Veterans Affairs and TRT

Update
The VA actually ran the labs I asked for. Here are the results:

Total T3-SO - 115ng/dL
Free T3 - 3.2 pg/mL
T4 - 7.8 ug/dL
Free T4 - 1.20 ng/dL
Reverse T3 - 15.3ng/dL
T3/RT3 Ratio - 7.5
TSH - 2.84 uIU/mL

Total Testosterone - 3.57 ng/dL
Free Testosterone - 72 pg/mL
Prostate Specific Antigen - .220 ng/mL
Estradiol-SO - 16.1 pg/mL
SHBG-SO - 29 nmol/L
LH-SO - 5.9 IU/L

Original
35 yo Marine Veteran. I’m at my wits end with the VA and want to hear from anyone that’s successfully navigated getting TRT through them.
I’ve had signs of low T for nearly a year (no random boners, periods of extremely low libido, slow muscle gain, extremely slow fat loss, exhaustion, difficulty sleeping, difficulty focusing, etc.) I eat pretty healthy (all homemade meals, good macro splits, lots of veggies and lean pork and chicken with eggs thrown in), workout regularly (4 times a week average, depending on my program), have an active job (about 50/50 split outdoors labor and computer) and have a relatively low stress life.

I requested, very specifically, that the VA run a test for my Free T, Total T, LH, and SHBG. They took blood and posted my results… With none of those tested. So I got another draw and they only tested Free T (72 pg/dL.)

So my request for knowledge is thus:
A) how do I get them to test for all those markers (plus a full Thyroid panel)?
B) How do I convince them to put me on TRT?
C) Are there any workarounds, advocacy groups, etc. that I can try to utilize?

Id be astonished if anyone fit this bill.

Even if they did take you into care, expect some archaic protocol like 1x per month Test C at 400mg. You know as well as I do that they aren’t there for your quality of life, they’re there to say they treated you.

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Please, don’t waste your time with the VA for your TRT. The VA is horribly mismanaged and good doctors are hard to come by. If by some chance you get TRT, there’s a saying, the cure is worse than the disease.

You would have a better chance if you went to any doctor outside the VA. There are private clinics, cash pay that are more up to date on hormones than in your typical sick care setting.

That tells us literally nothing without no lab ranges.

You can’t go to the VA with a laundry list of labs to test, because they will look at you like you have two heads. The VA is not only mismanaged but also underfunded.

If you’re lucky, they will test TSH and maybe FT4, but a thyroid panel is probably not going to happen.

You can go to Discount Labs and order your own labs.

First they need to believe you need it, the problem is most doctors aren’t taught sex hormones in medical school, TRT is a blindspot in most doctors training.

When doctors are unfamiliar with something, they tend to do nothing.

Did you ever fire shoulder launched weapons, hit your head or concussions while serving in the military?

Multiple documented head injuries. And a migraine disorder that started in Iraq after exposure to a shit show of burn pits. All documented.

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Your doctors should be checking growth hormone after traumatic brain injuries, because low growth hormone is common among traumatic brain injuries (TBI’s).

Growth hormone deficiency testing and treatment following mild traumatic brain injury

Pituitary dysfunction, specifically growth hormone (GH) deficiency, can occur following traumatic brain injury. Our objective was to characterize the prevalence of GH deficiency (GHD) testing and response to recombinant human GH (rhGH) treatment in adults with persistent symptoms following mild traumatic brain injury (mTBI) referred for assessment of pituitary dysfunction.

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Update I was contacted this morning by my local VA, they will have their lab scheduler call to set up all my labs (full Testosterone panel AND full thyroid panel)… I’m skeptical they’ll follow through, but I made the request through the Patient Advocate office through Secured Messaging, so I have a solid paper trail should they fail to do it again.

I don’t see GH as part of the testing.

Going through this right now and my buddy just did. You need to see a civilian doctor, get your test taken care of there, PAY OUT OF POCKET then use your test results to argue with your PCP to write the prescription. The VA says 2 consecutive test within a year with Testosterone less than 200 and you’ll qualify.

It isn’t hard, it’s the PCP who is, my last doctor was all for it then my new one stopped the process right away.

Where are you located? VA hospital care varies greatly from state to state. I get garbage care in Texas (super surprised by that) and get wonderful care for whatever I ask for within the Washington state VA.

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The only person I’ve heard of who had luck with the VA was that navy seal that transitioned to a woman (and now wants to go back). He had complete hormone therapy through the VA. Meanwhile, I can’t even talk to a therapist without a 12 month wait.

I’d recommend going to a clinic. It’s $100 a month out of pocket.

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