Where to get Testosterone prescriptions?

[DocGeezer]

Been on TRT for almost two years. It's been life changing. I take .9 to 1cc per week of Enanthate injected.

Took a while to dial it in, but 800 to 1000 seems to be the sweet spot for me. Then primary care physician retired, new guy want's it to be below 750. "Don't care how you feel, it's too high!!!" I'm thinking I may need a new doctor.

I check the local TRT type places and they're 400 a month and they require you go into their office 4 times a month for injections and I already do my own. I pay 25 bucks a month for 1 vial of enanthate at CVS.

I pay out of pocket anyway since it's cheaper than going through insurance. What's the best way to get a prescription called into my pharmacy. What types of medical options are there? Online options?
-Thanks

 

[testiculus]

Try a local urologist. In general urologists are more informed than other medical specialities with TRT. If you're in a major metro area look for a urologist that did a fellowship at Baylor in Houston under Lipshultz or Harvard in Boston under Morgentaler. If you're unable to find a good urologist locally. Defy would probably be your best option.

 

[Golfboy307]

If you are with a good doctor not trying to mark up prescriptions like crazy, get a 90-120 day supply from Wells or APS compounding pharmacies. I pay about $100 for a 10ml vial delivered.

 

[DocGeezer]

Try a local urologist. In general urologists are more informed than other medical specialities with TRT. If you're in a major metro area look for a urologist that did a fellowship at Baylor in Houston under Lipshultz or Harvard in Boston under Morgentaler. If you're unable to find a good urologist locally. Defy would probably be your best option.

I'm in Texas so finding a urologist educated at Baylor is very easy, actually rather hard to find any not educated at Baylor. How would you search for Fellowships under Lipshultz?

...and when did 155-721 (ng/dL) become the range, I thought everyone was shooting for 800 to 1100?

 

[testiculus]

I'm in Texas so finding a urologist educated at Baylor is very easy, actually rather hard to find any not educated at Baylor. How would you search for Fellowships under Lipshultz?

...and when did 155-721 (ng/dL) become the range, I thought everyone was shooting for 800 to 1100?

I don't have a good answer. The only thing I can suggest is to look at each Urologist's background and see if they mention a residency or fellowship in Lipshultz's clinic. He usually has 2 research fellows and 2 clinical fellows every year, plus who knows how many residents.

Each lab has their own range and in general labs have been lowering their "normal" range which really just represents the 2.5 percentile cutoff, not really normal. So going by the lab range as a treatment guideline is meaningless.

In general a good urologist will look to find the lowest dose that fully resolves your symptoms of hypogonadism rather treating to a number.

 

[Sergel]

You also have to consider what level of free/bio available T this 800~1000 total T takes you... Total T is not very useful. What is your SHBG/Free T number?

1000 is high, unless you have high SHBG this puts most males in superphysiological free T ...

I think you need a good TRT doc... I would not knock the lower doses until you have tried them, you might feel better... many, including me do...

 

[Daveleeander]

With telehealth or clinic you’re certainly gonna pay a considerable bit more than $25/ month. I pay $175/month for telehealth thru a clinic. If you’re looking for inexpensive go over to naps and order some. Or answer one of those ads on fb where you call in, get diagnosed and get a script. Don’t know what that costs though

 

[Cataceous]

Been on TRT for almost two years. It's been life changing. I take .9 to 1cc per week of Enanthate injected.

Took a while to dial it in, but 800 to 1000 seems to be the sweet spot for me. Then primary care physician retired, new guy want's it to be below 750. "Don't care how you feel, it's too high!!!" I'm thinking I may need a new doctor.
...

Don't be so quick to dismiss the new doctor. It sounds like you're taking 180-200 mg of testosterone enanthate once a week, is this right? If so then you are taking about triple the testosterone the average healthy young guy makes naturally. This is not TRT. Feeling good in the short term is not the whole story. How are hematocrit and lipids? As @Sergel notes, free testosterone is more important than total, but at this dose yours is pretty much guaranteed to be high. If you are injecting once a week and measuring at trough then your peak serum testosterone is probably 2,000-3,000 ng/dL. Your doctor is right to want to avoid this. Of course, as an adult you are free to disregard cautionary advice, but you should try to understand the uncertain long-term risks related to blood viscosity and cardiotoxicity, in case they end up applying to you.

 

[FunkOdyssey]

Don't be so quick to dismiss the new doctor. It sounds like you're taking 180-200 mg of testosterone enanthate once a week, is this right? If so then you are taking about triple the testosterone the average healthy young guy makes naturally. This is not TRT. Feeling good in the short term is not the whole story. How are hematocrit and lipids? As @Sergel notes, free testosterone is more important than total, but at this dose yours is pretty much guaranteed to be high. If you are injecting once a week and measuring at trough then your peak serum testosterone is probably 2,000-3,000 ng/dL. Your doctor is right to want to avoid this. Of course, as an adult you are free to disregard cautionary advice, but you should try to understand the uncertain long-term risks related to blood viscosity and cardiotoxicity, in case they end up applying to you.

You make a bunch of good points as usual. I would personally be hesitant to make changes to a protocol described as "dialed-in, "life changing," and has delivered consistent results over a relatively long period of two years. Yes, check your HCT, lipids, blood pressure, etc, and read up on the risks of supraphysiologic levels so you are well-informed. However, if everything looks good and the only cause we have for alarm is your Total T lab result, I'd be on team "find a new doctor".

 

[sammmy]

I'd say, try to lower the dose to get around 700 total T, to satisfy the new doctor. I don't believe a trough level of 700 and "between 800-1000" is a massive difference in terms of effects or side effects.