T Nation

Met with Urologist Finally, Injections Shot Down

Long story short, finally had an appointment with the Urologist. Super nice guy, younger… seems willing to help.

I was on Androgel before, no real raise in Test levels… been off for one year. Here are current labs:

Test : 203
Free: 9.9
Prolactin: 8.4
LH 2.9
FSH: 2.8
SHBG: 11.2 (Low)

Doc wants me to try androgel this time with an AI (Arimedex) to see if that will do anything. Says he does not allow inejctions unless my wife was an RN. Says noone here locally really does. (WTF)

He also wanted me to take 1MG of Arimidex daily which is obviously WAYYYY too much. I’d probably only take .25 every other day or so and get levels rechecked in a month.

Really sucks I have no other local options. I feel terrible, muscle aches, tired, no sex drive… ugh.

Your guy doesn’t seem to know anything about TRT. 7mg of adex per week??? Recipe for disaster. Maybe try a GP? If all else fails you can always go with one of the online clinics. They’re cash only and a bit pricey but at least you’ll be getting what you need. FTR, it does NOT require an RN’s training to stick a needle in your ass. Ask him if he’d be willing to have one of his staff train you and have you perform a proper self-injection in the office if that will make him feel better. Lots of people self inject. Hell, my clinic basically gave me a card with a link to a youtube video on how to do it, and I’ve had zero issues, rotating between quads, glutes, and delts.

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I’m surprised he would give you an AI without E2 numbers, yet won’t let you inject.

You didn’t mention your age, but you called a doctor “younger” which by my guess puts you at around 40 or older.

Your numbers (low LH / FSH) indicate secondary hypogonadism. SERMs can be an option for you. I’d certainly go with that over topical T.

See my problems? Locally noone can help… even the pros! UGH. So frustrating.

Start reading the stickies, start learning.

You have some options… educate your doctor or find a new one…

Don’t allow yourself to be powerless. You’re going to need to take action. Call your local pharmacies, both standard and compounding pharmacies.

Ask standard pharmacies if they can recommend a Dr’s who prescribes testosterone cypionate/ethanate (not gel) and anastrazole/arimidex for men with hypogonadism.

Ask compounding pharmacies if they can recommend Dr’s who prescribe hCG for men on hormone replacement therapy.

Call said doctors, explain your situation and see if it sounds like they’ll treat you. From that list, see if any of those Dr’s accept your insurance.

Take action.

Also dont forget that typically low T is a result of another condition and isnt the condition itself.


Do we have any other background info in your other threads.
You should not have multiple threads, info gets lost.
Have I suggested links for you to read before?

See About the T Replacement Category
advice for new guys
finding a TRT doc

Inability to absorb transdermal T is a symptom of low thyroid function.
Any thyroid lab results?
Check oral body temperatures as suggested in the thyroid basics explained link.

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Hostile, thanks for the info.

Regarding your last post… being a condition of another disorder… I’ve had so many blood results run that my physician is thinking I’m a hypochondriac at this point. I cannot find anything else other than my sugars being a little elevated 99 (120+ is over range) and low T from age 26 or so. I’ve had an abdominal ultrasound done and nothing showed other than a small kidney cyst.


My thyroid labs seem to check out fine, doc will not run anymore as he said since I’m in normal range it will get rejected by insurance. I finally got him to run a T4 and it was perfect.

TSH 1.43 ( Range: .36-3.74)
Free T4 1.0 (Range: .76-1.46)

The only other “conditions” i have are sometimes I get a bout of Non Bacterial Prostatitis, and my feet have been cold recently for no reason.

Need T3 and rT3 for a complete look at your thyroid function.

doc wont run them, guess i have to pay out of pocket… ill report back

Hostile, do I need ALL these?

T3, Reverse
T3 (Tri-iodothyronine)
T3 (Tri-iodothyronine), Free
T3 Uptake

Gets a bit pricey.

Only free T3 and reverse T3. Usually rt3 is the most expensive.

first endo appointment tomorrow wish me luck

praying someone can get to the bottom of all this

hoping finally someone will test my estrogen levels

hopefully they investigate thyroid

Hey bro, where about do you live? Wondering if your endo is anywhere near me.

Well, finally saw a new Urologist who is a major Andrologist in the area. He is a teacher at a university and has over 50 blind studies published. Seemed to know his stuff.

He wants me on Tamoxifen 10MG for 8 weeks. He hates topicals, and thinks my situation will improve.

Also wants me to have a dexascan in 8 weeks as he feels I may have some bone density issues from low T for a number of years.

Says Novadex therapy is better than Clomid. No AI prescribed. Honestly scared to take the Tamoxifen but what options do I have left?

Tamoxifen (nolva) is recommended by KSMan over clomid. Some people experience fewer sides.

Monitor your symptoms for E2 increasing. Many people seem to start getting E2 sides at about 2 weeks or so.

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Gonad he said E2 doesnt matter because of blocked estrogen receptors or something.

I did reading about long term tamoxifen use and fatty liver disease and cataracs

Seems its better than bone loss and my awful achy joints and NO energy i have currently

Bit scared to start this regimen as i dont know if theres any turning back

E2 sides do not only include full blown gyno. Docs only believe what they can see with their eyes. That’s why hypogonadism is a very underdiagnosed condition.

I just can’t believe how bad I feel.

If I knew in 10 years I’d feel this way still I don’t know what I’d do. Honestly get some dark thoughts sometimes.

I feel really emotional too for some reason, almost like crying from time to time.