T Nation

OK Dr.?

HI all,

age- 35
height- 5’10"
waist- 32"
weight- 210

I had my PCP check my TT levels as part of my physical and it came back back 160 (in the 250-1100 range) and referred me to an endo. Just met with him and he suggested pellet implantation but I said i felt more comfortable with IM shots. So he has me on one IM test shot of 100mg for the initial month. I have to do bloodwork in 2 weeks and in 4. In a month I will see him again.

When asked what he thought were normal TT levels for my age he was reluctant and said most likely 600-700. But then he quickly added that it depended on how I felt. Which could mean a lot of things but i’m interpreting that he is willing work with me.

What I would like to know, is this a good sign? I’ve read various TRT protocols stickies on this site and I know i should be doing bi-weekly shots of 100 mg. What should I bring up to the Dr. on my second visit? What do you guys think i should push for? I don’t even know how to bring up the discussion for arimidex and the hcg.

Any help would be gladly appreciated!

Doc makes $$$ with the T pellet surgery. If he wants you to have one 100mg dose per month, he is setting you up for failure, then the pellets are there as his option.

Didn’t think of that. Are most doctors like this? Any way i can make him think differently? He made it sound like would work with me.

KSman doesn’t know your doctor obviously, but you need to keep what he said in mind and be skeptical. Your doc may work with you but you need to study, or bring in a copy of KSman’s TRT protocol and discuss. Your doc needs to then provide you with good reasons as to why he would disagree with it. Bring those reasons back here and update us.

“The conjunctive use of anastrozole and tamoxifen has been linked to decreased efficacy”

We have seen some responses that would be funny if not so tragic. Some doctors feel empowered to states things that are not true, with the knowledge that patients are too stupid to know any different. I should stop, should not be hijacking this thread!

Thanks for the advice guys. I’ll definitely keep the suggestions in mind. I plan on discussing the protocols that KSman with him. I sure hope he’s as amenable as he claims to be. If not, well it’s time to move on!

KSman - In your experience, are specialists (urologists or endocrinologists) likely to work with TRT patients? or do i need to find a clinic? What TT levels should i shoot for?

[quote]KSman wrote:
“The conjunctive use of anastrozole and tamoxifen has been linked to decreased efficacy”

We have seen some responses that would be funny if not so tragic. Some doctors feel empowered to states things that are not true, with the knowledge that patients are too stupid to know any different. I should stop, should not be hijacking this thread![/quote]

This isn’t just his doctor talking out his ass, there was a study done a while back that showed the concurrent use of Arimidex and SERM resulted in a significant decrease in the effectiveness of both (anti-synergistic). I have posted the study on this forum before, but don’t have it handy currently.

VT, was that in the context of treating female cancers? If so, how could that apply to TRT? We routinely adjust AI doses based on lab results.

BH, you need to read the ‘finding a TRT doc’ sticky that I wrote 2 years ago that set out with:

“”"
The biggest problem for guys with hormone problems is finding a doctor who knows what he is doing. Most doctors are ignorant and unwilling and many who are willing are dangerous and stupid. Do not think that a specialist like an endocrinologist or a urologist is going to be able to help you. As a rule, these specialists are some of the worst offenders. An enthusiastic GP is your best bet.
“”"

[quote]KSman wrote:
VT, was that in the context of treating female cancers? If so, how could that apply to TRT? We routinely adjust AI doses based on lab results.

[/quote]

I don’t remember for sure, but it is more than likely dealing with female breast cancer specifically. However, if it resulted in more estrogen being present than would be expected running either of them solo, then there are more than likely considerations for TRT as well.

If I get a chance this weekend I will dig around and see if I can find the study and put into one of the stickeys (Estradiol?)

Lets not put it into the sticky if it is something that will simply confuse the readers. Remember that guys going there do not yet know very much and can easily misunderstand things. Again, E2 management with E2 lab work takes care of everything and SERM use is not ongoing; so effects would not be significant. I do see that testing and correcting E2 while on sporadic AI+SERM would be rare.