T Nation

TRT Scams

How do you know when you’re being scammed?

I recently got testosterone pellets. They were terrible and I felt worse every day. Went back to Androgel, to at least feel human again.

He said my thyroid was low, gave me Synthroid…felt a lot worse. Threw them in the trash after 5 weeks.

He said my DHEA was low, sold me some ‘pharmaceutical grade’ DHEA. Made me nauseous.

After 5+ years of this, I think I hereby declare TRT or HRT or whatever we choose to call it, a scam. It makes you feel better for a while but that’s just because your balls are still producing. Soon, they shut down and all you’re left with is too high hematocrit and hemaglobin.

I am now weaning myself off this gel crapola and won’t go near this stuff ever again.

IT IS A SCAM.

I am so sorry to hear this. I am starting my third month I think it is on HRT, and it is literally changing my life…in a good way…maybe you keep getting the wrong doctors…there are guys on here (especially KSman), that can pretty much tell you damned near everything you need to know about finding the right doctor, communicating with them, and going about doing it right.

[quote]bluecollarjock wrote:
I am so sorry to hear this. I am starting my third month I think it is on HRT, and it is literally changing my life…in a good way…maybe you keep getting the wrong doctors…there are guys on here (especially KSman), that can pretty much tell you damned near everything you need to know about finding the right doctor, communicating with them, and going about doing it right. [/quote]

Post back in a year.

Headhunter, I have been on HRT for a year and I feel that I am just now getting my levels in check. I think the key is to self-educate and know what you need to do to feel better. After five years of HRT, you should know enough to know that pellets are shit. If your thyroid levels are low, you probably aren’t going to absorb gels. Which thryoid levels were low? If your rT3 was high, then yes, synthroid is going to make you feel like shit.

Unfortunately, it takes a lot of time and $ to test and adjust your protocol as needed. Once I got my levels normalized, it made a huge difference. I, for one, am very glad I am on HRT.

Headhunter, sorry your experience with TRT has been so bad. Here’s mine. Perhaps it will help someone considering TRT to better understand the issues.

I’ve been on TRT for 20 months. I’m 57. My opinion is that TRT has been oversold. Some of the enthusiastic testimonials here and elsewhere may have led some folks to expect too much.

TRT will not make grandpa feel like 21, as Little Richard sang. It did improve my enthusiasm and mood, though. I think I picked up a few pounds of lean mass but nothing spectacular. It made fat loss a little easier. But one still has to train with intensity and eat clean, otherwise TRT will have little effect on fat and muscle. I know of a 300 lbs. couch potato on TRT, for example. No one who knows me would notice any difference in the way I look on TRT. My wife thinks I am a little more aggressive. She likes that sometimes, other times not so much. I say tough luck, baby.

When my diet, exercise, and rest are in good shape, then TRT gives me a boost. Mostly mental. But those improvements can be swamped by a poor diet, poor rest, or no exercise. Or stress.

TRT does’t turn back the clock, mores the pity.

Rising free testosterone levels (I presume) gave me a world-beating feeling that lasted about a week. Sadly, never to be repeated.

I’ve said this before. Adding anastrozole and hCG to parenteral testosterone is experimental medicine. Don’t blame your doctor if he won’t go along with it. Insurance likely will not cover the anstrozole and hCG, for the same reason.

The anti-aging doctors who promote this deal in cash only, and lots of it. They make claims for which there is no good medical evidence. They don’t publish their results, at least that I could find.

[quote]Turtello wrote:

I’ve said this before. Adding anastrozole and hCG to parenteral testosterone is experimental medicine. Don’t blame your doctor if he won’t go along with it. Insurance likely will not cover the anastrozole and hCG, for the same reason.

The anti-aging doctors who promote this deal in cash only, and lots of it. They make claims for which there is no good medical evidence. They don’t publish their results, at least that I could find.[/quote]

Anastrozole can lower and modulate E2 levels. What is experimental about that. When its used to lower E2 levels for breast cancer, its not experimental then. We know what it does and the dose-response is very linear and predictable; not experimental, more like applied engineering.

hCG prevents testicular atrophy and eventually organ failure of the testes. Why is that experimental? The science and biology is sound and well understood. The dose-response in HPTA repressed males is well understood.

Many anti-aging docs deal with cash because the insurance companies will not deal with them as they drive up claims costs. My doc got pushed out of BCBS because other docs, some with health insurance connections, in the State Medical Board did not like the fact that he has been turning health issues around and taking cash flow out of established disease management practices and diverting patients into health management. Once he got out of BCBS, the State Board of Medicine dropped threatening inquiries into his practices. And insurance companies and the whole establishment are not in health management, they are in disease management. Medicine is about making you feel less pain, not feeling good. Feeling good looks like a life style drug problem to the institutions, they do not want to pay for something that is not a disease and they really do not want a situation where 30-40% of males end up diagnosed with a disease called hypogonadism with life long treatment. So this work ends up been outside of the constraints of insurance.

No medical evidence? That is bull or some are claiming things that I have not seen. Docs do not publish, the good ones read research. Claims? Many AA docs to not advertise at all. Word of mouth, claims made by patients to friends and others count for something.

One problem is that if one has co-morbidities, lifting ones metabolism with TRT can have the results capped by the other problems. If hormones are a mess, nothing can be right. Hormone balance is the foundation. It does not mean that the rest of the house is in order.

HH,
What a bummmer. Sorry to hear your whole TRT experience has gone south. Last year after being on T3/T4 thyroid for two plus years I started to feel like crap; just tired no matter what I did. My doctor suggested I have a rT3 test done and I scored too high. My doc put me on straight T3 so I couldn’t convert to rT3, and after a few months I started to feel better due to lack of rT3. I don’t know if you have ever tried just T3 by itself, but it might be a shot.

[quote]KSman wrote:

Anastrozole can lower and modulate E2 levels. What is experimental about that. When its used to lower E2 levels for breast cancer, its not experimental then. We know what it does and the dose-response is very linear and predictable; not experimental, more like applied engineering.[/quote]

Anastrozole use in men is off label, hence, experimental. Its long-term efficacy and safety in men has not been demonstrated, or even much studied from what I could find. I would like to see what you have in regard to dose-response data.

Again, off label use.

Your argument is veering into conspiracy theory territory. Maybe your doctor was practicing unorthodox medicine and agreed to modify his practice to get the state board off his back. Any board action will be available to the public. Check him out.

No GOOD evidence.

The anti-aging docs imply quite a lot in their advertising, mostly unsupported assertions.

Anyone with medical data to share is free to write it up and submit it for publication. If it is no good it won’t be accepted for publication. Anti-aging docs don’t publish in legitimate medical journals, only in house organs controlled by them.

Testimonials and anecdotal reports may be interesting but, no, they don’t count for much.

Agreed. That is why medical studies have to be controlled for confounding variables.

What will good evidence look like? The studies will be big, many years long, prospective (not retro-spective), longitudinal (not cross-sectional), controlled (there will be control groups that receive no treatment), double-blind (neither patient nor investigator will know which treatment group a patient is in) and doubtless other criteria.

So far this has not happened. This is why doctors are reluctant to get on the anti-aging bandwagon and insurance won’t pay for it.

Dose response: I see again and again that there is the expected linear response of a competitive drug. Men need around 1mg/wk for every 100mg test ester per week. The numbers are probably a better relationship with FT or bio-T as SHBG bound T [SHBG-T] cannot aromatize. Once on SHBG, the dose corrections are very linear and simple to compute.

Off label: I disagree that off label is experimental. There can be lots of supporting research and clinical reports. The drug manufacturer has no motive to change the “label” because once the drug is released, doctors will prescribe as they see fit.

Adex safety: Men start taking 1/7th of a dose that is prescribed on-label for women. Women were also tested on higher doses yet. There are no side effects when E2 levels are as intended. Adex can be used to modulate E2 levels. I do not see a safety concern of any nature.

Conspiracy theory: Well that is what happened and I know exactly what he “does”. This is what can happen when a doctor moves in a direction faster than the rest of the herd. Think about what you said? What does orthodoxy have to do with medicine.

No good evidence: is in the eyes of the understander

Anti-aging doc claims: This point is unbalanced as you cannot hear the silence of the docs who are not making any claim or hype.

Publishing: So doctors who have knowledge of these things never publish in medical journals? Do you read medical journals? I just searched for “testosterone” in the New England Journal of Medicine and got 141 hits. I guess that none were written by doctors or read by doctors. Well this is at the top of the list:

“”“Risks of Testosterone-Replacement Therapy and Recommendations for Monitoring
Ernani Luis Rhoden, M.D., and Abraham Morgentaler, M.D. “””

“Testimonials and anecdotal reports may be interesting but, no, they don’t count for much.” Doctors learn from each other and from the responses of their own patients. This is basic to all fields of medicine. Why is this a problem when TRT is involved.

What do you want the studies to address:

Libido improved -known fact
Mood improved and depression caused by low T or elevated E levels -known fact
Reduced LDL -known fact
Improved endothelial function -known fact
Elimination of muscle wasting -known fact
Improved strength -known fact
Fat loss -known fact
Improved insulin resistance and sometimes resolution of type II diabetes -known fact
Improved energy -known fact
Improvement in functional balance -known fact
Fewer falls -known fact
Fewer fractures from falling -known fact
Higher life expectancy by fracture avoidance -known fact
Bone loss avoided or reversed -known fact
Improved skin properties -known fact
Brain fog eliminated -known fact
Greater physical activity -known fact
Quality of life improved -known fact [evaluated in clinical studies]
Reduces strokes and heart attacks -known fact

You are worried that a long term study could find guys in walkers with brittle bones, high blood pressure and diabetes are out living guys who are stronger, more agile, healthier and more active? Even if that was the case, what is the point of living, simply a measure of when you die or how you live?

What is your motive in all of this negativity? You are in charge of your own health care. One has a choice to be proactive or be passive. Nothing is gained by waiting for studies that may never happen.

The only scam is the ati-aging clinics that will prescribe to ANYONE. HH biological low testosterone CAN be treated succesfully. That being said if you are functioning fine i do agree that doctors are only going to make you worse, not better. The key to this whole thing is finding a COMPETENT practitioner, from your psts it is obvious you have not. The body has to be treated as a SYSTEM nothing works independently. A qualified functional medicine practitioner i have found is the best bet. Total analysis of all the bodies systems and treating only those things that truly need treating. This includes, diet, supplementation, lifestlye modification, and when warranted hormonal therapy. The appraoch your guys have taken is “oh you don;t feel great , here take some testosterone, life will be grand” Well…what if that was never the damn problem to begin with??? they have no fucking idea because they really don’t care. ITS YOUR DOCTORS THAT ARE THE PROBLEM…NOT HORMONE REPLACEMENT AS A TREATMENT.

HH - make a list of the doctors you have used to do this and analyze it before making a blanket statement about HRT that could prevent others from seeking COMPETENT help. As i recall you used a online service for awhile (which is a joke). then you went to the pellet guy and raved about his brilliance (regardless of what we tried to tell you). Now you have determined that hormone replacement is just a scam, due to your vast experience with the subject matter.

You know the two most improved benefits in 3 months for me, are brain fog and digestion…my head is 100 times clearer, memory improving, and my digestive system is functioning normal which hasnt been in years due to too many anti biotics and other internal infections…so yea, I wanted to see my abs again fast and get my muscle mass back, but alleviating some brain fog and digestion issues was a nice surprise.

With any of this stuff I think the key will be investigating everything on your own, reading up on forums like this, asking tons of questions to people who seem to have a lot of experience, and being open with the doctors you see. Ive learned through other medical nightmares, that rarely will anyone champion your cause, they either dont have the time or energy to do so, and for sure the insurance company’s do not give a rat’s ass about you…Ive been screwed up by more than one doctor (nothing to do with hormones, although the problems they caused did affect my hormones negatively), and now I research the hell outta anyone I am going to see in the medical field (MDs, PTs, etc).

This website is a wealther of information, with guys like KSman and BBB, and tons of others, who know thier stuff inside and out…

Morepain: My doc does the diet, lifestyle, supplements and does treat hormone problems in that context. Doctors who do not do hormone work also do diet, lifestyle and supplements. He also managed diabetesm thyroid and adrenal problems. And for those other conditions, can address the other steroid hormone issues at the same time.

Why are you implying that my doctor is not competent? He is probably one of the best.

You still seem to be grinding an axe and looking for something to kill.

The big problem that I thought was an issue is that some on TRT done right have not found the benefits they were seeking. So feeling better really is the issue and its elusive for a few. In most cases we see that the problem is doctors who do not know what they are doing.

[quote]morepain wrote:
HH - make a list of the doctors you have used to do this and analyze it before making a blanket statement about HRT that could prevent others from seeking COMPETENT help. As i recall you used a online service for awhile (which is a joke). then you went to the pellet guy and raved about his brilliance (regardless of what we tried to tell you). Now you have determined that hormone replacement is just a scam, due to your vast experience with the subject matter. [/quote]

I’ve gone the whole route: shots, gel, pellets, herbs,…

Its like global warming and climate-gate and all that crap. Al Gore and his scientists tell me the world is gonna fry, when all I have to do is look out the window.

Eat right, exercise, don’t smoke, don’t drink (I’ve seen the ill effects of these in many family members so I don’t need a scammer-scientist to tell me these.). Throw all that TRT/HRT stuff in the trash can. Only let a doctor (aka scammer) near you if you’ve got a broken leg or similar. Unless its an emergency like that, fuck 'em.

Read once about morticians in some country getting pissed at the doctors, who had gone on strike. Fewer people were dying and it was crushing the morticians’ business.

You all can poke yourselves in the ass with those needles and other crap – I’ll go walk my hill with my kettlebells.

/thread

[quote]Headhunter wrote:

[quote]morepain wrote:
HH - make a list of the doctors you have used to do this and analyze it before making a blanket statement about HRT that could prevent others from seeking COMPETENT help. As i recall you used a online service for awhile (which is a joke). then you went to the pellet guy and raved about his brilliance (regardless of what we tried to tell you). Now you have determined that hormone replacement is just a scam, due to your vast experience with the subject matter. [/quote]

I’ve gone the whole route: shots, gel, pellets, herbs,…

Its like global warming and climate-gate and all that crap. Al Gore and his scientists tell me the world is gonna fry, when all I have to do is look out the window.

Eat right, exercise, don’t smoke, don’t drink (I’ve seen the ill effects of these in many family members so I don’t need a scammer-scientist to tell me these.). Throw all that TRT/HRT stuff in the trash can. Only let a doctor (aka scammer) near you if you’ve got a broken leg or similar. Unless its an emergency like that, fuck 'em.

Read once about morticians in some country getting pissed at the doctors, who had gone on strike. Fewer people were dying and it was crushing the morticians’ business.

You all can poke yourselves in the ass with those needles and other crap – I’ll go walk my hill with my kettlebells.

/thread
[/quote]

If you really have problems with your HPTA then no matter how healthy your diet, how good your supplementation or how many
hills you walk up with your kettlebells - you will not solve your problems without TRT

[quote]KSman wrote:
Morepain: My doc does the diet, lifestyle, supplements and does treat hormone problems in that context. Doctors who do not do hormone work also do diet, lifestyle and supplements. He also managed diabetesm thyroid and adrenal problems. And for those other conditions, can address the other steroid hormone issues at the same time.

Why are you implying that my doctor is not competent? He is probably one of the best.

You still seem to be grinding an axe and looking for something to kill.

The big problem that I thought was an issue is that some on TRT done right have not found the benefits they were seeking. So feeling better really is the issue and its elusive for a few. In most cases we see that the problem is doctors who do not know what they are doing.[/quote]

not really sure why in the world you thought that was directed at you??? I clearly preface it with HH as in headhunter because i do not feel he has ever found a truly competent practitioner, as far as those that do have it all doaled in but still have not found relief as always i would defer to your expertise. The only axe i havve to grind is with doctors that have no business practicing HRt but inssist on doing it which then leads to guys such as HH thinking the whole thing is a scam. Sorry for the confusion.

[quote]Headhunter wrote:

[quote]morepain wrote:
HH - make a list of the doctors you have used to do this and analyze it before making a blanket statement about HRT that could prevent others from seeking COMPETENT help. As i recall you used a online service for awhile (which is a joke). then you went to the pellet guy and raved about his brilliance (regardless of what we tried to tell you). Now you have determined that hormone replacement is just a scam, due to your vast experience with the subject matter. [/quote]

I’ve gone the whole route: shots, gel, pellets, herbs,…

Its like global warming and climate-gate and all that crap. Al Gore and his scientists tell me the world is gonna fry, when all I have to do is look out the window.

Eat right, exercise, don’t smoke, don’t drink (I’ve seen the ill effects of these in many family members so I don’t need a scammer-scientist to tell me these.). Throw all that TRT/HRT stuff in the trash can. Only let a doctor (aka scammer) near you if you’ve got a broken leg or similar. Unless its an emergency like that, fuck 'em.

Read once about morticians in some country getting pissed at the doctors, who had gone on strike. Fewer people were dying and it was crushing the morticians’ business.

You all can poke yourselves in the ass with those needles and other crap – I’ll go walk my hill with my kettlebells.

/thread
[/quote]

I here you on the point you are making…about 90% of doctors do more harm than good. But as cymru said if your HPTA is truly non functional then it is an addressable medical condition but it has to be done by someone that understands it. For your particualr situation it is quite possible it was never necessary to begin with. For me i had problems from birth that prevent natural testosterone production so i have spent 40 years getting this right. It all comes down to the doctor and i have seen alot of bad ones and a few good ones and finally one that is truly fantastic. best wishes to you

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I agree; the problems we see are mostly problems with doctors or problems created by doctors. They are shaped by insurance and HMO’s etc and become a product of corporate disease management. It would be helpful if medical schools could launch a new generation that could understand these things. The fact that it is very hard to get proper medical sevices does create a lopsided supply and demand that allows some docs to turn this situation into high cash flows. In maximizing cash flows, they do not let regulations or ethics get in the way. And in places like southern California, there are huge amounts of money to be made by catering to the wealthy which allows prices to rise way beyond the means of most others. Insurance companies are happy with any situation that broadly denies services to a large population for conditions that are non life threatening.

Morepain: -understood and sorry.

[quote]KSman wrote:
I agree; the problems we see are mostly problems with doctors or problems created by doctors. They are shaped by insurance and HMO’s etc and become a product of corporate disease management. It would be helpful if medical schools could launch a new generation that could understand these things. The fact that it is very hard to get proper medical sevices does create a lopsided supply and demand that allows some docs to turn this situation into high cash flows. In maximizing cash flows, they do not let regulations or ethics get in the way. And in places like southern California, there are huge amounts of money to be made by catering to the wealthy which allows prices to rise way beyond the means of most others. Insurance companies are happy with any situation that broadly denies services to a large population for conditions that are non life threatening.

Morepain: -understood and sorry.[/quote]

no worries my friend…