Testosterone 266 - What Say You?

[johnt]

I want to my doctor for yearly physical. Prior to physical blood test was ordered for CBC, Lipids, Metabolic Panel, etc. Everything looked good. I'm 46. At physical I complained of difficulty losing weight even though I am working out 4 to 5 days per week. I would not describe myself as fat but have a gut that all of a sudden is hard to lose. Also, very irritable lately and moody. I asked doc about running Hormone panel. Doc only wanted to run TSH. I was able to convince to run Total Testosterone as she would not run Free. The reason she gave was that I really do not have low T symptoms since I am not complaining of libido/erection and fatigue.

I viewed results online today. Total Testosterone is 266 (Quest notes optimal range between 250 - 827). And the TSH w.Reflex to FT4 (not sure what the heck that means) is 1.87 (optimal is 0.40 - 4.50).

I know this is extremely limited info. Any thoughts?

I am hoping this will convince her to run full panel otherwise I guess I will go to Life Extension or use Discount Labs to run my own blood test.

 

[Vince Carter]

I want to my doctor for yearly physical. Prior to physical blood test was ordered for CBC, Lipids, Metabolic Panel, etc. Everything looked good. I'm 46. At physical I complained of difficulty losing weight even though I am working out 4 to 5 days per week. I would not describe myself as fat but have a gut that all of a sudden is hard to lose. Also, very irritable lately and moody. I asked doc about running Hormone panel. Doc only wanted to run TSH. I was able to convince to run Total Testosterone as she would not run Free. The reason she gave was that I really do not have low T symptoms since I am not complaining of libido/erection and fatigue.

I viewed results online today. Total Testosterone is 266 (Quest notes optimal range between 250 - 827). And the TSH w.Reflex to FT4 (not sure what the heck that means) is 1.87 (optimal is 0.40 - 4.50).

I know this is extremely limited info. Any thoughts?

I am hoping this will convince her to run full panel otherwise I guess I will go to Life Extension or use Discount Labs to run my own blood test.

All indications to me is that that's where you're heading, the tone has already been set by your Dr. You might be surprised, but even IF some HRT is prescribed for you, I don't see that it will be competently managed.

 

[johnt]

My thoughts as well Vince. I may need to reach out to Defy. You would consider 266 as low-T, correct?

 

[Vince Carter]

266 is absolutely in the realm of Low T, some have a cutoff of 300-350.

 

[johnt]

Last year my blood work showed Total Testosterone at 354 and Quest noted the low end of the optimal range was 300. Funny how they lowered the optimal range yet again. However, in their notes section it states "Men with clinically significant hypogonadal symptoms and testosterone values repeatedly less than approximately 300 ng/dL may benefit from testosterone treatment after adequate risk and benefits counseling."

 

[CoastWatcher]

You certainly deserve better medical care than you are receiving. I wish you all the best.

 

[PAUL-E]

You certainly deserve better medical care than you are receiving. I wish you all the best.

I agree and sometimes your better off doing your own research and going elsewhere. in a way you could be lucky seems like 90% of doctors don't give you the best care/protocol when it comes to HRT and could make you feel even worse.

 

[ERO]

You absolutely have low T and absolutely need a TRT specialist to get the care you deserve. Trading one average GP for another average GP is just going to prolong the issue of not getting proper treatment.

 

[johnt]

Its just amazing how many doctors are just not educated in this area. Overall, she is a really good doctor. During physical she spends at least 20 - 30 minutes for her exam. Most doctors have you in and out in 5 minutes. Just wish she was educated in this area. I must admit starting TRT does concern me a bit. Knowing it is a life long commitment and I am altering natural state of my body. Stopping my natural production freaks me out especially knowing my balls will shrink and in order to avoid that from happening I then need to introduce HCG, which is not naturally recurring in men. I have always been someone that does not like to take medication, etc.

 

[Jay]

Johnt
266 is still in normal with Quest ranges....Labcorp cutoff is 350 at the low, however, they have diff ranges for a reason (meaning if you had your labs at Labcorp you number would not come back 266 but rather 380ish. That being said, given your age AND you have a number of symptoms that are low T, then I would say you are a great candidate for HRT.

Honestly, I know most peoples tendency is to just get treated by their GP, but GPs are not specialists. Would you let your GP do heart surgery if you needed it? Go with Defy...they are the best in the business IMHO and you will save a lot time and frustration by trying to save a few bucks with your GP....just saying

 

[CoastWatcher]

I must admit starting TRT does concern me a bit. Knowing it is a life long commitment and I am altering natural state of my body.

You should think carefully before initiating TRT - it is a major commitment. But if your body is failing, in its natural state, to produce an adequate amount of this essential hormone, you aren't altering, you are restoring. Or so I believe.

 

[johnt]

Jay, if I go the HRT route, which I am strongly considering, I certainly will not have my GP handle the treatment. I totally agree with you, best to have a specialist handle. I was just trying to get as much done through the GP to get insurance to cover as much as the upfront cost as possible.

 

[Jackie Treehorn]

Jay, if I go the HRT route, which I am strongly considering, I certainly will not have my GP handle the treatment. I totally agree with you, best to have a specialist handle. I was just trying to get as much done through the GP to get insurance to cover as much as the upfront cost as possible.

John,

When Jay speaks of going to a "specialist," he's not talking about some Endo or Urologist that your PCP (primary care physician) refers you to. He's talking about a specialist that truly knows what he's doing with regard to TRT. He's talking about someone like Dr. Saya or Dr. Crisler at Defy Medical.

If you insist on going the route that will supposedly save you the most money, in order to utilize your insurance to the maximum extent, you're going to be chasing your tail round and round. You're going to find out through trial and error, that most of these supposed experts (Endos and Urologists) are clueless with regard to TRT. They utilize outdated protocols that cause more harm than good, and you will end up frustrated and feeling like crap.

Since nobody else here has said it, I'm going to go ahead and say it...your primary care physician sucks. Actually, she sounds pretty average compared to most PCPs out there (most are clueless with regard to TRT). She doesn't listen to you, and you're receiving sub-standard care from her. She knows nothing about TRT (which is average), and it's good to see that you recognize that. There's no reason why she shouldn't have ordered a blood test for your testosterone levels (total and free), along with a full thyroid panel to include TSH, FT3, FT4, RT3, and TPO antibodies.

As you can probably tell, my tolerance level for clueless, incompetent doctors is very low. I hate to see a guy like you make the mistake of going from doctor to doctor, feeling terrible, instead of cutting to the chase, and going straight to experts that can actually help you. Good luck.

 

[johnt]

Thanks Jackie. The more I research and hear from people with experience like you I realize that is the route to go. Feel a little overwhelmed at times as there is so much conflicting information about TRT. For example, last year I went to a doctor for a physical. The doc has three different board certifications, one of which is a cardiologist. When I asked about adding a hormone panel to my blood work the doctor inquired as to why and I explained my concern about Low-T. Doc cautioned me from using Testosterone noting that he has seen a few patients with cardiac episodes which he related to TRT usage.

I then read articles on Life Extension and other forums which note the overall health benefits to testosterone usage. Personally the two potential side effects that really get me nervous are the potential increase in red blood cells and testicular shrinkage.

Thanks again to you and everyone else that takes the time to share your thoughts and provide feedback.

 

[CoastWatcher]

Thanks Jackie. The more I research and hear from people with experience like you I realize that is the route to go. Feel a little overwhelmed at times as there is so much conflicting information about TRT. For example, last year I went to a doctor for a physical. The doc has three different board certifications, one of which is a cardiologist. When I asked about adding a hormone panel to my blood work the doctor inquired as to why and I explained my concern about Low-T. Doc cautioned me from using Testosterone noting that he has seen a few patients with cardiac episodes which he related to TRT usage.

I then read articles on Life Extension and other forums which note the overall health benefits to testosterone usage. Personally the two potential side effects that really get me nervous are the potential increase in red blood cells and testicular shrinkage.

Thanks again to you and everyone else that takes the time to share your thoughts and provide feedback.

The two side effects you mention, testicular atrophy and increased hematocrit/hemoglobin, are managed reasonably easily by capable doctors. In and of themselves, those issues shouldn't prevent you from pursuing TRT.

 

[PAUL-E]

The two side effects you mention, testicular atrophy and increased hematocrit/hemoglobin, are managed reasonably easily by capable doctors. In and of themselves, those issues shouldn't prevent you from pursuing TRT.

I agree people who are not on TRT also have heart attacks but I cant help but wonder if the ones that were on TRT where being properly monitored(hematocrit).

 

[CoastWatcher]

This thread, containing excellent posts from Dr. Saya and Nelson, addresses the issue of testosterone-driven heart disease. It is a NON-ISSUE.

https://www.excelmale.com/forum/sho...ler-Jasen-Nelson-thoughts&highlight=ambulance

 

[Sean Mosher]

I agree, there is definitely a lot of conflicting information, but you will most likely get very sub par care from and endo or PCP.
To echo several of the posts above, I'd strongly urge you to continue to do your homework on sites like this, ask questions and consider, once your bloodwork is complete, trusting your care to a TRT specialist.
There are 2 endorsed by this site, users of both companies on this site.
I personally go through PrimeBody and have been a happy customer for over a year.
(www.primebody.com).
Please keep us posted on your journey!

 

[johnt]

Thanks Sean. I live in Florida so looks like primebody would not work as they do not have any locations in FL.

 

[ERO]

Defy Medical is in Florida, but you do not need to visit their office unless you want to. They also have a tele-medicine model that many of us use and recommend.