Looking for a Specialist in the NYC Area

Pharma / TRT Testosterone Replacement
1

Hello all, even though I’m a newly registered user, I’ve been spectating and following the T replacement message boards for while now, reading and soaking in a lot of information. The boards have been extremely helpful being that I have been on TRT since May of last year and this therapy is still relatively new to me. The reason I am posting this is because I am based in NYC and am looking for a doctor who is credible and specializes in treating hypogondism (e.g. andrology certified and etc.).

If anyone would mine PMing any recommendations based on personal experience I would be extremely grateful. I have read through some of posts on here and I took note of the times when certain users mentioned satisfaction with their doctors (Bricknyce for example). I am not all that satisfied with my current doctor (who is based in Coney Island, urology is his specialty) as he does not really listen to my requests or experiences with regards to the treatment regimen (went from gels and am currently on pellet injections, better but I feel there are still some issues; felt he moved too fast and spent no time investigating as to why I am hypogonadal and what I can do to possibly restore my hormonal function) and how my body is responding. He does not address my questions/concerns regarding bodily symptoms and I feel as though I am only in and out of his office so that he may earn some quick money.

After beginning treatment with him, I have always tested in the sub 500- mid 500 TT range (my baseline was 196 before TRT) and he feels happy keeping me there, when for my age (which is 27), I know I should and can be higher. I dont expect to feel like a teen again but I dont believe it is unreasonable to want to feel as good as I possibly can. Furthermore, even though I request for E2 to be checked, he always refuses, so after a year and a half on TRT almost, I still have no idea where my baseline E2 is at. I would like some info about some of your experiences (if any) with doctors based in NYC if possible and may like to set up a consultation.

Some background info: Tested @ 196 after feeling horrible for the last 3 years of my life; symptoms included irritability, anxiety, trouble sleeping, insomnia, weakness, lack of libido,diminished energy and etc. Started on testim @ 5g daily for 2 months, felt better for the first week due to the introduction of some testosterone in my system, which thereafter the effects faded. he then switched to androgel @ 5 g daily for another 2 months, felt a little better (had a little more energy) I guess due to the quicker absorption, but the effects once again peaked as they did with testim. Am currently on 10 pellets of testopel every 4 months. I just am not happy with the lack of cohesion with regards to the management of my TRT protocol from my urologist. He is not open to suggestion/discussion and is not addressing my concerns; I still dont feel 100% as I did in my early 20s. As mentioned, I have always tested in the 500s on every form of therapy tried, so I think something is definitely off. Shouldn’t I be testing at least 600-1000? I know this is a long post but would really appreciate the help. Thanks in advance.

2

Andrologists in NYC and Long Island

Brett Mellinger (my doc)
Richard Schor (my friend’s doc)
Harris Nagler
Natan Bar Chama
Bruce Gilbert

Yeah, you can be higher, which is why I don’t understand why your doc is not open to putting you on the max dosages of 12 pellets for Testopel, or 10 grams for Testim or Androgel.

I don’t know what you mean by “should”. If you feel good at a certain level, you feel good. If you need more medication while still being in the clinical range (high normal value), then do that. But you have to find a doc who’s open to adjusting meds accordig to your symptoms.

I just got 10 pellets inserted yesterday. After he was done, the doc said, Come back in 3 months for a blood test and to tell me how you’re doing; this way I know whether to instert more next time.

If you live in NYC, then I strongly suggest you just take the darn LIRR to Garden City and see Dr. Mellinger.

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There are also some other good urologists I know of that deal with hypogonadism, but not with young men such as yourself.

At your age, you really need to go to someone that deals with fertility a lot too.

I’ve sent a few people to my doc, and all got fixed up. He has no problem keeping people in the 700 to 1000 range IF that’s what they feel best at.

4

Bricknyce does your doc prescribe AI’s if E2 levels are high?

5

Yes.

He prescribes HCG, clomid, arimidex, and T AS NEEDED.

In any case, I am still confused about all this talk of estradiol considering if one is in the normal range for T, there is little chance they will have elevated estradiol. In nine years I’ve never had a problem with estradiol, and neither has my friend whose been on TRT for four months. Actually my friend just switched from Testim to Testopel because he actually found rubbing gel on to be a nuisance after three months and said he feels better than ever.

6

Why not look for the reason why your testosterone levels are low? You are jumping the gun going on HRT if you are not primary. It going to be a bad ass rollercoaster ride. Looking for short term satification and not long term graditifcaition.

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I agree with Hardasnails. And a competent doctor will look into the cause of hypogonadism.

But how is he jumping the gun if he has secondary hypogonadism. I’m hypogonadotrophic (idiopathic) and still must take medication for my condition.

OP: Did he check LH, prolactin, and FSH and order an MRI before going about this?

8

Do you live in Brooklyn? If you live near Coney Island, then it’s so easy to get to Garden City if you drive. Belt Parkway/Cross Island Parkway to Grand Central/Meadowbrook Parkway. My doc is right off exit for Roosevelt Field Mall.

http://www.imppllc.com/?inc=doctorsbio&dr=65&p=doctors

You can see he deals specifically with fertility and hypogonadism.

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[quote]Bricknyce wrote:
Andrologists in NYC and Long Island

Brett Mellinger (my doc)
Richard Schor (my friend’s doc)
Harris Nagler
Natan Bar Chama
Bruce Gilbert

Yeah, you can be higher, which is why I don’t understand why your doc is not open to putting you on the max dosages of 12 pellets for Testopel, or 10 grams for Testim or Androgel.

I don’t know what you mean by “should”. If you feel good at a certain level, you feel good. If you need more medication while still being in the clinical range (high normal value), then do that. But you have to find a doc who’s open to adjusting meds accordig to your symptoms.

I just got 10 pellets inserted yesterday. After he was done, the doc said, Come back in 3 months for a blood test and to tell me how you’re doing; this way I know whether to instert more next time.

If you live in NYC, then I strongly suggest you just take the darn LIRR to Garden City and see Dr. Mellinger. [/quote]

Thanks for all of your help Brickynyce, it is much appreciated. Well what what I never understood, he always refused to increase my testim/androgel dose, and after only five months, he started me on pellets (which are more convenient and possibly more effective with zero risk of transfer, also more money in his pocket though) which I believe he did much too soon. Being that I was testing in the 500’s for TT, I could never understand his rationale for not wanting to increase dosages; especially combined with the fact that I always felt inconsistent with my energy levels/libido/ and well being since beginning TRT. Granted, I feel better after TRT and my issue could be the result of another underlying problem; but thats the point, he doesnt seem interested or too concerned in addressing the issue. Furthermore, for everytime he has performed pellet injections on me, he has used the same injection site (my left buttock) and has never rotated sites; I know this is bad practice and I can never see what hes doing which bothers me. This is why I am looking for another doctor. I am definitely interested in seeing Dr. Mellinger; I currently do not drive at the moment and my only option is the LIRR; which I may believe may be roughly a 2 hour commute from where I live.

Pre TRT, I do not remember exactly but I know FSH and LH were both low (1.x), TT was 196, FreeT was in the 20s, and prolactin was 7.6. No MRI has ever been done. The most recent lab tests show:

TT: 510 (250-1100)
FreeT: 108.1 (35-155)
SHBG: 19
LH: <0.2
FSH: <0.7
TSH: 2.68
DHT: 11 (25-75)* (I am on finasteride 1mg daily, I know that 5AR inhibitors can reduce testosterone, could this be contributing affecting my TRT results?)

*Also being that I am estrogen dominant (I tend to carry excess abdominal fat, water weight and bloat) and on finasteride, I medicate with .25mg of adex EOD as recommended by reading through these forums. I have been doing this since beginning pellet injections. Not sure if it is helping me or hurting that is why I need to get my E2 checked. Thanks for everything.

10

Sorry, double post. BTW, Brick, are any of those other doctors you mentioned located in the city by any chance?

11

Natan Bar Chama and Harris Nagler are in Manhattan. I’m not sure if Harris Nagler practices as a private doctor anymore because he recently became CEO of Beth Israel Hospital in Manhattan.

I don’t know what you mean by “soon”. There are men who go directly to pellets because that’s the option that goes best with their life, not because they failed with gels. I took gels for NINE years with great results (in 700 to 1000 range nearly all the time) and after being informed one day by my doc of Testopel, thought it over, and decided to go with the pellets. This decision was not made because I had problems with gels; it’s that I simply didn’t care to rub gel on every night for the rest of my life, remember to take medication with me when sleeping out of my home, or have a T-shirt on during sex soemtimes.

If you mean “soon” as in he didn’t bump you up from 5 to 10 grams of gel (which would almost definitely bring you where you want to be considering you’re at 500s with 5 grams), but instead just figured to put you on pellets, then I know what you mean.

However, as I wrote, pellets aren’t a last resort; neither are gels or injections. It’s what you desire AND WORKS that counts.

How do you know you’re estrogen dominant just because one of your problem areas for fat gain is the abdomen considering that’s where nearly all people gain fat initially when they over eat or are too sedentary. Ever figure you’re carrying too much fat because your fitness routine and diet aren’t up to speed? (Yeah, it can be that simple.) You don’t diagnose elevated estradiol by looking at someone, unless there are very severe, discernible things evident (eg, gynecomastia, delayed puberty) - not through seeing someone’s a bit bloated or where they have problem areas with fat.

About bloat and water retention… What DOCTOR diagnosed you with edema (real water retention, not just being a bit bloated).

Did you tell your doctor you take arimidex? If not, you’re beign deceptive to the doctor, because if something unintentional happens with you (not getting desired results from what he prescribes), he will not be able to make necessary adjustments. Docs don’t practice medicine by making recommendationsl; they practice by prescribing medication and performing surgeries. NO doc practices through writign on internet message forums, which is why we don’t have one person on here qualified or in the position to counsel you on your situation. I don’t know the credentials of everyone on here, but if ther eare some doctors on here, perhaps they are just lurking around or talking shop; they still are in no position to practice through the 'net.

How many pellet procedures have you gotten already. They are supposed to be done 3 to 5 months apart. WHO said they’re not to be done at the same site? I’ve gotten one implant procedure done on Friday. I’ll see in 3 to 5 months where he puts them again. I doubt he changes the location. Maybe he will, and maybe it’s procedure to alternate buttocks with implants. I just want to know what COMPETENT MEDICAL DOCTOR said sites have to be alternated.

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In Manhattan, NY University Langone Medical Center’s Dr. Andrew McCullough, and in Rego Park Queens NY his colleague Dr. Joseph Alukal both implant T pellets.

Dr. Andrew McCullough 646-825-6311

Dr. Joseph Alukal 718-261-9100

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[quote]Bricknyce wrote:
Natan Bar Chama and Harris Nagler are in Manhattan. I’m not sure if Harris Nagler practices as a private doctor anymore because he recently became CEO of Beth Israel Hospital in Manhattan.

I don’t know what you mean by “soon”. There are men who go directly to pellets because that’s the option that goes best with their life, not because they failed with gels. I took gels for NINE years with great results (in 700 to 1000 range nearly all the time) and after being informed one day by my doc of Testopel, thought it over, and decided to go with the pellets. This decision was not made because I had problems with gels; it’s that I simply didn’t care to rub gel on every night for the rest of my life, remember to take medication with me when sleeping out of my home, or have a T-shirt on during sex soemtimes.

If you mean “soon” as in he didn’t bump you up from 5 to 10 grams of gel (which would almost definitely bring you where you want to be considering you’re at 500s with 5 grams), but instead just figured to put you on pellets, then I know what you mean.

However, as I wrote, pellets aren’t a last resort; neither are gels or injections. It’s what you desire AND WORKS that counts.

I go to the same Doc as Brick. He did my second pellet procedure maybe 3 inches above the original spot. No problems. And my level tested at 804ng/dL two months after so far.

How do you know you’re estrogen dominant just because one of your problem areas for fat gain is the abdomen considering that’s where nearly all people gain fat initially when they over eat or are too sedentary. Ever figure you’re carrying too much fat because your fitness routine and diet aren’t up to speed? (Yeah, it can be that simple.) You don’t diagnose elevated estradiol by looking at someone, unless there are very severe, discernible things evident (eg, gynecomastia, delayed puberty) - not through seeing someone’s a bit bloated or where they have problem areas with fat.

About bloat and water retention… What DOCTOR diagnosed you with edema (real water retention, not just being a bit bloated).

Did you tell your doctor you take arimidex? If not, you’re beign deceptive to the doctor, because if something unintentional happens with you (not getting desired results from what he prescribes), he will not be able to make necessary adjustments. Docs don’t practice medicine by making recommendationsl; they practice by prescribing medication and performing surgeries. NO doc practices through writign on internet message forums, which is why we don’t have one person on here qualified or in the position to counsel you on your situation. I don’t know the credentials of everyone on here, but if ther eare some doctors on here, perhaps they are just lurking around or talking shop; they still are in no position to practice through the 'net.

How many pellet procedures have you gotten already. They are supposed to be done 3 to 5 months apart. WHO said they’re not to be done at the same site? I’ve gotten one implant procedure done on Friday. I’ll see in 3 to 5 months where he puts them again. I doubt he changes the location. Maybe he will, and maybe it’s procedure to alternate buttocks with implants. I just want to know what COMPETENT MEDICAL DOCTOR said sites have to be alternated. [/quote]