Since so much stuff in this forum gets lost in multiple threads on people’s individual cases, banter back and forth, and all out BS said by “experts” here - I wanted to write a little about what we do in our practice BEFORE we ever write a script for testosterone therapy.
first and foremost we run comprehensive labs - blood for thyroid, metabolic, lipid, etc (all your health markers). Urine for cortisol and sex hormones (about 99x more accurate and informational than blood as it gives you a four time look into every sex hormone as well as how each patients body is metabolizing them (this is EXTREMELY important as it tells us which detoxification pathway your body is preferring. I will attach a patients lab so you can see the kinds of reports we get.
food / lifestyle logs. I want to see how each of my patients eats and lives.
food and environmental allergens screen - food sensitivities and environmental allergens can play hell with your hormones. I want to see where my patients are having issues
basic health inventory and bodyfat assessment - don’t need an explaination here.
Guys - if you go to a doctor with a hormone deficiency and you get a script without a root cause investigation, 9x out of 10 your therapy will fail. You will end up on a cycle of constantly crashing or jacking your estrogen out of a good ratio, raising and lowering your testosterone , and requiring ancillary drugs to counteract your side effects.
In my practice we address the underlying issues. If someone is overweight (.most guys with low t are) we address that first. I will not put anyone over 19% BF on testosterone. It won’t work well and in fact will end up worse than before they started. We make lifestyle changes first. We address sleep, fluid intake, recovery, stress, adrenal health, liver health, and emotional well being first. Once we treat these issues about half my patients don’t end up needing androgen therapy. When they do, their body is primed to use it. This is why we don’t need to script anti estrogens. My patients body’s are primed to use the drugs.
When I hear shit on here about “most people need an AI” or “shbg is the gold standard test” for therapy I want to scream. Shbg can change as much as 49% every single damn day based on a multitude of factors. What matters most is discovering someone’s underlying metabolic conditions and the ways in which their bodies eliminate hormones so that we can tailor a treatment protocol for them.
Attached are some sample labs from DUTCH. Try finding this info from some bs blood draws / pro tip - YOU CANT. Start taking your own health seriously. It isn’t about testosterone only. Or simply hormones. It’s your entire lifestyle that needs to be analyzed. I bet 50% of guys on this forum don’t need drugs at all. Also guys - If you can’t get your dick hard, have no sex drive, etc, don’t immediately assume “my protocol isn’t right”. It’s likely a combo of you stressing yourself out and environmental toxins and neurotransmitters being off. So stop chasing numbers. That is all for now.