A new noob

Hi All,

I've been on TRT for about 4.5 years. I just crossed over to my 40s, and my TRT experience has not been good. My 2 doctors who have been my prescribers, won't adjust my 2 pumps of androgel upwards-even after constantly being in the low 100s (low as in 120 or below).

I once saw an endocrinologist who wanted to put me on 125mg of Test-e every 2 weeks. I said no thanks to that and continued using androgel.

Anyways, I'm here to find a good referral (hopefully I can get access to the referrals board soon).

Also, I'm a strength athlete (USPA powerlifter), so getting to normal test levels would make my life a lot easier. lol

Your gel l testing strategy, are you applying the gel 2hrs prior to your blood draw? If not, you'll never get a good result, gels and creams always have to be applied before the blood draw unlike testing when on injections. 2 pumps of Androgel is jsut enough to shut you down but not enough to be of any therapeutic benefit to you...you need new Dr(s)

Vince Carter said:

Your gel l testing strategy, are you applying the gel 2hrs prior to your blood draw? If not, you'll never get a good result, gels and creams always have to be applied before the blood draw unlike testing when on injections. 2 pumps of Androgel is jsut enough to shut you down but not enough to be of any therapeutic benefit to you...you need new Dr(s)

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I always apply the gel before testing, yes.

I need a new doctor, and that's why I'm here, because you're right-I'm a 330 pound man. My dose is quite low and basically useless. My current doc looked at my LH and FSH and said "you might have a pituitary tumor". I looked at my bloods and said "no, dummy, I'm shut down hard!" lol.

For the moment, I do supplement with hcg and extra gel, but I would bet that ~200 units of hcg e3d and ~160mg of gel isn't getting me to therapeutic levels, either.

You could check out two of are sponsors, defy medical and Prime body. I'm a happy patient of defy Medical.

Vince said:

You could check out two of are sponsors, defy medical and Prime body. I'm a happy patient of defy Medical.

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What costs are associated with defy / do they accept insurance and fsa?

GaWd said:

What costs are associated with defy / do they accept insurance and fsa?

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It's pretty hard to get insurance to pay for defy medical cost, the cost of are reasonable but out of pocket. We have many thread on that subject.

If you're primary Hypo (testes problem) there's no amount of HCG you can use that will get you any kind of appreciable endo T. I concur with my friend Vince here, try out Defy or PrimeBody but know that jsut about anything in the TRT world you will pay out of pocket for as most if not all do not accept or file insurance.

Thanks, guys. I'll keep looking locally for men's clinics that accept insurance, but I'll fall back on defy/prime, failing that.

Do fsa fund cover their expenses? That would make it easier to use defy.

Vince, I'm diagnosed primary hypognadal. Hcg recovers my nuts and helps with libido. Not sure if it does much for t levels, though. Never been tested when not on my prescribed dose of gel.

Might see if any A4m Dr. is in your area and takes insurance:
https://www.a4m.com/
or
See if a Functional Medicine DR. might work:
https://www.ifm.org/functional-medicine/
or
Someone here can make a recommendation.
Finding a GOOD DR that understands TRT, and accept insurance, is like finding a needle in a mountain of straw.
As noted above 2 great suggestions.
If you can find a DR that does not take insurance BUT will file with your insurance company for you, you will at least get covered for "out of network DR", and partial coverage.
BTY if you are not very knowledgeable on TRT, get Nelson's book for a starter ASAP.
It sounds like the DRs you have seen have no clue.
One other option is to find a DR who will work with you and does not get his/her nose out of joint if you provide them with supporting data for actions you would like to take.

I would be happy to answer any questions you may have about PrimeBody as a site sponsor.
Please feel free to reach out to me directly at: [email protected].

GaWd said:

Thanks, guys. I'll keep looking locally for men's clinics that accept insurance, but I'll fall back on defy/prime, failing that.

Do fsa fund cover their expenses? That would make it easier to use defy.

Vince, I'm diagnosed primary hypognadal. Hcg recovers my nuts and helps with libido. Not sure if it does much for t levels, though. Never been tested when not on my prescribed dose of gel.

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GaWd, just for discussion sake, what was your LH & FSH results when you were diagnosed with P-hypo?

Vettester Chris said:

GaWd, just for discussion sake, what was your LH & FSH results when you were diagnosed with P-hypo?

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At the time of my DX:

COMPONENT| YOUR VALUE |STANDARD RANGE
LH | 3.4 mIU/mL |1.7 - 8.6 mIU/mL
FSH | 3.8 mIU/mL |1.5 - 12.4 mIU/mL

At my last blood draw, I was of course wiped out. LH was undetectable, FSH @ .3, w/prolactin normal.

Note: as long as you're on gel or any kind of exo T you're just waiting money testing LH and FSH as you'll be shutdown as I think you stated.

Vince Carter said:

Note: as long as you're on gel or any kind of exo T you're just waiting money testing LH and FSH as you'll be shutdown as I think you stated.

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Right, I understand that, but my douchebag doc didn't seem to and referred me out for an MRI. lol

I can't figure out if it was to make more money, cover his ass, or if he truly doesn't understand that e[x]ogenous T=shutdown.

GaWd said:

At the time of my DX:

COMPONENT| YOUR VALUE |STANDARD RANGE
LH | 3.4 mIU/mL |1.7 - 8.6 mIU/mL
FSH | 3.8 mIU/mL |1.5 - 12.4 mIU/mL

At my last blood draw, I was of course wiped out. LH was undetectable, FSH @ .3, w/prolactin normal.

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If that was your lab results at baseline, before TRT, then the diagnosis should have been Secondary Hypo. Primary would indicate a surge of LH, usually over the reference range, due to lack of endogenous production from the testes/leydigs. It makes sense though that you are responding to HCG.

Since you are responding to HCG I would up that dose to 500iu 2 to 3 times a week. That will help until you get your TRT sorted out. We have data here that shows any HCG dosage under 350iu is pretty much useless. Search for one of Nelson's library here about HCG dosing. Defy isn't expensive my first appoint with me paying for labs was $250. They don't rake you over the coals like some TRT doc's do. It's very good price wise. As you have learned getting a good TRT MD is paramount. If you flag the insurance part it's unlikely you'll get anywhere because none of the TRT experts take insurance. Maybe in some cases for labs.

Vettester Chris said:

If that was your lab results at baseline, before TRT, then the diagnosis should have been Secondary Hypo. Primary would indicate a surge of LH, usually over the reference range, due to lack of endogenous production from the testes/leydigs. It makes sense though that you are responding to HCG.

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I concur I see secondary hypo here.

Vettester Chris said:

If that was your lab results at baseline, before TRT, then the diagnosis should have been Secondary Hypo. Primary would indicate a surge of LH, usually over the reference range, due to lack of endogenous production from the testes/leydigs. It makes sense though that you are responding to HCG.

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I'm going to reply by saying: I don't think I ever received a competent diagnosis. Just "Here's your testosterone, use 2 pumps (lol)".

After looking at it, I'm clearly Secondary, and I should have known better.

BTW, it's likely secondary due to metabolic syndrome, if you're interested in cause.