Criteria for Rx TRT:
Many docs are slaves to lab numbers and don’t consider symptoms. And for most that do consider symptom and labs, very few seem to consider low T to be a symptom that needs to be investigated instead of a condition that Rx TRT will fix. We know that low T can be symptom of some well known causes and most doctors do not consider that there might be another root cause that needs to be addressed. Docs are pushed into some of this thinking by HMO’s etc and insurance constraints, pressures and fears.
Labs for TT:
- can be misleading as this can be inflated when SHBG is high. That is why we need fT, even though its pulsatile nature makes the fT values uncertain and of course we need FSH and LH as part of this workup. We see docs who Rx TRT and don’t test LH/FSH, because drug reps don’t want to to confuse the issue with facts.
-Some guys need more T than others. A lowish T level might be OK for a guy who has never had high T, levels, little body and sparse facial hair. Take a short stocky hairy beast who grew up on high T and take him to the same lowish T level and he will be a wreck.
Dose: Doctors do not read more than bare minimum and ditto for thinking. Injected T; old grandfathered product literature suggests injecting every two weeks, predating disposable syringes, and thats what docs see, thinking is optional. Anastrozole 1mg/day in a estrogen positive breast cancer context, so prescribe that to males, brain dead.
The things that I complain about with docs are the things that guys report here. I think that words like stupidity, ignorance and malpractice are appropriate. Everyone here can see it without spending years in medical training. Now I am on a tangent!
“Efficacy of the T-Nation TRT Protocol”: What is suggested here, with the suggested follow up labs and dose changing methods and calculations works very well. Drug delivery suggestions reflect the reality of half-life of the drugs. There are the objectives of target T and E2 levels as well as testicular health for those that consider that important. However, in the realities of any case, we may run into other hormonal problems with thyroid/iodine, DHEA or cortisol and these need to be addressed if we keep the objective of health and vitality in mind. We also run into non-hormonal complications such as heart disease, high PB and other “diseases of aging” as well as other pathologies and “battle wounds”, and sprinkle in some depression and adverse life events. But overall, the suggested protocol is the best recommendation or starting point for guys whatever the complications might be with the caveat that in some cases, thyroid and/or adrenal problems may need to be addressed before starting TRT. I am not loosing sight of low HG in some guys, we do not see many cases of that here, or at least recognized and treated, low GH may need to be treated before the expected benefits of TRT can be realized. We have guys who “do everything right” and life is not great. Their docs have not been successful or not helpful. We do make collective efforts to see if we can help. In cases where there is degeneration involves, all aspects of pathology might not be resolvable. But overall, we see many who have life restored with T+AI+hCG.
Who is the “T-Nation TRT Protocol” right for?: The stupid answer is for guys who are self actualized who know that there is more than their docs offer or deliver who have thus landed here. In some respects it is easy to land here with a Google search. The quality of the content here creates very high algorithmic page ratings. I work here because I saw that T-Nation was a better community than the other “muscle boards” out there. Guys who are passive do not land here. For those that do land here, there is a lot to learn so they are proactive and educated. They can very quickly and easily understand more than their doctors in many cases and that really is needed in most cases. However, we do not see guys who are proactive who are getting perfect hormone management from their doctors unless they simply are trying to seek more understanding of there treatment I thought that I was trying to get off of my tangent, but not working.
We are here and this forum exists simply because there are needs that are not addressed/managed by the medical community. We are all about what doctors are not doing. -done!