Dealing with a New Endocrinologist

Yeah, he’s an endo…so focussed on textbook treatment that is decades old. He does ask and listen to how I “feel”, which is better than most. He said get tested in 4-6 weeks to make sure I am responding to the meds.

I’m tempted to stick to his every 2 week protocol until my first test just to play the game and bump it up to a (probably) more appropriate dosage.

After that I’ll go to weekly or twice weekly.

Yeah that’s what I would do. Play the game for 4 weeks, test as long after the 2nd shot as you can to get low numbers and you can always do the “I feel normal for a week or so then it’s like I run out, maybe a higher dose will help” thing and see what happens. It still boggles my mind that every 2 weeks is the textbook norm but it is what it is I guess.

I have a friend who refuses to go against his Dr’s advice and he pins twice a month. He feels like dog shit at the end of 2 weeks but just wont change. Are you sure you’re willing to do this just to “play his game”?

It’s a tough one, for sure. The first shot has to be in their office so they can “educate” me. That one will be a 200mg shot that should last 2 weeks on their protocol. After that I’m on my own.

I suppose right after that I could go weekly. I do think 100mg/wk is on the low side…so I want my results to reflect that. That way he can boost the dosage and I’ll be on my way.

Sucks cause we pay out the ass for insurance and when we use it we get a bunch of textbook drs who just want your T level at 400-600.

It’s a shame the real TRT experts are private. Some exist in insurance land I’m sure, but they are needles in a haystack.

I was with an old-school Endo originally and his protocol was the same. I eventually went to a new Endo as I wanted to keep it within insurance. Old school Endo’s think T levels at 400-500 are nailing it meanwhile you could feel worse. If you want to try to game it then time your labwork at absolute trough levels or even inject less on labwork weeks, and lay out a bunch of complaints including telling them it is negatively affecting your relationship/marriage. I laid that relationship line out plus telling them I travel a lot so need extra in case I’m not around to pick up my renewal (monthly) and they prescribed me the max allowed (200mg/week) on the condition I don’t give them any labs in supraphysiological range, which can get them in trouble. I thought that was a fair deal as it also allows me to experiment.

I still haven’t had a decent explanation from docs as to why the starting dose is 100mg/week when our bodies naturally produce much less (absorption?), indicating that although injections are bio-identical testosterone it doesn’t always have bio-identical results in resolving symptoms (energy, libido, etc.), and also why we can’t increase dose until symptoms resolved vs. just having “in-range” labs and calling it a day. I get that the majority of studies are 100mg/week but still no explanations. There are so many disconnects and a range in quality of medical studies that TRT can be tough to figure out. Then again, maybe you are one of the guys that does 100mg/week and problem solved…

I wish, but I doubt it. I started at 100mg/wk at the TRT clinic before I ended up at the endo. My Testosterone was 562 at the trough. Better than what I’ve got now…but not ideal.

With the endo/pa I saw for the first year or so on my first follow up my first trough value was 298ng/dl and he was like “good you were in range the whole time”… and I knew I was going to have problems.

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