T Nation

Clinic Doc Likes to Include AI in the Test Cyp Compound

T Replacement
#1

So I bit the bullet and finally went to a local men’s wellness clinic to get tested*. While I was there the clinic doctor told me he generally prescribes an AI and, if I didn’t misunderstand, has the pharmacy compound the AI into the testosterone cypionate prescription. Except for being very pro AI he seemed very serious about treating symptoms and not numbers, but he told me he preferred to keep estradiol between 10 and 25.

Based on everything I’ve read I’d really like to start with just TRT and no AI until I’ve at least seen my numbers after 8 weeks on TRT. If I can’t talk him into letting me start with just Testosterone I feel like I should just walk away, eat the sunk cost and find a better alternative. Am I being unreasonable? Should I accept the AI and see what my numbers are? Note that there is a cancellation fee if I go forward and decide to cancel later.

  • I don’t have my initial blood test results yet, should get them Monday afternoon. I did talk my GP into testing me about 5 years ago and came back around 380-390 TT but he was very anti-TRT and told me my numbers were perfectly acceptable for a guy over 40.
#2

It’s your body and your money. Seek the treatment that makes the most sense, not the one that a clinic physician wants to pursue based on his own personal beliefs.

And not for nothing, but the use of a compound pharmacy is a dead giveaway of the motivations here. Any CVS/Walgreens/Whomever carries testosterone and the need for it to be specially compounded is hard to justify, unless of course you’re a clinic that gets kickbacks for sending patients there. I think you already know what you’re going to do.

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#3

I believe most TRT clinics that compound testosterone create a blend that Ive come to really like. 200mg of Test C along with 20mg of Test E per ML. It gives me energy that I not had since the olden days before 2010. Other than that, I would just stick with the pharma stuff, with no AI or HCG mixed in.

#4

Called the clinic, my tests came in, will definitely be cancelling. The clinic made it sound like the doc had written my prescription (200mg Test per week) before seeing my test results.
Total T 520 ng/dl
Free T 8.17 ng/dl
Estradiol 21.8 ng/dl

This is nearly a 140 point increase over my test from 5 years ago (different labs so not quite apples to apples). All of this in spite of aging (I’m 53) and switching to a 12 hour night shift job.

#5

What’s the range for your free T? The lab I’ve used (labcorp) puts that at near the bottom of the range and certainly would qualify you for treatment especially if you had symptoms.

#6

I don’t have to hard copy yet, but they said it was in the normal range. I do realize it’s on the lower end. My symptoms are relatively mild and could be due to other medical issues. I fully expected my labs to come back with a total T in the 300s based on my test history.

Based on a bizarre health episode I had a year ago I think I am going to check for other endocrine issues with a GP and/or specialist before I look at TRT again.

#7

Your doctor just contradicted himself, any clinic/doctor that wants to control/suppress estrogen right out of the gate especially without side effects is a recipe for disaster.

I see men on these forums diagnosed with osteoporosis with estrogen in the mid teens.

I would say an estrogen of 20 is still on the low side, 30-35 is the optimal with some requiring higher levels.

I strongly urge you to run from this clinic!

#8

So it sounds to me like you’re on the fence about starting. Here’s what I’d do. Try to resolve any symptoms you have other ways. Lose some weight, start exercising (I’m making assumptions here), clean up the diet, etc. Maybe you’ll be fine for a good long while. You can always try it later on. If you do everything you can and still have symptoms you can’t ignore, at least then you can say you tried everything else, and this is what’s left.

#9

Thanks, Systemlord. I definitely won’t be starting with this clinic. The whole experience felt a bit shady. I should have trusted my gut and walked out.

#10

Wolf359 - Spot on. I had some big life changes in the last 3 years. I’ve lost about 35 pounds but could stand to lose another 20 or 30. The big box gym across the street has reopened and I have a membership so I have no excuse not to get in there.

Based on some health history which I had entirely failed to consider, I really do need to at least visit a GP and get some other checks. Even the doc in the TRT clinic told me to get a regular GP and get some other checks.

#11

If you’re in your 50’s you’re gonna wish you had started in your 40s once you notice how much better you perform with higher levels than what you naturally running at this age. On paper it may look great, but perhaps your body should be running a bit higher T. So dont wait til you have fallen off the cliff.

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#12

I was pretty ‘off the cliff’ in my 40s. That was when I tested out to a total T of 384. I managed to put on a fair amount of muscle in spite of that. I agree though, that we should not wait until we’ve crashed before we seek help. Now that I know my numbers have rebounded, I need to sort out my other health issues, then I’ll revisit TRT with a better provider.