T Nation

TRT Doctor Massachusetts

Hi everyone. I am a 37yr old male with Testosterone level of 33.20 ng/dl, according to my doctor the reference for normal is 241-827. He agress that I should see an endo and discuss TRT. He recomeneded Dr. Yassa and a Dr. Slovik has anyone had any delaings with either of these doctors?

I origionaly was going to go the out of pocket route and use Boston Testosterone Partners due to their stellar reviews and customer service but would rather utilize my health insurance if at all possible. I’m lookg for a knoledgable doctor that will listen to me and improve my qualitity of life.

Based on everything i have read and discussions with BTP ideally I would want Testosterone Cypionate 200mg/week, HcG, and Anastrozole. I have 2 small children and don’t want to mess around with Gels or pelets and the roller coaster that can come with them. I think that injections are the way to go and the BTP protocl seems to be on point with what i have researched.

Anyone know of any endo doctors in Mass or souther NH who accept BCBS and don’t make you start with clomid, creams, or pellets. I want to fix what is wrong the first time and not deal with a doctor who is not fully versed in TRT.

no one else from Mass out there to provide any recomendations?

I’m from Mass and have been looking for a knowledgeable TRT Dr. for 2 years. I’ve been to several and called more and haven’t found one who knows TRT inside and out. They all kind of know the mainstream approach but not the nuances.

I’m not happy with my current TRT Dr. but I haven’t found anyone better.

This is the email I sent to the endo and my PC doc. The endo doct responded that they wanted the Chief to review my email and referal before setting up an appointment. I have a feeling they are not going to want to see an informed patient. What does your doc have you doing for TRT Foxrun?

Email to Endo:

Dr. Y recommended that I contact either you or X to set up an appointment to discuss my testosterone levels and the symptoms I have been experiencing for approximately the last 15 months. A copy of the email I sent to Dr.Y is provided below this email to help provide some background to you (this includes T levels and symptoms i have been experiencing). The way I understand the treatment plan below to work (thanks to Google) is that the Testosterone Cypionate 200mg/week would raise my testosterone levels to the “normal” range, the Human Chorionic Gonadotropin (HcG) prevents testicular shrinkage and keeps my body producing testosterone naturally while on therapy, and the Anasrozole or some similar estrogen blocker to combat estrogen levels caused by the conversion of testosterone to E2 levels. To me this seems like the best way to get my levels back on track. I have no interest in using gels or creams due to the fact that I have 2 small children. Implantable pellets do not interest me either because of the need to implant them and the fact that they can cause uneven hormone levels. I want to find a way to treat this, get my hormones back on track, and keep them there without having to experiment with different delivery methods and prescriptions.

‎What is your experience with Testosterone Replacement Therapy?
‎In my opinion for TRT to be successful we should focus on a 3 pronged approach:
‎1. A source of Testosterone; administered weekly.
‎2. A low dose anti-aromatase (AI) to inhibit conversion of Testosterone to Estrogen.
‎3.HcG. This is necessary to keep my testicles from shrinking and undergoing permanent damage.
What are your thoughts concerning this approach to treating the low testosterone?

I realize I am not an endocrinologist or doctor but I have been living with this, the related side effects, and overall lower quality of life for some time and this has led me to research how best to get back to the old me. I do not take going on TRT lightly and I hope you take my thoughts and the information provided seriously.

I look forward to hearing back from you and if you are amicable to setting up an appointment. (I will probably need new labs done since my last ones were completed in September of 2013).

Email to primary care:

I hope this email finds you well. At my last annual physical we ran a full blood panel and had my testosterone levels checked and the results came back on the low side of reference range, 330.20 ng/dl to be exact. Lately I have noticed an increase of some things that I brought up during my physical which were bothering me. I have noticed that my sex drive is very low, almost nonexistent and that I never experience morning erections, I feel fatigued and tired a lot of the time, i am very moody, and easily irritated, and I seem to be packing on more weight around my midsection even though i have cleaned up my diet and increased the amount of exercise I do every week. Based on my symptoms above and the wonders of Google it appears to me that I am suffering from low testosterone or Hypogonadism. Everything I have read says that for my age I should have testosterone levels in the 800-1000 range and not the 300 range and that this low testosterone may be what is causing the other symptoms such as lack of interest in sex, fatigue, etc… I would like to know what you think I should do going forward to remedy this situation. Based on some recommendations for friends I made some inquires to a well know TRT clinic in Massachusetts, but they do not accept health insurance and I would prefer to have this documented in my medical files and shared between my providers. They recommend a treatment of Testosterone Cypionate 200mg/week, HcG, and Anasrozole. I am wondering if I should meet with an Endocrinologist or even you again to discuss all of this and see what my options are moving forward. I have done a lot of research on TRT and understand it is not something that should be taken lightly. I also think given the fact that I have 2 small children that the treatment plan laid out by TRT clinic makes a lot of sense. I really would like to be able to live my life without the symptoms mentioned above being part of my daily life. I would appreciate your professional opinion and recommendation regarding this matter.

I just recently started test. cyp. injections. I’m doing them subQ even though my Dr. only knows about doing them IM. Prior to injections I was on compounded cream, which did get me into the top of the range but I saw no benefit to libido, ED or anything else. My Dr. does know about AI’s but only prescribes them in extreme cases. He also does not prescribe HCG, which is really what I want to try next. If I could find a Dr. who prescribes HCG I’d switch.

Just checking back in. I met with a Urologist last week. We talked about the symptoms I was having, my lab work from last September, and my goals going forward. I spoke to him about what i had gathered from this site and some others and he is not onboard with HcG. He did mention that Test Cyp shots and an AI may be a good protocol for me. He gave me a scrpit from clomid (take Mon, Wed, Fri) and did some addional lab work. I see him in a month and hope to move on to 200ml Test Cyp per week with Arimidex for an AI. I’ve noticed in taking 2 doses of the Clomid that it seems to give me headaches and heartburn. Is this a common side effect?

does anyone know of any docs in Massachusetts or souther New Hampshire that will perscribe Test Cyp, HcG, and an AI. Seems kind of BS that the only way to get proper treatment is from a clinic that does not accept health insurance. I’ll probably end up going the no HcG route for now and keep looking for a new doc.

You can’t go to a TRT doctor and ask for 200 mg a week. No doctor likes to be told by the patient how to do their job, and they will just think you are trying to do steroids “legally”. 200 mg is double the regular dose and would count as supraphysiological for most men; i.e., it would put most men well above the healthy range and cause side effects such as too much red blood cells, hypertension, cardiovascular issues, etc.

Most doctors worth their salt would start a patient at 100 mg (or sometimes lower) and increase the dose only if blood tests show that you are not attaining good blood testosterone levels. You can of course find the chop shop Florida clinics that will start people with 200 mg but they are into it for the money and popularity, not for the benefit of patients.

If you must do steroids, then do steroid cycles and be done with them - that is probably healthier than being on a light cycle permanently under the guise of “TRT.”

Seekonk I have read numerous articles and other post stating that 100-200mg per week is standard protocol. What’s with all the steroid talk at the end of your post? I also could care less if the doc likes to be told how to do there job or not.

I am the one with low levels and I am the one paying them for a service. If he is going to be perscribing medication to fix my hormonal levels and I am going to be injecting/injecting these medications I think at the least he needs to listen to what I have to say and respond to my questions/concerns and recomendations.

Im from Mass and have had many issues with finding a TRT Doc.

Many of the Endos i have spoken with really dont know a lick, or are willing to venture down the path of HCG or an AI. It’s all by the book.

At the current moment, I’ve elevated my T levels to the mid 400’s. Thats up from around 200 as of about 6+ months ago. I know thats not normal for me or someone my age, but the book says im within normal range, so according to them… I’m fine. It’s been a very frustrating journey.

I think I would have to attribute my recent steps in the positive area to seeing a doc for applied kinesiology.

As you will read, this is a rough journey formost of the men on this board.

NeedT the Urologist I have found seems pretty good in regards to everything but he does not believe in HcG. Seems like unless you want to pay out of pocket and go to one of the “clinics” there is not much hope otherwise here in Mass. Anyone try looking in southern New Hampshire?

From my experience, even out of pocket clinics are hard to get scripts for hcg.

Have you considered UGL?

If UGL stands for what I think it does, then yes I have. Just don’t know how to go about it. Haven’t noticed much of anything except headaches and some reflux from the clomid.

Ugl is under ground lab

That’s what I thought.

[quote]danielson660 wrote:
I have been using mens health boston for over a year,they are great located in brookline mass,also they accept insurance,give them a call 617 277 5000 also check out there website.[/quote]

Do they offer HCG and an AI if you need it? Last time I checked with them the answer was no to both, but things may have changed.

Has anyone had any luck yet finding a doc willing to prescribe AI/HCG?

If you know that reccomended dose is between 100-200mg then how do you know 200mg is what you need? Why not 100mg?

You will not get anywhere with your doc barging in and demanding a dose that you have no clue how you will respond to. How about you find a doc, establish some report and work with him/her?

[quote]21Marine wrote:
Seekonk I have read numerous articles and other post stating that 100-200mg per week is standard protocol.
[/quote]

Endocrine Society Clinical Practice Guidelines: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCEQFjAA&url=https%3A%2F%2Fwww.endocrine.org%2F~%2Fmedia%2Fendosociety%2FFiles%2FPublications%2FClinical%20Practice%20Guidelines%2FFINAL-Androgens-in-Men-Standalone.pdf&ei=MFVrVKazKor2igLhp4DYBw&usg=AFQjCNE-EIBzHNWSme-6BtEI9rHTITIzEw&bvm=bv.79908130,d.cGE&cad=rja

“75-100 mg testosterone enanthate or cypionate administered IM weekly, or 150-200mg administered every two weeks.”

That would be the dose most doctors would start with. Of course they should then adjust either up or down depending on symptoms and how your blood levels of testosterone respond to the treatment. Any patient ordering 200 mg per week right off the bat would raise red flags.

(Many experts will argue that the frequency of administration recommended above is outdated (e.g., every two weeks is too infrequent). But pretty much nobody who knows TRT is disputing the average dose per week recommendations, at least not as a starting dose.)

anyone find a good DR yet.that excepts insurance

Bump

I’m in almost the same situation as 21Marine. My urologist prescribed and has scheduled testopel implants. After research, I don’t want the implants and would like to try test cyp shots.

Looking for a knowledgeable urologist/Endo in MA that will work with me on this trt journey. Any info is appreciated!