T Nation

Good or Bad Deal with TRT Dr?


#1

I just contacted a local Bioidentical Hormone Replacement clinic to talk to them about becoming a patient. The woman I talked to was very helpful and answered all of my questions. However, since I have no experience in this area, I can't tell if the package they offer is a good deal, or even if it's "too good to be true." This is what they told me:

  • The price for the initial consultation is $395, paid out of pocket. It includes a DEXA scan, 90 minute consultation with a doctor, and the ordering of bloodwork.
  • Blood work is submitted to insurance. If insurance refuses to pay, there is no cost to the patient.
  • Once the doctor reviews the bloodwork, he prescribes a treatment plan which may include prescription drugs and/or OTC supplements.
  • The average cost of treatment is $100 per month, but this of course depends on the specific case.
  • No followup visits are required, blood work is to be ordered every 6-12 months, and patients have unlimited access to doctors by phone and email at no additional cost. If a prescription needs to be changed or treatment is not working, all that is needed is a call to the doctor for him to make adjustments.
  • On average, patients come in once a year for blood work after the first visit. Other than that, treatment is largely self-directed.

For you guys who have gone to a BHRT clinic rather than an endo for treatment, does this all sound about right? It honestly almost seems too good to be true -- just pay $400 dollars and have a doctor willing to work with you to optimize your hormones forever. Since a DEXA scan usually costs $150 and ordering thyroid bloodwork myself would cost $180, not to mention the fact that I've been unable to find a doctor who takes my concerns seriously, it seems like a no-brainer, right? Any input from more experienced guys would be greatly appreciated.


#2

How old are you, a DEXA scan might be stupid if you are young. At 25YO, insane.

You have primary hypogonadism. Were your testes checked for repairable vascular abnormalities?

You can do this and always have the option of doing something different if the cost get out of hand.

Ask for the costs of:
100mg T cyp per week
1mg anastrozole per week
250iu hCG EOD - you must protect your testes at your age unless sperm count is now zero

Ask for there costs to test:
TT
FT
E2
CBC and lipids - is cholesterol low
TSH, fT3, fT3


#3

KSman, thanks for the reply. I am indeed 25.

How have you determined primary hypogonadism? Note that my TT is 770 ng/dl. I have not been checked for vascular abnormalities, as none of the doctors I’ve reached out to have been willing to take me seriously enough to even run tests. The last endo I spoke to refused to even see me. I have begun looking at BHRT providers out of desperation more than anything.

Would a prescription for Test cyp be necessary because my TT is currently so high?

I have labs for TT, FT, and E2. TSH, fT3, fT4 will cost me 60 dollars out of pocket because I can’t find a doctor to order them. I’m not sure how much they would cost at the clinic but I will call and ask. My concern with ordering myself is that I’ll find abnormalities in thyroid function as I did in FT and E2, but “mainstream” doctors won’t be willing to treat me. Then I’ll be back in this same position, but 60 dollars poorer. At a certain point I’d like my insurance to start picking some of this up (especially if I end up needing rT3 and liver function tests as well) but I can’t find a willing and competent doctor. Hence: BHRT clinic.


#4

Stay away from the low T clinic. They will take your $400 and if they’re honest they’ll send you away without TRT. Your TT at 777 is very good and it would have been higher at 8 AM than at 10:50. The low free T and possibly the thyroid are probably your problems. If that FT number is accurate, your SHBG is too high. It looks like you need advice on how to lower your SHBG.


#5

[quote]Freddy77 wrote:
Stay away from the low T clinic. They will take your $400 and if they’re honest they’ll send you away without TRT. Your TT at 777 is very good and it would have been higher at 8 AM than at 10:50. The low free T and possibly the thyroid are probably your problems. If that FT number is accurate, your SHBG is too high. It looks like you need advice on how to lower your SHBG. [/quote]

Thank you for your reply. I agree that low FT, elevated E2, and possibly hypothyroidism are my issues. It was my hope that the clinic would help me sort out these issues, but now that you point it out, they’re probably much more used to dealing with cut and dry age-induced hypogonadism. This is definitely something for me to consider. I did ask about thyroid issues and was told that the clinic treats them as well as “all other hormone problems,” but who knows how true that is.

My current plan moving forward: Find a general care Dr. to order thyroid tests (TSH, fT3, fT4,) and discuss frequent urination. Additionally, ask for test confirming/disputing low FT and checking level of SHBG. Also order CBC with lipid profile.


#6

I guess that there was not enough info for me here and my fast scan of your other threads did not work well.


#7

Hey I dont mean to stray off topic but, I’m still unable to send PM’s and was wondering if you lived near the Toronto area. I know most of the private BHRT clinics are situated there… if you are hit me up i’m almost in the same boat as you are.


#8

[quote]c_Motion wrote:
Hey I dont mean to stray off topic but, I’m still unable to send PM’s and was wondering if you lived near the Toronto area. I know most of the private BHRT clinics are situated there… if you are hit me up i’m almost in the same boat as you are.[/quote]

Sorry, nowhere near Toronto. I’m in the States.