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Expensive High Dose from Clinic or Less Expensive Lower Dose from Dr?

Looking for some opinions. When I started looking into HRT, I had all the classic signs of lowT, but was also severely overweight (400ish). Dr told me to go home, continue to diet and exercise, and when I was a healthier weight, then it may be an option to investigate…

1.5ish years of hard work later… no significant gains/loss (350ish) and Dr still would not entertain the idea that maybe lowT was an issue. So…

I went to Universal Men’s Clinic (UMC) and test came back at 120ng/dl… at the time I couldn’t afford the $2700 for treatment so, another year went by with feeling shitty and no significant results from exercise.

Went back to UMC about a year later (330ish by now) and tested at 140ng/dl… started TRT that day, 200mg E7D… that went well, started feeling much better, workouts were better, sex was better, ETC…

About 6 months in, I talked to Dr about “highs/lows” I was feeling and he put me on E5D protocol…

So, here’s my dilemma…

  • Cost $2700 for 18 months of treatment at UMC, no matter the protocol, so I like that they have me at a higher dose, but I use about 11ml in 18 month time, so I could go through a regular Urologist/Endocrinologist and use my regular pharmacy and GoodRx to get that for about $350… BUT…
  • UMC is checking bloods at day 7-8 when I’m on E5D protocol… not sure how that is ok? I’m not complaining, but shouldn’t bloods be taken on day 5 to get accurate levels on E5D protocol?
  • Bloods have been TT=650-750ng/dl on day 7 (which is not correct, cause they should be drawn on day 5)… I just had bloods done 2 days after pin and TT=1500… at these levels, if I go through a Urologist, they will not keep me on 200mg E5D…? This is ok though, because I’m on TRT to live the healthiest life I can, not for a lifelong blast… but since I pay UMC the same $$$ regardless of ML used, I want to get the biggest bang for my buck ($2700).
  • AI is included in TestC, and LDL came back elevated… wondering if the AI is causing elevated levels and is even needed.

I know that’s a lot to touch on, but just wanted some input from all you smart guys and smart ass’s alike.

Thanks,

Ler

TLDR; Universal Men’s Clinic provides me a $2700, 18month blast of 200ml TestC, E5D. Should I drop dose to go with less expensive and most likely healthier TRT proscribed by a Urologist/Endocrinologist?

1500 peak isn’t that crazy, lots of people just don’t test then so they never see the numbers that high, but they would if they did test then.

700 total T at trough is totally fine. Some would consider that on the lower side even. If you think you should have tested on a different day, then re-test and share what you get

I would get them to remove the AI. We see people complaining about clinics that do that constantly. At best it’s usually too much AI. At worst it’s completely unneeded and crashes estrogen to the point you feel pretty bad

Is what you’re doing now working for you? Do you have any issues that aren’t being resolved?

Usually an endo/uro will want to start with 200mg every OTHER week, which is a horrible way to do TRT from both a dosage and frequency perspective, but that’s what you’ll be dealing with if you go away from a clinic. On the other side of that argument is you’re already using a clinic that includes the AI in their T, which is a pretty good sign they don’t know what they’re doing either.

If your insurance would cover it, I might would talk to a uro or endo and see what they say. If they want you totally off of anything for months before they’ll even think about prescribing, then I think that’s pretty clear direction that you’d be better off with the clinic now (esp if they’ll give you T without the AI in it). If they are OK with working with you and starting you off at 200mg/week or so and letting you guys figure things out from there… then I’d give them a shot.

It very much depends on the doctor you can find IMO. There aren’t many uro/endo’s that know TRT though, so I don’t have very high hopes. If you don’t have luck going the endo route, perhaps a different clinic or telemedicine would be a better option.

Thanks, everything feels great at 200mg E5D, hurts the pocket book a little though. :stuck_out_tongue:

The 1500 peak measurement was from my PCP… I told her it would be high due to being close to pin and we weren’t concerned, cause it was just “annual physical” stuff with T stuff added.

Take your blood work and current protocol to your primary care physician. Explain that you’re not willing to pay so much for a clinic and that you’d like him/her to handle it. Use the extra $2,000/yr to go on a vacation or invest in Apple.

Recently left my clinic (because at this point I know more than they do about my treatment) and I’m going to save thousands because testosterone is insanely cheap.

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I’ll add: your numbers look good. Eventually you’ll get dialed in and you’ll land on the dose that makes you feel the best. For now enjoy the good levels and keep working on that weight loss. I know you probably don’t see it, but dropping 70lbs is great progress and you’ll get where you want to be eventually. Just keep it up.

That was my first course of action… She said she isn’t comfortable handling HRT.

“Not knowledgeable enough”

BRO… I’m at 260 now!!! Impedance measurement says 27%.

I’m doing well.

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  1. Nothing wrong with trying to find a cheaper route.

  2. I would stay with the current test dose, since it is working.

  3. I would discontinue the aromatase inhibitor.

  4. Try to stick with trough labs if possible.

Your doc is potentially creating problems for him/herself by not measuring at trough when levels are expected to be lower. Peak levels are short lived, you spend the majority of the time somewhere between peak and trough, and trough levels is how you measure a protocols success.

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They check at peak levels because they want to show you a big number and make you feel good about it. “Look how high your testosterone is! Isn’t this great?” It’s marketing. Without knowing trough levels you’re only getting a fraction of the information you need. But hey, at least it’s pretty expensive too.

but they are checking past trough, day 7-8 when I’m on E5D…

Is it possible that they just forgot/missed that you had moved to e5d and meant to ask for a trough day, just ask/remind them next time around.

No, I have reminded them. They have their set “way” of “7 days after last injection”

There is no such thing as seven days past injection when you inject every five days. I feel like they should be able to do that math.

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So the only way to that then is to skip/delay an injection and wait 7 days to do the labs. Or just tell them that it was 7 and do it on 5.

If they can’t figure this out I question their ability to treat you.

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Did the same.

Ya, but I don’t “skip”, just postpone for 2 days.

I recently switched from an insurance covered endo to Defy. Cost me a lot more but I get to keep my dose where I want it plus I enjoy the comfort of a legal script. You’re right about how ridiculously cheap I could do it on my own by comparison.

It wasn’t just money for me (I can for sure afford it). Some of it was the hoop jumping. Although, if I had McLaren money, I would be popping $8 var pills, and pinning 2 iu of GH straight from the pharmacy (just giving you a hard time here).

You going up in dose, or just keeping the previous?