I, with a little help, derailed a recent thread on using the KSMan recommended TRT protocol. Eyedentist is not a fan of self-administered TRT and is fairly suspect when it comes to the advice given here in general. I'll let him get further into his feelings on the matter, but, in short, I don't share his opinion.
When I travel for work, I don't let the company travel person choose my flights or book my travel. The reason is that no one cares more about that trip more than I do. I make sure that the departure and arrival times fit my schedule. I make sure that I chose the seat I sit in (it makes a difference). I make sure that have my F.F. status registered (potential upgrades, priority boarding, etc.). What I've learned over the years is that no one cares more about all those 'little things' than the guy whose butt is in the seat. I travel a lot, so these little things will often turn into a big deal. The obvious continuation of this analogy is the question, "Do you fly the plane?". No, I don't fly the plane, but I do reserve the right to choose to drive, so in the end, I am in control of the ultimate path I take to get to my given destination.
Health care is a similar matter for me. I don't take a doctor's word as gospel truth. I make no apologies for questioning these professionals. It's called self-advocating, and I think it's something that all responsible patients should do. In my experience, the more confident and competent a doctor is, the more they are willing to engage in a meaningful conversation.
In the previous thread I made an reference to a large surgery I had several years ago. When I was told I needed it, I completely immersed myself in the literature. There were several ways to address my particular condition and they all had compromises. I wanted to figure out which was the best for me. I eventually arrived at the same surgery my specialist recommended. The first surgeon I saw was against it. The second surgeon I saw, who is world-class in his field, said that it would be irresponsible to give me any surgery other than the one I wanted. What I came to understand that it wasn't that I was a poor candidate to receive the surgery I wanted, but rather the first surgeon was a poor candidate to administer the surgery I wanted. It was a more complicated procedure than what he recommended and he simply wasn't up to the task.
I think this is often the case with TRT. Doctors often see reasonably healthy guys looking for TRT that could potentially benefit from it, but they don't necessarily need it. Their level, while low, still fall in the 'normal' range and they can have sex and be generally productive. Adding TRT successfully to their lives may help them, but it also might be a pain to administer properly and there really isn't a lot in it for the doctor. If the doc has tried 1/2-assed protocols previously, then he may very well believe that TRT is much ado of nothing or an overall negative. Keep in mind, this is just shoddy doctoring, not a meaningful appraisal of TRT.
I've personally read a lot of Pubmed articles on TRT, testosterone, HCG, A.I.'s, SERMS, etc. Like I've said before, I don't have an endo's understanding of the hormonal cascade, but I'm not uneducated on it, either. I understand the effect of the 1/2 life of different T esters. That alone seems to be a hurdle that many doctors fail to clear! At the end of the day, I have nothing close to a doctor's macro view of the human body, but I have a much better understanding (and, frankly, a lot more interest) of how I feel, my life situations and my overall health.
Is TRT an 'easy' way to lose fat? Who cares if it is? Regardless of my screen name, I've always been lean and have been athletic my entire life. This really has little to do with me, but I find it staggering that a doctor would want their patients to take 'the hard way' to getting healthy. Diet is something that should be addressed by everyone regardless of weight, and twice in the last week or so I've told people this in threads.
Many obese men don't react well to TRT because they can't control estrogen. Of course, many doctors won't even test E2, so they don't know this. There are a large portion of men that do react very well to increases in testosterone and shed fat because of it. They often don't lose that much weight because as fast as the fat is coming off, muscle is being added. This is not a bad thing. While we may not see large differences in BMI, that's not the holy grail. We've all heard the stories of body builders at 8% body fat being told they're obese because of a high BMI. The truth is that men who carry more lean muscle into their later years are more active, live longer and live better lives. Why would we want to limit this?
Mild/moderate doses of testosterone that keep a man on the higher side of a physiologically 'normal' blood values can do people a hell of a lot of good. It is important to take precautions to not induce problems that might be caused by the addition of testosterone, but those concerns can usually be addressed without too much drama. At the end of the day, I really don't care if a doctor wants to pass some sort of moral judgement on me. Honestly, he can pack sand. I'd love to have a smart doctor to bounce ideas off of and speak freely to, but until the day that I find that guy, I'm stuck on an internet forum with people who are often in a very similar situation.