26 years old, 6’2”, 159 pounds. weightlift 3 days a week and cardio 2. diet 2800 calories where i live i cannot find the right doctor so i had to go to usa to get treatment in the hospital of miami with an endocrinologist. overall he took the time tk see my test but the treatment he offered seems weird to me after all the info i searched before the appointment i was unhappy. i have a microadenoma which is not secreting prolactin, my acth is 69 (high) but no symptoms of cushing.
total test: 180
free test: 2.2 low from a range of 3.6-11
prolactin 9.36
lh 1.91
low sperm count of 5,600,000 normal is at 20,000,000
tsh3: 1.2 ref range .51-4.95
insulin growth factor low of 100.0 range is 117-139
shgb of 59 high
t4 1.00 range .71-1.85
i dont have e2
ast alt are within range of normal
no liver abnormalities
low heart pulse of 38-41
did an mri and doctor said it might be hormonal
i dont have anything else. the doctor said clomid first but then i asked why since my shgb was high and he said “youre right” and said to start with hcg of 1000 ui Imgur: The magic of the Internet 3 days a week for 1.5 month and retest to see what happens.he diagnosed me with primary hypo Imgur: The magic of the Internet. my testis are fine and it seems all of it is in my pituitary. hes not willing to combine trt with hcg because he doesnt like it and he believes e2 is not a must to measure. im depressed because i cant find the right treatment. any help guys? i just dont know what to do. i know i have low t, i know i have lowish lh and starting with hcg seems good but i dont know much about it. he offered gel but i said no. lastly hes not willing to freeze sperm because he says you can make babys after 6 months of hcg.
why docs dont do e2? should i get treated? this is the 6th endo without success and my symptoms are killing me.
symp: ed, no energy or motivation, no libido cant think straight, depression, anxiety, cold hands and feeling cold, insomnia, almost to no sperm when masturbating.
picture of myself Imgur: The magic of the Internet
ive spent thousands of dollars to get treatment and still cant find any and i dont know where to go
Most endo’s are clueless, you need to go private because there just aren’t many doctors who know how to do TRT. You’re missing quite a few labs, the quality of your insurance determines the level of care you receive. You might give Defy Medical, they don’t take insurance but have reasonable cost.
Endo’s don’t check or monitor E2 levels because nobody told them it was a good idea, doctors learn nothing about male hormones in medical school so they must follow outdated guidelines. Any endo you see is going to be like the last one, TRT isn’t their specialty. Most endo’s treat people for thyroid and diabetes, TRT is a gray area of medicine for them.
thanks so much for replying. well right now im in the usa with my mother and all my family is worried because of me. i literally cant make my own decisions and this medical stuff is killing me with stress. my mother does not like the idea of private medicatjon and would like a doc instead. since i live with her and dont have enough money what can i do? should i not do the treatment of hcg 1000ui 3 days per week?
i read that will raise e2 and the doc doesnt even check e2
It seems the private doctors are the only ones who know how to do TRT, you’ll never get the care you need going through insurance. The type of doctor you should be looking for are the Go-Getters, the type of doctor who goes through medical school and doesn’t stop there, like a guy going through high school, then onto college where high school wasn’t enough.
These type of people don’t settle for average, they strive to be the best and do be their best they find they are unable to do so under the sick care model, insurance companies restrict doctors from doing what’s necessary. Doctors who take insurance can only take action when the insurance company says so.
So you can see how hard it is to for a doctor to do his job when some other entity is controlling his actions, he’s like a puppet and the insurance companies are pulling the strings. Your mother is making an uninformed decision on your behalf and the consequences are the quality of your life. How you feel on TRT is determined by the skill of the doctors.
You’ve got an average doctor and average doesn’t cut it for TRT. As men age their testosterone levels fall and estrogen rises, then later in life older men get prostate cancer. When women hit menopause they become estrogen dominant and if genes permit breast cancer develops. So proper hormone balancing is important!
You doctor doesn’t even check estrogen though, it may take a few years before doctors realize what happens when estrogen is left unchecked. You’re not supposed to inject more than 500iu of HCG per injection, only bad things will happen.
Your mother needs to make an informed decision based on information, not blindly making decisions based on ignorance.
again system, thanks for taking your time. i did a lot of research and talked with my family and i might go to defy in personal. https://www.defymedical.com is this the one you recommend? also can i do everything online?
That’s it! I just signed up today myself, I’m in California. Being in California I have tons of options out here, but none can compare with the cost and experience DR. Saya has with hormone replacement. There are so many other services Defy offers, boggles the mind.
Your experience with Dr. Saya will be vastly different than any of your other experiences. You can set it up to where you can order everything in the patient portal, it’s up to you if you want to do everything online or in person. If distance isn’t too great I would at least go in person the first time, then checkups could be done online.
The HCG will do nothing for your high SHBG, only moderate doses of testosterone will. Dr. Saya I imagine will put you on two moderate doses twice weekly, HCG and a low dose AI if necessary. You won’t have to fight the doctors anymore, they are there to serve you.
wow thanks a lot! since im in miami right now and dont think i can stay for much longer than two week. if i got offered to visit another doctor that its not saya, should i?
Doctors learn nothing about hormones in medical school? Funny. I had two semesters that involved just that in med school and then a three year fellowship in endocrinology focusing almost solely on sex hormones. You’re a smart guy with a lot of knowledge but sometimes the doctor hate you spew is ridiculous.
not that im saying docs are stupid or anything, but i have’t found one single endo who cares about e2 or shgb and some doesnt like hcg with trt and im 26 and worried about infertility
Doctors may study but when it comes to practice …failure. Unless your an Endo in let’s say in Florida for example with concentrated older people that are into anti-aging it is extremely difficult to find a good trt Dr. Or else why the F would I be in this forum.
It seems urologist are more knowledgeable in trt in NYC metro area. Endos seem most knowledgeable and experience on diabetes in my area. Maybe most.
But there are doctors who rarely PRACTICE trt but make u think they know it all especially when there first protocol is inject 200 every 2-3 weeks.
I would love to get a referral from @physioLojik on a Dr you know in the NYC area that is knowledgeable on trt.
I’ll say something though I went to a urologist 1st who was a reproductive specialists brought my labs had tt readings of 439.200,200. He ran his own labs. Including prolactin, LH, FSH, first Dr to sheck those numbers. Results came back 380 total t and He said all is good. I almost fell to the floor. I said so I should take Viagra the rest of my life, he said yes.
So then I went to Endo who saw all my labs and immediately said I need t and prescribed it. After being on this forum It made me think he is no good because does not prescribe HCG and did not treat my boderline thyroid. Now in hindsight,this Endo was ok. I switch to another urologist who seems to know more about trt. Bye he even lacks some expertise that I get from the Endo. So between both of them, I should be fine.
There are bad apples in every field for sure. I’m an endo in Ohio and We have a huge positive track record of patient satisfaction. I’m not saying all endos are great. Of course they aren’t. But to say we are all idiots is also ridiculous. The good ones (like me haha) go to large amounts of seminars and do tons of CE curriculum. It also doesn’t hurt I’m a competitive bodybuilder. I just get sick of the constant bashing on this site. It’s pretty lame.
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I agree …I was still typing my post as you wrote yours…added stuff on bottom… I say that this site made me think my Endo was an idiot but turns out I need him.
then could you let me know any good endos around florida? do you recommend good ones? because after 6 endos at age with no good diagnose of what i have (i even self diagnosed with secundary hipo since i have low lh and low t because of microadenoma) im starting to consider defy at tampa. i dont see any other options. i saw 2 uros and one wanted me to try clomid when i had shgb of 79 fuck that
o and im in miami just to visit a good endo who was recommended by me and well recognized here. he first wanted to treat me with clomid (shgb of 59) and i said no becauss of shgb then he offered gels but i dont want to mess with that and thennn he offered either hcg or trt but not both. i went with hcg since im 26 and he said to take 1000iu 3 days a week for 6 weeks and re test. what do you think? o and he said e2 will not be evaluated so yeah all kinds of gynos. sad part is that all my family wants me to get treated and we are paying so much for this. next step def defy
so what do you recommend? saw 2 uros 4-5 endos at age 26 they wanted to do trt but without much care and protocols like once every 2 weeks and none cares about e2 or shgb. they say its normal range when its at 59-79. im at a point to just go defy when i really want to be in a good endos hands
I just saw your pic. I would never think you had low t as I think you look really good. Wish I had your body.
Anyway…
I got the testosterone prescribed and just injected 2x a week. Dr did not know. He just prescribed the Testosterone. When Dr wrote labs to get I often write down other tests I wanted. Drs are so busy when they get results backs , they don’t even think “oh I did not order that”. If lab asks who wrote that in just say the office.
At your age you may try clomid 25 mg ED or EOD. And see what response you get. I tried that am 41, it helped somewhat but not enough probsbu because of my age. Clomid should def increase sperm count , and load I might add 
, and maintain fertility.
If you call a compound pharmacy, a busy one, you can ask them which Dr prescribes lots of trt medication. See if they give you names.
There’s one called hallandale pharmacy in Florida. I can not vouch for them but I do know they make HCG.
Have you seen Finding a TRT Doc
Have you read the stickies? Seriously, there is an entire section addressing your specific question. Have you followed any of the suggestions? It doesn’t sound like it, in fact is sounds like you’re Dr. shopping hoping someone will tell you what you want to hear, rather than what you need to hear. Follow the steps outlined in the stickie, they work.
I don’t say this to be rude, however countless guys come here complaining about the same thing without realizing there’s a great resource available. They then spew hatred against Docs and the medical profession when they don’t get what they want. It’s ridiculous and sad. Maybe there’s a legit reason 6 independent Endos have disagreed with your self diagnosis.
Good point. There was 1 guy on here I looked up his username on line. And it turns out they basically legally wanted Testosterone for ‘trt’ but they really wanted to be on a constant light steroid cycle. Sometimes we don’t get their real story. I don’t usually look up usernames but when I did for this person…And all they want is a Dr that prescribes a generous amount.
And there must be quite a few guys who shop around because I believe my first urologist dismissed me thinking I was one of those guys. He told me without me asking.l “I would never give testosterone”
everyone says that ha! but you know what? i have symptoms of ed, tiredness, etc all kinds of low t symp. anyways i do have a strict diet maintaining my weight until i fix this tho (2700 cals daily at 6’2 160 pounds) my problem is coming from low lh, high shgb of 59-79, and of course low t of total 2.2 and free 180. im at a point that i do want to keep fertility but fertility living everyday feeling like not wanting to get out of bed? im tired of looking for treatment. i didnt tried clomid because of my super high shgb and i read in this forum about it so i decline it. he offered gel but we all know its a bad choice so he told me hcg or trt so i chose hcg 1000 3x a week to see if it works. i tried clomid and my anxiety went thro the roof haha! but yeah my diet and training is strict. but i know that if i had normal t i would be better. energy and motivation are not there
not rude at all. the thing is, of i ended up doing what the endos said i woulda been infertile by now. injections of trt without hcg or anything once every two weeks. clomid when shgb is high, no one still have said what i have (diagnosed) i dont especially want treatment but i do want a doctor who can actually tell me what i have (diagnose) Imgur: The magic of the Internet this doctor diagnosed me with this and well i havent looked much into it but i will. my testis are great but it seems my pituitary gland is failing. I remembered the doctor who said that i needed an mri of pituitary gland said he doesnt know what to do. i have low lh probably due to my microadenoma (doctor havent tell me if the tumor is active or not) in my opinion (im no doctor) i might be secundary hipo. and the fact that docs says i have normal t level (free at 180 and quests says its low) makes me feel depressed. sorry for my english
I am in Ohio - South of Columbus. Could you point me in right direction of a good Endo or a Doctor that would work to get numbers in the optimal range and not average or below. . My regular doc says my numbers fall in the average range. I would say low average - and obviously won’t do anything. He was supposed to set me up with some an Endo at The Ohio State University - that has yet to happen.
Thanks