T Nation

HRT/TRT Side Effects

After 3.5 years of doing HRT, a lot of reading, and following the advice of stellar posters like KSMan and Happydog, I should probably point out one of the biggest side effects of all this: I no longer trust ANY doctor. Not just a TRT guy, but I now think that just about the whole profession is full of ignorant/evil people who just want to make a lot of money.

My view is now very jaundiced: the guy who wants to give you the high blood pressure medicine is a whore for a pharmaceutical company. The woman who says your kid needs an operation needs to make another payment on her vacation home. None of them care in the least about your well-being, they just want the $$$$$$$$. They feel entitled to rob you since they spent so much time jumping through hoops.

Its going to be a long time before I even THINK of going near any doctor ever again.

[quote]Headhunter wrote:
After 3.5 years of doing HRT, a lot of reading, and following the advice of stellar posters like KSMan and Happydog, I should probably point out one of the biggest side effects of all this: I no longer trust ANY doctor. Not just a TRT guy, but I now think that just about the whole profession is full of ignorant/evil people who just want to make a lot of money. My view is now very jaundiced: the guy who wants to give you the high blood pressure medicine is a whore for a pharmaceutical company. The woman who says your kid needs an operation needs to make another payment on her vacation home. None of them care in the least about your well-being, they just want the $$$$$$$$. They feel entitled to rob you since they spent so much time jumping through hoops.

Its going to be a long time before I even THINK of going near any doctor ever again.[/quote]

Point well taken, and I do agree because of my experience as well. But I have to say two things here - one is that docs are people, and people will be people. You will find most are in it for the buck, learn as much as they need to and think the box “is” the universe. It will be a search to find one who really cares, you find this in every walk of life.

Two, because of our situation, the above problem is heightened. Meaning because our hormones are not right, we are either crying at them or yelling at them, even though we think we are reasoning with them.

But I do think that most are brain-washed through all those years of schooling, and those that aren’t have little energy left to ebb against the flow of capitalism and the “industry”. The few that do endure need to found.

The main theme, is that the body heals itself. Save surgery, docs don’t really do much but allow you to understand your situation, or provide relief to symptoms through meds.

So, as much as I agree with you, I also believe there is nothing wrong with educating your doc - and helping the next guy who goes to see him. Now whether or not the doc is teachable goes back to him being a person, and back to square one.

This is a fun game, no?

Game: An activity providing entertainment or amusement.

No. For two reasons. My life is not merely an amusement and there’s nothing fun about dealing with someone who’s willing to trade my health for his financial gain. There’s no excuse for incompetence.

You are either the kind of person who has the self respect to take pride in what you do and does it to the absolute best of your ability or you are not. The circumstances you are in have no bearing on that.

Your blood test results come back. They show very elevated E2 (which you had to insist the doctor to test). It happens again. You complain that Androgel by itself is not helping you, how about some estrogen control?

His response is to cut your Androgel dose in half.

He tells you that HCG is ‘pseudo-science’ and that only women with breast cancer require estrogen control.

Now, multiply the above experience by 8 (that’s right, I’ve been to 8 ‘specialists’) and add in a few plusses and minuses — one of the 8 actually scripted me for HCG (I was shocked).

Now, I’ll plead guilty to making an improper induction, but what would most humans conclude?

Physician’s follow the same bell-curve as all other professions. Some are incompetent, most are mediocre, and a few are exceptional. Often the only way to obtain proper treatment is to refuse the status quo and seek out exceptional practitioners. This is the only way to ensure your treatment and care is based upon science and not upon “opinion” and prejudice.

Your “friendly” family doctor works inside of a cage built by the FDA and the fear of litigation. They are not trained, nor are they willing, to look outside of the box. They have a lifestyle to maintain which is far more important than your health or well-being. If the FDA approved rat poison to treat depression or heart disease, I have no doubt that doctors would be prescribing it without reservation, regardless of it’s efficacy or side effect profile.

I would also like to add the following. It is unreasonable and foolish to ask your doctor to support and encourage the use/abuse of medications to build muscle and reduce fat above and beyond what is “normal” for you. If you are hypogonadal and it’s impacting your health and well being, you have every right to be properly treated. Expecting your doctor to become your “dealer” is unreasonable and unfair.

[quote]bugs wrote:
Physician’s follow the same bell-curve as all other professions. Some are incompetent, most are mediocre, and a few are exceptional. Often the only way to obtain proper treatment is to refuse the status quo and seek out exceptional practitioners. This is the only way to ensure your treatment and care is based upon science and not upon “opinion” and prejudice.

Your “friendly” family doctor works inside of a cage built by the FDA and the fear of litigation. They are not trained, nor are they willing, to look outside of the box. They have a lifestyle to maintain which is far more important than your health or well-being. If the FDA approved rat poison to treat depression or heart disease, I have no doubt that doctors would be prescribing it without reservation, regardless of it’s efficacy or side effect profile.

I would also like to add the following. It is unreasonable and foolish to ask your doctor to support and encourage the use/abuse of medications to build muscle and reduce fat above and beyond what is “normal” for you. If you are hypogonadal and it’s impacting your health and well being, you have every right to be properly treated. Expecting your doctor to become your “dealer” is unreasonable and unfair. [/quote]

My first test came back at 164 ng/dl, 240-950 being normal.
I’ve had consistently low numbers like that, until I began using HCG and upping my dose of Cyp on my own.

Study after study shows that we need Test +HCG+ AntiE. If Happydog and KSMan know all this, why don’t the guys who make hundreds of thousands per year? Those doctors are either ignorant or malpracticing since they don’t understand the field they are supposed to be the EXPERTS in.

[quote]bugs wrote:
If the FDA approved rat poison to treat depression or heart disease, I have no doubt that doctors would be prescribing it without reservation, regardless of it’s efficacy or side effect profile.
/quote]

Rat poison is indeed approved by the FDA to treat heart disease.

Medicine: http://en.wikipedia.org/wiki/Warfarin

“Warfarin was originally developed as a rat poison.”

Poison: http://en.wikipedia.org/wiki/Rat_poison#Anticoagulants

[quote]Headhunter wrote:
Study after study shows that we need Test +HCG+ AntiE. If Happydog and KSMan know all this, why don’t the guys who make hundreds of thousands per year? Those doctors are either ignorant or malpracticing since they don’t understand the field they are supposed to be the EXPERTS in.
[/quote]

The issue is the FDA. If a physician prescribes a medication (like HCG or an AI) which has only been approved to treat females for fertility or for breast cancer, the chance for a successful malpractice suit and/or loss of medical license increases considerably. You are asking your doctor to prescribe a medication for “off-label” use which is not something they are keen to do. The fact that there is ample research which supports the safe and effective use of HCG and AI’s to treat male hypogonadism and estrogen dominance does not mean that physicians can prescribe them without consequence.

[quote]KSman wrote:
Rat poison is indeed approved by the FDA to treat heart disease.

Medicine: http://en.wikipedia.org/wiki/Warfarin

“Warfarin was originally developed as a rat poison.”

Poison: http://en.wikipedia.org/wiki/Rat_poison#Anticoagulants

[/quote]

My point exactly.

[quote]bugs wrote:
Headhunter wrote:
Study after study shows that we need Test +HCG+ AntiE. If Happydog and KSMan know all this, why don’t the guys who make hundreds of thousands per year? Those doctors are either ignorant or malpracticing since they don’t understand the field they are supposed to be the EXPERTS in.

The issue is the FDA. If a physician prescribes a medication (like HCG or an AI) which has only been approved to treat females for fertility or for breast cancer, the chance for a successful malpractice suit and/or loss of medical license increases considerably. You are asking your doctor to prescribe a medication for “off-label” use which is not something they are keen to do. The fact that there is ample research which supports the safe and effective use of HCG and AI’s to treat male hypogonadism and estrogen dominance does not mean that physicians can prescribe them without consequence. [/quote]

I am not about to defend physicians.

to HH: good AIs have been in clinical use for about 10 yrs. (No one here remembers Testolactone and Cytadren.) I have been arguing for about 5 yrs that an AI alone can be used to treat hypogonadism in aging men, the obese, the diabetic…etc. I have done so, off-label, and for free, and men have become testo-competent, reversed their anemia, and so forth. And the effects can last longer than the one month treatment period. (All anecdotal, no data from me is published)

I even wrote a study, got an FDA approval to go forward, but because of more paperwork, I did not go forward. When I re-applied the Drug Company was no longer interested. WIth its product coming off patent, it was no longer dollar-wise to fund physician-initiated research.

to bugs: much of what you say is true. Docs do not want a complicated solution when a shot every two weeks works for the majority of cases. (I happen to disagree, but I do not educate others.) But once a drug is approved, it can be prescribed off-label for any purpose. Expense and litigation are limiting factors.

And skepticism. Although one may think that every issue has a discrete answer, there isn’t agreement on many points raised. Every MD should be his/her own critic of the literature, and too few are.

Hey Headhunter
I to believe this site is awesome and really makes you take control of your own medical destiny. You mention lots of reading and articles. I was asked what are you reading and what are they selling when asking my doc questions. Do you have any studies proving what we all know works that have been done by a credible medical institution? The reason I ask is if we want to set our Docs straight we need concrete material to show them.
That may make me seem like a none believer, nothing could be more from the truth. Any one who read a bodybuilding magazine ten years ago has to laugh as everyone else talks about the latest and greatest supplements we all knew about ten years ago. Bodybuilders are always on the cutting edge.
Back to my original point do you have any studies showing hcg and estrogen control are needed, that we can share with the Docs

Stuff for docs to read… has been posted here before [may times] and can be found with research. Has this material been collected in one spot? Not really, as threads get stale and are out of sight. A dedicated site would have a permanent index. On sites like this you have to use the search functions and read what you can find for a few months… I am serious about the reading for months.

Otherwise, I am thinking that I should write a book.

There is a lot of research material that is medical research oriented. But not directly focused on medical treatment. There are reasons for this and one reason is that there is little profit in HRT for drug companies unless they can create a non-bioidentical drug that can be patented to secure a huge monopoly on very high profits. Remember, if there is no major money to be made, no one is doing to take the time to have your doc out for lunch or a conference to learn about prescribing an expensive solution to the wrong problem.

[quote]oldpipes wrote:
Hey Headhunter
I to believe this site is awesome and really makes you take control of your own medical destiny. You mention lots of reading and articles. I was asked what are you reading and what are they selling when asking my doc questions. Do you have any studies proving what we all know works that have been done by a credible medical institution? …
Back to my original point do you have any studies showing hcg and estrogen control are needed, that we can share with the Docs
[/quote]

How about this one, showing the benefit of AI alone.

Effects of Aromatase Inhibition in Elderly Men with
Low or Borderline-Low Serum Testosterone Levels
BENJAMIN Z. LEDER, JACQUELINE L. ROHRER, STEPHEN D. RUBIN, JOSE GALLO, AND
CHRISTOPHER LONGCOPE
Endocrine Unit (B.Z.L., J.L.R.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114;
Departments of Medicine and Obstetrics and Gynecology (C.L.), University of Massachusetts Medical School, Worcester,
Massachusetts 01655; and AstraZeneca Pharmaceuticals (S.D.R., J.G.), Wilmington, Delaware 19850

We investigated the ability of the orally administered aromatase
inhibitor, anastrozole, to increase endogenous testosterone
production in 37 elderly men (aged 62�??74 yr) with
screening serum testosterone levels less than 350 ng/dl. Subjects
were randomized in a double-blind fashion to the following
12-wk oral regimens: group 1: anastrozole 1 mg daily
(n 12); group 2: anastrozole 1 mg twice weekly (n 11); and
group 3: placebo daily (n 14). …
Mean SD bioavailable testosterone increased from 99 31
to 207 65 ng/dl in group 1 and from 115 37 to 178 55 ng/dl
in group 2 (P < 0.001 vs. placebo for both groups and P 0.054
group 1 vs. group 2). Total testosterone levels increased from
343 61 to 572 139 ng/dl in group 1 and from 397 106 to
520 91 ng/dl in group 2 (P < 0.001 vs. placebo for both groups
and P 0.012 group 1 vs. group 2). Serum estradiol levels
decreased from 26 8 to 17 6 pg/ml in group 1 and from 27
8 to 17 5 pg/ml in group 2 (P < 0.001 vs. placebo for both
groups and P NS group 1 vs. group 2). Serum LH levels
increased from 5.1 4.8 to 7.9 6.5 U/liter and from 4.1 1.6
to 7.2 2.8 U/liter in groups 1 and 2, respectively (P 0.007
group 1 vs. placebo, P 0.003 group 2 vs. placebo, and P NS
group 1 vs. group 2). Scores for hematocrit, MOS Short-Form
Health Survey, International Index of Erectile Function, and
American Urological Association Symptom Index Score did
not change. Serum prostate-specific antigen levels increased
in group 2 only (1.7 1.0 to 2.2 1.5 ng/ml, P 0.031, compared
with placebo).
These data demonstrate that aromatase inhibition increases
serum bioavailable and total testosterone levels to the
youthful normal range in older men with mild hypogonadism.
Serum estradiol levels decrease modestly but remain within
the normal male range. The physiological consequences of
these changes remain to be determined. (J Clin Endocrinol
Metab 89: 1174�??1180, 2004)

I have printed out studies from The Journal of Endocrinology and Metabolism as a prime resource. Not one doctor I went to would even LOOK at them. I suppose it was because they were pressed for time and wanted to see as many patients ($$$$$$$$$$$) as possible, before
their golf date that afternoon.

I know…I’ve probably just had lousy luck.

But what if one of you guys saw 8 of our high school’s students, on 8 different occasions, doing something stupid or bad? What would you conclude about my school?

This post was flagged by the community and is temporarily hidden.

I’ve had bad doctors and I have had good doctors. Just like I have had bad plumbers and good ones.

Fortunately I have had more good docs than bad ones. But for two of them I would be dead today.

Sorry you have had such bad luck.

[quote]oldpipes wrote:
…I was asked what are you reading and what are they selling when asking my doc questions.[/quote]

This tells you a lot about your doctor. It tells you that the source of his information is people selling things (drug companies) so he naturally assumes that must be where your information comes from.

[quote]Do you have any studies proving what we all know works that have been done by a credible medical institution? The reason I ask is if we want to set our Docs straight we need concrete material to show them… Back to my original point do you have any studies showing hcg and estrogen control are needed, that we can share with the Docs
[/quote]

God forbid that he should use your body to tell him what you need. If your estradiol levels had been checked before starting TRT then any rise in estradiol levels afterwards would show that your T is aromatizing and needs to be controlled. Ask him why he isn’t checking this important hormone level? Ask him if he knows that estradiol is an androgen receptor antagonist and that testosterone isn’t much help if the androgen receptors are blocked by estradiol and so anyone familiar with the basic functions of the HPTA would know that estradiol needs to be watched as well as testosterone.

Maybe instead of feeling like you need to convince him of what to do, maybe you should be feeling that he needs to convince you that he knows what he is doing.

I’ve been going to a different doctor every week here where I live hoping to find a doctor that knows something about this issue of TRT+AI+HCG. What is disappointing is that I have exhausted the LEF and WHN listing of doctors available through my insurance company. Not one of them had a clue. I had all my lab slips going back for several years and the newest one just done a few weeks ago showing my E2 levels at 53 despite using Adex as a research chemical and not one of them knew what to do about it. I thought these LEF and WHN doctors were supposed to be cutting edge? What a frickin’ joke!

Every doctor I went to just looked at me as if I was stupid when I explained to them what takes place in the body when a man introduces transdermal gels into his body. I had to explain aromatization, HCG therapy for my shrinking nuts, the use of AI’s to control increasing estradiol levels, and on and on it went. All I have done is wasted time and money seeing these uninformed doctors trying to educate them on this subject.

I would take my former doctor copies of medical studies from medical journals and he wouldn’t even look at them. We went back and forth on the use of Arimidex. He would rather sign over one of his children than to write me a script for it. His answer for my high E2 levels was to stop TRT or quit using Testim and go to injections by getting only one shot a month at his office! Get out!

When I tried to talk to him about starting HCG therapy for my testicle atrophy he instead gave me a referral to a urologist to be castrated so I wouldn’t have to worry about my shrinking nads anymore! Insane!

This has been the biggest nightmare of my life since going on this therapy. If I had known these doctors were this ignorant about this stuff I doubt I would have ever signed on to it.

[quote]Raw Power wrote:
I’ve been going to a different doctor every week here where I live hoping to find a doctor that knows something about this issue of TRT+AI+HCG. What is disappointing is that I have exhausted the LEF and WHN listing of doctors available through my insurance company. Not one of them had a clue. I had all my lab slips going back for several years and the newest one just done a few weeks ago showing my E2 levels at 53 despite using Adex as a research chemical and not one of them knew what to do about it. I thought these LEF and WHN doctors were supposed to be cutting edge? What a frickin’ joke!

Every doctor I went to just looked at me as if I was stupid when I explained to them what takes place in the body when a man introduces transdermal gels into his body. I had to explain aromatization, HCG therapy for my shrinking nuts, the use of AI’s to control increasing estradiol levels, and on and on it went. All I have done is wasted time and money seeing these uninformed doctors trying to educate them on this subject.

I would take my former doctor copies of medical studies from medical journals and he wouldn’t even look at them. We went back and forth on the use of Arimidex. He would rather sign over one of his children than to write me a script for it. His answer for my high E2 levels was to stop TRT or quit using Testim and go to injections by getting only one shot a month at his office! Get out!

When I tried to talk to him about starting HCG therapy for my testicle atrophy he instead gave me a referral to a urologist to be castrated so I wouldn’t have to worry about my shrinking nads anymore! Insane!

This has been the biggest nightmare of my life since going on this therapy. If I had known these doctors were this ignorant about this stuff I doubt I would have ever signed on to it. [/quote]

I started Test Eth, 100mg a week for three weeks and only HCG twice injected during that time. (It was IMPOSSIBLE to get). My bloodpressure was up and down by the third week, bad panic attacks all day and at night too. My Estrogen tested at the beginning at 29. Now in my 3rd week it is at 43.

[quote]Headhunter wrote:
After 3.5 years of doing HRT, a lot of reading, and following the advice of stellar posters like KSMan and Happydog, I should probably point out one of the biggest side effects of all this: I no longer trust ANY doctor. Not just a TRT guy, but I now think that just about the whole profession is full of ignorant/evil people who just want to make a lot of money.

My view is now very jaundiced: the guy who wants to give you the high blood pressure medicine is a whore for a pharmaceutical company. The woman who says your kid needs an operation needs to make another payment on her vacation home. None of them care in the least about your well-being, they just want the $$$$$$$$. They feel entitled to rob you since they spent so much time jumping through hoops.

Its going to be a long time before I even THINK of going near any doctor ever again.[/quote]

HH, have you tried any alternative medicine practitioners and, if so, what’s your opinion of them?

[quote]Raw Power wrote:

Every doctor I went to just looked at me as if I was stupid when I explained to them what takes place in the body when a man introduces transdermal gels into his body. I had to explain aromatization, HCG therapy for my shrinking nuts, the use of AI’s to control increasing estradiol levels, and on and on it went. All I have done is wasted time and money seeing these uninformed doctors trying to educate them on this subject.

I would take my former doctor copies of medical studies from medical journals and he wouldn’t even look at them. We went back and forth on the use of Arimidex. He would rather sign over one of his children than to write me a script for it. His answer for my high E2 levels was to stop TRT or quit using Testim and go to injections by getting only one shot a month at his office! Get out!

When I tried to talk to him about starting HCG therapy for my testicle atrophy he instead gave me a referral to a urologist to be castrated so I wouldn’t have to worry about my shrinking nads anymore! Insane!

This has been the biggest nightmare of my life since going on this therapy. If I had known these doctors were this ignorant about this stuff I doubt I would have ever signed on to it. [/quote]

This is sad and disgusting to read. I’m sorry for you.

Everybody likes to shit on “the internet” and “the boards”, but in all honesty, you can get better advice here in one day than you would in 10 years of seeing these clowns.

It’s a real shame for those who were born before the advent of digital technology.