The goal of testosterone replacement therapy (TRT) is to return serum testosterone levels to within physiologic range and improve symptoms in hypogonadal men. Some of the symptoms aimed to improve upon include decreased libido, erectile dysfunction, infertility, hot flashes, depressed mood, and loss of muscle mass or hair.
Wouldn’t the Endo simply see the there are no symptom resolution or improvement in lab numbers and simply raise the dose?
Your endo is clueless, and isn’t familiar with TRT, so all bets are off. It may be a long difficult dialing in process for you.
Let’s say he increases the dosage to 60mg, then 70 and in the end you need 120. 6 months in and you are still struggling…
This isn’t my first rodeo, seen this play out countless times before and it usually ends with the patient either giving up on TRT and performing a restart or the realization it’s time for a new doctor.
I thought I would save you from a months long headache, but you seem willing to endure with this clueless inept doctor.
Any doctor following medical guidelines is already 10-20 years behind the times. This mostly makes TRT a bad choice for insurance based healthcare.
Yes but it could be a long game where you feel bad in the interim. I would prefer to see you not suffer. Your call. Try to advocate for more… even 75mg would be better
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I go to a urologist with a focus in andrology and fertility. I’ve seen him for 22 years. He was the chairman of urology of a hospital here on Long Island for some time. He’s awesome and I will be sad when he retires.
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Oops, I guessed the wrong specialty! I remember you seemed happy with your quality of care from your specialist, which we don’t see often outside of Men’s Clinics
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@Friscokid your provider is giving you enough to shut you down, but not enough to fix low T.
Defy Medical is about $1500 a year for 200mg/wk script and minimal bloodwork. I sincerely recommend this approach.
As an alternative, Matrix Hormones is somewhere around $1600.
There are many clinics, but these two are recommendable. Neither will give you some ridiculous dosage like 50mg/wk.
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Here is how this typically works out:
They’ll give you 100mg/week, but not to start. The hope is you’ll feel better and you will take the 50mg. They don’t expect it, but they will do 50mg if they can get away with it. The expectation is you will not feel any better, or you’ll feel a little better, and you might a day or so post injection. If either apply, you’ll be able to “convince” them to increase the dose, which was the plan anyway. You’ll feel better on 100mg than 50mg, they’ll show you “within normal range levels” which you, or their patient, will likely take. That’s the plan. Some endos have verbalized as much to me. They are not clueless or inept, they know exactly what they are doing and they have strategy. Systemlord is right about this though: they are not interested in this. Uros are interested in biopsies, endos? Who knows? But it is not testosterone, no benefit to society as they see it.
It’s good for me. Guys talk abound, maybe get on the internet and then talk around, show up in my office and get an immediate dose increase, which is probably a starting dose for me.
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Thank you for the input here. Greatly appreciated.
So…What do i do here.
Cancel the Rx order and all further appointments with my endo and start the process all over with Defy or Matrix?
Depends how fast you want to start with defy or whoever (i use Dr Mike at Defy). Get a copy of your bloodwork so you don’t have to pay for it twice.
Probably smartest to not fill script but it likely doesnt matter either way.
Ya, I guess that was a follow up question. Should i pick up the Rx and have a back up supply incase of a zombie apocalypse or some other supply chain catastrophe?
Then start over with Defy?
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I wouldn’t go through the effort. Easier to just get UGL test, to be totally honest.
I did read a thread on either this forum or another one, that some healthcare-wide organization tracks prescriptions to make sure people arent double dosing their stuff (usually for painkillers, etc.)
One dude got flagged for filling 2 test prescriptions. That being said, i did the same (not intentionally) when i almost switched to Matrix from Defy (i backed out once i ran the numbers and found defy to be cheaper). Didnt get flagged. YMMV.
Im usually given a little surplus over my prescription dose in case i have a lapse or whatever. I’ve heard this from more than one client of “generous” Dr. Mike.
I guess I was hoping to get more into a speedy symptom resolution or at least a start with this Endo. I was super excited.
As ive been feeling shity for months.
I was hoping to be on the road to recovery and in better health by now. How long of a process is it to get started with Defy?
I feel like i have to start all over now and that sucks
Thanks in advance!
https://www.cdc.gov/drugoverdose/pdmp/index.html
The Prescription Drug Monitoring Programs (PDMP) exist for this purpose, mainly for opiods, but technically applies to controlled substances. Doctors are mandated to review it, but it is not specified how often. Probably varies by state. We do catch them, always fun conversations.
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So, that a big no-no then.
Thanks for the info.
I was just really friggin hoping to get a start on feeling better this week.
Deflating!!
WELP…I did a thing today.
Called Defy first thing this morning, Talked to a nice lady named Marissa.
Filled out some forms, submitted my blood work and results of my most resent physical and I have a phone consult with a doctor tomorrow afternoon!
Wish me luck and thanks to everyone for the ongoing support!
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Very good choice. I started at another clinic, poor care, went to an Endo with decent care, but finally settled with Defy and have been more than happy.
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OK, so. Here’s how everything came out after my consult with Defy
140mg Test cyp. split into two doses weekly.
.25 AI to be taken “As Needed.”
No HCG.
My order is at the Pharmacy now and I should be able to start sometime around the first of the yr. depending on UPS shipping schedule.
I’d like to thank everyone who helped guide me into working with Defy on this. I called them Monday morning. Gave them my blood panel and proof of recent physical, filled out documents, had consult with doctor on Wednesday and now my Rx is being shipped. WOW!!!
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Good choice. You likely won’t need the AI so don’t go crazy with it.
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Took my first shot last night (Half dose) sub Q with a 27g 1/2 inch needle.
With me being on the leaner side.
Can i use this same protocol IM? Delts, Quads, etc.
If so, can i also switch back and forth from IM to SubQ as long as i stay semi lean?
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I think you may need a 5/16" needle to do subq, but all the big guys i know (who are injecting a lot of oil), don’t do subq. I imagine this to be a volume problem more than anything.
Anyways, you can swap back and forth and i doubt you’ll notice a difference, but if you want to continually do IM i recommend (in this order):
Ventroglutes
Glutes
Shoulders (sometimes a mobility issue)
Anything else
Quads
Some people have done fine with quad shots. All 3 of the ones i did were debilitatingly painful, but your mileage may vary (has to do with nerve endings).
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