Seeing Urologist Soon - Any Major Points?

Sorry what do you mean by this?, apologies for being a little dim :rofl:

Im off to see the urologist soon, so hopefully he will see if its primary/secondary hypogonadism (how will he check for this? Woukd it be blood tests), check LH and FSH and then take steps to see if can be rectified, im guessing he may prescribe clomid or enclomiphene citrate? Any idea how long course will be if so, and will it be 1 tablet per day for X weeks? Does tamoxifen not do the same thing? Hopefully can be rectified without TRT… but if not then obviously will have to go down needle route… which will be test enanthate 1 pw i reckon… but if can be done without TRT for life then will defo do that!

Ive asked if my stupid mistake dabble with AAS would have any impact on my boys, which im told it wont have so very much grateful of that… is there any way this can be explained in a little more detail at all as would put my mind to rest etc… and id be very grateful👍🏽

In otherwords, Jatenzo is reversing my diabetes.

Ah i see, thats great news :+1:t4: @systemlord @highpulls @middleages

Im off to see the urologist soon, so hopefully he will see if its primary/secondary hypogonadism (how will he check for this? Woukd it be blood tests), check LH and FSH and then take steps to see if can be rectified, im guessing he may prescribe clomid or enclomiphene citrate? Any idea how long course will be if so, and will it be 1 tablet per day for X weeks? Does tamoxifen not do the same thing? Hopefully can be rectified without TRT… but if not then obviously will have to go down needle route… which will be test enanthate 1 pw i reckon… but if can be done without TRT for life then will defo do that!

Ive asked if my stupid mistake dabble with AAS would have any impact on my boys, which im told it wont have so very much grateful of that… is there any way this can be explained in a little more detail at all as would put my mind to rest etc… and id be very grateful👍🏽

@highpull @systemlord @middleages abd anyone else that can help please?

Hi All,

Further to my last post, I’ve now seen the urologist. He gave me a blood test, ultrasound and a prostate exam which I was not expecting! Stated that my bladder was holding some urine so not emptying fully.
Had the ultrasound and he said it’s fine and you have emptied fully,
Prostate exam showed as a little enlarged but smooth and nothing to worry about.

Oh he had a feel of my testes abd said they were fine and not small etc.

Anyway I have an appointment soon him again.
I asked if the tests woukd include certain areas I.e. t3 ad t4 etc… he said they wouldn’t do that… asked about a few other areas, Cortisol and estrogen etc and he said don’t need to for now…
The areas to be tested are as below:

U&E with Creatnine
TFT (TSH & FT4)
FSH & LH
Test
Prolactin

I’ve had my shbg tested previously and tests as shown before, but was a little confused why he wouldn’t test for as much as poss right now?

I’m due to see a respiratory consultant soon as well for a CT scan as what they thought was asthma/copd has finally turned out to be neither after waiting for a test for 2 years, doc said showing a restrictive pattern and that’s it, so shouldn’t have been taking inhalers really, hopefully get to the bottom of that too soon :confused:.

Anyway back to urologist, he started (if I needed it after blood test results come in), going on about gels and cream and I said not interested in any of them… and then he disclosed to me that injections were better (which I already knew from the feedback and content ive read on here).

I asked if it would be test e or sustanon or what and how often?

Surprisingly, he said it would be most likely test undecanoate, but then said and an injection every three months, which I believe should be every 2 months?

Should I ask for a loading period here?
More frequent injections?
Should I be asking how if he’s going to check if it’s secondary hypogonadism? And if the pituary is firing/sending messages to the testes or is that what lh and fsh will check?
Any other additional questions?
Should I be asking to take something for control of estrogen?

Im not that fond of needles, so every 3 months sounds ok and it will be on the NHS but im just worried as heard Nebido/test undecanoate not that good and not good to have so infrequently, plus should i be running anything alongside it?

Please let me know lads and thanks?

If you think you’re healthy, you haven’t had enough tests.

I discuss several options, when applicable, with the pros and cons of each and let patients decide. However, I would advise you listen to your doctor and start with his recommendations, unless they are unreasonable in your mind. You can always adjust and make changes later.

No, he is doing this.

No, cross that bridge if you get to it. Most do not.

That does limit options.

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I don’t see why you can’t get sustanon, you need to be a bit more forward and tell your doctor you want sustanon.

Sustanon should be injected no less than every 10 days in my opinion. Sadly the NHS isn’t the best place to get treatment for hypogonadism.

The problem with nebido is you can feel symptoms of low-T towards the next injection leaving you symptomatic for weeks.

So unless the doctor is wise enough to move to a shorter injection interval, your treatment will be much less effective.

Can i ask what you mean by this please?

Yes will listen to urologist, and will listen to pros and cons, im just concerned as ive heard a ot if doctors making mistakes in this field and its important to let them know etc. I just think 3 months is quite a long time but from what ive heard from test undecanoate its a slow ester so not as effective? If he doesn’t recommend a loading period, should i push for this and whats the best method please?

I know you’re saying dont have to be concerned about estrogen, but in your opinion with a high dose of test u, is is likely that there will be a high conversion rate of have high conversion to estrogen due to the high test levels? Do i need to be concerned about this?

Ok, ill ask about this or see what options he comes up with and then discuss this.

Ok so if sustanon should be injected every 10 days (id prob push for 1 x pw as then easier to know when having it etc). How much should be doing? 1ml x pw?

In your opinion would taking test undecanoate taking 1 x p3 months be a major difference from sustanon every 10 days or week? I see what you mean by the interval, however, if i started on 1 x 3 months and then pushed for 1 x 2 months, woukd that be better?
Should i be asking to run anything with either sust or test u?

With a high dose of test u, is is likely that there will be a high conversion rate of have high conversion to estrogen due to the high test levels? Do i need to be concerned about this?

Please let me know what you think cheers :+1:t4:

This (male hormones) is a field of medicine, or more accurately an ignored area of medicine, a few doctors have been disproving past beliefs while the rest of the medical community is playing catch up.

I strongly believe the biggest problem are the treatment protocols (injection intervals) and the doctors unwilling to listen to the patient when he says he feels better with higher levels and do to fear disregards what the patient is telling him.

As long as HCT is within reason, higher T levels (high normal) are fine.

The anabolic doc has a good take on Test U and why it isn’t the best choice. Test U can take 5-6 months to reach steady states, a long dialing in process and could take a long time to find the right dosage in some cases.

Also men on TRT are sometimes having to readjust the dosages down the road, and having to wait for levels to decrease because levels are too high or vice versa just isn’t convenient or pleasant.

Sustanon actually has multiple (four different duration of action) esters in it. The cypionate and enanthate are preferred, but are only available in UK from private cash only clinics.

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It means that with today’s technology, if you have enough tests, they will eventually find something to justify a treatment.

There are a lot of opinions regarding TRT. I’m saying you need to have a pretty good relationship with your doctor to get away with pointing out his “mistakes.” I have zero experience with undecanoate. I would think the dosing frequency utilized is not the best.

I would ask your doctor about his experience with high E2 side effects. I would not be oblivious to them, but I wouldn’t go looking for them either. Ask your doctor what his plan would be if you encounter any.

Good luck.

@highpull @systemlord @ksman @middleages and any others!

Hi All,

OK so further to my last post, i have seen the urologist and these are my results attached. Can anyone look at these and tell me what they think please… is there anything wrong with these results?

Urologist is saying same as the Dr. I’m borderline low test.
So he’s advised he wants me to go on to testogel for a month and see if that helps, if it does and helps my symptoms, then he will prescribe test undecanoate 1 x 3 month (which obviously ill try push for 1 x 2 month but not sure if he’ll go for it).
Asked about sustanon, he says that not available and its only test undecanoate that is… plus side its on the NHS so i’m guessing its just a payment for prescription.

Anyone tried the testogel? Pros and cons etc? Is this twice x day?
Don’t need to rub on balls apparently.

Im based in UK so not sure if there are any alternative options, or if this urologist is just playing it safe etc?

Please let us know what u think?
Cheers lads

I doubt any TRT practitioners use gels. Most use, creams, injections or pellets and all outperform the gel. But, many GPs prescribe it and I’m sure men are happy with it or they would have stopped prescribing it some time ago.

I suppose pros would be it is not an injection (if you do not want injections) and it is not applied to the scrotum if that is a problem for you. Transfer to others is an issue, so is absorption.

That may not be enough time to see results, especially if you fail to absorb a meaningful amount of Test. I respect your doctor for allowing you to have a trial of TRT with low normal test.

There are oral options in the US and Canada, so it’s only a matter of time before it’s available in the UK. What I find strange is the oral version I’m on (Jatenzo) is test undecanoate, but has a very short half-life and must be dosed twice daily.

Hopefully the gel will do something decent, as you say everything outperforms it, is this not really worth it? I said id rather go on injections but he said this is to check if it helps symptoms first and can easy come off it if needed?
I asked about transfer to others especially mrs and kids, he said not to worry, are gels not different to the creams in saying that once on and soaked in, then not likely as transferable etc?

Yes, i see what you mean, i think hes saying just give it a try, if it does help symptoms then can move onto injections, but the only one available is TU?

Can i ask what you think about all the other levels? LH, FSH, T4 and TSH? (That seems low, but dr just said its all ok?)

Yes, if i could do oral choice id be straight on it, ill be looking out for Jatenzo then most defo! But jist depending on when! Could be a long time… :sob:

They all look great. The testosterone is low, which is strange considering the LH is better than midrange. I think it’s a bit premature to say testosterone is borderline low without knowing the Free T result.

This exists so some must be getting good results, or at least they are happy. Does not hurt to try.

Not sure about this. I suppose if it s not working you can stop and not feel different…because it wasn’t working.

Right, once absorbed. The difference is creams are absorbed more efficiently and are usually put on the scrotum, plus the volume of cream is much less than the gel, which is placed on the torso and arms. Easily transferred from there. Scrotum, not so much except with sexual contact within four hours after application.

Im just a bit concerned about this, everything else is looking fine and why didnt the doc ask to do Free T? Is this not Free T4, should i be asking for a independent blood test before going on anything then, as far as i can see he’s not checked hemocrit and hemoglobin either?

The first time this was checked by GP… mean cell haemoglobin level… 32.9 (range 27 -32).
But then it says hemoglobin ac1 level, normal, no further action.
hemoglobin ac1 level - 29nmol (range 20-41).
Test was 9.6 at this point…

2nd time - this wasnt tested but test was 10.8

In the recent result it was 10.9

Could it be that i just need to change my lifestyle and get back into the gym to see if test increases naturally first before delving into gels/injections which will naturally stop my own bodies creation of it as far as i understand? Abd then defo cause a lifetime needing TRT, either gel daily or injections etc…

Or from what im hearing from the doc, he’s saying we can start on the gel, if its not raising it much then can stop n natural test will start again?

How do i know how much test my body is producing currently naturally?

Please let us know your thoughts :+1:t4:

Your testosterone is low enough to warrant TRT and that may have been enough to move forward and therefore Free T testing is redundant.