T Nation

Stupid Things That Docs Do and Say


#76

I went to a clinic today, asked the doctor to run bloodwork for me. told him my situation and the only thing he wanted to test was LH lol and total testosterone and when i explain the reasons why i needed more example (low waking body temperature, fatty liver) he told me I read to much and “there are to many cooks in the kitchen” wtf does that even mean??? I said listen all you guys do is write prescription and send people for lab work so can you do your job or not???

he didnt want to test my liver enzymes,tsh,t3,t4,ft3,ft4,rt3 and told me i didnt need e2 then i explained my e2 was in high normal range on my pre trt blood tests and by raising testosterone we raise e2… he told me i read to much… i told him your not going to take care of me so if i dont who will and walked out…


#77

[quote]KSman wrote:
Reading all of these things makes me think that these doctors have personality defects and a lack of personal regard and compassion. [/quote]

I tend to agree. I have the impression that many who are attracted to medicine as a career field are there because of:

a) the money
b) power, and the need to satisfy a huge ego and a desire to be some sort of god
c) perceived prestige and social status (did you know that people trust doctors only slightly
more than they trust used-car salesmen?)
d) because they weren’t smart enough to get into any other career field (there are tons of
docs out there with C minus averages)
e) personality defects, as you point out (including sociopathic and sadistic tendencies)
f) because they enjoy manipulating and controlling others (nurses can sometimes fall into this category - Florence Nightingale had a dark side, after all)
g) psychiatric or psychological problems (they hope that somehow they can get themselves straightened out if they become a psychiatrist)
h) easy access to drugs

The ones with honest intentions are rare and often don’t last long, because their idealism eventually collides with reality and they learn that they cannot fix everything. Or they burn out.


#78

[quote]iroczinoz wrote:
Went for a blood test to just check my Thyroid levels after being on a higher dose for 3 months. GP (female).
Her: Who thought of this great idea to get thyroid tests?
Me: I want to check if I am dosing correctly or I need to adjust.
Her: Thyroid issues is what women have you are male.

I get the feeling with all the supplements like DHEA being banned around the world and the difficulty in getting treatment for testosterone deficiency etc… Is all in the favor of the government.

Live a shorter life, government saves on paying out pensions.
If the government was so concerned about your well being, alcohol & smokes would have all been banned decades ago. But no, it is a great money revenue business, people die earlier so they are in a win win situation.

[/quote]

This is pretty much what I’ve suspected all along. The standard wisdom these days is that tobacco must be banned because it causes too many cases of cancer and emphysema, etc., and these kinds of chronic/serious conditions cost the health care system too much money.

What they don’t tell you is that the tax revenue realized from tobacoo sales more than covers any health care costs.


#79

[quote]Alba_Agus_Eirinn wrote:

[quote]KSman wrote:
Reading all of these things makes me think that these doctors have personality defects and a lack of personal regard and compassion. [/quote]

I tend to agree. I have the impression that many who are attracted to medicine as a career field are there because of:

a) the money
b) power, and the need to satisfy a huge ego and a desire to be some sort of god
c) perceived prestige and social status (did you know that people trust doctors only slightly
more than they trust used-car salesmen?)
d) because they weren’t smart enough to get into any other career field (there are tons of
docs out there with C minus averages)
e) personality defects, as you point out (including sociopathic and sadistic tendencies)
f) because they enjoy manipulating and controlling others (nurses can sometimes fall into this category - Florence Nightingale had a dark side, after all)
g) psychiatric or psychological problems (they hope that somehow they can get themselves straightened out if they become a psychiatrist)
h) easy access to drugs

The ones with honest intentions are rare and often don’t last long, because their idealism eventually collides with reality and they learn that they cannot fix everything. Or they burn out.[/quote]

Ouch, that seems a little harsh. I’m working on getting into med school at present, and I just want a decent job that pays the bills (and maybe a little more :D). Some of the stuff you mentioned are definitely perks, but I don’t think most docs are the miserable fuckers you make them out to be.

Though some of the things people have wrote about their docs saying on this thread honestly scare the living shit out of me (one more reason to learn this stuff myself so I can take the health of myself and my family into my own hands), I think a lot of it has to do with doctors that are misled or don’t keep up with their reading. Some of the things that are preached as canon are not only utter bullshit, but propaganda. Perhaps an even bigger problem is that many refuse to think outside the box for fear of work-related repercussions which, unfortunately, is not an unreasonable fear when you consider the vast investments in time, money, and playing politics that are required to get there in the first place.


#80

[quote]Apoklyps wrote:

[quote]Alba_Agus_Eirinn wrote:

[quote]KSman wrote:
Reading all of these things makes me think that these doctors have personality defects and a lack of personal regard and compassion. [/quote]

Fair enough. Let me note that I didn’t say that all doctors were like this. I should have qualified my statement by saying that many who have bad (or less than truly good) intentions are attracted to a career in medicine because of the things I enumerated in my original post.

The reason why the comments you’ve read (mine included) are scary and harsh is that a lot of of the men who post in this forum seeking help and advice are here because they are not getting the help they need from their doctors. Their attempts to get that help are often blocked by doctors who are ignorant, badly trained, have little motivation to learn what their patients really need, and who are so uncaring that they dismiss their patients’ complaints as trivial or unwarranted.

Few doctors would ever deprive a patient of treatment because they have diabetes. But many do just that when it comes to hormone replacement therapies, and it’s all because the treatments, particularly testosterone replacement, are controversial, not well understood, and have a stigma attached because testosterone use, even for a bona fide medical reason, is often conflated with the steroid abuse seen in some bodybuilders. Part of the overall problem is that to a certain extent, the medical profession has become corrupted and co-opted by a pharmaceutical industry that finds that keeping patients sick and forever dependent on medications is far more profitable than curing them. That corruption and co-optation leaves many people somewhat suspicious of the medical establishment as a whole.

As a result, the men I speak of are very unhappy, and rightly so. They are simply trying to treat a medical condition that can have a seriously deleterious impact on their quality of life as well as their ability to function. To say nothing of the fact that they know that there is an increasing amount of good research coming out that shows that hypogonadism (i.e. low testosterone), if left untreated, is directly correlated with significantly shortened life expectancies and also increases the risk of serious cardiovascular events occurring, as well as poorer quality of life overall.

Perhaps being scared by some users’ posts is a good thing. The fear you feel may motivate you to remember why you’re becoming a doctor - to look after your patients, with monetary considerations coming in second. It may also motivate you to give your patients the best possible treatment you can instead of blowing them off because it’s easier to do so.


#81

First TRT injection was last Friday.

Doc (female GP): We will see you in two weeks for your next injection.

Me: 2 weeks? I don’t want that kind of roller coaster ride. Can we do another next week?

Doc: NO. 2 weeks.

Me: Fine - 2 weeks (my ass).

Monday - I call and ask for a script to be sent to the pharmacy for self injections at home.

Doc: Yes, I can call in a script for Androgel.

Me: WTF? I am not on gel and I don’t want it. I told you that. I want injections at home. It will cost me at least $120 a month for office visits.

Doc: Well, sorry but the possibility of abuse is too great with Test. I will NOT give you a script for it.

Me: Do you give scripts for Aderol, Ridelin, Percocet, Vicodin and Insulin?

Doc: Yes

Me: Well, those ALL can and are being abused and sold on the street. Better pull ALL of your scripts then. This is about the money for you. I will be moving to a different doctor for my TRT.

Doc: Okay

Really? WTF? I don’t get it. I know the injections should be more frequent. Got an appointment with my Urologist for the 3rd of Oct. And they already told me they would write a script for it. They were SHOCKED that my PCP wouldn’t write it.


#82

I gave all symptoms of Low-T to my GP and he wrote me a script for Adderall. This is even after i told him I’m a recovering drug addict of 20 years, he said: “it’s not physiologically addictive.” My ass it’s not, I could pay for my TRT with this script. Bye-Bye doc.


#83

I can’t make this stuff up… The female endo was trying to impress her new female nurse practitioner, who was also in the room.

Female Endo: I bet your testicles have shrank from being on TRT!
Me: Nope, because I use hCG.
Female Endo: looking at me scornfully Well, I bet you’ve developed gynecomastia!
Me: Nope. I use anastrozole and cabergoline.
Female Endo: (frustrated because she can’t stump me) Well, you need to be off all that stuff.

Needless to say, I don’t go to her anymore.


#84

I have many. Some are close to or verbatim to what was said by the doctor or endo, others are similar or same idea.
Such doctors also practiced for years, worst with endos.

Doctor said:
All of my other patients just take T and do fine.
He never ran into any problems with giving T, or anything like I was talking about.
I was the only one who brought up such ideas and concerns.

When my Estradiol was the low forties pg/mL (lab range: < OR = 39 pg/ML)
Doctor said: Estradiol is slightly high but not much.

When my Free Testosterone was 43.1 pg/mL (lab range: 46.0 - 224 pg/mL) from my doctor’s tests.
Recommended to Endo 1 from my doctor for low T.
Endo 1:

  • Said: I’m not testing for testosterone. Blood testing isn’t accurate and you can’t afford the tests.
  • Didn’t see anything wrong with my labs that I came with from my other doctor.
  • Did not take my low T and my symptoms seriously at all.
  • Joked, poked me in my belly button and said: We all get depressed around this age (early 50).

I also noticed at this same time that my nipples were surprisingly larger than usual and sore when I hardly brushed them with my shirt, strange. I am underweight, not overweight, no problem with belly fat.
Endo 1 said: Do your nipples drip?
I said: "No,"
Endo completely ignored it.
(A couple of months later, possibly first time I tested for my estradiol, which was at mid teens pg/mL, so I’m not sure how to explain the nipple problem. This was a month prior to starting TRT.)

Endo 2
I went for low T, and check for all Endo 2 could find out about my whole endocrine heath.
Endo 2 found I have hypercalciuria, which is serious. More on that and so forth in my other posts.
Note: a year prior to seeing Endo 2, I asked for my first Bone Density Test from my PCP for my curiosity. Tests showed I have osteoporosis, which I never knew I had. (Right or wrong, my PCP told me to take Vitamin D, and that was it.)
A year later when I saw Endo 2, I had a Bone Density test which showed my osteoporosis worsening to severe osteoporosis in a year.
Endo 2 said that my osteoporosis is definitely severe, though not as severe as they first though…whatever that means.
I repeatedly told Endo 2 how I also was concerned about my osteoporosis coming from low T, plus worsening as my T worsened.
Endo 2 mostly ignored what I said, my words just went through the air.
Endo 2 was HIGLY perplexed, and many times said:

I CAN’T UNDERSTAND how a man your age has osteoporosis…and why I have osteoporosis.

First tests by Endo 2 (used another testing facility than my PCP) showed:
Free T at 50 (reference range 47 to 244 pcg/mL).
(PSA at 0.7, with no baseline PSA to compare…was written by Endo 2 next to my free T results, though I do to remember her discussing this if she did.)

Endo 2 said of my Free T: Your Free T is low (or sort of low?) but it’s not low.

Endo 2 sent me to her colleague Endo 3 who said:
Low testosterone can cause osteoporosis, but you do not have low testosterone.

ONE MONTH LATER
Endo 2 tests showed my Free T at 29 pcg/mL (same testing place, reference range 47 to 233 pcg/mL)

The most salient part of this is how Endo 2 acted and looked, and her attitude of reluctance, disgust having to say the following to me of my test results:

You have low testosterone. This and you hypercalcuria are causing your osteoporosis.

I wonder what was causing my severe osteoporosis before a month ago, when it wasn’t from low T - ha!

Endo 2 told me later that she could give me a TINY amount of testosterone.
I decided to go to my PCP, who was at least more open with treating my low T, though I wrote in other posts of how it’s not going well…you know what I mean.


#86

I used to live in a 2nd world country in the 90s and even the doctors there were not as stupid as posters in this thread are claiming. I’m pretty sure at least half of the people here are making things up.


#87

Sad, but this is the crap that happens. If these things never occurred, there would not be so many people needing to find forums like this.


#88

Well boys and girls, I think I have a story to end all stories.

Background: I have a history of mental illness.

Meeting with my psych doctor, we decided that it would be best for me to go on lithium, as I have been through many many antidepressants with not much result. However, once he discovered I was using test he insisted I stop using before he would prescribe me lithium. I informed him that I was on TRT doses as I was suffering hypogonadism- which I don’t think he understood.

Then, get this, he asked me if I had been hearing voices since I started BECAUSE STEROIDS CAN CAUSE THAT. This is problematic for two reasons- 1) I have a small history of hearing these things which means he hadn’t bothered reading my case file and 2) he was a doctor that thought testosterone caused people to hear things that aren’t there (audio hallucinations).

Being desperate, I did as he said and stopped taking my test. Needless to say, my mood worsened, my energy dropped and I was in an incredibly dark place. I got my bloods done with my GP (is that what they call it in the states?), who called me in a panic as soon as he got my results. My test was down to 1.2 (I think that’s about 110 in American readings). I had the results sent straight to the psych doctor who then would not prescribe the lithium to me because my bloods weren’t satisfactory. This guy was clearly in way over his head and I am dying to see him again to rip him a new one for the HELL he put me through.

Yes, I am back on test and no I will never stop my treatment at the orders of an absolute fool again.

Lesson learned, I should have realized how stupid he was once he said steroids cause hallucinations.


Mid 40s, Hard Work = No Gains, Losing Motivation
#89

Here’s one contribution I can make to this thread:

I do research with one of the world’s top, say top 5, famous urologists (nothing much to do with TRT).

Urologists and other doctors often read “throw-away journals” which briefly summarize actual research published in harder-to-read peer-reviewed journals.

In one issue of the throw-away journal “Urology Times,” an endocrinologist?s musings on TRT were described in an interview format:

After my BS sensor went off, I emailed the doctor the following:

"Hello Dr. Sokol,

As a researcher intimately engaged in the PSA controversy, I appreciate how a “one size fits all” attitude is often folly.

Regarding your Urology Times contribution, “Men too often receive T for “soft” indications,” you write that, as far as what serum testosterone level you consider too low, you “go by <250-300 ng/dL, measured in the morning on repeated testing, with associated signs and symptoms of low T. The Endocrine Society guidelines recommend using the lower limit of normal range for healthy young men”"

Given the wide range of testosterone values found in healthy young men, I was wondering how you determined to apply <250-300 ng/dL as a threshold value for everyone. (The Endocrine Society guidelines for testosterone therapy, “Testosterone Therapy in Men with Androgen Deficiency Syndromes: An Endocrine Society Clinical Practice Guideline”, reference research that doesn’t actually support this threshold).

I appreciate your time. Thank you."

Any good academic physician who cares about what they’re doing would be able to respond to a question like this by citing studies. After a few weeks and a reminding prod, she responded with this email containing a quote from the Practice Guideline:

"Hello,

Below is from the Endo guidelines:
2.3 Older Men with Low Serum Testosterone Concentration

Summary of Evidence-Based…METHOD OF DEVELOPMENT OF …GUIDELINES1.2 Screening for Androge…2.0 Treatment of Androgen…2.2. Testosterone Therapy…2.3 Older Men with Low Se… <<2.4 Patients with Chronic…2.4.2 Glucocorticoid-Trea…CITING ARTICLES

2.3.A RECOMMENDATION

We recommend against a general clinical policy of offering testosterone therapy to all older men with lowtestosterone levels. (REFERENCES)

We suggest that clinicians consider offering testosterone therapy on an individualized basis to older men with consistently low testosterone levels on more than one occasion and clinically significant symptoms of androgen deficiency, after explicit discussion of the uncertainty about the risks and benefits of testosterone therapy. (REFERENCES)

The panelists disagreed on serum testosterone levels below which testosterone therapy should be offered to older men with symptoms. Depending on the severity of clinical manifestations, some panelists favored treating symptomatic older men with a testosterone level below 300 ng/dl (10.4 nmol/liter); others favored a level below 200 ng/dl (6.9 nmol/liter).?

What is interesting is, if you look at the research the Endocrine “Society”'s journal cites in this “Recommendation”, it doesn’t actually support the recommendation - something that I guess was lost on her. In fact, to my knowledge, a study evaluating the T levels of eugonadal males with verified no symptoms has never been done. My guess is it varies by individual, which is what the cited sources actually state or imply.


#90

Glad to see I am not struggling alone with Drs. From the UK - 35 and no issues until I was given a SSRI (after investigating since I found it causes T levels to drop) for sleep issues. Numerous side effects that carried on after I came off the drugs - low energy, weight gain, drastic reduction of libido… My Drs response

“Perhaps we should give you a different SSRI for your “issues””
“I can prescribe you viagra” - But Dr the problem is libido - “yeah it won’t help with that”

Upon doing a private blood test for T and getting a reading of 164 ng/dl
"Well if you ask for a private test looking for problems the lab will find one"

After doing a full blood work

“Your levels are all normal” - new reading 247 ng/dl
"You have male pattern baldness so its not Low T" - been going bald for 5 years problems started in Feb
"You have facial hair" - been growing since Apr trim about once a week/fortnight
"sex once a week is normal" after I told him I was having sex 5/6 times per week prior to SSRI treatment
"I won’t prescribe T treatment because you are heavy" - Low T promotes weight gain and reduction in muscle mass

In the UK we have a “free” central health service but getting treatment is like getting blood out of a stone and its full of Drs who think that “take a painkiller” is good advice when you go with a problem.


#91

A medical group cannot recommend T for all cases of low T, unless there are symptoms. So they dance around that problem and really cannot address the problems full on. Yes, its all a crock of shit, especially in the common wealth countries and many others with socialized medicine.


#92

Try this one…a coworker was diagnosed with severe low T. His doc feels he will need 150mg/week. So he gives him a 600mg shot once a month!! When his nipples start burning 2 days after his injection he asks the doc to check his estrogen that he may need arimidex. The doc answers, “we can check it but if your estrogen is high I’ll have to lower your testosterone.” Geez! Talking about screwed up on so many fronts!


#93

Repeating my self…

Doctors need to have a good memory to get through training.

Deductive reasoning and critical thought are not required.

Because of things like this, many docs are technicians as they in no way masters of their field of work.


#94

Went to a doctor for HCG/anazstrazole refill.

Said my body must have ‘adapted to TRT’ and thus I had low testosterone and because of that my testes were shrinking and therefore I should go off TRT.

Then as an argument for why she shouldn’t prescribe me HCG: ‘some patients I give HCG for the HCG diet just stop responding and they don’t lose weight and maybe the same thing is happening to you’.

Oh, also one thing she thought could be a cause for testicle shrinkage could be the gabapentin I take messing with things.


#95

Upon hearing that I had low temps, took iodine, and now feel better, my GP responded, â??Whoa, that might have been a mistake. Maybe youâ??re supposed to run at a lower temperature.â??

When he saw that I had a total Test level of 270 at 3pm on one blood draw and a total Test level of 213 at 9am at a second blood draw: â??You don’t have low testosterone. Maybe youâ??re Mr. Opposite Man, and your test levels are higher in the afternoon and lower in the morning.â??


#96

Recently saw an endocrinologist, because it would be good to see if I have primary or secondary hypo. Man, this guy, Dr. Lyko had so much bullshit spewing out of his mouth…

  1. Testosterone injections are not well tolerated by the body, and result in little to no absorption. Standard of care is to use a gel.
  2. It is not standard to use an aromitization inhibitor during TRT, and if someone on TRT has E2 increases, they should come off TRT completely until the E2 is under control.
  3. Injections should be no less then 2 weeks apart, any more frequent and you don’t produce the peaks and troughs that your body needs.

For bonusies.
My T4 number is fine, mid range, my T3 is below range. He wants to treat the T3 by having me take added T4. Even though labs suggested the T4 isn’t being converted to T3. He claims dosing of T3 is a fad thing that was only appropriate 100 years ago.

I think I found a winner.