Considering self administering TRT

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PapaC2000

New Member
I'm a 42yr old Canadian. I have been feeling symptomatic for more than a year now, and made a dr visit to discuss. A blood test was done for total T and PSA. Total T came in at 17.5 nmol/L and PSA was 0.7 (can't remember units, but it was nice and low). After insisting, I was granted another blood test for TSH (1.45 mIU/L), FSH (3.0 IU/L), LH (4.2 IU/L), Estradiol not sensitive test I don't think (61pmol/L -ref range was <162), bio avail Test (4.9 nmol/L -ref 3.6-11.2), SHBG (71.1 nmol/L -ref 10-70).
When these results were discussed, the doc explained that even though SHBG was elevated and bio available was lowish he cannot prescribe as long as total and bio available are anywhere in the range regardless of symptoms. A referral to an endocrinologist for a "second opinion" was suggested to appease me, however I think it could be many months before I get in to see them.
I am at the point that I just want to feel better. I have access to testosterone, hcg and if needed an AI, but the missing piece here is getting blood test requisitions for monitoring. I asked if I could just get a monthly order for blood work, but the secretary replied that further blood work should come from the endo if they order it.....but to let them know if my symptoms change or get worse in the meantime.
I have a mind to start my own protocol and recontact my GP and inform them about it and see if the request for blood work is received differently knowing I am on.
I don't have health insurance or benefits, so a script isn't a priority for me.

Thoughts/advice?
 
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CoastWatcher

Moderator
I'm a 42yr old Canadian. I have been feeling symptomatic for more than a year now, and made a dr visit to discuss. A blood test was done for total T and PSA. Total T came in at 17.5 nmol/L and PSA was 0.7 (can't remember units, but it was nice and low). After insisting, I was granted another blood test for TSH (1.45 mIU/L), FSH (3.0 IU/L), LH (4.2 IU/L), Estradiol not sensitive test I don't think (61pmol/L -ref range was <162), bio avail Test (4.9 nmol/L -ref 3.6-11.2), SHBG (71.1 nmol/L -ref 10-70).
When these results were discussed, the doc explained that even though SHBG was elevated and bio available was lowish he cannot prescribe as long as total and bio available are anywhere in the range regardless of symptoms. A referral to an endocrinologist for a "second opinion" was suggested to appease me, however I think it could be many months before I get in to see them.
I am at the point that I just want to feel better. I have access to testosterone, hcg and if needed an AI, but the missing piece here is getting blood test requisitions for monitoring. I asked if I could just get a monthly order for blood work, but the secretary replied that further blood work should come from the endo if they order it.....but to let them know if my symptoms change or get worse in the meantime.
I have a mind to start my own protocol and recontact my GP and inform them about it and see if the request for blood work is received differently knowing I am on.
I don't have health insurance or benefits, so a script isn't a priority for me.

Thoughts/advice?
Where do you live? As a Canadian, I can assure you that doctor who claimed he couldn't prescribe TRT for you because of certain lab values is wrong. It's up to his or her clinical judgement. It is so frustrating that so many who live here get a run-around.
 

CoastWatcher

Moderator
I am in the greater Ottawa area. Halfway between Perth and Smiths Falls Ontario. Doctors office is in Carleton Place
For a while there was a doctor practicing in the Ottawa area who had knowledge and interest in this area. Of course he closed his practice. I'm in Toronto, with a good doctor, and we know of some in Hamilton. Let me see if a name in your area can be found. If not, your plan may be worth further investigation.
 

PapaC2000

New Member
So from looking at the lab tests I did get, especially the SHBG and bioavailable...do you see valid reason to treat with TRT if the symptoms are effecting quality of life? I just don't fancy waiting to have my levels slip off the chart (which keeps getting adjusted). Fairly certain it will get there in time....
 

ratbag

Member
No I wouldn't start until you know your free T and E2 sensitive and complete thyroid panel. Only because if something simple is off it can be corrected possibly without TRT. Low FT3 for example has many symptoms similar to Low T so you really should rule that out before you begin TRT.
 

PapaC2000

New Member
I see. I did plug my available info into a calculator to get estimated free T.
So I guess theres more to the thyroid issue than I currently understand (which is minimal). I thought that the TSH was a screening to see if complete T3 or T4 panel was needed?
 

CoastWatcher

Moderator
I see. I did plug my available info into a calculator to get estimated free T.
So I guess theres more to the thyroid issue than I currently understand (which is minimal). I thought that the TSH was a screening to see if complete T3 or T4 panel was needed?

TSH is an indirect measure of thyroid function and, sadly, the only test far too many doctors will run. You need to obtain ft3, ft4, rt3, and both antibody panels.
 

CoastWatcher

Moderator
Private Blood Testing in Canada

There is such a service in Canada...or part of Canada, Ontario, Quebec, and Manitoba. It is far from as comprehensive as it ought to be (either in geographic coverage or in terms of its offerings), but it is a step toward allowing men to control their own health care...an expensive step. No - the sensitive estradiol test does not appear to be offered. I will still test via discountedlabs.com on my visits to the States.

https://bloodtestscanada.com/
 

ratbag

Member
Coastwatcher where do you go to get Labs in the USA? I suspect I may have to go to the same place as nothing is offered in NY or VT.
 

CoastWatcher

Moderator
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