T Nation

Back and Forth with Doctors to Get Treatment

Hey guys I’m new here,

Just wanted to consult you folks because I have seen 3 different doctors with 3 different answers. I have kaiser insurance and they’ve been near impossible to work with.

27 y/o, 5’7, 170 lbs. I workout 4-5 times a week, with 3 days of cardio an hour on the bike, 3 days of lifting and sometimes those days lineup. I eat clean, an omelette with chicken sausage and vegatables for breakfast, lunch chicken breast with salad or vegetables, snacks typically nuts, fruits, yogurt cup, dinner either chicken breast again or chicken sausages. Target 2500 calories a day.

Was on anti depressants for anxiety for 3 years and had a generally low sex drive most of my life. But it wasn’t until I used a prohormone cycle, as well as a sarms cycle 6 months apart with the last one 9 month ago I had issues. I used Tamoxifen for PCT on those, but never got my levels feeling right (also was an idiot and didn’t do bloods afterward).
I’ve been feeling Low T symptoms for about 9 months since the end of the PCT period, basically hindsight is 2020 i feel like a dumbass for doing them to begin with but here I am.

I’ve seen 2 kaiser doctors who only tested Total testosterone. (refused to do other tests such as thyroid etc) because my 2nd test was “Within Range”.

2/11: 111 ng/dl Range 123-895

2/19: 124 ng/dl Range 123-895.

I saw a Low T Clinic physician who ordered a more comprehensive panel

2/14
Total Testosterone 133 ng/dl Range: 250-1150
Free Testosterone 28.1 pg/ml Range 35-155

Estradiol <5 pg/ml Range 0-47 (this is low I know that)

PSA 0.3 range 0-2.5

Hemocrit 42.8 Range 39.5-49.7

Basically, my Kaiser doctors don’t know much and have told me outright that I have normal levels and nothing to be concerned about. My Low T Clinician has said I should absolutely be doing testosterone therapy with levels less than 200. Kaiser has told me they won’t do further test because they believe I am fine and have nothing to be worried about which is frustrating but i’m stuck with their BS HMO system so I can’t really just “find another doctor”. My only hesitation is that i’m young, so I’m interested to hear your guy’s thoughts. I generally feel the symptoms of 0 sex drive, weight gain if i’m not super disciplined about my diet, losing muscle, fatigue, and insomnia is my worst symptom. All of that started 9 months ago and i’ve waited to see if my body went back to natural homeostasis which it has not.

You need testosterone, at least. Any chance of getting more labs:

Lipids
CMP
IGF-1
TSH
free T4
free T3
FSH
LH
prolactin
DHEA-S
SHBG
VitD

I can try to get the extra labs, I’m just getting push back from my doctor and i’m in Hawaii so we don’t have any Labcorp offices. I need a doctor to request all of those blood test for me.

Ian

I have Kaiser as well and well HMO’s are F******* useless for TRT or thyroid unless your TSH is off by a large margin. Being an HMO you might as well be going to the VA for TRT.

As far as the Low T Clinic ordering a comprehensive hormone panel, you must be joking! I’m afraid you’ve just been quacked a second time. These Low T centers are bad news.

Consider Defy Medical, a popular telemedicine clinic. As far as finding an experienced TRT physician in Hawaii, not happening.

System lord,

Yeah Kaiser has been very frustrating for me because I’ve made obviously not the best choice with previous pro hormone use but they just give me a hard time and offer no help.

Okay, I will look into Defy Medical, I also heard about Entourage Medical for telemedicine. Do you have any thoughts on them? Every doctor i’ve seen in Hawaii has been kind of a joke for this

It’s not just Hawaii, it’s a worldwide problem. Male sex hormones has been ignored for several decades do to studies that associated prostate cancer with TRT users, so most doctors even today would rather not prescribe it.

Add to that there’s no money in TRT, less of a reason to prescribe it as it prevents and treats many diseases which takes money out of big pharma pockets. Can you guess who who puts doctors through medical school and controls prescribing guidelines for doctors?

Man, they ought to put you on the payroll. Or, at least comp their services. Many Low T centers do the exact thing your company does.

It’s a simple recommendation from personal experience, if I had the good experiences with other doctors/clinics, I’d be recommending them as well.

You’re right though, all these typical Low T Clinics all practice the same, minimal blood testing which hints that they care less about balancing all your hormone so they you feel optimal and more about selling services.

Looking into Defy, do you have any thoughts on Entourage medical?

Ian

No personal experience with Entourage medical, only Defy Medical which is spoken highly of just about anywhere.

Thanks again for all the responses.

Last Update, Kaiser doctor ordered one more Total testosterone test and after lifting the last two days and fasting last night I came out to 171 ng/dl for this mornings test. So a bit higher than previous tests but still pretty low especially since i’m 27.

Ian

Ian, I don’t know where your doctors got that number from but from everything I’ve read, those Testosterone numbers are trash, ESPECIALLY FOR A GUY YOUR AGE.
Some National T clinics will treat guys outside the continental US but many do not. I had to be diligent to find someone that continue my treatment for what I can afford and I don’t know how that will pan out yet. I have to be diligent. Many local doctors would gladly take my money at an absorbent amount of money for TRT but I can’t afford that.

My Total Testosterone was high 500’s and my Free Testosterone was only 8.1

I started with a willing NP who got worried when she realized she was in over her head and exited my treatment. My experience so far is that this process is in no way, hastle free. Be diligent and look down every Avenue you find. TRT is not as well studied as a lot of other medical sciences and insurance companies loath it.

Other guys here will chime in if you ask for help, all have different but valuable experiences with male hormone health.

I may be wrong but your T numbers look awful to me. Kaiser’s range is lower (especially for you age) than any other test I’ve seen. I can’t believe they are getting away with that!

Be diligent and keep looking!

I wonder if your Kaiser doctor even knows Total T is bound to SHBG, therefore not bioavailable. Free T is bioavailable and the only test that matters for measuring testosterone. I have Kaiser and their endo’s are retards! They really don’t know a darn thing about TRT, the only thing they are tasked with doing is keeping levels in ranges, beyond that they know nothing, natta, zilch!

All they are doing is managing a number, that’s why I went to Defy Medical.

I honestly don’t think so, I tried to explain to them that 111,129, 133, 171 are not normal by any standard even though thats their range. They basically asked me if I was a doctor or not so thats when i decided today I’m done with them on this subject. So I sent some messages to Entourage and Defy and I am going to compare both.

Entourage already got back to me and immediately said they would help me out since they have no doubt there’s a deficiency. Thanks again for all your advice Systemlord, pretty much seems like telemedicine is the way to go living in Hawaii.

Now I just have to overcome the fact there is no lab corp here or affiliates and only a “clinical labs of hawaii” LOL

Thehokiefloyd,

Yeah man, thats kind of what i’ve realized too. The problem with their test is they don’t even change the range for age. they have one range for all men for all testosterone testing, it is the most asinine thing i’ve ever seen. But it is what it is, I’m going to look elsewhere for some help! Thanks for all the advice and discussion here!

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I’m just glad you found an useful service there man, I’ve been through A LOT to maybe get some help. I’m sure there is a work around on labs. There shouldn’t be a state promoted monopoly on a medical service. You’ll get what you need, I’m sure of it.

I think everyone here means well and I have gotten a lot of help from the guys on this board. I think I underrated the support I would need before I got here.

These “doctors” should all be called out by name and put on the internet, so everyone is aware of their ridiculous bs. Their licenses should be taken away.

These ranges (123-895) are lab ranges and has nothing to do with healthy ranges, the endocrine Society defines low testosterone below 300 ng/dL, so it’s obvious the Kaiser doctors are ignoring the endocrine Society guidelines.

Like I said there are a bunch of retards, they see levels in lab ranges and assume they’re normal without actually fact-checking.

Sadly critical thinking and analytical thought is not needed to practice medicine.

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Yeah, I’ve never even seen a guideline range that low. That’s insane! I would think most 90 old men would have a level of T in that range.

Yes, I just did a quick search on google and I can confirm that the majority are very inadequate :joy:

I don’t think they try systemlord. If they had to try, they would. Someone has to come up with a monetary system to motivate doctors without having to rob Peter at the Expense of Paul…I don’t think it’ll happen soon. We’re kinda treated like the hair loss industry, but with many more laws and not as much industry quality.

…money…makes the world go 'round.

Defy, Low t nation, dr Keith Nichols are who I know and talked to. The other clinics and docs all are having old school protocols. I would use defy in a heart beat if I was to choose a clinic. They all have there problems , but they actually let you talk to a doctor. Other clinics never put the doc in the phone. Never ever … you don’t get answers.