T Nation

57 With a Difficult Doctor


#1

I finally got my doctor to acknowledge my low T. Last time I got her to authorize a blood test, she was sure I could raise it with maca. Well, 2 months later I insist we try again and came back with low numbers again. 395 and 68.5 FT. Could not get her to check E2, maybe next time.

She said that I should start táking androgel, but from what I have read here that it may be a problem as I work out 5 days/wk and that I would just sweat and shower it down the drain. Hoping I can get some advice on what I should ask her to preccribe.

Age 57
5'9
183 lb
Ex smoker, ex drinker
Very low colesteral
If anyone needs more info, I will try to furnish it.

Thanks


#2

I would get a new doctor. I personally would not go to a female doctor for a mans issue. She has never walked a day in a mans shoes. She has no idea how a man is supposed to feel.

Thats just my opinion. Take a look at the Finding a TRT doc sticky thats where i started a few weeks ago.


#3

Any one have an idea of what I should ask for instead of the androgel?


#4

Read the advice for new guys sticky and come back with more info. Be open minded to the other problems discussed there. You need a perspective wider than T tunnel vision.

Low cholesterol is a problem. Why low? Is this a change?


#5

My cholesterol has always been low. I have been eating very clean for the last 21/2 yrs. Went from 212 to 168, added some lean mass as I was too thin before due to over-training and not enough cals.
Waist size is 34
Very little body hair, but most on top is still there.
Body fat is probably around 14%.
I carry almost all fat in my lower back and abdomen.
Supplement w/ whey, mono-creatin, BCAA, glutamine, around workouts. Morning mutivitamin and evening ZMA.
I work out 2 days on/1 off for a 5 day split. HIIT cardio 3 times a wk.
Hardly ever any morning wood but it will work if worked!
Mentally, I really don’t have much zest for like outside of working out. I get frustrated at doing everything right working out smart and eating smart, but not losing the fat or seeing the gains in muscle.
If you would like more test info, let me know and if iI have it I will post it.


#6

Please post body temps per last sticky and ‘thyroid basics’

  • describe history of iodine intake from iodized salt and vitamins that have iodine

Cholesterol levels of or below 160 are associated with increased all-cause mortality - not healthy. Cholesterol is the foundation for creation of all steroid hormones, and vit-D. There was nothing wrong with 212, some think that 180 is ideal. But more important is your HDL.

Read some of this: http://en.wikipedia.org/wiki/Steroid_hormone

You also need healthy fats:

  • EFA’s: fish oil, nuts, fax seed oil or meal
  • olive oil

Fats are very important, your brain dry weight is mostly fat. Also important for all cell wall structures and permeability.

No vitamins or minerals?
Anti-oxidants?

Extreme low fat diets cause hormone disruption.

Describe your stress levels. Include factors such as accidents, job loss, loss if loved ones or relationships, infections chronic or acute.

As per the sticky, extreme diets and/or over training wreck your hormones.


#7

I actually eat about 30% of my daily amts in healthy fats. also 2400mg fish oil and I do take a mens multi-vitamin. Snack on nuts and use olive oil and avocado in my salads.
Stress levels are manageable
HDL 57 mg/dl.

The only iodine I get would be from processed foods and I don’t get much of that.
Just got a call from the doctors office and they said they would start w/ inj. testosterone, but didn’t say what kind and that it would be done in their office. From what I have read here, twice a week is best and I will see if they will let me do it at home. I sure as hell can’t see going there twice a week. They get it sent from the ins. company. Any thoughts on what to ask them?


#8

You can get scripts and get yourself. From the insurance company is bogus. Sounds like a battle. Insist on the benefit of injecting twice a week, thus self injecting.

Iodized salt is rarely used in prepared foods or restaurants. You have described your self as iodine deficient and your TSH is consistent with that.

You may need to eat more animal fat to increase T.

At your age, testing LH/FSH really does not mater when its age related decline.

Need a DRE. Will need to track hematocrit, PSA and E2 and manage E2


#9

Got a call from my doctors minion today. Said the doctor looked at my chart again and now thinks that I am not a candidate for injected test. after all. Said the dose my ins. co. would send was too strong and wants me to use Androgel. For the hell of it. I went to pick it up at my pharmacy and low and behold, it’s not covered and would cost over $400.00!!! I’m. Going to set appt. with the doctor and try to make my case in person using the info I have gleaned here and on the net. I have read that a good starting point is 200.ml twice a week with an AI. Based on your experience, do my numbers warrant that roseate?


#10

Got a call from my doctors minion today. Said the doctor looked at my chart again and now thinks that I am not a candidate for injected test. after all. Said the dose my ins. co. would send was too strong and wants me to use Androgel. For the hell of it. I went to pick it up at my pharmacy and low and behold, it’s not covered and would cost over $400.00!!! I’m. Going to set appt. with the doctor and try to make my case in person using the info I have gleaned here and on the net. I have read that a good starting point is 200.ml twice a week with an AI. Based on your experience, do my numbers warrant that roseate?


#11

Doesn’t sound like your Dr. is looking out for your best interest.
As for a starting point… I do 100mg a week and it took my test levels into the 700 range. I also take an AI. My Dr. Started me on Androgel also and my insurance only covered part of it. Cost me around $198 a month. Do yourself a favor and find another Dr. and get a script for Injections. $10 Generic at Wal-Mart is easier to swallow and the 10ml bottle lasts like 5 months.


#12

That is not cost, that is co-pay: $10 Generic at Wal-Mart

Bogus: “200.ml twice a week” That is 1/5th liter. Doses are mg’s, not ml’s. You dispense by the ml when you know mg/ml.

100mg T ester per week provides good results. High doses create estrogen problems.

Insurance companies do not dispense drugs! “Said the dose my ins. co. would send”


#13

Well, doc still wants to go with the androgel and I picked it up 2day. No direction from her on starting dowager so I thought to ask what you think. Also, apllication info ranges from shoulder, upper arms, flanks, inside of thighs, even scrotum. What do you think is best? Will retest in 2 mo. Anything I should watch for symptom-wise?


#14

May sting scrotum [may sting] and some will object that transfer to wife/GF is probable. Inner arms also absorb well, but then people say that hugging transfers are possible. When guys use high strength compounded creams, application to inner arms seems to be the basic instruction.

Doc or pharmacy owes you dose instructions.


#15

We know that you are probably iodine deficient and your TSH is a concern.

Is is really hard for you to check your body temperatures?
***Please post body temps per last sticky and ‘thyroid basics’ ***

If you have a thyroid problem, there is a good chance that you will not absorb transdermal T and that will be a waste of $$$.


#16

Thanks KSman, I really appreciate your input and will do on the temps. Also started adding 1/4 tsp iodized salt in the morning. If I need more, let me know. Also, 5,7.5, or 10g to start. I don’t think my doctor even knows.


#17

1/4 tsp iodized salt cannot address an iodine deficiency, RDA’s will tread water.

Humans can store up to 1.5 grams of iodine. If you did a 0.75 gram iodine replenishment, it would take 5000 doses of the 150mcg [millionths] to get 0.75 grams. That would never work.

If you have a thyroid problem, there is a good chance that you will not absorb transdermal T and that will be a waste of $$$.

Normal young males make ~10mg T per day, for ~70 per week. If you take 100mg and absorb 10, you would be OK. You can test after one or two weeks. If T levels are not much better or lower, that is the thyroid non-absorption issue; then you need to self inject.

How many grams to take? How many mg’s per gram?


#18

What do you reccomend for iodine supplementation? After all, I can’t see eating 5000 kelp tablets at 150 mcg. How much iodral at 12.5mg can a person take at first to build up levels and then do I start maintaining with the Rda?


#19

Alright KSman, I’m doing the drill slowly but surely. Bought 30 Mg potassium iodide supplement from health food place. It was the closest I could get to Ioderal(sp). In one of your other posts you reccomended that he take his supplement for 14 days to build up and then go on a maintenance level. Would that be the 150mcg dose? Mine is 4 tabs for the 30mg and with the added kale I’m eating I figure spacing them out over the day should prevent any discomfort. Do you think I should go for the same 14 days or go by my body temp? Bought a thermometer to check myself out like you reccomended and will give you more history. For a start, temp was 96.6 at 4pm. I appreciate your knowledge and patience.


#20

[quote]trhoads155 wrote:
Got a call from my doctors minion today. Said the doctor looked at my chart again…[/quote]

Did your doctor look at your chart here online at T-Nation? Mr.Rhoads I would ask one of the T-Nation techs to help you delete your medical lab pic/post as it shows lab address, your name and date of birth.

Do it as soon as possible before some smart ass gets into your private records. Best of luck.