if that doesnāt work then heāll go to the next thing. There ARE people that are happy with andro gel, there just arenāt a lot of themā¦
I appreciate and understand what you are saying. A co worker had to use ANDROGEL prior to being moved onto injections. Im assuming (and hoping) it is just a step in the process that he has to go through. At my 2 month checkup i will be more inclined to suggest better methods of treatment than i was yesterday. And will by then have some experience on how the androgel is working. He is a new doctor and i have only seen him twiceā¦ still in the process of feeling one another out before we get more comfortable with each other.
T concentrations will reach peak levels within hours after administration of androgel, therefore you will know fairly early on if androgen is going to work. More often androgel will shut down your natural production and leave you with lower levels than pre-TRT.
Endocrinologists typically specialize in thyroid and diabetes and not TRT, so a new doctor may not be any different than the last. I went through three endos are all were equally clueless, I realized I would have to seek a private doctor that actually specializes in this area of medicine.
I will say it was a good feeling of validation when he prescribed something for my low testosterone where as other doctors had simply dismissed the symptoms and only looked at my total T levels saying they were normal. Validation and some bitterness over the past 3 years of feeling like crap being told everything was fineā¦