T Nation

My Doc is an Idiot!

Hey all,

I know a lot of you reading this thread will either shake your heads sadly in agreement, or roll your eyes thinking, “No shit, Sherlock”, but I just felt like ranting, ergo this post.

Went to see my GP yesterday. He prescribed me with 1% Androgel about three months ago. I told him I was getting only a partial response and still was having issues with ED. I asked him if we could up the dose. He agreed that we could look at doing that, but not without bloodwork to see where my current T-levels are sitting. He probably also wants to see where my hematocrit levels are to be sure that I can continue taking the Androgel.

He suggested I try Viagra or one of the other ED meds to deal with that issue. I told him that I was reluctant to do that because of all the horror stories I’ve heard about people going deaf or blind or simply dying of a heart attack after taking Viagra, et al. He brushed the concern aside by saying that millions of men take Viagra without incident.

I then asked him if he could refer me to an ED specialist, arguing that an injectable med, or one of the new alprodastil gels might be a better choice. His response was that the ED specialist would probably just ask why I wasn’t taking Viagra in the first place. He also reminded me that testosterone alone would be unlikely to resolve the ED issues. He simply left the office for a moment, handed me a bloodwork form, a physician’s sample of Cialis, and walked out.

Since bringing up the issue of ED with my doctor, he seems to have had little to no interest in finding out why my libido is poor and why I have ED. I think he’s simply written me off as a ‘Type 2 diabetic, overweight, won’t exercise or eat the way he should’ type of patient. If anything, the last few times I’ve seen him, he has had this rather casual, don’t-give-a-shit attitude. His office was totally empty, and on a couple of prior visits I’ve had, I didn’t see a lot of patients waiting. I get the impression that his attitude may have something to do with the fact that he is approaching retirement age.

I know one reason why I won’t be getting my LH, FSH, T3 and T4 levels checked properly - the form he handed me is a standardized form authorized by the Ministry of Health here in Ontario, and it doesn’t even have any check-boxes for the standard endocrinological tests. Looks like I’d have to see an endo before getting any of those things looked at. Given his attitude about referring me to an ED specialist, I get the feeling an endo referral is out of the question.

Canadians think their health care system is wonderful. It isn’t, and it sucks. Badly. I personally know one manager in the Ministry of Health who admitted to me that the health care system in Ontario is very badly broken.

Sure, if you get a heart attack in Ontario, you’ll get treated properly. But quality of life issues are basically ignored, and health care outside of the really serious stuff is rationed to the point it might as well be unobtanium.

I’m getting to the point where I’m thinking about finding a new doctor. Problem is, in Ontario, there is a severe doctor shortage. Many of the new docs that are taking new patients are few and far between, and don’t want to deal with chronic or complicated health problems.

My only option at this point is to hope my doctor will allow me to stay on Androgel until I can get into a clinic like the Masters clinic in Burlington, which I’m told has a very long waiting list.

If I were rich, I’d leave Canada in a heartbeat and go somewhere where my problems can be effectively treated. Canadians pay some of the highest taxes anywhere in the OECD, but they’re getting fewer and fewer services for that money, and what they are getting isn’t all that great.

I agree greatly with your argument on how doctors basically ignore quality of life issues. Ever since puberty started I became depressed without any melancholy issues, just low energy, lack of motivation, anhedonia, and I begged my family doctor to test my sex hormone levels. He only checked testosterone, free testosterone and prolactin and my free testosterone was 0.7 ng/dl or 6.6 pg/ml, and my total testosterone was 383 ng/dl. I was 18 years old at the time. My levels are supposed to be way higher than that and my doctor simply said they’re fine.

I went to a walk-in clinic the other day and I told the doctor there about how my TSH levels were fine in the previous blood tests I’ve done, but I still have symptoms of hypothyroidism. She fucking said TSH alone is enough to determine thyroid function. :confused:

My symptoms started back in 2008. It’s sad that doctors don’t give a shit about finding the reason for your symptoms. They simply match them to what they think is appropriate and give you the diagnosis. For me, it was depression and I was told to take antidepressants. I don’t believe that at all. I was never depressed before puberty.

Alphaepiston, I too have some symptoms of depression. Like you, my symptoms chiefly centre on lack of motivation, apathy, and some degree of anhedonia.

I will not take antidepressants, especially the SSRI’s, because they tend to make ED and other sex-related problems worse, not better. Plus there seems to be some evidence, anecdotal and otherwise, that they only work 30-40% of the time. They also carry serious risks of inducing manic, homicidal and suicidal behaviour in patients who are not severely depressed. If they work at all, they seem to work best in severely depressed patients who need to be stimulated and activated.

I’ve even heard isolated reports that some who have taken a course of SSRI’s find themselves totally unable to get an erection after stopping the drug. I suspect, though, that such unfortunates were likely taking high doses for a long time, and said doses caused some form of brain damage.

Since starting on TRT, some of the depression-related issues have eased a little, but I still feel I’m about 50% of the way to where I think I should be. At least I’m feeling a bit more motivated and positive than I was before TRT. But still, it’s not enough.

I have a theory about why doctors essentially will not treat endocrinology-related disorders properly. The endocrine system is the linchpin that keeps the body together - and included in the endocrine system is the hypothalamic-pituitary axis (HPA).

When the HPA and the rest of the endocrine system is all buggered up, patients get sick with myriad, almost Protean problems. Untreated, this means that a patient with endocrine/HPA problems will always be in the doctor’s office getting treatment. Plus, doctors are lazy. It’s a lot easier (and profitable!) to simply reach for a prescription pad and dole out drugs that really don’t fix anything than it is to take the time to find out what’s really wrong and provide the appropriate treatment. A scrip takes ten seconds to write. In-depth investigation can take hours and involve thinking hard about things.

Or maybe I’m just paranoid.

Resolving low testosterone and other hormonal problems, properly done, seems to keep patients out of doctor’s offices.