Doctors new protocol is to drop dose to 80mg E3.5D. Frankly, if I stick to the current protocol of 100mg E3.5D, I feel amazing and my levels are by no means abnormal, then why not take the blood work 2 days after when these were taken just to meet the criteria I am being graded against?
Clearly how I feel and other metrics are going out the window when Kaiser is looking to determine whether an increase or decrease is needed. If TT is out of range, then by Kaiser standards, the dose needs to be adjusted.
It is extremely frustrating and given my history with Kaiser (related to the other health issues) I am absolutely not surprised. I think I will just push the blood work back a few days in the future and ensure I meet their restrictive parameters.
Lastly, if TT was the only metric they are looking to utilize for determining to increase or lower a dose, they cap their metric at approx… 75% of other credible sources. The range seems to be somewhere in the ballpark of 200ng/dl (Kaiser) - 1200ng/dl depending on source.
I will say, he is better than the last Kaiser endo that I moved away from. She explicitly said, regardless of how the patient feels, I will not be letting TT go over 400ng/dl because at that point, they are within range…
That last statement is 100% accurate as to how she worded it.
If anyone has recommendations for other sources aside from Kaiser, it would be much appreciated. I cannot go back to the levels I was at… I was lifeless in every sense of the word and quite honestly, I don’t think I would be able to survive going through that again
Some doctors don’t care about optimising levels, they believe is keeping levels minimal for safety, but really the doctor is overly conservative and/or is nervous. My first endo at Kaiser contacted me when my trough levels came in at 440 ng/dL, she was happy with these levels without even asking me how I felt beforehand.
This is mostly how managed healthcare works, they are managing a number, in fact some doctors make the diagnosis before you are seen and you complain about symptoms in the office visit and there mind is already made up.
I can assure you if you continue on course you will not be refilling your next prescription because more than likely your TRT treatment has been canceled temporarily (90 days) until you can show levels are within range.
They will be contacting you within 90 days to have your levels rechecked at which point if levels are still out of range, they will pull the plug on your TRT for months and doctors could refuse to treat you do to noncompliance.
You need to make other plans now, or you will see an interruption is treatment. Your Kaiser doctors can’t allow levels out of range, there are no exceptions and your doctor could get in trouble.
As for other sources other than Kaiser, providers that take insurance most likely will be bound by the same rules about keeping levels in range, you need a private doctor who can allow out of range TT levels due to your particular situation.
There are telemedicine options, a lot of private clinics don’t take insurance. If the cost is above $150 average per month, you are paying too much.
Testosterone treatment appears to be effective and efficacious in reducing depressive symptoms in men, particularly when higher-dosage regimens were applied in carefully selected samples.
So this practice of keeping men on the lower end of the ranges is harmful to some individuals.