Thanks again. I’m learning. My question regarding the time of day for lab work was because the nurse indicated it did not matter. But, to my mind, if the prescription Is based on the numbers/symptoms, then you could have a different prescription based on morning levels, compared to early afternoon levels, or compared to late afternoon. My point is if I had done my labs at 8: AM, would my prescription have been different since the numbers would have been higher? Make sense? The 580 number was from about 4-5 weeks ago, done in the morning. I’m going to try and post a screenshot of the lab…
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Most T clinics would prefer the afternoon (I am guessing). You will get lower numbers, and it is easy for them to give you a script, which makes them money. Obviously not all clinics, but some of them really want you as a patient.
No, it doesn’t matter what your numbers are. You may have been denied if too high, but when you go on Testosterone, your body will basically produce near 0 Testosterone. It isn’t like a supplement to natural Test, it is replacement. If I stopped cold turkey, in a few weeks, my Test levels would probably be under 50 ng/dL, even though when I started, my natural numbers were close to 400 ng/dL.
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I informed the nurse that I wanted more time to research things, and that I put a hold on the prescription with the pharmacy. She just sent me this email. Crazy.
"Actually that is not a massive amount of testosterone to optimize levels. I actually start low and go up when we do the 6 week follow up.
But if you would feel more comfortable even starting lower you can do the testosterone 1/2 ml twice a day that will give you 200 mg a day.
I have several men that have started where you are and now take about 1000 mg a day. Bio-identical testosterone does not compare to synthetic testosterones like Androgel, Testim, or Fortesta. The bio-identical is identical to the hormones your body produces and does not have the side effects that synthetics have.
I understand your concerns.
Given my 580/260 total T, and freeT of 3, I don’t believe that’s a healthy range to be in, so, it seems that TRT is the likely course of action to take. Considering the numbers, I function fairly well. Or I’ve forgotten what functioning well is really like. My main symptoms are loss of energy, motivation, and libido… irritability, brain fog.
I’m still trying to upload a lab photo. Bear with me.
I forgot to mention my T-3 needs to be addressed-2.3pg/ml, and ANTI-T Peroxidase-38. Iu/ml
One of the pitches I hear from docs like Keith Nichols, are that in the past, T levels near 1,500 were once considered normal. Now, they are supraphysiologic. Any truth to this?
Years ago, one of the labs top end went to 1500ng, or so the legends foretold. Were there lots and lots of men getting tested that were actually that high? Or is that simply where the standard TT test tops out at? I think it’s the latter.
Just because 1% of the population hits 1000+ng doesn’t mean it’s normal. I think @anon18050987 made the analogy of guys that are 7 feet tall: they do exist, but are they normal?
My personal approach, forget the TT number. Forget the dose, 200mg or 1000mg. Take as much testosterone as you can while keeping your BP, lipids, CBC and overall health in a good range. Think longevity. If you can run your TT 1500+ at have all those markers come back looking good, then do it! If you can’t, then lower your dose down in small steps. Whatever dose or TT that turns out to be, that’s “optimal” for you
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“If you share your SHBG, I can parse your 580 vs 260”
Did you get a look at the labs? I don’t know if they’re helpful or not.
Topical T don’t offer much in the way of control when it comes to getting the desired testosterone levels, injections however do.
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Thank again. Clearly, the nurse is shooting for supra physiologic levels by virtue of her prescription. All of those hand written notations on the labwork like “SHBG 100+”, are her own personal optimal levels/reference ranges.
Now, are you suggesting my tt of 580, and ft of ~8-16 could be optimal for me?
Here’s the thyroid numbers
https://photos.app.goo.gl/oNmvUJqtzsYTpRWD7
By “optimal” I mean overall health. Sorry, I thought that was clear. Symptoms aside, is anyone really optimized hormonally with numbers like mine.
suspect she gets her numbers from whatever she learned from Rouzier. Just guessing.
I’ve spent years trying to figure out SHBG and still don’t know it all, but my experience suggests it’s bad to be too low or too high. I certainly would not recommend shooting for 100+.
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I think the SHBG sweet spot is around 20-30nmol, personally. If she’s saying she wants patients SHBG to be 100+, then no wonder she’s advocating for TT of 2000ng
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Hmmm zero carbs, tons of exercise, low calorie lol. Don’t see a ton of pro-SHBG arguments out there. More transport & storage, but less action. The FT result would be the same either way, so weird.
Idk I think they just have an idea that testosterone isn’t harmful at any dose, no matter how high, so just feel like He-man while you can
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I can’t say as a fact that Rouzier teaches this approach as she is proposing it. I’ve heard Dr. Nichols (also a Rouzier protege,) talk general dosing around 100mg twice daily as a ballpark figure that works for a lot of men. Nothing approaching her 1,000mg a day for some of her patients with numbers similar to mine. So, maybe she’s just taking some of Rouzier’s principles, but taking them beyond what he would even advocate. At any rate, I effectively dumped her the other day. Now I’m back to square one.
100mg/g Lipoderm (10%)
apply 0.5-1.0g every 12 hours to scrotum
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I read this entire thread.
The place you went to is a trt mill. $$
They are claiming you need to be at very high levels and what they call optimization to support the scripts they are writing.
You are 63 with 530 total t in the morning.
The cream they prescribe I believe is compounded and comes from a specific lab Dr rouzier and his “trained” clinicians are involved in. Again $$
Hence the compounded thyroid treatment she wants to give you as well which you probably don’t need.
greed is very powerful and overcomes even the Drs that started off not so greedy and pioneered many aspects of TRT.
Just like defy keeping empower pharmacy in biz. Defy could not resist prescribing AI , I mean who else would order .1 mg compounded AI capsules??
Not so sure about this. When I’ve attended, there are paying exhibitors, however Neal makes it clear they have no financial arrangement with him. He charges a flat fee for service to his patients (unless that has since changed) and they get their labs and prescriptions from wherever they choose.
I might as well just name the clinic.
Macdonald Healthcare, Kennewick WA.
ARNP Debra MacDonald.
I was going to use my own local compounding pharmacy.
Also, Rouzier doesn’t treat patients any longer. Just gives the BHRT courses, to my knowledge.
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