Are All Endocrinologists Idiots?

[SkyWarn]

I just had my 3rd experience with a new endocrinologist. He reviewed my labs and looked at my total T of 1003 (reference range top limit was 950) and said that I am overdosing and if I don't immediately lower this I will have a coronary event in the next 5 years. He then told me for my age (55) it should be no higher then 400.

 

[Cataceous]

I'd soften it a little: Yes, the majority of endocrinologists seem to lack up-to-date knowledge regarding treatment of hypogonadism.

 

[Systemlord]

My three previous endo's while some are better than the others, they are all operating more or less in the dark. My endo targets the low 400 ranges for therapy for everyone and only pays attention to TT levels and are all about the numbers because they have little knowledge and therefore are managing numbers, not symptoms.

The goal for treatment should be the relief all symptoms of hypogonadism. You want to get TRT through insurance, then you may have to deal with these headaches.

 

[SkyWarn]

My three previous endo's while some are better than the others, they are all operating more or less in the dark. My endo targets the low 400 ranges for therapy for everyone and only pays attention to TT levels and are all about the numbers because they have little knowledge and therefore are managing numbers, not symptoms.

The goal for treatment should be the relief all symptoms of hypogonadism. You want to get TRT through insurance, then you may have to deal with these headaches.

Thankfully I have a good Urologist who knows his stuff regarding TRT.

 

[SkyWarn]

It’s not an endo thing. These doctors aren’t used to a knowledgeable patient base. In the Information Age they still feel no need to continuously learn.
That’s the difference between the leaders and the masses in medicine imo.

Very well said! I honestly believe that most of us on these forums are more knowledgeable about TRT then many doctors.

 

[trt reznor]

WELL, the potential is there. Too much misinformation and consensus without healthy conjecture though imo. It would be very easy to consider yourself educated just reading here, but it’s just 1 resource. This site is for profit(correct me if I’m wrong), and moderated by opinionated people. Still worlds ahead of most resources for male health.

Agreed. It’s a great resource, however it still has dangerous and potentially fatal levels of misinformation circulating if you don’t proceed with caution and just take anyone’s advice.

 

[Larry P]

I agree my doctor does not care to read or study and learn. He follows guidelines that are years out of date. He too treats me on my labs not on how I feel. I treat me to how I feel. He thinks I should have TT around 500, but my natural TT taken years ago is closer to 900. I am starting to see another doctor that is current on TRT and thinks my current doctor is an idiot.

 

[Systemlord]

He follows guidelines that are years out of date. He too treats me on my labs not on how I feel. I treat me to how I feel.

I am starting to see another doctor that is current on TRT and thinks my current doctor is an idiot.

Your current doctor has made the choice to be the idiot. I believe doctors who treat the numbers are just too lazy to utilize that brain of theirs and treating the numbers gets them through the day a bit easier.

We humans are programed to go the path of least resistance, some of us more than others.

 

[Whatzup]

That is interesting. My primary care doctor saw me Monday and said if I felt good on my total of 1,065 to continue. (Cypionate 100mg weekly).
I you're Endocrinologist thinks for your age (55) it should be no higher the 400 then why do TRT or better yet how can you even do TRT.

 

[Bernie]

That' funny. I'm 60 and workout with a prominent research endocrinology at my gym. He constantly asking me about my workout routine and what I am taking as I compete in physique competitions. I told him my levels fluctuate between 800 and 1200 ng/dL. His response was "Those are fine levels". I workout 2-3 hours a day (resistance and cardio training). Haven't experienced a cardiac event yet! My dad had a heart attack at age 55 with a very sedentary lifestyle.

 

[Jntsrgn]

Very well said! I honestly believe that most of us on these forums are more knowledgeable about TRT then many doctors.

I am a physician and I agree with you. I come here to learn.

 

[apsjiml]

I just had my 3rd experience with a new endocrinologist. He reviewed my labs and looked at my total T of 1003 (reference range top limit was 950) and said that I am overdosing and if I don't immediately lower this I will have a coronary event in the next 5 years. He then told me for my age (55) it should be no higher then 400.

Most healthy guys really do have a level in that upper portion of the range of course shbg is a huge factor here reflecting free inbound levels. I think the doctors with experience with this issue know that most guys do not feel well with a total testosterone of 400 or less

 

[jmatt64]

Thanks guys for this thread. Just had some blood work 520 ng/dl (55 yrs) and on the fence whether or not to start a trt. My doctor agreed to a trial period. Plan to start my first injection in 4 days. Let's see how I feel!

 

[apsjiml]

Thanks guys for this thread. Just had some blood work 520 ng/dl (55 yrs) and on the fence whether or not to start a trt. My doctor agreed to a trial period. Plan to start my first injection in 4 days. Let's see how I feel!

I think with 520 if it were me, I would want to know what my sex hormone binding globulin was, lh , fsh and estradiol sensitive. I would want to know exactly where I was at. Elevated shbg will increase the half life of testosterone making total testosterone look ok but actually make less available free testosterone

 

[Will Brink]

I'd soften it a little: Yes, the majority of endocrinologists seem to lack up-to-date knowledge regarding treatment of hypogonadism.

I'd harden a bit and say most endos truly suck at TRT/HRT. For what ever reason, Urologists tend to be much better, and even most internests, GP, etc are better at it. Knowledge of hormones is supposed to be their damn speciality, and to date, not met an endo who didn't outright suck at it. No one can know everything, and I understand when say a cardiologist is not up on the latest data and best practices for TRT, but I have no empathy for endos who are cluess about HRT/TRT at all. That's supposed to be their specialty. And if people think they're piss poor at TRT/HRT, they tend to be even worse at managing thyroid issues, again supposed to be their specialty. So as a rule, I tell people to avoid endos for TRT/HRT if they can, and seek out a Urologist etc. Endos with a clue are rarer than RDs who know anything about nutrition, but that's another topic....

 

[Cataceous]

I'd harden a bit and say most endos truly suck at TRT/HRT. For what ever reason, Urologists tend to be much better, and even most internests, GP, etc are better at it. Knowledge of hormones is supposed to be their damn speciality, and to date, not met an endo who didn't outright suck at it. No one can know everything, and I understand when say a cardiologist is not up on the latest data and best practices for TRT, but I have no empathy for endos who are cluess about HRT/TRT at all. That's supposed to be their specialty. And if people think they're piss poor at TRT/HRT, they tend to be even worse at managing thyroid issues, again supposed to be their specialty. So as a rule, I tell people to avoid endos for TRT/HRT if they can, and seek out a Urologist etc. Endos with a clue are rarer than RDs who know anything about nutrition, but that's another topic....

Obviously one anecdote isn't too meaningful, but my experience was different. I saw a urologist first. He took one look at my total testosterone of ~330 ng/dL and exclaimed "That's normal!", and basically kicked me out of his office. The endocrinologist I saw next at least had the sense to order tests for total T, SHBG and albumin, which clearly indicated a below-range calculated free testosterone. She prescribed testosterone cypionate injections, though the protocol was the ancient 200 mg every two weeks, which I ignored in favor of EOD injections.

 

[Will Brink]

Obviously one anecdote isn't too meaningful, but my experience was different. I saw a urologist first. He took one look at my total testosterone of ~330 ng/dL and exclaimed "That's normal!", and basically kicked me out of his office. The endocrinologist I saw next at least had the sense to order tests for total T, SHBG and albumin, which clearly indicated a below-range calculated free testosterone. She prescribed testosterone cypionate injections, though the protocol was the ancient 200 mg every two weeks, which I ignored in favor of EOD injections.

Good to hear! That's more as it should be in terms of which speciality should be up on the topic of TRT/HRT.

 

[apsjiml]

Good to hear! That's more as it should be in terms of which speciality should be up on the topic of TRT/HRT.

I will say that more urologists are getting it a little better for sure. I have a buddy that is getting testosterone from his urologist. When his family doctor left he found another doctor who insisted he take a drug test because it is a controlled substance only to later tell him she would not do it. I can see why so many guys just get ticked off at this sort of thing.