Dude, this is a very good posts, as are all the rest of yours. I have no 'net beef with you.
I understand that I'm very lucky to have a top notch doc. Even my own mother is grateful for him because she witnessed me having a near nervous breakdown at 22 years old because of hypogonadism. I follow his orders without question at this point because I've had nothing but success with him, and he treats symptoms as well as lab values.
Very few times have there been any adjustments made in my medication. I used Androgel for a very long time, and recently switched to Testim because Androgel was drying out my skin this past winter and it wasn't absorbing the way it usually does. I was getting lower readings than usual - lower than in NINE years. So he switched me to Testim, which has a better emolient (pentadecalactone), and everything is running liek it usually does. (Getting Testopel Friday, as written above.) So when I say to him "Doctor, I think something's wrong... " or "I'm not feeling like myself..." he listens and takes it seriously.
MANY doctors aren't like that - and I'm fully aware! There are numbskulls in every walk of life.
On the other hand, I see and meet men who are completely negligent, careless, and non-compliant with their medication. Or as with nutrition and exercise on this board and in real life, they engage in more mental masturbation and thinking than they do complying and DOING!
Maybe I am a bit thick-headed at times. I actually am considered by many in real life (especially in my profession, which is in healthcare) to be "exceedingly patient" (exact words by many). However, I honestly believe that once the right doctor is reached, this shit is not much of a friggin' project.
Here's how my whole thing worked, step by step:
1) Prescribed Androgel for 5 grams.
2) Take Androgel.
3) Don't feel like myself. Tell doc, "Doc, I still don't exactly feel like myself."
4) Doc says, "Alright, we can go to two packs, which is the highest dose; but keep in mind it might take some time to feel good again. I'm gonna write you a script for some Viagra in the meantime too; you might need some help with your erections in the meantime."
5) Lab values are higher. I ignore them though and go about life for the next three months waiting to feel like myself again.
6) Life returns to normal after several months.