2nd Opinion

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River Rat

Member
Hi All - I am 50 years old and have had symptoms of TRT for over 1 year. I do not drink, smoke or do any drugs and have never done steroids in my life. I eat a pretty balanced diet and used to run about 20 miles per week but since I am tired all the time, I stopped. About a month ago I went to a Urologist who prescribed 200 mg of Testosterone Cypionate by injection every 14 days. The Urologist made the diagnosis of primary hypogonadism based off of 1 low testosterone reading of just over 200. Normal range for this test was 268. Seeing that I was not feeling well, I was thinking he was correct as my symptoms all pointed to Low T. I started the protocol provided by my doctor except that I injected 100 mg every 7 days. I read on this forum that this is more effective. I have been on TRT for 1 month and have not experience much of a change but it has only been 1 month. I have gained 7 pounds and I assume its all water weight. Also, morning erection have come back.

At the same time I scheduled the appointment with the Urologist, I also scheduled an appointment with an Endocrinologist. My appointment with the Endocrinologist was this week and she was not very complimentary of the Urologist's diagnosis of primary hypogonadism without adequate testing and was visibly upset that he prescribed Testosterone Therapy without conducting numerous blood tests first.

We discussed the situation and decided that I would stop taking testosterone therapy for 2 months and then she ordered a multitude of tests to include Testosterone Bioavailable (she said this included Total and Free T), FSH, LH, and Prolactin. Also, she ordered the following tests that I had done immediately; Thyroid Auto AB, T4, T3, TSH, Iron Panel, Ferritin, Basic Metabolic Panel, CBC, and Hepatic function. The tests I completed immediately came back in range. It is interesting that my Ferritin and has been high for 5 years and after being on TRT for 1 month, is now well within the normal range.

Two questions, 1) is my decision to come off TRT correct based on the scenario above, and 2) are there additional tests that I should have done when I am off TRT.

I want to have the correct tests done so that I do not have to go through this waiting game again. The Endocrinologist stated that she is more than willing to prescribe TRT via androgel if needed. She stated that she would prescribe injections if androgel does not work.

Any thoughts are appreciated.
 
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Ardoc

Member
At a glance it seems like your Endocrinologist has a lot more knowledge of TRT than your Urologist, who prescribed an ineffective and antiquated protocol (every two weeks). Also it is common practice to get 3 or more low Test results before concluding there is a problem. Also without other testing how can he assume primary?
I would suggest also testing for SHBG
 
Most med insurance companies won't pay for TRT until at least two test 1 month apart. Mine required two and both needed to be bellow 250.

I'd work with the doc that is giving you all the right tests and dump the other.

If you want non professional opinions post up your bloods here. Just remove the personal parts like name and addy. Many here are very experienced in reading blood work and will offer you their opinion and suggestions. If you can fix your tiredness without TRT do it. Stabing yourself 1-7 times a week gets old fast.

You could look into thyroid, cortisol, and sleep apnia(sp?) they can give you your symptoms as well.

hth
 

River Rat

Member
My insurance company did cover the costs but I think that additional test should be done to have an accurate diagnosis as well as base line for future reference. I have had my thyroid, and cortisol tested. My thyroid tests typically come in a couple of points high but were well within range when I had tested last week. My cortisol is fine. I had a sleep apnea test which concluded that I have mild sleep apnea. I stop breathing on average 18 times per hour which the technician said is mild sleep apnea. I am waiting for the official response from the doctor.
 

River Rat

Member
I will have PSA tests done as well. Sleep study results came in today and confirmed that I have moderate sleep apnea. Who knows, maybe this is my issue. I have been on TRT for a month and do not feel much different. I am curious how I will feel once I stop taking T.
 
My insurance company did cover the costs but I think that additional test should be done to have an accurate diagnosis as well as base line for future reference. I have had my thyroid, and cortisol tested. My thyroid tests typically come in a couple of points high but were well within range when I had tested last week. My cortisol is fine. I had a sleep apnea test which concluded that I have mild sleep apnea. I stop breathing on average 18 times per hour which the technician said is mild sleep apnea. I am waiting for the official response from the doctor.

my insurance doesn't pay anything. i have to pay out of pocket...it's a rocky road.
 
My insurance company did cover the costs but I think that additional test should be done to have an accurate diagnosis as well as base line for future reference. I have had my thyroid, and cortisol tested. My thyroid tests typically come in a couple of points high but were well within range when I had tested last week. My cortisol is fine. I had a sleep apnea test which concluded that I have mild sleep apnea. I stop breathing on average 18 times per hour which the technician said is mild sleep apnea. I am waiting for the official response from the doctor.

Yes, I am fortunate from the perspective. Hopeful to find out why I am tired and foggy headed all the time .

Don't take Coastwatchers post about how bad one injection every two weeks is. So much can go wrong with 200mg every two weeks. Spiked E2 and prolactin, HCT- your blood so thick your blood pressure goes thru the roof.

Don't think TRT is not for you just because this protocol did not work. If your free doc won't work with you then free means nothing since you are still tired and foggy and he could jack you up even more by not knowing what he is doing.

Spend some time on this forum and learn what a real modern TRT protocol looks like then go talk to you doc. If you are into reading there are 3 excellent books out right now that will bring you right up to speed on all things TRT. https://www.amazon.com/Testosterone-Replacement-Therapy-Recipe-Success/dp/0983773947 scroll down for the freq bought together.

hth
 

River Rat

Member
Don't take Coastwatchers post about how bad one injection every two weeks is. So much can go wrong with 200mg every two weeks. Spiked E2 and prolactin, HCT- your blood so thick your blood pressure goes thru the roof.

Don't think TRT is not for you just because this protocol did not work. If your free doc won't work with you then free means nothing since you are still tired and foggy and he could jack you up even more by not knowing what he is doing.

Spend some time on this forum and learn what a real modern TRT protocol looks like then go talk to you doc. If you are into reading there are 3 excellent books out right now that will bring you right up to speed on all things TRT. https://www.amazon.com/Testosterone-Replacement-Therapy-Recipe-Success/dp/0983773947 scroll down for the freq bought together.

hth

Thanks for the advice.
 

River Rat

Member
So I stopped taking TRT yesterday. It my be the placebo effect but it I am already feeling lightheaded and have a headache. I have been taking 100 mg of Testosterone Cyp each Sunday. Need to stay off TRT for a couple of months to have adequate testing done.
 
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