Urologist is reluctant to prescribe an aromatase inhibitor, about to head back for a follow up my latest labs after bringing up the subject.
He was super defensive and argumentative when I brought it up. I mentioned how my elevated e2 is cancelling out the benefits of the increased test, mentioned androgen receptor availability, and he rudely asked me if I had a degree in endocrinology. Then said he normally only prescribes when there’s gyno, and estradiol is over 100 pg/mL.
To add to my frustration, these urologists never tested for secondary hypogonadism! I didn’t know about it then (9 months ago), but I do now. No LH or FSH tests, just free and total test, you have hypogonadism let’s do TRT… I’ve had to push them to monitor E2 at all, and they were reluctant at first (always carried fat on chest, obviously worried about this).
So basically, my short summary is:
Initial tests:
- 3/2016
- TT - 286 (348-1197)
- FT - 6.1 (8.7-25.1)
- 4/2016
- TT - 382 (348-1197)
- FT - 8.3 (8.7-25.1)
- 5/2016
- TT - 211 (348-1197)
- FT - 9.4 (8.7-25.1)
Started TRT - Test Cyp 100mg/week (shortly moved to 50mg E3.5D)
- 7/2016
- TT - 355 (348-1197)
- E2 - 26 (<29)
Increase to 150mg/week (split E3.5D)
- 9/2016
- TT - 843 (348-1197)
- FT - 27.2 (8.7-25.1)
Stay here for a bit, but not feeling better at all. Finally start pushing them to investigate this more. Reading and researching online, I have a feeling that the problem is elevated E2, lots of the symptoms.
- 1/2017
- TT - 915 (250-1100)
- FT - 241.6 (35-155)
- E2 - 41 (<29)
- Prolactin - 6.9 (2-18)
- SHBG - 17 (10-50)
- TSH - 1.15 (0.4-4.5)
- T4 Free - 1.1 (0.8-1.8)
- T3 Total - 94 (76-181)
- AST - 17 (10-40)
- ALT - 25 (9-46)
Had convo with other doc about AI I described above. I also moved back down to 100mg/week (split E3.5Days). For this last test, since I had to push the doc to even prescribe test E7D, instead of E14D like the medicine label recommends, I injected 100mg exactly 3.5 days before the bloodwork (had injected 50mg 3.5D before this injection).
- 2/2017
- TT - 1017 (250-1100)
- FT - 252.2 (35-155)
- E2 - 48 (<29)
- Prolactin - 11 (2-18)
About to head to the urologist to discuss the results, and see what they have to say. Any thoughts?
KSMan, I’ll post a full rundown of all the questions from your sticking in a main thread about my TRT experience, just wanted to start off discussing the current situation, and how to deal with doctors who clearly don’t know anything besides what the pharma companies told them…