T Nation

Getting Dr to Prescribe HGH

I’m wanting to be be prepared for my visit this Friday. Thanks to KSman for pointing it out I have learned since my last visit that I am also GH deficient. Probably not horrible (IGF-1 = 68 range 84-233, and HDL Cholesterol = 34 range 40-85). But I feel like that if I am in fact deficient, and taking it will make improvements, or keep me from aging prematurely why shouldn’t I be prescribed it.

I am making improvements with just Test Cyp, and HCG right now. If E2 is still on the high side I will also have to ask him to prescribe a AI. As for as the HGH goes I want make sure I have valid reasons for needing it other then the lab. I do have very thin skin, as to where if I scratch like a dry patch on my face it will bleed very easy. Other things are very dry skin, decreased muscle mass, low energy, memory problems, and other side effects also associated with low T.
If anyone has any suggestions for me I would be happy to hear them.

Low T causes loss of collagen in the skin, making it frail and thin. Low IGF-1 probably has similar ‘aging’ effects.

I had IGF-1=78 and HGH was very helpful. Prior to that, TRT had restored skin thickness and elasticity. My main benefits were how I feel, so there are effects inside the brain. Some are direct effects of GH and others would be from IGF-1.

I had my appointment today and my TT went up from 828 four weeks ago to 994. E2 also went up from 36.7 to 37.9. I have know idea why it went up. I have been on the same dose for the last 2 months. Only thing different is the addition of HCG since last lab. I asked the doc about possible HGH and a AI. He told me my T was to high and wants me to lower my dose. He said my E2 will come down with the T. I told him it wouldn’t come down enough to put me in he optimum range. He would not right for it.

I also asked about my low IGF-1 and if there was a chance he could right me for HGH. He looked at my old lab and said he will test it again in 6 weeks and go from there. I didn’t put up to much of an argument about the AI since he may be willing to right for HGH if needed. I am thinking of getting a AI from a on line source. Anyone recommend a particular brand? I seem to respond very well to meds.

I had my appointment today and my TT went up from 828 four weeks ago to 994. E2 also went up from 36.7 to 37.9. I have know idea why it went up. I have been on the same dose for the last 2 months. Only thing different is the addition of HCG since last lab. I asked the doc about possible HGH and a AI. He told me my T was to high and wants me to lower my dose. He said my E2 will come down with the T. I told him it wouldn’t come down enough to put me in he optimum range. He would not right for it.

I also asked about my low IGF-1 and if there was a chance he could right me for HGH. He looked at my old lab and said he will test it again in 6 weeks and go from there. I didn’t put up to much of an argument about the AI since he may be willing to right for HGH if needed. I am thinking of getting a AI from a on line source. Anyone recommend a particular brand? I seem to respond very well to meds.

[quote]cobra003 wrote:
I had my appointment today and my TT went up from 828 four weeks ago to 994. E2 also went up from 36.7 to 37.9. I have know idea why it went up. I have been on the same dose for the last 2 months. Only thing different is the addition of HCG since last lab. I asked the doc about possible HGH and a AI. He told me my T was to high and wants me to lower my dose. He said my E2 will come down with the T. I told him it wouldn’t come down enough to put me in he optimum range. He would not right for it.[/quote]

The difference in E2 levels between tests is 3.27% which is probably just normal variation. However, you should expect higher E2 with HCG, since this promotes intratesticular E2 formation (if I recall correctly), and with higher total testosterone.

Tnew:Told=1.20
Rnew:Eold=1.033

I am surprised that E2 did not increase more simply based on TT levels.

Your increase in T from hCG is not surprising.

You new TT looks fine to me.

Get the E2 down and you will be very surprised in how much better you feel.

How has FT changed?

We cannot post sources here, some will not be aware of why.

hCG does not always increase E2 with the normal small doses recommended here. And most of the time any increases will be small and will be managed in the routine E2 lab work and AI dose adjustments.

TT is mostly T+SHBG and that is inert. The liver removes it. Older guys have increasing amounts of SHBG which reduce FT and weakly bound T [T+albumin]. With frequent injections, TT and FT levels are quite steady and the FT labs are very useful. TRT should have a goal of FT near or above the non-age-adjusted FT upper range. If that means that TT is above range, it really does not matter how much T+SHBG exists in serum. T+SHBG cannot release T to T receptors, it is tightly bound. Now E[123]+SHBG can transport and release estrogens and is often referred to as a transport method for those hormones. It is very common to find the community interested in hormones stating that SHBG transports T. The only truth in that is that SHBG locks up T that is then managed by garbage collection in the liver. Note that increased E levels leads to more SHBG which depresses FT. Lowering E2 can increase %FT.

E2 management is mission critical to QOL.

He doesn’t see the need to do FT labs. He is another young Doctor with a ego problem. I will wait him out to see if labs 6 weeks from now show I am still GH deficient, and see if he writes me for HGH. Also if TT goes down on new labs (I told him I won’t settle for TT less then 800’s) and E2 doesn’t, see if he will go ahead and write for a AI. If not, or if insurance doesn’t cover the costs of the HGH I will go to the TRT Doc in KC area.
It sucks starting over with new Dr’s that don’t know the protocols, trying to get them to treat correctly so my insurance will cover the costs.