Sorry guy,LOL.
I just got an email from www.allthingsmale.com
For whatever reason, his site has been down. It’s still not up, but it should be soon. I still recommend very much that when his site gets back up, you give Dr. Crisler a call.
It’s kind of sad that you had to “sell your GP” on the tests you wanted to have done. Doesn’t sound like an expert to me.
Steve.
[quote]comguy1 wrote:
Sorry guy,LOL.
I just got an email from www.allthingsmale.com
For whatever reason, his site has been down. It’s still not up, but it should be soon. I still recommend very much that when his site gets back up, you give Dr. Crisler a call.
It’s kind of sad that you had to “sell your GP” on the tests you wanted to have done. Doesn’t sound like an expert to me.
Steve.[/quote]
Thanks for the info regarding Dr. Crisler but I won’t be able to use him as a physician due to me living in another country. Sadly I don’t have unlimited funds to throw at this thing. 
I don’t think one should expect their physician to be an “expert” in HRT. I guess that’s what specialists are for like endos or specifically life-extensionist doctors. I wasn’t expecting it to be a cakewalk, but he is relatively open minded which is nice. If my free T scores below “normal” I’m betting that he would proceed with therapy. Getting him to prescribe an anti-estrogen may be more difficult since he wasn’t willing to get my estradiol levels checked.
The All Things Male site seems to be back up now (Thurs, 4/27) for anybody who is interested.
Estradiol not important!!! Sorry, but your doctor is a jackass. One of the things that will suppress your testosterone levels is elevated estrogen. When estrogen gets too high it suppresses your testosterone levels, and belive me you’ll fell like absolute poop when it happens. Low energy, loss of mental focus, sore joints, lack of libido, in some cases breast soreness and general feelings of depression.
I find it funny your doctor won’t test to see if your estrogen is high, but will put you on anti-depressants, which, by the way, will also suppress your testosteron levels.
A lot of doctors aren’t knowledgeable about hormones and wil diagnose symptoms of hormone imbalance as depression.
Just so you have a reference, these are the tests he should be conducting.
Testosterone (free and bound) Total
Estradiol
Complete thyroid panel
FSH
LH
DHEA
PSA
[quote]tommyboy wrote:
Estradiol not important!!! Sorry, but your doctor is a jackass. One of the things that will suppress your testosterone levels is elevated estrogen. When estrogen gets too high it suppresses your testosterone levels, and belive me you’ll fell like absolute poop when it happens. Low energy, loss of mental focus, sore joints, lack of libido, in some cases breast soreness and general feelings of depression.
I find it funny your doctor won’t test to see if your estrogen is high, but will put you on anti-depressants, which, by the way, will also suppress your testosteron levels.
A lot of doctors aren’t knowledgeable about hormones and wil diagnose symptoms of hormone imbalance as depression.
Just so you have a reference, these are the tests he should be conducting.
Testosterone (free and bound) Total
Estradiol
Complete thyroid panel
FSH
LH
DHEA
PSA [/quote]
I know, it’s frustrating as hell, especially after I told him I had problems with gyno as a teenager! I wouldn’t want to take any T without an anti-e. I doubt I could convince him to prescribe me Arimidex co-commitantly, since we don’t have any kind of baseline for estradiol.
The more I think about it the more I feel like I’m pissing in the wind here. I think I may just go to the blackmarket as I have some aquaintances I can trust for sources. I’m not interested in getting any bigger or leaner just improvement in energy, recovery, mood, joint pain, and brain fog. I like the fact I can titrate my dosage as well this way according to how I feel subjectively.
I’m a big believer in the therapeutic effect rather than any number. Some enlightened doctors are willing to do this in regards to thyroid function, but with HRT it seems very rare.
That’s what pisses me off so much about most doctors… they make great robots, but they can’t think independently. Isn’t it ridiculous that someone has to “train” their doctor for this kind of thing. After doing a few hours of research on the internet you can learn more about HRT than 95% of endocrinologists. If that doesn’t sound fucked up, I don’t know what does.
[quote]yorik wrote:
The All Things Male site seems to be back up now (Thurs, 4/27) for anybody who is interested.[/quote]
I was on the site yesterday. Interesting none the less. I read through his word.doc on typical protocols for HRT. He seems to like using Androgel first then try injections if it doesn’t work out. He said most people get a better response from the Androgel as well since it has more DHT production. Better for libido.
He said he doesn’t like to put people on too high a dose too quickly since they may get spoiled from the greater subjective effects, compared to when they have to go lower to put the serum values in a more favourable range. I’m not sure I agree with that too much. Obviously he’s worried about health problems associated with supraphysiological levels, but on the other hand he doesn’t want his patients feeling “too good”?
I guess he’s just being conservative. I’d rather have my doctor monitor my health markers(cholesterol, PSA, triglycerides, hemocrit, liver and kidney function, etc…) instead and go from there. There may be more risk that way. I’m sure they’re managing a balancing act of giving appropriate care and not getting sued. Makes sense I guess, but it’s not how I would want to be handled. It may be fine for others though.
If you seriously need HRT, do not go the black market route, because you never know what you are getting, and also you really should have a doctor adminster the therapy based on what your blood tests say. If your testosterone is low, the doctor is going to aim for a range consistent with a healthy 21 year old male, so that would be around 700-900 ng/dl. Some tests have differrent criteria, but this is a common range. The doctor is not going to give you enough test to put you in the supraphsyiological range, but enough to feel good and normal.
As for estrogen management, Arimidex would be optimal. A lot of doctors don’t like to prescribe it because technically it is a chemotherapy drug for women. If you can get it great. If not, there is an OTC product I use that I have had a lot of success that my doctor turned me on to. It’s called Myomin. The company that makes it (Chi’s Enterprise) formulated it to combat fibroid cysts in women which are estrogen dependent. The product basically acts as an aromitase inhibitor. It has worked well for me and I get 100mg of test cypionate a week and haven’t had any estrogen issues.
Oh, and as a side note, concerning your acne problem. Stay away from Accutane.
It can cause depression and also alter insulin resistance. Try getting a prescription for Triaz 3% Benzoyl Peroxide wash, then follow up with Erycet which is an Erythromycin (antibiotic) pad you wipe on your face. Then apply a product called Avar Gel to the infected area. Just be aware that Avar is a sulfacetamide gel and tends to smell like sulphur. If you put mositurizer over it it can almost smell slightly like rotten eggs, so only use it before bed.
These are all prescription products, but they work great together.
OK.
I am actually being serious here for a moment.
First off, great thread.
OK. I have felt like shit for about 2-3 months now. I am feeling like I may be in need of HRT, but that may be a bit premature. I know that I have been psychologically out of kilter since this started but not before.
My problems have basically showed up big time and right now. I am wondering how much the psychological influences the physiological. What have any of you guys made of that relationship?
I have contacted a couple of local endos and am dealing with this whole fucked up system just now. They want me to have a referral. I don’t even have a good GP. Anyway …
some things that have happened in recent times (last 2-3 months):
as a result, i:
So what I am getting at … if HRT is like a diamond (forever), did you guys rule out psychological factors first? I hate to go down this path and put a permanent fix on something that will repair itself.
Of course, I will follow reasonable medical protocols.
Another thing to note … similar thing happened to me about 15 months ago. I attributed it to ephedrine use and pyschological factors.
Hmmmm … thanks in advance for any feedback,
JOG
sounds to me like you have depression.
[quote]JOG wrote:
OK.
I am actually being serious here for a moment.
First off, great thread.
OK. I have felt like shit for about 2-3 months now. I am feeling like I may be in need of HRT, but that may be a bit premature. I know that I have been psychologically out of kilter since this started but not before.
My problems have basically showed up big time and right now. I am wondering how much the psychological influences the physiological. What have any of you guys made of that relationship?
I have contacted a couple of local endos and am dealing with this whole fucked up system just now. They want me to have a referral. I don’t even have a good GP. Anyway …
some things that have happened in recent times (last 2-3 months):
as a result, i:
So what I am getting at … if HRT is like a diamond (forever), did you guys rule out psychological factors first? I hate to go down this path and put a permanent fix on something that will repair itself.
Of course, I will follow reasonable medical protocols.
Another thing to note … similar thing happened to me about 15 months ago. I attributed it to ephedrine use and pyschological factors.
Hmmmm … thanks in advance for any feedback,
JOG[/quote]
If it’s only been the last few months I wouldn’t think that HRT would be in order. Sounds more like depression attributed to psychological factors not biology, although the two are intimately linked. Psychological factors can greatly affect the biological. Stress can lower testosterone, increase cortisol, raise or lower catecholamines, and vice versa. Eustress(good stress) can have the opposite effect. Achieving a goal, being in love, thinking positively, participating in leisure activities, etc… can greatly turn around your biological markers influencing mood.
Ephedrine can whip your adrenals to a pulp with extended use. After cessation most people feel like ass… it’s normal.
You may be better off seeing a psychologist to get over this little hump. Of course I could be wrong. Men in hypogonadal states have a limited ability to deal with stress. HRT is usually for life though, and since this is not a longstanding issue I wouldn’t think you’d want to take that drastic a measure.
Good luck.
[quote]tommyboy wrote:
If you seriously need HRT, do not go the black market route, because you never know what you are getting, and also you really should have a doctor adminster the therapy based on what your blood tests say. If your testosterone is low, the doctor is going to aim for a range consistent with a healthy 21 year old male, so that would be around 700-900 ng/dl. Some tests have differrent criteria, but this is a common range. The doctor is not going to give you enough test to put you in the supraphsyiological range, but enough to feel good and normal.
As for estrogen management, Arimidex would be optimal. A lot of doctors don’t like to prescribe it because technically it is a chemotherapy drug for women. If you can get it great. If not, there is an OTC product I use that I have had a lot of success that my doctor turned me on to. It’s called Myomin. The company that makes it (Chi’s Enterprise) formulated it to combat fibroid cysts in women which are estrogen dependent. The product basically acts as an aromitase inhibitor. It has worked well for me and I get 100mg of test cypionate a week and haven’t had any estrogen issues.
Oh, and as a side note, concerning your acne problem. Stay away from Accutane.
It can cause depression and also alter insulin resistance. Try getting a prescription for Triaz 3% Benzoyl Peroxide wash, then follow up with Erycet which is an Erythromycin (antibiotic) pad you wipe on your face. Then apply a product called Avar Gel to the infected area. Just be aware that Avar is a sulfacetamide gel and tends to smell like sulphur. If you put mositurizer over it it can almost smell slightly like rotten eggs, so only use it before bed.
These are all prescription products, but they work great together.
[/quote]
Tommyboy,
Have you ever had estrogen related problems in the past, or is the Myomin just a precaution? Just curious…
It’s true, with the blackmarket you can never be 100% sure what you’re getting, but you can say the same about doctor’s care. You can’t guarantee they know what they’re doing with respect to HRT. I’d rather have a great HRT protocol with suspect drugs, than pharmaceutical grade drugs with a doctor who’s clueless. You can’t make use of the drugs if the doctor isn’t willing to prescibe them. From what I’ve read not that many doctors are willing to get in to the high normal range.
A lot of what I’ve said earlier is based on frustration with doctors over the past few years. I don’t have much confidence in them anymore, but I believe there are some exceptional one’s. You just have to find them. What I’d like to do is try the black market first, see if I get any relief, then if I do, search for a qualified doctor that can manage my HRT from there on in if need be. For all I know, HRT may provide no relief at all. I’d like to know that as soon as possible though, rather than dick around for who knows how long trying to find the right doctor.
I looked up the Myomin product you suggested. It’s a combination of 5 different chinese herbs meant to block estrogen, for anyone else who didn’t know. Since I’ve had gyno in the past I’m not particularily eager to put my trust in an herbal product. It’s a little risky, and if I did start having gyno problems while on the Myomin I wouldn’t want to scramble around looking for Nolvadex and possible get moobs in the meantime. I know that sounds a little hypocritical, trusting the black market but not herbal products.
At least I know the drugs are researched to have efficacy where as the herbals are a total crapshoot. Supplements are unregulated as well, so it’s not like they’re any more “safe” than the black market.
Regarding my acne… it’s totally cleared up the last week since introducting vitamin B2 again, going from 10-20 new whiteheads a day to practically none. I haven’t experienced the usually lethargy and sedation as I have in the past which I’m attributing to the iron supplementation I’ve been on the last couple months. Vitamin B2 is a cofactor with iron in a number of processes. Taking B2 while being deficient in iron can cause a deficiency making one feel much worse. I’m suspecting that’s what may have happened.
Interestingly testosterone supplementation is supposed to help with a number of different anemias. Perhaps hypogonal states may result in iron and B2 deficiencies, or vice versa.
[quote]Tommyboy,
Have you ever had estrogen related problems in the past, or is the Myomin just a precaution? Just curious…
It’s true, with the blackmarket you can never be 100% sure what you’re getting, but you can say the same about doctor’s care. You can’t guarantee they know what they’re doing with respect to HRT. I’d rather have a great HRT protocol with suspect drugs, than pharmaceutical grade drugs with a doctor who’s clueless. You can’t make use of the drugs if the doctor isn’t willing to prescibe them. From what I’ve read not that many doctors are willing to get in to the high normal range.
A lot of what I’ve said earlier is based on frustration with doctors over the past few years. I don’t have much confidence in them anymore, but I believe there are some exceptional one’s. You just have to find them. What I’d like to do is try the black market first, see if I get any relief, then if I do, search for a qualified doctor that can manage my HRT from there on in if need be. For all I know, HRT may provide no relief at all. I’d like to know that as soon as possible though, rather than dick around for who knows how long trying to find the right doctor.
I looked up the Myomin product you suggested. It’s a combination of 5 different chinese herbs meant to block estrogen, for anyone else who didn’t know. Since I’ve had gyno in the past I’m not particularily eager to put my trust in an herbal product. It’s a little risky, and if I did start having gyno problems while on the Myomin I wouldn’t want to scramble around looking for Nolvadex and possible get moobs in the meantime. I know that sounds a little hypocritical, trusting the black market but not herbal products.
At least I know the drugs are researched to have efficacy where as the herbals are a total crapshoot. Supplements are unregulated as well, so it’s not like they’re any more “safe” than the black market.
Regarding my acne… it’s totally cleared up the last week since introducting vitamin B2 again, going from 10-20 new whiteheads a day to practically none. I haven’t experienced the usually lethargy and sedation as I have in the past which I’m attributing to the iron supplementation I’ve been on the last couple months. Vitamin B2 is a cofactor with iron in a number of processes. Taking B2 while being deficient in iron can cause a deficiency making one feel much worse. I’m suspecting that’s what may have happened.
Interestingly testosterone supplementation is supposed to help with a number of different anemias. Perhaps hypogonal states may result in iron and B2 deficiencies, or vice versa.[/quote]
I am taking Myomin because I am receiveing Testosterone injections. The Myomin keeps my estrogen levels from going up due to the test injections. I was also using Arimidex but ran out of it. The Myomin seems to be doing fine on it’s own.
I too am also very skeptical about herbal products, but this is one product that has worked exactly as it’s been described.
I understand your point about the black market, but say you bought a bottle of test cypionate off the street. There is no way of knowing if it is legit. So now you’d be injecting lord knows what into your body. Not to mention you wasted your money and are getting no benefit from the drug. If you can get the legit version of the drug off the street then that is great, provided you yourself know the proper way to adminster it for HRT.
I would seriously try looking for another doctor, a good endo or a doctor that is into anti-aging therapy. It’s true a lot of doctors don’t know squat about HRT, but fortunately a lot more of them are learning about it because it seems the incidence of low testosterone and high estrogen is becoming more common in guys as young as 27.
BUMP…
Great thread. Im in Michigan, and when I get my money together, Im going to that Doc for my total bloodwork. Im assuming everythings gonna be ok, Im 26, but ya never know, and its always good to be sure…
Dopamineloveaffair,
I have an appointment next week with a doctor I found through a link on www.allthingsmale.com. The link is www.worldhealth.net. He is actually a neurologist of all things, but he is part of the same organization as Dr. Crisler(A4M I think). He is in my provider directory as a doctor covered under my insurance, but I never would have thought to look under neurology.
Anyway maybe there is a doc near you that is associated with the same group.
Thankfully he does not require a referral from my primary care physician, which I found is the case with some specialists.
I had lab draws done about a month and a half ago as ordered by my regular doc. Long story short, I got a phone call two weeks later from the nurse saying everything was “normal”. When I asked if the doctor had looked at the lab reports himself or if someone else(ie. the lab company, her based on the ref. ranges, etc.) had made that determination she became very defensive. She cut me off and explained that the doctor had looked at them.
Everything went downhill from there. I was pissed to say the least, but I was determined not to give up. I requested a copy of the lab reports from the nurse to be mailed to me. When they arrived what I received amounted to a sheet of paper that said everything was again “normal”. No shit. That’s what she told me over the phone.
Eventually I did get a copy of the reports, but it was like pulling teeth.
Here are some of my levels for comparison:
Total T 517
Free T 80
Bioavailable T 167
SHGB 28
I have a hard time believing my total T is 517. It was around 520 when I was 19 and around 320 just a couple years ago at 28. And even though my free and bio T are technically within normal, they leave something to be desired.
I am experiencing many of the same symptoms you report and won’t stop searching for a doc that will help me out until I find one. I know it takes forever sometimes to get in to see a doctor and then you have to wonder if they’ll even help you, but don’t give up. Good luck.
[quote]tommyboy wrote:
Tommyboy,
Have you ever had estrogen related problems in the past, or is the Myomin just a precaution? Just curious…
It’s true, with the blackmarket you can never be 100% sure what you’re getting, but you can say the same about doctor’s care. You can’t guarantee they know what they’re doing with respect to HRT. I’d rather have a great HRT protocol with suspect drugs, than pharmaceutical grade drugs with a doctor who’s clueless. You can’t make use of the drugs if the doctor isn’t willing to prescibe them. From what I’ve read not that many doctors are willing to get in to the high normal range.
A lot of what I’ve said earlier is based on frustration with doctors over the past few years. I don’t have much confidence in them anymore, but I believe there are some exceptional one’s. You just have to find them. What I’d like to do is try the black market first, see if I get any relief, then if I do, search for a qualified doctor that can manage my HRT from there on in if need be. For all I know, HRT may provide no relief at all. I’d like to know that as soon as possible though, rather than dick around for who knows how long trying to find the right doctor.
I looked up the Myomin product you suggested. It’s a combination of 5 different chinese herbs meant to block estrogen, for anyone else who didn’t know. Since I’ve had gyno in the past I’m not particularily eager to put my trust in an herbal product. It’s a little risky, and if I did start having gyno problems while on the Myomin I wouldn’t want to scramble around looking for Nolvadex and possible get moobs in the meantime. I know that sounds a little hypocritical, trusting the black market but not herbal products.
At least I know the drugs are researched to have efficacy where as the herbals are a total crapshoot. Supplements are unregulated as well, so it’s not like they’re any more “safe” than the black market.
Regarding my acne… it’s totally cleared up the last week since introducting vitamin B2 again, going from 10-20 new whiteheads a day to practically none. I haven’t experienced the usually lethargy and sedation as I have in the past which I’m attributing to the iron supplementation I’ve been on the last couple months. Vitamin B2 is a cofactor with iron in a number of processes. Taking B2 while being deficient in iron can cause a deficiency making one feel much worse. I’m suspecting that’s what may have happened.
Interestingly testosterone supplementation is supposed to help with a number of different anemias. Perhaps hypogonal states may result in iron and B2 deficiencies, or vice versa.
I am taking Myomin because I am receiveing Testosterone injections. The Myomin keeps my estrogen levels from going up due to the test injections. I was also using Arimidex but ran out of it. The Myomin seems to be doing fine on it’s own.
I too am also very skeptical about herbal products, but this is one product that has worked exactly as it’s been described.
I understand your point about the black market, but say you bought a bottle of test cypionate off the street. There is no way of knowing if it is legit. So now you’d be injecting lord knows what into your body. Not to mention you wasted your money and are getting no benefit from the drug. If you can get the legit version of the drug off the street then that is great, provided you yourself know the proper way to adminster it for HRT.
I would seriously try looking for another doctor, a good endo or a doctor that is into anti-aging therapy. It’s true a lot of doctors don’t know squat about HRT, but fortunately a lot more of them are learning about it because it seems the incidence of low testosterone and high estrogen is becoming more common in guys as young as 27. [/quote]
I’m not sure if I’m following you here. You ran out of Arimidex so your doctor told you to buy Myomin instead? Why didn’t your doctor just prescribe more Arimidex? Was it a price issue since Arimidex is quite expensive?
Don’t worry I’m not writing off traditional healthcare, it’s just painfully slow up here in Canada getting specialized care. Would you believe it takes people 6 months sometimes to get an MRI due to the wait periods? A lot of people I know just travel across the border to get an MRI the same day, and pay out of pocket. Don’t get me wrong, the quality of care here is generally excellent. Socialized healthcare has it’s problems though. You don’t see the marketing for clinics here as you do in the states probably due to the publicly funded aspect of our system. It’s not as profit oriented, so it affects the availability of antiaging clinics, and and so forth. I’m still looking though, it may just take me a little longer.
[quote]FCFighter wrote:
Dopamineloveaffair,
I have an appointment next week with a doctor I found through a link on www.allthingsmale.com. The link is www.worldhealth.net. He is actually a neurologist of all things, but he is part of the same organization as Dr. Crisler(A4M I think). He is in my provider directory as a doctor covered under my insurance, but I never would have thought to look under neurology.
Anyway maybe there is a doc near you that is associated with the same group.
Thankfully he does not require a referral from my primary care physician, which I found is the case with some specialists.
I had lab draws done about a month and a half ago as ordered by my regular doc. Long story short, I got a phone call two weeks later from the nurse saying everything was “normal”. When I asked if the doctor had looked at the lab reports himself or if someone else(ie. the lab company, her based on the ref. ranges, etc.) had made that determination she became very defensive. She cut me off and explained that the doctor had looked at them.
Everything went downhill from there. I was pissed to say the least, but I was determined not to give up. I requested a copy of the lab reports from the nurse to be mailed to me. When they arrived what I received amounted to a sheet of paper that said everything was again “normal”. No shit. That’s what she told me over the phone.
Eventually I did get a copy of the reports, but it was like pulling teeth.
Here are some of my levels for comparison:
Total T 517
Free T 80
Bioavailable T 167
SHGB 28
I have a hard time believing my total T is 517. It was around 520 when I was 19 and around 320 just a couple years ago at 28. And even though my free and bio T are technically within normal, they leave something to be desired.
I am experiencing many of the same symptoms you report and won’t stop searching for a doc that will help me out until I find one. I know it takes forever sometimes to get in to see a doctor and then you have to wonder if they’ll even help you, but don’t give up. Good luck.[/quote]
What a horror story dealing with those docs. I had my testosterone checked about a year and a half ago with a different doc. All she said was that it came out “normal”. I never got the lab values. I think it was total T, prolactin, and TSH that she had me check. I’ve noticed a lot of doctors not wanting their patients to be involved in the process. I’m not sure whether it’s a conrol issue or whether they think the patient will bastardize the information they’re given out of ignorance.
Thanks for the link! There’s three doctors in Toronto on that list which are about an hour and a half of where I live. One of the clinics had a website, http://www.longevity.ca/
FCFighter,
How old are you BTW?
[quote]Velvet Revolver wrote:
FCFighter,
How old are you BTW?[/quote]
Just turned 30.
[quote]FCFighter wrote:
Velvet Revolver wrote:
FCFighter,
How old are you BTW?
Just turned 30.[/quote]
Thanks.
God Ive heard from so many people in there 20’s and early 30’s with low T.
[quote]FCFighter wrote:
Here are some of my levels for comparison:
Total T 517
Free T 80
Bioavailable T 167
SHGB 28[/quote]
Anyone else have numbers to report?
I get my results next week. Mysteriously though, my symptoms have cleared up … pyschological in large part I am sure.