Help Finding a Good Doctor Around Dallas/Ft Worth, Texas?

Does anyone know of a good endocrinologist in the Dallas/Ft Worth area in Texas? I am having a bad time on TRT and am on my third attempt of which none have gone well. I clearly have some other thyroid or adrenal issue going on but it is getting very expensive going to my urologist for my T, a cardiologist for palpitations and then going to random doctors to manage the side effects. I found one that does not take insurance but is supposedly very good with thyroid issues, but I have read anecdotal reports that he does not treat adrenals. I am dying to find a doctor willing to look at the big picture to figure out why this is not working for me. Thanks

I donā€™t know if defy does telemedicine but if so that may be a good way to go. Iā€™ve not used them personally but Iā€™ve heard good things from @hrdlvn (I think it was him) so maybe he can chime in.

Also, it may help if you post what protocols youā€™ve tried, how long on each and what the results were.

Thank you for the suggestion, when I used defy in the past and started having problems they did not seem very concerned, they just sort of shrugged their shoulders and changed testosterone dosing around.

I do have a running log in the TRT section, I was taking 18mg test e per day and two weeks in switched to 16 mg per day and I am about a month in total now.

I am not having symptoms of high estrogen, but I have not had labs done quite yet since getting on. I am convinced at this point that I have some sort of thyroid or adrenal issue going on. I am now feeling extremely low on energy, I cannot focus on anything throughout the day and I am waking up with severe hypoglycemia symptoms. I feel incredibly nauseous to the point that I gag when eating my breakfast, I am shaky and sweaty and have a rapid heart rate/palpitations all day. Definitely feel like I am dying in the mornings, not even exaggerating. Eating helps only a little bit. I was desperate for some relief today and tried rubbing a good amount of hydrocortisone cream onto my forearms (read that it can be used in place of cortef in certain doses), and about 30 minutes later my stomach seemed to calm down and my heart rate has since slowed. My TSH has been above 2.0 during every one of my tests for the last 3 years.

It seems that I am always ā€˜within rangeā€™ on tests on my pre-trt labs but after I get on the doctors only focus on the testosterone levels and not on what else is going on. And then if they do focus on thyroid they donā€™t do anything since itā€™s ā€œin rangeā€ and most donā€™t seem to care about cortisol.

Iā€™m just getting sick of trying new protocols and having them all fail. I feel like death and I can barely force myself to work at the moment. I have somewhat of a libido for once but overall I definitely feel worse than before TRT, so I know something else in my body is not functioning correctly. If I keep going at the rate Iā€™m going I will burn out and itā€™s going to be a lot harder to receive medical care without a job. I found a doctor through stopthethyroidmadness who is supposed to be good with treating thyroid problems that donā€™t show up in labs, however some reviews have stated he doesnā€™t treat adrenals. This could be problematic and cause me to be even more screwed up if I am treated for being hypo. I am being as patient as I can but I really need a doctor who ā€œgets itā€ as opposed to all these doctors who treat separate systems or just go by the lab ranges because I feel so awful that I spend all day wondering if I should continue this. I canā€™t afford all this treatment plus ER visits when things go wrong

One of the best is Dr. Nichols but heā€™s in Chattanooga, TN and you have to make at least 1 trip to see him to ā€œestablishā€ the doctor/patient relationship due to TN laws. Might be worth considering if you can swing it.

Which doctor did you try at Defy? The first one I used didnā€™t seem very great but I switched to Dr. Saya and he has been better so far.

I had similar-ish adrenal problems and ashwagandha ksm-66 helped with that. My cortisol levels were high. There really isnā€™t much a TRT doc can do besides adjust the dose.

Post the thyroid labs. Hereā€™s what you need tested.

@touchindeez I am a happy defy patient for just over 6 years. If you worked with them and did not find a good protocol it sounds like you need closer attention than tele-medician can provide. I wish you luck in finding a good local doctor.

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@dextermorgan Defy are very knowledgeable in different subtle endocrinology fields, but I dont know why they start people on testosterone and HCG together which seems to prevent people to understand how they feel on testosterone alone and they seem to advise 2 times a week injections instead of ED. Maybe dont want to pin people so much, but a friend of mine is not feeling well enough with their protocol and now he will try 30mg ED no HCG for a few weeks.

I would think if it didnā€™t work for a majority of their clients they wouldnā€™t do it. They have to have enough paying customers to stay open. If they are open then itā€™s likely a majority have to be decently happy. I donā€™t know enough about what they do to have an opinion but Iā€™ve seen several folks here speak highly of them so they must be doing something right.

@dextermorgan
I had consultation with them about my pituitary issues and I was very impressed by their knowledge about a thing like pituitary that basically nobody knows a shit about it. Also they have flexible approach not just ā€œinject testā€, first they try other options - cabergoline, clomid, etc. I guess also they try to not cause patients to inject more than necessary and maybe a decent number of people feel GOOD ENOUGH with two times a week.

Just I dont believe there would be many people that will feel worse on ED injections than two times a week, but many people would feel better with ED than 2 times a week. @systemlord who is also a Defy patient has explained it many times. By the way I think everybody should read and listen to what this guy is saying(@systemlord ). He seems like the most patient and at the same time knowledgeable user here.

HCG on the other is not well tolerated by many. Personally for me I know its a disaster to start more than one thing at a time

To answer your question about a good TRT Doc in Dallas/Fort Worth area, look into Dr. Jordan Grant. Heā€™s out of Paris, TX, so close by. Very well regarded.

Wasnt this the doc that wanted to keep always estrogen between 20 and 30 with AI?

Not that I know of ā€“ as far as I know heā€™s anti-AI. Youā€™re not thinking of Dr. Rand in CA are you?

This is pretty normal if you ask me, your body is adjusting to the change in hormone levels and what you are feeling is common because your levels are not stable until after 6 weeks. Iā€™m not saying you donā€™t have other problems going on, only that this is to be expected.

Your dosing may be a little on the high side, have you ever tried anything closer to 10-12mg daily?

Reason I ask is because 10mg was way too much for me and felt terrible. A lot of guys are too aggressive with dosing because they are afraid of lower numbers and believe high levels are always better.

@systemlord What according to you are symptoms of too high dose?

For me 10mg daily is way too damn much T for me, I felt more intense than when on 25mg EOD which had my levels at 829 and Free T 35> (6.8-21.5). Iā€™ve heard daily protocols are more anabolic because levels are so static.

I ask because when I start I plan to start on high daily dose and want to know how to understand if reduction is needed. My pre TRT testosterone now is not so crap and I will need to target at least 1000 total t.
I was suggested to start 30mg ED but maybe 25mg may be better for meā€¦