T Nation

How to Find The Right Doctor?

Hi all, and thanks in advance for your input. I have been using TRT for about 3 years with good success. My ability to gain and maintain muscle, reduce fat, recover from injuries and maintain good sexual function are greatly increased by TRT. I work hard in the gym 5 days a week (been doing so for 10 years) and my TRT has enabled me to do so with good gains, fewer injuries and a much improved quality of life.
I started out with a “normal for my age” T level (I’m 67 YO), so it was a challenge to find a doctor to prescribe T without a hypogonadism diagnosis. I did finally find one and have been very pleased with the results. I am currently injecting 1/2ml weekly to maintain a T level of about 900.

I recently moved to the Phoenix, AZ area and have a doctor here who is reluctantly prescribing for me, but he’s not paying as much attention to my other levels as I think he should, which tells me he’s not as well informed about this therapy as I’d like. I’m also having some testicular atrophy as a side effect he and won’t even discuss using hCG or some other approach to counteract it. He also has difficulty discussing how other levels such as estradiol, pregnenalone, progesterone, SBHG etc.factor into the overall program. For these reasons I’m not sure that I’m getting the full benefit of what I’m injecting, as well as protecting my general health.
So here (finally) is my question: How do I find a doctor near me that really understands this therapy and believes in it? I’d prefer someone who actually spends time in the gym and understands the challenges, but maybe that’s asking too much. Any recommendations?

Ask some of the guys in your gym for a referral, bound to be more than a few on TRT. You could also get an idea of what to expect.

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Sick care or managed health care doctors typically aren’t very good at TRT, even the endocrinologists who typically specialize in hormones, diabetes, thyroid and not TRT since its low cost, low profit almost non are doing it.

You need to be looking for a private doctor in anti-aging who specialize in all thing anti-aging including TRT, thyroid optimization, growth hormone releasing peptides, etc…

I grew tired of playing the doctor lottery wondering if the next doctor would be more informed and went with Defy Medical which is a telemedicine clinic. All medications are mailed to me UPS and consultant are over the phone.

Top rate TRT doctors is standard, Dr Saya is king and is the medical director, Dr Calkins is the right hand man and even the PA Mike can run circles around most doctors.

One thing I noticed is we talked about things the endocrinologist never ever spoke of, it seems like every consultation were talking about ways of improving my health, noticing biomarkers that are out of place taking action before things get out of hand.

Mike had noticed iron levels were low normal and suggest I do something about it before it becomes a problem, it just so happens I quit eating steak 3 months ago and why my iron had decreased.

My sick care doctors would never have alerted me until it was too late or outside the reference ranges like they are taught in medical school.

You should be able to find s good doc locally. Find someone who solely Practices trt and is private. Otherwise it’s a roll of the dice walking into endos. I would google and read their sites and see if the sites focused on trt or everything under the sun. If the is focused on trt find out if he’s a high volume or low. Some integrate into sports medicine and many of these guys are on trt themsleves. I personally , like yourself, want a doc that uses his own advice. Otherwise he cannot relate to my issues.

Or if you want confidence and don’t mind traveling. Call the doc I use Dr.Keith Nichols tier1hw.com. You have to fly out to see him once and he can prescribe and guide. He’s good and has many older men under his care.

Some of the guys use defy medical around here. Telemedicine. Would be my last resort. But they will do right by you and way better than the current doc. They are affordable as well and won’t give you the run around. Jsut make sure you have pre trt labs ready for their review. Maybe call the other docs office and ask them to email those ore trt lab results to you. They are your results and I believe they have to give them
To you.

Nelson Virgil runs excelmale.com and is legit. Not sure if location.

Or go Watch tot round table on YouTube and there are docs on Those videos. Listen and call the ones you find to be the right doc for you.

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This is required by statute in most states. The doctor must have a face to face with the patient prior to going with the telephone. If the state does not require a face to face meeting, the doctor is required to be licensed in the state in which the patient resides. That is why reputable doctors will require you to come in to their practices/office in person. Pretty big pain in the ass to maintain licensure in every state.

The feds are on to the telemedicine/internet game. I know an FDA agent assigned to this. The guy orders “experimental” peptides off the internet by the way. They’ll ignore you if you order them, but order $100k worth and they will think you are dealing and that they won’t ignore.

Regarding the telemedicine outfits, they are watching them. Once they get big enough, they’ll move in and the result will be large fines. Follow the money.

As for the patients, its not incumbent on them to verify that the doctor is practicing within state and federal statues. Nothing will happen to them (other than they will need to find another doctor) if the clinic is taken down.

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Just last week…

https://www.justice.gov/usao-nj/pr/seven-people-charged-new-jersey-massive-health-care-fraud-scheme-involving-telemedicine

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Great feedback, thanks!

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Didnt Trump just pass some legislation regarding telemedicine? I would hope that the feds would do something for the patients if they do end up shutting everything down. That big bust that just happened with the 60 Drs that were arrested for opiates, there is now a person at every office and clinic helping them all get into rehabs and get treatment.

Opiates or Test. Massively different. So many folks are dying because of negligence. Trt not really.

Trump passed something making telemedicine more legit and legal on the books a couple months ago I believe. Regarding my point about opiates im well aware the difference, i have been on methadone for a decade now. Funny thing is these T clinics are basically set up the same way with the same protocols. However someone before me was talking about the feds waiting shut down the telemedical clinics when it becomes financially profitable to do so and all i was saying was that if that happened hopefully they would help guide patients to local clinics and Drs and not just cut thoulsands of patients off cold turkey disrupting lives and causing many to begin injecting potentially dangerous ugl test

Misunderstood and good! Yah I have been there done that as well. Blows.

The latest legislation expands opioid-specific telemedicine services, exempting the technology from certain requirements. It also modifies the provisions regarding electronic prescriptions and post-surgical pain management.

The telemedicine portion spelled out that states will be able to seek federal reimbursement under Medicaid for telemedicine services of substance abuse disorders including medication-assisted treatment, counseling, medication management and medication adherence.

The legislation specifically targets people in high-risk groups including American Indians and Alaska Natives, adults under 40, individuals with a history of non-fatal overdoses and individuals with co-occuring serious mental illness and substance use disorder.

They could shut them down now, if violating federal and/or state statutes. Licenses could be revoked or suspended, there could be probation, etc., but why? Fines? That is another story. They will definitely want to recoup the money invested in the investigation and then some. That is why they watch and wait, let the business build and thrive.

Most of us know or at least know of guys getting their products underground on the internet. Of course, there are issues with that, but the government does not care. They do watch this activity, however. As soon as someone gets the big idea to buy in bulk and sell for profit, they will really be watching. They will let it go, for a while, while the dollars build up. Then they’ll move in.

It will not be of concern where the patients go. Clinics that are closed are required to make arrangements for their patients. If they do not, another fine…….

I keep a couple years worth of my dose just in case something happens. Unfortunately I don’t know if its dosed correctly so i won’t use it for regular trt especially with labs. It is somewhat reassuring that technically they would have to make arrangments for me but I don’t completely trust that if its just going to be another fine. The owners would probably be looking at complete financial ruin at that point anyway, possible prison time and toying with the idea of suicide so it probably wouldnt be a big priority of theirs to find me a Dr.