Need help addressing Endo...

[Anchors Away]

Hello all! First time poster, long time lurker. This forum has become a daily "surfing stop" due to it's wealth of information and apparantly well informed and well intentioned members!

I guess I should give a short background to better explain my situation. 29yrs old, dealing with terrible fatigue for about 8 months. Finally nailed it down to Testosterone, level tested on Jan 4th was 49 total test, needless to say we have a problem. Doc did what apparently docs do and gave a prescription for Androgel and referred me to an Endo. Endo did full blood workup 3 weeks later with total levels a little better @ 179 total test. I was told to continue the gel and see him again in 6 weeks to recheck levels and go from there. The appointment is still three weeks out but I got around to thinking about the blood draw I need to have done so I pulled out the order to check for any special instructions. To my surprise when I looked at the order it's just an order for just the total test levels... Not a total makeup!

While I'm brand new to the world of Low Testosterone and the replacement thereof this is raising a big red flag. If it shows that my Test is rising, that's great. But how do we know that estrogen is not going out of control?!? I guess I come here for advice. I'd like to be informed when I raise my concerns with him but being new to the game I don't have the knowledge to back it. What should my major concerns at this point be?

I understand that the consensus will be to contact Chip and skip the endo but I feel I should give him a chance before I do anything else. Once he proves that he doesn't have my best interests in mind he will be done with me...

Thanks for any and all advice any one of you may be able to give!

 

[JOWS6]

That's what my primary physician did as well. She called me and told me my testosterone was low and to provide her with a pharmacy number so I could pick up a script for Androgel. I refused and asked for a referral to an endocrinologist but he is no real help either.

If you want my advice, my advice would be to give doctors one shot, one chance and that's it. Tell them that you want a more comprehensive examination of your blood to gain a bigger picture of what's going on hormonally. If they feed you some kind of bull, fire them. It's not worth it wasting your time trying to get them on the same page.

What you want in a blood test is:

Basics:
- complete blood count
- hepatic (liver function) panel
- metabolic panel (cholesterol, trigylcerides)

Testosterone Panel:
- total testosterone
- free testosterone
- Bioavailable testosterone
- FSH
- LH
- E2 (NOT estrogen, NOT total estrogen, NOT Estriol but E2: Estradiol)
- Prolactin
- DHT

Adrenal panel:
- DHEA-s
- Pregnonolone
- Cortisol

Thyroid Panel:
- TSH
- T4
- T3
- FT4
- FT3
- RT3
- Thyroid Antibodies
- Thyroid Peroxidase

If you'd like, I can break down what each of things means and what they are specifically testing for. PM me your number.

-James

 

[cjw2021]

He already proved that he doesn't know what he is talking about by prescribing you gel. Gel raises estrogen very high and DHT high enough to fry your hair off quite easily. Plus if it even does work, it only does for several hours. You might as well be a full time PMSing woman. Over a short period of time the estrogen sides outweigh any positives from the gel therapy. That was my personal experience too. Just check estradiol and SHBG. Gel absorption is haphazard at best, which is why your levels are still that of an 8 year old boy. You can either waste your time and money trying to convince someone who thinks they are gods amongst men who don't even have the knowledge and resources to help you or you can call Chip and be out less money than you would with any doctor for 4-6 months worth of well being and hard ons.

 

[Kennedy0612]

If you are 29 years old, and your total test level is 49, you have more than a problem. At that low level, Androgel will do nothing. You need to get your A## to a Endo ASAP, even 179 is far far far to low, and 279 is borderline to low, but some short sided doctors would argue that. 300 was not low enough for most doctors to give me any sort of therapy .. When I was about 33.

 

[nate212]

^^ When you see the endocrinologist ask about what they think about the estradiol levels and hormone binding globulin etc. you know the labs that were not done.

At 29 free t less than 100 is markedly low man. Need to figure out why.

As above, if not confident after a couple visits look elsewhere.

 

[CHIP WADOWSKI]

Anchors Away... Here's the deal, shooter (after you come to me).... You may run into the endo of the Universe that has HIS shit spot on. If its a female endo, run. You don't have a pussy and she doesn't have a dick. If he give you the "we'll try BI-WEEKLY" injections, or cream, or gel, or says you dont need an Aromatase inhibitor (AI), OR HGC, and than says lets see how you do over the course of the next 3-6 months.... tell him to GET FUCKED. SERIOUSLY. At a total test level of 49, you'll be lucky if you don't put a bullet in your mouth in the next 3-6 WEEKS!

http://www.steroidology.com/forum/t...erapy/593966-why-choose-maximus-hrt-read.html


http://www.steroidology.com/forum/t...-transformation-blood-work-chip-wadowski.html

 

[Anchors Away]

Thanks for all the input fellas, it's greatly appreciated.

I've pretty much been keeping on good terms with this doctor for the time being because I was waiting for the results of the MRI he ordered to check for Pit. abnormalities. That came back clear so now I'm open to other options.

Regarding AI's and hCG. I brought up the concerns about atrophy and fertility and the possibility of using hCG and he said... "when you're ready to have more children... Come see me at that time." That was the first bad impression he left. Hell, he hasn't even been open to considering injections instead of gel!

Sure has been a rough ride... I think I'll fill out the medical questionaire right now...

Thanks again!

 

[cjw2021]

Very true, if I were you with the test level of 49 I would stay away from tall bridges until you get Chip to fix it.

 

[Anchors Away]

Drew the last straw with the Endo today... I had called a few days ago and spoke with his nurse telling her that I wanted to have a complete blood panel done before my next appointment to get a more complete picture as to how things were progressing on the gel. Got a call back today where she informed me that the doctor denied the request because all he needed to see was the total test. When I asked how I can get into direct contact with him to discuss the matter she informed me that he only has direct contact with his patients during office visits... DONE... Faxed my info to Chip as soon as I got off the phone, can't wait to hear back from him!

Thanks again!

 

[mlc31]

Drew the last straw with the Endo today... I had called a few days ago and spoke with his nurse telling her that I wanted to have a complete blood panel done before my next appointment to get a more complete picture as to how things were progressing on the gel. Got a call back today where she informed me that the doctor denied the request because all he needed to see was the total test. When I asked how I can get into direct contact with him to discuss the matter she informed me that he only has direct contact with his patients during office visits... DONE... Faxed my info to Chip as soon as I got off the phone, can't wait to hear back from him!

Thanks again!

Welcome aboard, Anchor. You are in very good hands.

 

[Kennedy0612]

Drew the last straw with the Endo today... I had called a few days ago and spoke with his nurse telling her that I wanted to have a complete blood panel done before my next appointment to get a more complete picture as to how things were progressing on the gel. Got a call back today where she informed me that the doctor denied the request because all he needed to see was the total test. When I asked how I can get into direct contact with him to discuss the matter she informed me that he only has direct contact with his patients during office visits... DONE... Faxed my info to Chip as soon as I got off the phone, can't wait to hear back from him!

Thanks again!

Are you sure he is a real doctor.. Even a bad doctor will tell you that total test is not the best gauge number..... Free Test/ the testosterone which can be assigned to anything, is probably just as important. It sounds as if you have a bad doctor, or an ignorant doctor.

 

[qcomer]

Are you sure he is a real doctor.. Even a bad doctor will tell you that total test is not the best gauge number..... Free Test/ the testosterone which can be assigned to anything, is probably just as important. It sounds as if you have a bad doctor, or an ignorant doctor.

On a side note for this part -- primary docs really are that dumb.

Ive switched docs 3 times because they all would only check total test and refused to check e2, DHT, DHEA, LH, FSH, T3, t4, etc. Infact, they got defensive when I asked for them. I then had to provide them material on why those numbers are important.

LOL. And these are the kind of people makin the big bucks!

 

[DynamiteChilli]

Low T+Dumb Dr.=No Treatment

Hello all

Male, 33, 6'5" 205. In good shape dont know bodyfat, but on the lean side.
First post here, but have been reading the chatter. I am very concerned and have been for quite some time. I would love for you to chime in with your feedback. I have been miserable for the past year at least, probably longer, but progressively over this last year.

Symptoms:
Serious Fatigue
Lack of Endurance and recovery from workouts or activity
Decreased Libido and erections
Decreased Cognition and mental clarity
Anyways, you get the point. So I go to my Dr. and tell him the wood in the morning is not erect. He tells me that "it's not normal for a guy to wake up with an erection".. Hmmm. Sounds like something I have never heard, or at least against everything I have been told. I tell him my symptoms and tell him I want a blood test for my test. Long story short, blood test comes back and my free test is 63pg/ml. Ref Range given is 47-244pg/ml. During the visit I didn't see the numbers, he just told me it was normal and no need to be concerned. I got a copy of the test and saw the numbers and was like ??? He didn't do total test or DHEA. SHBG, or any of the other ones you listed. TSH was mid-range(2.4). I can only imagine my free test is probably somewhere in the 200 ballpark.
I am concerned about this and don't know what to do. I feel like my levels are dangerously low for a guy my age. My Dr doesnt seem to give two shits that I feel terrible and my ogeneral sense of well-being is just pitiful. The free test test proves the point that what is plaguing me is low T. It's funny too because for the first time in my life I have been pulled towards the line of AAS. I have never considered it before, but it's like intuitively my body is telling me it needs it...

Do I go the Endo route and try and get therapy. I really need a solution that I can utilize my PPO on. Especially if it concerns longer term testosterone replacement therapy (TRT). I have considered just doing a cycle(I know you guys don't recommend that) to get myself feeling better, but I really want that to be a last resort. I am not about getting all ripped and huge in the gym, but I am about feeling and maintaining a sense of wellness and balance in my everyday life. I take a couple of naps a day and im always dragging ass big time. I know this is not how I want to live.

Please any guidance on the fastest quickest road to restoring my health will be gratefully accepted...

 

[cjw2021]

"I can only imagine my free test is probably somewhere in the 200 ballpark. " You mean total test? The only way to get SHBG down is to contact Chip and get on with him. Even if you supersaturate your test levels with a shot, your SHBG will be high, and you will have lower free test. The endo can't help you there, as he thinks your 80 year old hormone levels are normal, and even if he gave you test, it wouldn't be enough.

 

[DynamiteChilli]

Yes.. I meant I imagine my total test is probably somewhere in the 200-250 ballpark.
So, what your saying is that supplementing with whatever test the Dr. did prescribe(if he were to) would not be enough to make a difference??
But if I supersaturate with a shot it will increase my total test?? I hear what you are saying about decreasing my free test.

So basically your saying my SHBG is probably high. That wasn't tested, but maybe I should get that work-up to know for sure..

How do I get in contact with someone like Chip that can help me? Even if I do I am pretty sure my insurance doesn't cover that...

 

[cjw2021]

Chip is pretty cheap. The bottom line is that your doc has no clue how to drop SHBG and never will as he doesn't even see you have a problem. I don't know for sure your SHBG is high, but it doesn't hurt to get it tested. Generally if your free test is low, SHBG is high. You need total test levels done to know that for sure though. Chip was cheaper for me than me paying for my stuff and seeing my doc after insurance. Just go to maximushrt.com and follow the directions - dial the # with questions, whatever.

 

[CHIP WADOWSKI]

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