-height: 6.0 ft
-waist: Major Abdominal Fat
-describe body and facial hair: Lots of body hair, Facial hair is thick on neck and really patchy on cheeks
-describe where you carry fat and how changed: Lots of abdominal fat and large breasts
-health conditions, symptoms: Low Total Testosterone of 292
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: No
-lab results with ranges: Total T of 292 after two separate labs currently waiting on results of a MBC Panel and CBC Panel
-describe diet: horrible fast and processed foods until lifestyle change two months ago. Now its fish, chicken breasts, veggies, cottage cheese, whole foods, etc
-describe training: was super lethargic and lazy until i got off my ass two months ago and began a very active landscaping job along with training twice a week.
-testes ache, ever, with a fever: Sometimes they do ache although its very rarely
-how have morning wood and nocturnal erections changed: Lots of nocturnal emissions and morning wood, no problem with libido ever.
I will keep this short as possible.
I am 22 and recently thought about why I am so tired and gain weight so easily and why my voice never really dropped or penis grew during puberty. This led me to hypothyroidism and eventually to this forum then to a general practitioner. On our first meeting i explained my symptoms and he felt around my thyroid and ordered blood tests to check for under active thyroid and testosterone levels. I called a few days later and the receptionist told me this.
"Your blood work shows no sign of under active thyroid but you have low testosterone levels."
"What were my results/levels?"
"Well, your T3 and T4 levels are in range but your total T is at 322 and that is a little low"
"Okay whatâ??s the next step?"
"Come in for an AM confirmation Lab test"
I go in and give an AM blood draw and wait a couple days to call for results. That phone call went like this. Again with secretary...
"Mr. Radass, Your blood results came back and showed Low total t levels. You can come in and get your prescription for Androgel and we'd like to see you in two months to do a follow up check are you available on xx-xx-xxxx date?"
"Well, if itâ??s possible id like to talk with the GP about my options and a few other issues before I start any routine. is that possible?"
"Sure, howâ??s tomorrow?"
That follow up meeting just happened today.
Based on a quick glance through the stickies here and some other websites I wrote down some questions to bring along with me for this meeting. here they are.
- What is the root cause of my Low T and can we fix that so I can avoid TRT altogether?
- I'd like to go on an Aromastaze inhibitor, I believe I am estrogen dominant and want to keep my estradiol levels in check
- Don't you need to do some more lab work and a prostate exam before I begin TRT?
- What are my options of TRT and the pros and cons of these options?
Now I had read a good portion of the stickies and was expecting an ignorant doctor but nothing like what I experienced at the appointment today. Here is a quick review of appointment.
Doctor walks in room and begins explaining what androgel is, how to use it, and reading the fine print of this androgel pamphlet. He is basically selling me the androgel like a used car salesman would. I stop him and ask,
"I am interested in the root cause of my Low T, is there anything we can do to figure out what that might be?"
He Replied, "well I checked for primary and secondary causes and didn't see any so TRT is the next step for you."
He then continued to ramble on about this Androgel pamphlet. I stopped him again and said,
"I have an intimate relationship and am worried about the transfer of gel to her I don't think the androgel application is the most affordable either, don't they make compound creams?
He continued to explain that,
"After two hours it won't transfer and more general bullshit about not having any other cream besides Androgel or its generic brand."
I stopped him again and said,
"What other options are there that dont include daily application?"
He replied, " Ohh well theres a shot we can do once every two weeks."
I said "I'd prefer that over daily application."
He replied, "Okay the nurse will be right in to administer that and come back in two weeks two get your next one and well see each other in two months for a follow up appointment"
"Doc, if you have the time Iâ??d like to discuss a few more concerns with you. From what Iâ??ve read, an aromastaze inhibitor is often used to prevent estradiol from becoming dominant, I've read that arimidex is often used as an off label inhibitor. I believe I am already estrogen dominant and would like to explore my options with an AI along with testosterone. "
He then pulled out his iphone and looked up arimidex and said,
"no no that is prescribed for breast cancer and the like and i've never heard of it being used with testosterone we usually just give the testosterone as is and nothing along with it okay?"
I bit my tongue and moved on to the next concern,
"don't you need more lab work to check before I go on TRT?"
"weâ??re going to draw for a GBC panel and MBC panel today but were just going to start the Testosterone today as well"
I bit my tongue and moved on,
"Okay doctor, what exactly are you using and at what amount" (notebook and pen in hand)
He replied, "I'm using Testosterone cypionate at 150mg every two weeks, then in two months we will draw blood and check T levels and readjust if we have to."
I then asked about the effects he expects and he told me the general increased libido, attitude, energy, etc. I asked if it will have any effect on a strict weight training program and diet i'm on and if it will affect my weight loss or muscle gain and he said no it wonâ??t effect that. So then he tells me okay i'm going to prescribe you the vial and I want you to bring it in every two weeks to your appointment and i'll see you in two months. Thanks bye!
By this point I was pretty upset but also eager to begin TRT to help facilitate weight loss and help increase my mood and energy levels and such. So I got the 150mg shot and decided to turn here for insight.
So now i'm hoping that he prescribed me the vial of T which means I can self-administer if this board directs me too. I' also planning to bring in multiple peer reviewed studies on Aromastaze Inhibitors and there effect on Estradiol and application with TRT and get him to prescribe me an AI but that wonâ??t be for two months.
Thoughts on this situation/doctor/TRT/anything else?
Sorry for the super long post but I felt it necessary to explain my situation
Thanks for everything you guys do