T Nation

Hampton Roads/Tidewater VA TRT

Ok, this kind of a last resort for me. Can anyone please private message me with any potential TRT doctors in the Hampton roads area of Virginia. I was recently diagnosed with Low T and would like a competent doctor who can treat me. I followed the stickies on the board but mainly ran across private docs not accepting insurance or the 1’s that did want me to use pellets…Any help would be appreciated. Thanks

There are no qualified TRT docs in Tidewater area. Just piece of shit uros and dumb endos. They accept insurance, but they do not know anything except shoot you with 200 mg cypionate in the ass twice a month.

Thanks for the info. I recently had a physical b/c I was experiencing lack of energy, foggines and most important lack of sex drive and erections. The last issue causing stress in my marriage. I was able to talk the doctor into running most of the tests posted by Kaman. The only 1’s that came back so far, overall t at 240 in a lapcorp range of 300_1100. Free t came in at 6.4 in a range of 5.0 to 21.0. PSA was .4. Not good for a 39 year old, I will be 40 in August. I’m waiting on other labs. Trying to find a trt doctor is becoming depressing with most wanting to put me under with pellets. Was hoping someone could point me to any freaking doctor with experience in various. Ok my rant is over.

Forgot to add I am 6’1 and 240 and compete in Olympic lifting and some cross fit. Though recently I would rather not train, I’d rather go home and take a nap. What’s the freaking deal

You do not want to go to regular uro/endo fuckers. Yes, they are covered by insurance, but they are stupid as shit, have God complex, because they have MD diploma on the wall, and ‘X years of experience’. Besides, they have malpractice insurance, and they have to stick to “standards of care” down to the T in order to minimize legal risks. So if you say that you need to try arimidex, etc, chances are they will not agree. If you are persistent, they can easily discharge you from practice because you annoy them.

Chance to educate them and change their approach is practically zero, it is very rare that an MD listens to what you have to say about TRT.

Are you able to pay a knowledgeable doc out of the pocket? I am talking about $600 for initial consult, plus travel fee outside of state. Unfortunately there are no qualified TRT docs in VA.

Yes, I can afford to pay out of pocket but with my insurance I thought I’d give that try. Of course that’s not proving successful. How frustrating.

There are few popular names in TRT:
Dr. Shippen in Pennsylvania, he is about 70 y/o, and you need to wait couple of months for appointment. There is Dr. Crisler in Michigan, he is the controversial one, because of his personality primarily, but he has a lot of good info in his site allthingsmale, there is Dr. Mariano, in CA. Mariano is psychiatrist by trade, but with extensive knowledge in hormones. There are also network clinics, such as lowtestosterone, or bodylogicmd, or agelessmale. They usually practice standard protocol, cypionate+arimidex+HCG.

But before starting anything you need to test a few things:
-SHBG

  • thyroid: T3/T4/free T3/free T4/reverse T3/TSH
  • adrenals: cortisol AM, maybe urine 24 hr cortisol/ZRT labs saliva 4-point test
  • LH/FSH
  • prolactin
  • Estrogen sensitive
  • DHT

If you go with one of the network clinics, they will sell you a test package (they obviously make money off it), all of that for ~$600.

I am in Virginia Beach and didn’t even try to find a Dr here. Pointless. I know a few guys who do TRT locally, and all have the pellets… not good.

You will wait 2 months for an apt with an endo, only for them to be a complete waste of time. My recommendation (and what I did) is to fly to either Mariano or Crisler and get things started. Yes - its expensive at first. Flight + hotel likely $400-600, then another $600 for the initial consultation. My insurance partially covered the initial consultation since it was in-person, but gives no coverage on the follow-up phone calls, which are about $300 per hour. Again, at first, its expensive as you need to speak with the Dr more often. Once everything is ironed out, its definitely do-able, especially when compared to the benefits you gain and the quality of life you get back.

I won’t go into the details of my treatment, but the monthly out of pocket pharmacy expense for me is about $120.

-Jim

Also - the local guys dealing pellets aren’t cheap. I know guys spending well into the thousands per year for sub par treatment.

-Jim

Thanks for the info. I’m waiting for the results of most of the panels mentioned. I followed the sticky for what to get checked when i went for my general physical. I don’t think my doctor tested everything (ex. estradiol, T4, T3) so I will need to get another draw. When my low T numbers came back he side stepped any concern. I was shocked at the low value and generally concerned. Once i receive all numbers and get another draw i will post… Still find it frustrating that their seems to be a lack of competent TRT doctors in tidewater/Hampton roads va.

I’m in Norfolk. I cant believe we don’t have a local urologist/endo with some type of TRT depth and breadth…

I was in Northern VA at the time of my hormone crisis. My test came back at like 90, and my e2 came back at about 90. Not good. I saw 5 endos over the course of a year… two accused me of steroids and refused to talk after initial blood work, the other three had no idea what to do and said to come back in a few months for followup bloodwork.

I wouldn’t spend too long dealing with local Drs… you are only going to get frustrated.

-Jim

Your doc likely will not order those labs for you. The fact that he did not order estrogen tells that he is plain zero in hormones. a lot of people agree that in TRT managing estrogen may be even more important than testosterone itself.

Uros are useless. I saw 3 of them, one in Sentara was honest with me. He said - people come to uros to treat hormones, I do not understand why. We, uros, are not trained in hormones. Sure, I will do to you what the ‘standards of care say’. Standards say - inject 200 mg cypionate in the ass every two weeks. They do so. If you feel worse - not their problem. They will tell you ‘it is all in your head’, ‘anxiety plays big role in your condition’.

Endos are even worse, because they pretend they have hormonal knowledge. Same shit, but they behave as if they know what they are doing.

What you guys call ‘frustrating’ I call criminal. This situation is not localized to Hampton Roads. It is everywhere in the US. It is worse in the rest of the world. Here you can find handfull of specialists, who will try different meds, do tons of labs. In other countries they do not even have sensitive estradiol lab available. So you need to become more knowledgeable in hormones than uros and endos. Which is not difficult, they practically have zero knowledge. They just follow handbook, approved by insurance industry. It has nothing to do with your libido, they consider their job done when they get your testosterone level “into the range”. This is exactly what one of the uros told me.

This is very uplifting) jk…Well, had a local doctor get back to me saying he would review labs with me and prescribe T injections from compounding pharmacy. He was initially pushing the pellet option, which I do not want. He said he could bill me out of network but I believe that is extremely high. I first want a competent doc who will review labs and recommend best course of action on why my T is low. Still waiting for other labs. This seems to be taking to long for my liking.

There is alot more to it than just T injections. Most pair the injections with HCG, and an AI at a minimum. Might be hard to get a Dr on board with all of that if they aren’t familiar.

-Jim

Yes, I’ve read the stickies regarding the correct protocol. He mentioned an AI but failed to mention HCG which of course raised some red flags.

Just joined the forum, and also live in Hampton Roads. Did you happen to find anyone yet?

njmall0ry: If you want any assistance with your “case”, please create your own thread and read the advice for new guys sticky.

KSman - no offense, particularly since this is my first post, but since this thread is about findng a solution to the lack of competent doctors in Hampton Roads, I’d like to know the answer as well rather than just referring him to start his own thread. I don’t think there’s anything wrong with the question, I’m looking for the same answer as I am running into the same problem.

Thanks.

After a quick google search, this is the dead end thread I found. Would be great if anyone has any suggestions for this area specifically for TRT docs. I can tell you Urology of VA, the two docs I have seen there are as described in this thread earlier. Pretty amazing they quality of care is so rampantly different from area to area.

Any updates or suggestions, would be beneficial to me and anyone else that will be searching the same criteria.