T Nation

Using Gel, Doctor Set Target of 500. Is that Low?

#6

Yes

Go to worldlinkmedical.com and look for docs there. Jsut found out about this database recently. Al trained by a great doc

#7

Your doctor is nervous about prescribing TRT because he doesn’t know what the blank he’s doing. Androgel isnt going to work for you, get on injections two or more times per week, not 200mg every 2 weeks.

If androgel was gonna work for you, you would see your levels elevated within a couple of weeks of application, not months later.

Your doctor targeting 500 ng/dL is a mistake, Trump is just below 500 and is 72 years old. your doctor should be concerned about optimal free testosterone.

Typical of sick care doctors, they target a number and are happy when it hits target without any input from the patient. They don’t care how you feel, they care more about the number so they don’t get in trouble.

High normal testosterone is shown to be safer and healthier than levels at mid normal ranges, men with high normal testosterone have the least cardiac events than those in the mid normal ranges.

Be prepared to figure out your own case because sick care doctors aren’t very good at TRT, they have no formal education or training and most are clueless.

2 Likes
#8

Yes.

That is the way the pharmaceutical rep trained them on utilization of gels.

They do not.

2 Likes
#9

It does feel like he’s slow walking or pussy footing. He’s an Urologist, seems like he’s a good doctor? But man I wish I knew why he’s got this plan.

I should speak up more. When I go in there, I just accept whatever he has to say, then I’m out the door. Im already worried he thinks I’m risky for some reason, so that inhibits my asking about high normal levels. He should be able to tell I’m not athletic and not just out to get on try for working out (though I’d like to.) But yea…I have a gut and tits, so…

#10

Thanks a lot to everyone responding so far. Getting this figured out means a lot to me.

I have an appointment with the original urologist in a month (also another in 3,) but in the meantime, next week I have a general practice doc visit. GP doc is easy going and I was thinking of asking if he’d be willing to work with me on this.

Maybe I ask to try for 800? Something else?

I’m looking for endocrinologist as suggested as well. There’s maybe one nearby, though.

#11

You’re doctor doesn’t specialize in TRT, they specialize in treating the prostate and fertility concerns. Endocrinologists treat diabetes and thyroid and also don’t specialize in TRT, no doctor in sick care specializes in TRT.

So you see you have little chance of finding a knowledgeable TRT doctor inside sick care because no one has been educated or trained in TRT. Doctors mostly follow outdated guidelines, like 200mg every 2 weeks which clinical studies show are terrible for the patients.

You either have to figure out your own case, dosage and injection frequency and figure everything out on your own provided you doctor allows you to take the reins.

You have a rough road ahead of you.

1 Like
#12

There is nothing wrong with wanting to optimize for body building purposes. It’s none of their business. Now a clinic will ask your goals and make sure they Get you to the correct levels for building muscle ECT. Spend the money its worth it. With insurance paying for your bloodwork at Defy it makes the leftover out of pocket cost around 1 k for the first year. Much less for subsequent years

#13

Dude get a Trt doc none of these docs are specialists. You will keep having problems

I don’t know about you, but my hormones are a big deal . I am not letting some guy who specializes in sick care medicine to heal me with TRT.

You take your Lamborghini to jiffy lube and I’ll take mine to my exotic car repair shop certified.

#14

If you don’t have the money, you don’t have it, do there’s not much to discuss there. If your regular doc is reasonable, be straight with him. Tell him the gel isn’t doing anything and you looked on the internet and found out that a lot of people don’t do well on it. He should be willing to look it up and do something else, or find you a specialist that is covered by insurance. Welcome to the American healthcare system, my least favourite so far.

#15

Thanks guys, I’m looking at Defy to see if there’s a way I can afford that, and I feel a little more confident about what I should want out of HRT. I’ll ask my regular doc and urologist if they are going to help me out or not. In the meantime, I’ve contacted Defy to see about getting the ball rolling, my insurance can help with labs as mentioned.

Glad this forum is active, I definitely need help.

#16

I talked with defy, and they want or suggest that I use their labs service. Is that just the upsell? Are you using them in conjunction with your insurance?

#17

Do you have any prices?

#18

I used them for a partial first lab for like 3 things i didnt have on previous blood work then I told them i wanted a lab slip so my insurance could pay. I just used it today. Free blood work. They emailed a hand written lab order on a rx pad.

#19

Here is what they sent,

All new patient will be scheduled for an initial evaluation with our one of our doctors or physician assistants once lab results are received. The cost for the initial evaluation is $250 and will include:

  • Initial TRT/HRT consultation
  • Complete Lab Review and Discussion
  • Review of medical history & present symptoms
  • Physical Examination (PE review only for telemedicine patients)
  • Custom treatment plan
  • Q&A

After your initial evaluation:

The Medical staff requires at least two follow up appointments per year for patients on HRT/TRT (every 3-6 months) at the discretion of your physician. For example, if adjustments or changes to your treatment protocol or medications are being made, labs are routinely monitored at 3 months. Once a patient is stable and not requiring active adjustments, labs are often collected at 6 month intervals. You can choose to have your follow up with the Doctor or Managed Care Provider.

The follow up costs are as follows (you have the option of who you’d like to have your follow up consult with):

Follow up lab review w/ Dr.- $165
Follow up lab review w/ Managed Care Provider - $90

To begin testosterone therapy, we will order you the following initial blood work:

  1. Comprehensive Metabolic Panel- $15
  2. CBC- $15
  3. Lipid Panel- $15
  4. Testosterone Free and Total- $35
  5. Estradiol Sensitive- $38
  6. DHEA-Sulfate - $33
  7. TSH-$21
  8. PSA-$21
  9. LH-$12
  10. Sex Hormone Binding Globulin - $44
  11. IGF-1 - $30 (If this test is purchased individually the cost is $34)
#20

I have a GP doc visit in a week, I am thinking I should see how many of the required tests he will authorize, using Defy’s list.

#21

Just explain you are going to defy regardless and it would be great if he could save you the much needed money.he has the the ability to run any test your insurance covers or you want to pay for

#22

Yep, they’re making a nice upcharge there.

For $254:
Lipids
CMP
CBC
IGF-1
TSH
free T4
free T3
FSH
LH
prolactin
DHEA-S
estradiol
total testosterone
free testosterone
SHBG
PSA
VitD

#23

Shit, wish I had known I could have done that. I paid them for my lab work, could have made insurance foot the bill

#24

You still can, you can get the proper paperwork from Defy, I believe they do charge a $25 fee. So $25 for all those labs, a steal if you ask me.

Insurance would never have paid for it without paperwork showing the reason it was ordered and by a doctor.

1 Like
#25

It depends. My insurance said they wouldn’t reimburse with those papers for out of network labs even though the whole panel cost less than 1 test from an in network lab. They would rather pay $3000 than like $250. I can basically get all the lab work i want as long as they are codes on the approved list which I haven’t ran into any not on the list yet.