T Nation

Pituitary Adenoma. Don’t Know What To Do


#1

currently endo said he won’t treat it since i have no vision symptoms but he did offered trt but with bad protocol (once every 2 weeks with an shbg of 77?). from what i keep hearing and seing over this forum its better to go anti aging (defy?) than taking care of an endo when it comes to hormones. i would actually go defy but since i have an adenoma i dont think its the best thing to do? my endo thinks e2 is for women and do not test it with men. does defy have patients with adenoma? im between searching for a doc or go defy?


#2

If you determined with proper evaluation of symptoms and labs that you need trt - at least the Dr is giving you t. You can always inject on your own protocol.


#3

Starting TRT with a doctor who thinks E2 is for women would be reckless, no estrogen monitoring or management we all know can be a recipe for disaster. You can’t even get a proper evaluation from this endo because he doesn’t know anything about sex hormones.

I doubt an experienced hormone doctor would prescribe TRT to someone if there was a danger do to a pituitary adenoma, you don’t want to spend the rest of your life feeling the way you do now.


#4

Pituitary adenomas are common, however, those requiring surgery are fairly rare.

I suppose you could source testosterone from this doctor, if you are able to self inject you can go once a week. He’ll probably prescribe 200mg so you could go 100mg/week and hope that’s enough. Follow up labs may be an issue though as he won’t check E2 he probably won’t follow others properly either. You might ask what would be checked and how often if considering staying with him.

Regardless of who handles your TRT, the adenoma needs to be followed. Is your prolactin elevated?


#9

mine does not require any type of surgery. the thing is, i would not like to self medicate myself. like you said he prescribed the dosage and me splitting stuff and checking everything without doc recommendations or doing stuff on my own feels weird. i do prefer managing stuff with docs or someone who knows. one of the reason im considering either looking for an experienced doc or go private


#10

the thing is, i would not like to self medicate myself. like you said he prescribed the dosage and me splitting stuff and checking everything without doc recommendations or doing stuff on my own feels weird. i do prefer managing stuff with docs or someone who knows. one of the reason im considering either looking for an experienced doc or go private


#11

Totally understandable. Anyone prescribing twice a month injections is not seeing many TRT patients in their practice. If they were, they would have heard plenty of complaints and seen poor outcomes and would have figured out another approach, like at least weekly. Not checking E2 is another disqualifier.

You’ll likely need to find a concierge practice specializing in TRT. Personally, I’d look for a local doctor, but I prefer face to face interaction with my doctors. If you go telemedicine, check out the laws in your state. Most states require the doctor to be licensed in the state in which the patient resides, and many require a face to face consultation/examination prior to going to telemedicine.

Good luck.


#13

same here, altho i already exhausted every little endocrinologist where i live with no success. not a single one cares about a full hormone panel or specialize in trt. heck what do they specialize in anyways? because not even thyroid. i still dont have t3. like i said. my only way to fix this is either going telemedicine or finding a specializing trt doctor. BUT how do i find a specializing trt doc? they are all under endocrinology? so if i fly to lets say New york because i found a good reputable endocrinologist (by reviews) that does not mean he knows a lot about trt. and if he does what costs more? flying over there for trt and other stuff or go telemedicine? where i live there are anti aging clinics so that means telemedicine over here is legit? thanks highpulll


#14

The main problem with endocrinologist is they have the wrong mind set to be able to do TRT effectively, they are brainwashed to follow guidelines (their religion and bible) and the reference ranges guides their decision making progress, critical thinking and reasoning is far removed from the decision making process.

This is sick care or managed healthcare, minimal testing to save on healthcare costs at the expense of the patient, no estrogen monitoring or management because their bible doesn’t say anything about estrogen management. A guy comes into the office needing TRT and the doctor looks at the guidelines and it says 200mg every two weeks, so the doctor does it because that’s what the bible says he should do.

This happens more often than not, in reality the doctor doesn’t know jackshit about TRT.


#15

Just because an Endocrinologist got rave reviews does not mean he knows trt well. Unless you read the reviews and they mention trt.

Tell us your city. Sometimes we know people b


#16

Mostly diabetes, thyroid, some infertility.

Do you know anyone on TRT? Do you train at a gym? Look around, you can often tell which guys are on TRT. Strike up a conversation seeking advice. Google low testosterone clinics in your area, then do a little research on them. There is a lot of information on the internet, with varying degrees of accuracy, but learn as much as possible so you’ll be able to vet your doctor. I would look for one whose major focus is TRT.

I agree, prior to going to the trouble of traveling I’d want to be pretty sure about the doctor. Anti-aging clinics might be a good place to look into. As for being legit, just because they exist does not mean they’re legit. Someone in my area just got shut down.


#17

this is total shit man. same thing happend with other stuff like nutrition. they learn old stuff and decides to follow that. the eating 6 meals, the not eating after 6. wtf i need help and cant get it.


#18

currently live in san juan. i went to all the recommended ones (by people around here) none checked my full thyroid i still dont have e2 or t3 one of the “best around here” who ordered mri ordered the mri before checking prolactin and he said the case was hard for him so he transfered me to an hospital that specialize in endocrinologist. want to know what? they said i might have cushing sindrome because my cortisol is at 21and acth 61. no symptoms, they dont check e2 or shbg they said o we start trt once every two weeks and if you feel good then youre golden. also we dont believe in hcg you will lose your fertility. they dont offer clomid either” o and the guy who ordered mri said “you want viagra?” i got my reasons to be depressed. i dont know whats worst, finding a good doc or getting badly treated


#19

hey mate! san juan. already went to the recommended ones and top ones (even hospital) with no success. anti aging clinic around here wont accept me because im young (24) and they do pellets only.


#20

any tips?