T Nation

Why Do Most Doctors Suck at TRT?

I know we’re not going to answer this definitively but the question has to be asked. Why do doctors suck so much at TRT? It seems like this HUGE gaping hole in their training and if even one person got a clue in an are they could book themselves out for months with guys like us who are done with the bullshit.

I’ve seen doctors who wanted to nothing but weight loss, a doctor who wanted to do nothing but arimidex, a doctor who wanted to just do Clomid, a doctor who wanted just TRT but wouldn’t monitor E2 and sure as hell wouldn’t Rx arimidex. None of these guys would Rx HCG. All the urologists said if I wanted to have children don’t do TRT or freeze some sperm first. When I told them I thought there was therapeutic benefits beyond fertility (I like my big full testcles hanging low between my legs) they looked at me like I was nuts.

How is it I know the literature better than they do? There is strong evidence TRT helps correct obesity and breaks the cycle associated with metabolic syndrome yet none of these guys wanted to pursue it this way. The one guy who wanted to do TRT looked like he didn’t know what E2 or HCG is let alone how to Rx.

For the majority of us it’s pretty simple and they could get away with knowing how to appropriately Rx just 4 meds: Test, Clomid, arimidex (or another AI), and HCG and effectively treat just about all primary and secondary cases.

How has medicine failed so miserably with TRT and how is this being allowed to go on? It’s an area that medicine just doesn’t seem to care about and I’m baffled…

The answer I usually give for this is, I think that public perception has equated “steroids” with “gigantic hulking rage monsters who are killing themselves and teaching high school kids to kill themselves through their evil cheating ways”. Since TRT uses the same medication as steroid users use, all of a sudden TRT = Steroids = Evil Cheating Teen Killers. So with that in mind, doctors either: A) Don’t want to prescribe steroids because of the (insanely wrong) idea that they have a huge list of side effects that will kill every single person taking them before age 45; B) Don’t want to test for hormone issues because they don’t want to have to treat hormone issues; C) Don’t want to prescribe testosterone because they think it will label them as drug pushers; or D) They honestly want to treat low T, but there’s so little medical research out there (since the gov’t basically only allows studies of steroids with cancer and AIDS patients), that these doctors are stuck using protocols they learn from other doctors that were formulated in the 60s and 70s. Obviously there are SOME doctors who know what they are doing, but they are few and far between and should be cherished.

It’s a shitty situation.

I see a lot of similarities between steroids and pain killers: Because some people have done some incredibly stupid things with them, they’ve become hard to get for people who actually need them or will use them responsibly and intelligently. It doesn’t matter that 1000s of people use them recreationally and do so safely, the <1% of users who have harmful effects from using them wrong set the tone for everyone else. Not a perfect analogy, but a lot of similarities there. And you can substitute PKs for LSD, Alcohol, Guns, Weed, and fireworks.

If you haven’t seen the documentary “Bigger, Stronger, Faster: The Side Effects Of Being American” I would highly recommend it. For the most part it’s fair and balanced, and I don’t recall any major infractions with the science.

“All the urologists said if I wanted to have children don’t do TRT or freeze some sperm first.”

I would still do this. I know hCG is supposed to keep you fertile, but I’ve heard somewhere that that may not be the case if you’re on TRT for a long time (like over a decade). I can’t find where I read that, and I may be remembering things wrong, in which case you should completely ignore me (or at least this paragraph). If I seriously wanted to have kids someday I’d freeze some guys now just in case, but I personally would rather have various dental procedures every day for the rest of my life than have children.

In addition to what has already been said:

-$$$…there just simply is not a lot of money to be made in easy proper treatment. Adex is now generic, T is dirt cheap, and self-administered protocols keep the patients out of the office until its time for their yearly or biyearly checkout. What’s the incentive?

-Ego…lot of docs are stuck in their ways and won’t be corrected, evidence be damned

-Lack of training…not a lot of time spent in medical school on this (probably due to the $$$ factor) so they just are ignorant and don’t know it.

I’m sure money plays a part. Then again an endo could spend about an hour of time really looking into TRT and be THE person to go to in their area. Also, don’t know about you but it’s been 3 visits in 4 months getting everything worked out with another in 2 months. My first visit the doctor was paid $300 for 30 mins and subsequent visits have been $150-$225 depending on time. That’s the actual insurance paid and not billed.

Not a bad use of time.

I just feel like us men are really getting screwed by the medical community. There should be some kind of men’s health awareness initiative that isn’t just a pharmaceutical company’s Low T advertisement.

[quote]dbsmith wrote:

I just feel like us men are really getting screwed by the medical community. There should be some kind of men’s health awareness initiative that isn’t just a pharmaceutical company’s Low T advertisement. [/quote]

The problem with that is that with all the metrosexual and feminisits out there, caught up in their movement, there is not enough room to be a real man anymore. We are demonized as rapists, philanderers, and drunken buffoons. Ever seen a manly man portrayed in a positive light in a non-superhero blockbuster movie (Denzel excluded)?

Fuck that…I’m doing my part to take back my life from these fuckers. You should do the same.

Watch Expendables 2 and eat steak and drink bourbon :slight_smile:

[quote]VTBalla34 wrote:

[quote]dbsmith wrote:

I just feel like us men are really getting screwed by the medical community. There should be some kind of men’s health awareness initiative that isn’t just a pharmaceutical company’s Low T advertisement. [/quote]

The problem with that is that with all the metrosexual and feminisits out there, caught up in their movement, there is not enough room to be a real man anymore. We are demonized as rapists, philanderers, and drunken buffoons. Ever seen a manly man portrayed in a positive light in a non-superhero blockbuster movie (Denzel excluded)?

Fuck that…I’m doing my part to take back my life from these fuckers. You should do the same.

Watch Expendables 2 and eat steak and drink bourbon :)[/quote]

You’re right about the perception of it. The funny thing is I’d guess almost every obese male is hypogonadal to some degree making this one of the biggest men’s health issue out there. Not only would recognizing and treating this in these men make them feel better but a large number would be aided in losing weight as a consequence. This is also about fighting obesity in my mind. Obviously, not that everyone with hypogonadism is obese. This single treatment treats SO MANY issues simultaneously that I think test levels should be part of routine physicals.

That said I’m taking back my life too…

Ditto on the steroids concerns.

Male docs also have the attitude that 1) it’s normal and 2) suck it up, buttercup.

I can’t tell you the number of stories I’ve read from guys who got blown off from a malke doc but ended up with a female one who understood and was willing to treat.

Myself included… it was night and day.