New Here. TRT Needed

Hello Everyone!

First of all I’d like to state that when I was 17 I was diagnosed with Mosaic Klinefelter syndrome. I’ve tried a lot of testosterone replacement therapies from doctor administered injections, Androgel, Axiron, to self administered injections. When I moved to Florida, I was introduced to a doctor that was giving me 1 cc of 200mg cypionate a week. This sky-rocketed my test about to a high total T: 1294, all of which didn’t make me feel all that good. On top of that my back and shoulders broke out with acne very badly. The doctor wouldn’t address my concerns so I left him and went to a new doctor who now has me at a solid total T: 600. I now self administer .5 cc of 200mg cypionate a week; I feel good and my acne is clearing up to the point of it almost being totally gone.

However, despite feeling good and the acne clearing up how do I shed the body fat I have? (yes I know, diet and exercise… ALL of which I am doing and have been doing since Janurary)

I’ve attached my lab records of when my old doc had me too high and lab results of where I currently am with my new doc. The 2 lab results are over a 3.5 month difference.

Lastly, I do have a follow up appointment with my new doctor this Tuesday 6/19/18 - so if there is anything you see on my results or anything that should be checked or asked, please mention is so I can bring it up at the appointment.

Also, any recommendations on treating back-acne?

You really need to be properly evaluated in order to know if you are on the correct protocol suited to your blood biomarkers and it doesn’t sound like you’re working with an experienced doctor. Injecting testosterone once weekly is not ideal as your hormone levels will be swinging wildly throughout the week. You won’t find many here who inject weekly, it just suboptimal.

Your SHBG will determine dosing and injection frequency. Whatever you do DO NOT take any hair loss drugs to control the acne, finasteride, propecia and accutane can cause permanent sexual dysfunction and debilitating symptoms for life! Say no to any drugs for acne.

You really need to include the most recent labs.

Sorry, I literally just signed up today. I have my labs here both old and new, however they are in PDF form and the upload does not allow that format.

I’ve never bothered uploading my labs, I just type it in. No one will take an interest in your case without all labs.

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OLD LABS:
Total T: 1247
Dihydrotestosterone: 37
Estradiol: 34
PSA Total: 0.3

NEW LABS:
Total T: 600
Also did a Comprehensive Metabolic Panel and CBC, but didn’t check anything else I guess…

Currently seeing a Endocrinologist - is this the right doctor for this?

FYI, I’m now 30 and turn 31 next week.

MUST get your SHBG tested. Demand it.

That’s not even close and am certain that’s the wrong E2 tests, you need the sensitive E2 labs. I doubt this doctor will be able to balance out your hormones on these tests alone, he doesn’t even know he has the wrong E2 labs and no SHBG testing.

You need to understand insurance is useless for TRT, because there’s no standard of care model for TRT so you have every doctor doing something different. Add to this most have no training on how to properly administer a proper TRT protocol, endocrinologist are the worst when it comes to TRT.

I was force to go private because my Kaiser endo’s are all stupid, most go private to receive proper care as insurance doctors are kind of filling in the gap, hormones are an area that’s been neglected for the past 70 years so most doctors are unfamiliar with hormone therapy in general.

Well I have an appointment tomorrow, which labs should I request to be tested?

Also, you are correct systemlord, I doubt this doctor knows what he is doing. He just seems like another doc to speak the same bullshit and do the minimum. I’ve been looking for a decent doctor. The doctor I was seeing prior with the high level of T was an anti-aging doctor more or so than anything else.

I’ve read on other forums that perhaps a Urologist would be better or better yet just my normal PCP, what are your guys thoughts?

Defy Medical is the popular choice.

I do have one local in Tampa, FL and have made contact with them via online chat. Thanks for the recommendation!

Since they do not take insurance I will be unable to seek their help.

However I found a doctor that takes my insurance and specializes in TRT, HRT and such. Ive requested to get the following blood tests done;
Testosterone, total

· Testosterone, bioavailable

· Testosterone, free

· Estradiol (sensitive assay)

· Steroid Hormone Binding Globulin

· Follicle Stimulating Hormone (FSH)

· Luteinizing Hormone (LH)

· Dihydrotestosterone (DHT)

· Prostate Specific Antigen (PSA)

· Blood Chemistry Panel

No metabolic panel or CBC since that was just done.

That’s what I said in the beginning, I’ve done a complete reverse on that course in a years time. Only way to go if I want to feel normal again, I get it you’re not there yet.

“SEX” Hormone Binding Globulin (SHBG) and maybe they call it differently where you are but I’d hate for your test to not get done because of a misprint. SEX hormone, not “steroid”. :)))

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Thanks for the heads up! Ive got an appointment for this Friday.

I just think its mad fucked up that so many men out there have this issue and there are hardly any knowledgeable doctors out there.

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Good luck with everything. I’m fairly new here and have been on TRT, HRT etc for the last 2 months. Learned a ton on here between the stickies and super helpful folks like ksman and system lord.

As SystemLord mentioned, many folks here have decided to pay for their treatment privately to ensure they get the best help. I went from Urologist who really doesn’t understand the ripple effect of TRT injections (Estradiol follows increased test levels, testicles can shrivel up etc). I decided to go with Defy as well and they’ve been incredible. The benefits greatly outweigh the costs if you can afford it. Also understand that insurance carriers are so behind the times you’ll probably have a challenge getting them to approve hcg (if you end up getting hcg to inject which is very common). I feel like Defy is completely on my team and are some true experts when it comes to all this.

Good luck!

Insurance companies are in business to collect premiums, not to pay claims. It does not matter what is best for the patient. What matters is their bottom line.

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A small update:

I visited with a new doctor and got new blood work done as follows:
HDL cholesterol: 35
Triglicerides: 240
FSH: 1.0
LH: 0.2
DHEA Sulfate: 288
Progesterone: <1.4
Estradiol: 25
Total T: 600
SHGB: 2.9
PSA: 0.4

Doctor also wants to put me on HGH @ 250 units 3 times weekly.

Thoughts?

You forgot to include ranges.

That’s the lowest SHBG level I’ve ever seen, I don’t understand how you are holding onto your testosterone.

Sorry, I noticed that after I posted but didn’t have time to update…

HDL cholesterol: 35

40
Triglycerides: 240
<150
FSH: 1.0
1.6 - 8.0
LH: 0.2
1.5 - 9.3
DHEA Sulfate: 288
85 - 690
Progesterone: <1.4
<0.5
Estradiol: 25
< or = 39
Total T: 600
280 - 827
PSA: 0.4
< or = 4.0

What I thought was the SHGB test results were incorrect. Sorry about that as well.

Lastly, I could have sworn my doctor said to put me on HGH but when I logged online to check the status of the order it came up as chorionic gonadotropin aka HCG. Any idea as to why he would want me on this?