Urologist visit in 10 days

[funkymonk]

And I want to be prepared. It took me a month to get into see this guy, after waiting a month before to get into my PCP.

21 years old
never cycled anything hormonal
test, serum 291 (280-800 pg/nl)
LH 1.8 (1.7-8.6 mIU/ml)
FSH 2.8 (1.5-12.4 mIU/ml)
estradiol 23.6 (7.6-42.6 pg/ml)

I figure I have secondary hypogonadism.

If he agrees that testosterone replacement therapy (TRT) is the best option instead of a Clomid/hCG restart, I want to push for the following protocol:
-100mg test C EW
-.5mg Arimidex (anastrazole) EoD
-250iu hCG 2xWeekly

I'm technically "normal" for test, but everything above is teetering on low, and I do suffer symptoms of low T. I have no libido, get morning wood maybe once or twice a month. Recovery and mental "clarity" aren't perfect, but I could definitely make a case against them.

I'm choosing not to bring up gaining fat/losing muscle unless he asks. The last thing I want him to think is that I crashed my T in an effort to get a legal source of juice.

Is there anything else I can do to prepare? I've printed out studies/paperwork to help me get what I want, but will they do any good or make the Dr not wanna listen to me at all? Think it will be easy for me to push for shots if he offers the gel/patch?

 

[cjw2021]

I bet you an internet reputation point that he'll deny you anything but 250mg of testosterone every 2 weeks, IF you even get that far. I don't care how good your reasoning is for adding Human Chorionic Gonadotropin (HCG) and an Aromatase inhibitor (AI), I highly doubt he'll give it. Urologists are the worst too. They like to stare at poop, not play endocrinologist. Just call Chip and get a referral to his doc, he will be a hell of a lot cheaper and give you what you need to be feeling normal again. You are wasting your time otherwise (I know I've been there). But, see what he says, spend the money, and then call Chip.

 

[funkymonk]

I bet you an internet reputation point that he'll deny you anything but 250mg of testosterone every 2 weeks, IF you even get that far. I don't care how good your reasoning is for adding Human Chorionic Gonadotropin (HCG) and an Aromatase inhibitor (AI), I highly doubt he'll give it. Urologists are the worst too. They like to stare at poop, not play endocrinologist. Just call Chip and get a referral to his doc, he will be a hell of a lot cheaper and give you what you need to be feeling normal again. You are wasting your time otherwise (I know I've been there). But, see what he says, spend the money, and then call Chip.

Even though I'm only 21? I thought Chip primarily dealt with clients over 30?

 

[cjw2021]

Oh yeah that might be a problem. Good luck at the urologist. I think you'd be way better off going through a general MD or endo but maybe I'll be proved wrong. In any event the best you'll get with any of them is what I mentioned above. They will laugh in your face if you bring up Human Chorionic Gonadotropin (HCG) and an Aromatase inhibitor (AI) with test.

 

[Ken]

Even though I'm only 21? I thought Chip primarily dealt with clients over 30?

I dont think Chip is gonna care how old you are... He's gonna look at your numbers AND how you feel, as it seems to me he cares about your lightswitch and whether its working correctly or not...

 

[riprockwell]

I bet you an internet reputation point that he'll deny you anything but 250mg of testosterone every 2 weeks, IF you even get that far. I don't care how good your reasoning is for adding Human Chorionic Gonadotropin (HCG) and an Aromatase inhibitor (AI), I highly doubt he'll give it. Urologists are the worst too. They like to stare at poop, not play endocrinologist. Just call Chip and get a referral to his doc, he will be a hell of a lot cheaper and give you what you need to be feeling normal again. You are wasting your time otherwise (I know I've been there). But, see what he says, spend the money, and then call Chip.

I agree with this. I think there is a low chance you would even get an injectable. Most likely he would prescribe you gel if any. Also, Docs are scared of death of AI's. Even if your Doc was smart enough to give you at least a once a week injection, he would have you come to his office to do it instead of yourself doing it.

Lastly, remember ranges at medical labs vary and you need to base it how you feel. My docs range was 160-750. While some other labs have a range of 350-1400.

I work with Chip so call him and see what he can do. I am sure he will be chiming in shortly. Goodluck.

 

[CHIP WADOWSKI]

Hey FUNKYMONK,

The first thing that I'll say, is that I'm impressed by the fact that a guy your age is lobbying for a conservative, very realistic protocol. Age...? Now thats a tough one. But the best part about being CHIP WADOWSKI, is that I can attempt to extend myself and my knowledge to anyone that truly needs it, or that meets required HRT/TRT criteria, but our doctors make all final decisions on protocols. I will be very honest and say that I think it will be very difficult to get you on protocol, given your age and the fact that your numbers are
(in the BULLSHIT RANGE ^$#@%$***@!!!!!!!!!!!!!). I'd truly love to help everyone that needs it, yet sometimes my hands are tied. My advice, if you are lobbying for injectable therapy would be to tell him you need the testosterone portion of your therapy administered every fifth day and supply him with information regarding the half-life of the Cypionate ester.

At that point, he will either comply with your therapy request because he realizes that you know more about HRT/TRT than he does, OR he'll deny it because he'll be pissed that YOU KNOW MORE ABOUT HRT/TRT THAN HE DOES!

.....OR, he may be one of the FEW docs out there that actually are versed on the subject, and if he excelled in "HRT 101", he'll be on the same page as you and you'll be off and running.

I can't back this statement up with any "medical data", but my feeling on why most docs won't touch a guy your age, even when you DO have labs supporting your condition, is the fear of feeding the "PSYCHOLOGICAL MACHINE". They don't want to be the one who starts a very young guy on true therapy, for fear that it could spin out of control and lead to a younger guy using HRT/TRT as a catalyst for "cycling". And in a great many respects, I TOTALLY AGREE WITH MY THEORY. (I just kissed my own ass).

What I'll NEVER agree with is how they tell you that you are "in range", yet you feel like "hammered SHIT", as RIPROCKWELL would say. And they don't have the balls to tell you that they simply will not get involved due to the theory I stated above. Or better yet, that the just truly don't KNOW how to medicate you properly.

You don't go to a heart specialist for a kidney infection

Go to your urologist. Be as mature with him as you seem to be on the board, here. Stroke his ego. Tell him that your BALLS are in his court. So are the tits that you DON'T ever want to grow. ASK him right from jump street what his views are on injectable therapy along with the MEDICALLY NECESSARY ancillaries (hcg, AI) to insure a proper, synergistic form of therapy. If he tells you that he doesn't believe in it, ASK him if you may plead your case. Then supply him with your research. I don't wanna bust your balls, but if it gets to that point, chances are, his ego has already "rushed the stage" and he'll say, "I have a medical license, I've read all the reaserch, blah, blah, blah. Then you know your FUCKED.

But....Like Patrick Swayze said in "ROADHOUSE",

BE NICE
YouTube - Roadhouse

 

[RJ]

i got my testosterone replacement therapy (TRT) 'protocol' thru a urologist before i decided to go with Chip. He was very cool, mainly because he knew one of the guys i competed with who owned a local gym and understood the AAS lifestyle and what it could do.

That being said, like cjw said, he was scared to death and would not give me any Human Chorionic Gonadotropin (HCG) or an Aromatase inhibitor (AI). 200mg EOW and that was it. So as it was all i had, i just kept a keen eye on my BW. Luckily i stay pretty under control everywhere else. I'm still on the same amount with CHip, but now I have giant balls again and I feel even better.

You will know within five minutes if the guy is down or not. You'll be out a co-pay, but if he's not, don't even waste your breath. Check in your area for local endos that have the term HRT on their website. Thats usually a good start.

 

[funkymonk]

Thank you all for your input. Chip, I will get into contact with you if the uro is a dead end, but I'd like to go thru my insurance if at all possible.

My PCP already said "it's either nothing or we'll just put you on shots," very casually, so I'd like to think that my uro will be as cool with it as my PCP was. We'll see.

 

[Mr.White]

good luck man...I tried staying through my insurance as well for over a year and a half now..2 general practitioners and 2 endocrinologists later and no success...I've been in contact with Chip in hopes he can get me straightened out..

I am curious about the urologist, I was suggested to one and I figured it would be a deadend..let us know what he says

 

[funkymonk]

Going in Monday morning. Will keep everyone updated.

 

[Blondie_Bombshell]

My friend is 22 an goes to a clinic here with no trouble. Why are you going to a urologist again? Unless you have urinary, prostate, bladder, kidney issues I dont see the point, most are not willing to address your wants especially with a normal test level but good luck!

 

[Welter]

asking as someone who is completely ignorant to the law about HRT and, someone who has never cycled. I thought if you ever went to your doctor/insurance for HRT you risked never being covered by health insurance providers forever? did i dream this up? or did i read it somewhere?

 

[funkymonk]

Just got my hands on my second set of bloods (long story). TSH and T4 direct were measured this time and are both normal (not even high-normal or low-normal).

Now I'm perplexed. I am interested to see what the doc has to say tomorrow.

My friend is 22 an goes to a clinic here with no trouble. Why are you going to a urologist again? Unless you have urinary, prostate, bladder, kidney issues I dont see the point, most are not willing to address your wants especially with a normal test level but good luck!

PCP referred to endo
insurance said go to our uro of choice

I'd rather get covered by insurance.

asking as someone who is completely ignorant to the law about HRT and, someone who has never cycled. I thought if you ever went to your doctor/insurance for HRT you risked never being covered by health insurance providers forever? did i dream this up? or did i read it somewhere?

Never heard this, but if you give your doc reason to suspect that you're using testosterone replacement therapy (TRT) as a steroid source (IE: crashing your T levels and getting exposed in subsequent testing), things certainly won't proceed smoothly.

 

[cashout]

Don't generalize like this. My urologist is fantastic.

He was very open to working with me on my current protocol, which I brought to him and demonstrated.

I was at 579 ng/dl of total test and and I explained to him that that was low for me. I pulled out all my blood work for the past 15 years and he saw that my test levels were over 1000+ since the time I was in my early 20's to mid-30s.

He agreed that 579 was a big drop for me and prescribed 200 mg Test weekly, .5 mg adex m/th, 5-ar inhibitor daily.

He went so far as to suggest we add Human Chorionic Gonadotropin (HCG) to my program as well. For me at 40, with two happy health kids and and a satisfied wife in a good marriage, Human Chorionic Gonadotropin (HCG) was only a cosmetic option. But, I went with his suggestion.

I feel better now than I have in 5 years and my numbers are fantastic.

My point is, don't bag on every MD because there are plenty of good ones out there who are willing to work with folks.

Regards.

I bet you an internet reputation point that he'll deny you anything but 250mg of testosterone every 2 weeks, IF you even get that far. I don't care how good your reasoning is for adding Human Chorionic Gonadotropin (HCG) and an Aromatase inhibitor (AI), I highly doubt he'll give it. Urologists are the worst too. They like to stare at poop, not play endocrinologist. Just call Chip and get a referral to his doc, he will be a hell of a lot cheaper and give you what you need to be feeling normal again. You are wasting your time otherwise (I know I've been there). But, see what he says, spend the money, and then call Chip.

 

[cjw2021]

My experience and the experience of 90% of the other people on this board are what I said. You got lucky, and we are all happy for you.

 

[funkymonk]

Just got back.

Very very very impressed with this guy.
He asked all the right questions, knew his stuff, and was very open to testosterone replacement therapy (TRT) via gel or injections (even self-administered). He was concerned about me losing fertility at such a young age (21). I asked about hCG, and he said that it's something we could look into.

I'm getting my bloods done again in a day or two, and then making a followup appointment. He said that if my test truly is low, he'll give me the choice or testosterone replacement therapy (TRT) if he feels that it's a wise option.

 

[CHIP WADOWSKI]

Good for you, Chief!! At least theres one youngster that doesn't get the door slammed in his face! Just be smart about the OPPORTUNITY you've been given and don't let this take off like a runaway train down the wrong side of the tracks. Not saying you will, but just looking out for you.

 

[PGHRam]

funky,

where do you live?

 

[funkymonk]

Southern California. Insurance referred me to this guy after the PCP ok'd me for further inspection. I definitely get the vibe from this guy that he 100% would not put me/you/someone on testosterone replacement therapy (TRT) without a 100% warranted need.